The development, evolution, and status of Holland's theory of vocational personalities: Reflections and future directions for counseling psychology.

PubMed

Nauta, Margaret M

2010-01-01

This article celebrates the 50th anniversary of the introduction of John L. Holland's (1959) theory of vocational personalities and work environments by describing the theory's development and evolution, its instrumentation, and its current status. Hallmarks of Holland's theory are its empirical testability and its user-friendliness. By constructing measures for operationalizing the theory's constructs, Holland and his colleagues helped ensure that the theory could be implemented in practice on a widespread basis. Empirical data offer considerable support for the existence of Holland's RIASEC types and their ordering among persons and environments. Although Holland's congruence hypotheses have received empirical support, congruence appears to have modest predictive power. Mixed support exists for Holland's hypotheses involving the secondary constructs of differentiation, consistency, and vocational identity. Evidence of the continued impact of Holland's theory on the field of counseling psychology, particularly in the area of interest assessment, can be seen from its frequent implementation in practice and its use by scholars. Ideas for future research and practice using Holland's theory are suggested.

Inflated speedups in parallel simulations via malloc()

NASA Technical Reports Server (NTRS)

Nicol, David M.

1990-01-01

Discrete-event simulation programs make heavy use of dynamic memory allocation in order to support simulation's very dynamic space requirements. When programming in C one is likely to use the malloc() routine. However, a parallel simulation which uses the standard Unix System V malloc() implementation may achieve an overly optimistic speedup, possibly superlinear. An alternate implementation provided on some (but not all systems) can avoid the speedup anomaly, but at the price of significantly reduced available free space. This is especially severe on most parallel architectures, which tend not to support virtual memory. It is shown how a simply implemented user-constructed interface to malloc() can both avoid artificially inflated speedups, and make efficient use of the dynamic memory space. The interface simply catches blocks on the basis of their size. The problem is demonstrated empirically, and the effectiveness of the solution is shown both empirically and analytically.

Determinants of quality management systems implementation in hospitals.

PubMed

Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem

2009-03-01

To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. A search strategy was performed on the Medline database for articles written in English published between 1992 and early 2006. Using the thesaurus terms 'Total Quality Management' and 'Quality Assurance Health Care', combined with the term 'hospital' and 'implement*', we identified 533 publications. The screening process was based on empirical articles describing organization-wide QMS implementation. Fourteen empirical articles fulfilled the inclusion criteria and were reviewed in this paper. An organization culture emphasizing standards and values associated with affiliation, teamwork and innovation, assumption of change and risk taking, play as the key success factor in QMS implementation. This culture needs to be supported by sufficient technical competence to apply a scientific problem-solving approach. A clear distribution of QMS function within the organizational structure is more important than establishing a formal quality structure. In addition to management leadership, physician involvement also plays an important role in implementing QMS. Six supporting and limiting factors determining QMS implementation are identified in this review. These are the organization culture, design, leadership for quality, physician involvement, quality structure and technical competence.

Pebbles, Rocks, and Boulders: The Implementation of a School-Based Social Engagement Intervention for Children with Autism

ERIC Educational Resources Information Center

Locke, Jill; Wolk, Courtney Benjamin; Harker, Colleen; Olsen, Anne; Shingledecker, Travis; Barg, Frances; Mandell, David; Beidas, Rinad

2017-01-01

Few evidence-based practices, defined as the use of empirically supported research and clinical expertise for children with autism, have been successfully implemented and sustained in schools. This study examined the perspectives of school personnel (n = 39) on implementing a social engagement intervention for children with autism. Semi-structured…

Is Openness to Using Empirically Supported Treatments Related to Organizational Culture and Climate?

PubMed

Patterson Silver Wolf Adelv Unegv Waya, David A; Dulmus, Catherine N; Maguin, Eugene

2013-01-01

The overall purpose of this study is to investigate workers' openness towards implementing a new empirically supported treatment (EST) and whether the workers' openness scores relate to their workplace culture and climate scores. Participants in this study (N=1273) worked in a total of 55 different programs in a large child and family services organization and completed a survey measuring their attitudes toward ESTs. Results indicate that work groups that measure themselves as being more open to using ESTs rated their organizational cultures as being significantly more proficient and significantly less resistant to change. With ESTs becoming the gold standard for professional social work practices, it is important to have accessible pathways to EST implementation.

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

PubMed

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

2016-12-01

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

Models for Implementing Response to Intervention: Tools, Outcomes, and Implications

ERIC Educational Resources Information Center

Shapiro, Edward S., Ed.; Zigmond, Naomi, Ed.; Wallace, Teri, Ed.; Marston, Doug, Ed.

2011-01-01

Providing a unique "on-the-ground" perspective, this book examines the implementation of three empirically supported response-to-intervention (RTI) models in four different school districts. The book addresses the complexity of putting RTI into place in the elementary grades, showing how the process actually took place and what impact it…

Tales of Refusal, Adoption, and Maintenance: Evidence-Based Substance Abuse Prevention via School-Extension Collaborations

ERIC Educational Resources Information Center

St. Pierre, Tena L.; Kaltreider, D. Lynne

2004-01-01

Despite availability of empirically supported school-based substance abuse prevention programs, adoption and implementation fidelity of such programs appear to be low. A replicated case study was conducted to investigate school adoption and implementation processes of the EXSELS model (Project ALERT delivered by program leaders through Cooperative…

Parental Support for Chinese-English Bilingual Education: A Survey of Parents of Primary and Secondary Students in Shanghai

ERIC Educational Resources Information Center

Wei, Rining

2011-01-01

While many studies conducted outside China attest to the importance of parental support in determining the extent of success in implementing a bilingual education (BE) programme, few empirical studies have been conducted into the strength of parental support for Chinese-English BE in mainland China. This paper reports upon a survey targeting…

Class-Wide Positive Behavior Support and Group Contingencies: Examining a Positive Variation of the Good Behavior Game

ERIC Educational Resources Information Center

Wright, Robert A.; McCurdy, Barry L.

2012-01-01

The Good Behavior Game (GBG) is a powerful group contingency with a history of documented empirical support. The purpose of this study was to compare two interdependent group contingencies, the GBG and a positive variation, the Caught Being Good Game (CBGG), in a school implementing school-wide positive behavior support. A kindergarten and…

Evaluation of a Standardized Method of Quality Assurance in Mental Health Records: A Pilot Study

ERIC Educational Resources Information Center

Bradshaw, Kelsey M.; Donohue, Bradley; Fayeghi, Jasmine; Lee, Tiffany; Wilks, Chelsey R.; Ross, Brendon

2016-01-01

The widespread adoption of research-supported treatments by mental health providers has facilitated empirical development of quality assurance (QA) methods. Research in this area has focused on QA systems aimed at assuring the integrity of research-supported treatment implementation, while examination of QA systems to assure appropriate…

Everyday Teaching and Outdoor Learning: Developing an Integrated Approach to Support School-Based Provision

ERIC Educational Resources Information Center

MacQuarrie, Sarah

2018-01-01

In the UK, teachers are increasingly being encouraged to support and undertake outdoor learning. Despite such support there is a paucity of research that has considered how outdoor learning can be implemented and offered on a regular basis by teachers. The lack of empirical research that has centralised the role of the teacher is at odds with the…

Bridge over Troubled Water: Using Implementation Science to Facilitate Effective Services in Child Welfare

ERIC Educational Resources Information Center

Mildon, Robyn; Shlonsky, Aron

2011-01-01

To maximize benefits to children and their families, effective practices need to be used competently in child welfare settings. Since the 1990s, researchers and policy makers have focused attention on empirically supported interventions (ESIs). Much less attention has been paid to what is needed to implement these in a range of real-world…

Scaling up School-Wide Positive Behavioral Interventions and Supports: Experiences of Seven States with Documented Success

ERIC Educational Resources Information Center

Horner, Robert H.; Kincaid, Donald; Sugai, George; Lewis, Timothy; Eber, Lucille; Barrett, Susan; Dickey, Celeste Rossetto; Richter, Mary; Sullivan, Erin; Boezio, Cyndi; Algozzine, Bob; Reynolds, Heather; Johnson, Nanci

2014-01-01

Scaling of evidence-based practices in education has received extensive discussion but little empirical evaluation. We present here a descriptive summary of the experience from seven states with a history of implementing and scaling School-Wide Positive Behavioral Interventions and Supports (SWPBIS) over the past decade. Each state has been…

Supporting Evidence-Based Practice in Schools with an Online Database of Best Practices

ERIC Educational Resources Information Center

Powers, Joelle D.; Bowen, Natasha K.; Bowen, Gary L.

2011-01-01

In spite of multidisciplinary recommendations to use evidence-based interventions in schools and a growing knowledge base of such practices, most schools are not using empirically supported interventions. On the basis of a careful analysis of barriers to the implementation of the best researched programs, an online, free, and publicly available…

Rethinking our approach to gender and disasters: Needs, responsibilities, and solutions.

PubMed

Montano, Samantha; Savitt, Amanda

2016-01-01

To explore how the existing literature has discussed the vulnerability and needs of women in a disaster context. It will consider the literature's suggestions of how to minimize vulnerability and address the needs of women, including who involved in emergency management should be responsible for such efforts. Empirical journal articles and book chapters from disaster literature were collected that focused on "women" or "gender," and their results and recommendations were analyzed. This review found existing empirical research on women during disasters focuses on their vulnerabilities more than their needs. Second, when researchers do suggest solutions, they tend not to be comprehensive or supported by empirical evidence. Finally, it is not clear from existing research who is responsible for addressing these needs and implementing solutions. Future research should study the intersection of gender and disasters in terms of needs and solutions including who is responsible for implementing solutions.

Testing some major determinants for hospital innovation success.

PubMed

Caccia-Bava, Maria do Carmo; Guimaraes, Valerie C K; Guimaraes, Tor

2009-01-01

Hospitals have adopted new policies, methods and technologies to change their processes, improve services, and support other organizational changes necessary for better performance. The literature regarding the four major areas of strategic leadership, competitive intelligence, management of technology, and specific characteristics of the organization's change process propose their importance in successfully implementing organization innovation. While these factors may indeed be important to enhance hospital performance, the existing literature contains limited empirical evidence supporting their relationship to successfully implementing innovation in hospitals. This study aims to empirically test these relationships proposed in the literature by researchers in separate knowledge areas. A survey of 223 hospitals has been used to test an integrated model of these relationships. The response rate and the representativeness of the sample in terms of hospital size and geographical location were found satisfactory. The quality assurance/compliance managers for each hospital were the target respondents to questions, which require a corporate perspective while reducing the chance of bias for questions regarding top management leadership abilities. The results provide clear evidence about the importance of strategic leadership, competitive intelligence, management of technology, and specific characteristics of the hospital's change process to the hospitals success in implementing innovation. Given the importance of hospitals to change their processes, improve services, and support other organizational changes necessary for better performance, a great benefit is that the main factors for successful innovation have been brought together from scattered literature and tested among hospitals. Further, the items used for measuring the main constructs provide further insights into how hospital administrators should go about developing these areas within their organizations. This study is a first attempt at empirically testing the importance of strategic leadership, competitive intelligence, management of technology, and specific characteristics of the hospital's change process for the success of innovation efforts.

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

PubMed

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

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

Technological advances in the treatment of trauma: a review of promising practices.

PubMed

Paul, Lisa A; Hassija, Christina M; Clapp, Joshua D

2012-11-01

Given the availability of empirically supported practices for addressing posttraumatic stress disorder and other forms of trauma-related distress, the development and implementation of new technology to deliver these treatments is exciting. Technological innovations in this literature aim to expand availability of empirically based intervention, increase treatment adherence and acceptability, and overcome barriers commonly encountered with conventional trauma-focused treatment. Much of the current research on these technological developments consists of brief reviews and case studies of the separate therapy modalities. Although this work serves to document the appeal and utility of these innovations, it does not provide comprehensive information about the host of options available. To that end, the three general categories of technological advances in trauma therapy (i.e., videoconferencing, e-Health, virtual reality) are reviewed here, including information regarding their empirical support and suggestions for future research and clinical practice.

Implementation of a Culturally Appropriate Positive Behavior Support Plan with a Japanese Mother of a Child with Autism: An Experimental and Qualitative Analysis

ERIC Educational Resources Information Center

Cheremshynski, Christy; Lucyshyn, Joseph M.; Olson, Deborah L.

2013-01-01

The purpose of this study was to empirically investigate a family-centered approach to positive behavior support (PBS) that was designed to be culturally responsive to families of diverse linguistic and cultural backgrounds. A Japanese mother and a child with autism were the primary participants. Multiple research methods were used. A…

Scaffolding in Complex Modelling Situations

ERIC Educational Resources Information Center

Stender, Peter; Kaiser, Gabriele

2015-01-01

The implementation of teacher-independent realistic modelling processes is an ambitious educational activity with many unsolved problems so far. Amongst others, there hardly exists any empirical knowledge about efficient ways of possible teacher support with students' activities, which should be mainly independent from the teacher. The research…

Health Education about AIDS among Seropositive Blood Donors.

ERIC Educational Resources Information Center

Cleary, Paul D.; And Others

1986-01-01

This article reviews the theoretical and empirical work that resulted in the New York Blood Center health education and psychosocial support program for blood donors who are notified that they are HIV (Human Immunodeficiency Virus) antibody positive. Also describes how the program is being implemented. (Author/CT)

Factors Influencing Worker Morale: Evaluating Provider Demographics, Workplace Environment and Using ESTs

ERIC Educational Resources Information Center

Patterson-Silver Wolf, David A.; Dulmus, Catherine N.; Maguin, Eugene; Cristalli, Maria

2013-01-01

Objectives: Mental health organizations are strongly encouraged to implement empirically supported treatments (ESTs); however, little is known about their working environments. The present study investigated how provider demographics, workplace environment, and whether ESTs were used affected the worker morale. Method: Frontline workers…

From Research to Practice: Lessons Learned

ERIC Educational Resources Information Center

Toth, Sheree L.; Manly, Jody Todd; Nilsen, Wendy J.

2008-01-01

Research has informed practice since the origins of developmental psychology, but only recently has basic science and practice begun to be consistently integrated with one another. In addition, considerable research documents the utility of empirically-supported interventions, yet it has been difficult to implement such interventions outside of…

At-Risk Student Averse: Risk Management and Accountability

ERIC Educational Resources Information Center

Vasquez Heilig, Julian; Young, Michelle; Williams, Amy

2012-01-01

Purpose: The prevailing theory of action underlying accountability is that holding schools and students accountable will increase educational output. While accountability's theory of action intuitively seemed plausible, at the point of No Child Left Behind's national implementation, little empirical research was available to either support or…

Internal Control, CPA Recognition and Performance Consequence: Evidence from Chinese Real Estate Enterprises

NASA Astrophysics Data System (ADS)

Zhang, Chuan; Zhang, Lili; Geng, Yi

In recent years, internal control has caught more and more attention over the whole globe. However, whether internal control could improve business efficiency also lacks the empirical supports. Based on a sample size of 146 Chinese real estate enterprises, this study analyses the CPA’s recognition degree on firm’s implementing internal control, and its performance consequence. The evidence suggests that CPAs are able to give exact evaluation on firm’s internal control implement, and the higher the internal control implemented, the better performance the enterprise will have.

Participant Diversity in Special Education Research: Parent-Implemented Behavior Interventions for Children with Autism

ERIC Educational Resources Information Center

Robertson, Rachel E.; Sobeck, Emily E.; Wynkoop, Kaylee; Schwartz, Rachel

2017-01-01

Evidence-based practices for children with disabilities have empirical support for their effectiveness; however, the demographics of participants making up the evidence base are generally unknown, leaving generalizability of the evidence unclear. This study presents a systematic literature review of participant racial and socioeconomic…

Self-Monitoring for High School Students with Disabilities: A Cross-Categorical Investigation of I-Connect

ERIC Educational Resources Information Center

Clemons, Lachelle L.; Mason, Benjamin A.; Garrison-Kane, Linda; Wills, Howard P.

2016-01-01

Self-monitoring interventions are well supported within the empirical literature as improving classroom engagement for students with disabilities. However, studies implementing self-monitoring interventions in high school settings are rarely conducted despite their potential to improve student academic and behavioral outcomes. In an investigation…

The importance of education, understanding, and empirical research in social work: the nuts and bolts of the business.

PubMed

Long, Kimberly; Wodarski, John S

2010-05-01

Over the past three decades, existing literature has demanded, and continues to demand, accountability in the delivery of social services through empirically based research and implementation of established norms: this is, and of itself, the true basis of social work. It is through these norms and empirically established models and theories of treatment that a social worker can really do what he/she wants to do: help the client. This article will describe the nuts and bolts of social work; i.e. those theories, models, and the established norms of practice. It is the desire of the author's that all social workers be educated in the nuts and bolts (basics) and that education will be based on empirical evidence that supports behavioral change through intervention and modification.

Implementation Science: Why it matters for the future of social work.

PubMed

Cabassa, Leopoldo J

2016-01-01

Bridging the gap between research and practice is a critical frontier for the future of social work. Integrating implementation science into social work can advance our profession's effort to bring research and practice closer together. Implementation science examines the factors, processes, and strategies that influence the uptake, use, and sustainability of empirically-supported interventions, practice innovations, and social policies in routine practice settings. The aims of this paper are to describe the key characteristics of implementation science, illustrate how implementation science matters to social work by describing several contributions this field can make to reducing racial and ethnic disparities in mental health care, and outline a training agenda to help integrate implementation science in graduate-level social work programs.

Implementation Science: Why it matters for the future of social work

PubMed Central

Cabassa, Leopoldo J.

2016-01-01

Bridging the gap between research and practice is a critical frontier for the future of social work. Integrating implementation science into social work can advance our profession’s effort to bring research and practice closer together. Implementation science examines the factors, processes, and strategies that influence the uptake, use, and sustainability of empirically-supported interventions, practice innovations, and social policies in routine practice settings. The aims of this paper are to describe the key characteristics of implementation science, illustrate how implementation science matters to social work by describing several contributions this field can make to reducing racial and ethnic disparities in mental health care, and outline a training agenda to help integrate implementation science in graduate-level social work programs. PMID:28216992

Assessing E-Learning System in Higher Education Institutes: Evidence from Structural Equation Modelling

ERIC Educational Resources Information Center

Ali, Muhammad; Raza, Syed Ali; Qazi, Wasim; Puah, Chin-Hong

2018-01-01

Purpose: This study aims to examine university students' acceptance of e-learning systems in Pakistan. A Web-based learning system is a new form of utilizing technological features. Although, developed countries have initiated and established the concept for e-learning, developing countries require empirical support to implement e-learning.…

A Step Forward in Teaching Addiction Counselors How to Supervise Motivational Interviewing Using a Clinical Trials Training Approach

ERIC Educational Resources Information Center

Martino, Steve; Gallon, Steve; Ball, Samuel A.; Carroll, Kathleen M.

2007-01-01

A clinical trials training approach to supervision is a promising and empirically supported method for preparing addiction counselors to implement evidence-based behavioral treatments in community treatment programs. This supervision approach has three main components: (1) direct observation of treatment sessions; (2) structured performance…

Helping Schoolchildren Cope with Anger: A Cognitive-Behavioral Intervention. Second Edition

ERIC Educational Resources Information Center

Larson, Jim; Lochman, John E.

2010-01-01

This guide presents information and clinical tools to implement the Anger Coping Program, an empirically supported intervention for students in grades 3-6. Practitioners are taken step by step through setting up treatment groups, teaching vital skills for reducing aggression and disruptive behavior, and building strong partnerships with teachers…

Treatment Integrity of Interventions with Children in the School Psychology Literature from 1995 to 2008

ERIC Educational Resources Information Center

Sanetti, Lisa M. Hagermoser; Gritter, Katie L.; Dobey, Lisa M.

2011-01-01

Increased accountability in education has resulted in a focus on implementing interventions with strong empirical support. Both student outcome and treatment integrity data are needed to draw valid conclusions about intervention effectiveness. Reviews of the literature in other fields (e.g., applied behavior analysis, prevention science) suggest…

Empirical Evidence in Support of a Research-Informed Water Conservation Education Program

ERIC Educational Resources Information Center

Thompson, Ruthanne; Serna, Victoria Faubion

2016-01-01

Based on results from a 2008 research study of regional citizen knowledge concerning watershed issues, a water conservation education program was designed and implemented. Findings from the initial study demonstrated program success as evidenced by knowledge gain and willingness to "commit" to water saving behaviors in 94% of students. A…

Impact of Portfolio Assessment on Physics Students' Outcomes: Examination of Learning and Attitude

ERIC Educational Resources Information Center

Gunay, Abdulkadir; Ogan-Bekiroglu, Feral

2014-01-01

In spite of the commendations for the use of portfolio assessment, there is still little evidence indicating that such assessment actually supports and encourages student learning. Hence, this research study aimed to empirically identify the effects of implementation of portfolio assessment on student learning and attitudes. True-experimental…

Adoption of Comprehensive School Physical Activity Programs: A Literature Review

ERIC Educational Resources Information Center

Hunt, Kari; Metzler, Michael

2017-01-01

Recent research has provided preliminary insight into the implementation of Comprehensive School Physical Activity Program (CSPAP) components in P-12 schools, but additional empirical support is needed to establish the CSPAP model as a viable conceptual framework. The purpose of this review is to examine the extent to which the CSPAP framework is…

Implementing Dialectical Behavior Therapy with Adolescents and Their Families in a Community Outpatient Clinic

ERIC Educational Resources Information Center

Woodberry, Kristen A.; Popenoe, Ellen J.

2008-01-01

Dialectical behavior therapy (DBT), an empirically supported treatment for adult women diagnosed with borderline personality disorder (BPD), has been increasingly adapted for use with adolescents across a variety of settings. This article describes a community-based application of DBT principles and strategies for adolescents and their families.…

Implementing Research-Based Substance Abuse Prevention in Communities: Effects of a Coalition-Based Prevention Initiative in Vermont

ERIC Educational Resources Information Center

Flewelling, Robert L.; Austin, David; Hale, Kelly; LaPlante, Marcia; Liebig, Melissa; Piasecki, Linda; Uerz, Lori

2005-01-01

Despite the popularity and perceived potential effectiveness of community-based coalitions in helping to prevent and reduce adolescent substance use, empirical evidence supporting this approach is sparse. Many reasons have been suggested for why coalition-based prevention initiatives, and community-level interventions in general, have not…

From Learning Object to Learning Cell: A Resource Organization Model for Ubiquitous Learning

ERIC Educational Resources Information Center

Yu, Shengquan; Yang, Xianmin; Cheng, Gang

2013-01-01

The key to implementing ubiquitous learning is the construction and organization of learning resources. While current research on ubiquitous learning has primarily focused on concept models, supportive environments and small-scale empirical research, exploring ways to organize learning resources to make them available anywhere on-demand is also…

Mixed Methods Evaluation of Statewide Implementation of Mathematics Education Technology for K-12 Students

ERIC Educational Resources Information Center

Brasiel, Sarah; Martin, Taylor; Jeong, Soojeong; Yuan, Min

2016-01-01

An extensive body of research has demonstrated that the use in a K-12 classroom of technology, such as the Internet, computers, and software programs, enhances the learning of mathematics (Cheung & Slavin, 2013; Cohen & Hollebrands, 2011). In particular, growing empirical evidence supports that certain types of technology, such as…

The Semistructured Interview for Consideration of Ethnic Culture in Therapy Scale: Initial Psychometric and Outcome Support

ERIC Educational Resources Information Center

Donohue, Brad; Strada, Marilyn J.; Rosales, Rocio; Taylor-Caldwell, Aundrea; Hise, Dortha; Ahman, Sarah; Lefforge, Noelle L.; Kopof, Monique; Devore, Greg; Soares, Bruno; Radkovich, Ben; Laino, Rowena

2006-01-01

There has been recent pressure for practitioners to consider cultural variables when implementing evidence-based interventions. Therefore, the Semistructured Interview for Consideration of Ethnic Culture in Therapy Scale (SSICECTS) was empirically developed to address this issue. First, psychometric properties of a 6-item scale were evaluated in…

Reverse-Scaffolding Algebra: Empirical Evaluation of Design Architecture

ERIC Educational Resources Information Center

Chase, Kiera; Abrahamson, Dor

2015-01-01

Scaffolding is the asymmetrical social co-enactment of natural or cultural practice, wherein a more able agent implements or performs for a novice elements of a challenging activity. What the novice may not learn, however, is how the expert's co-enactments support the activity. Granted, in many cultural practices novices need not understand…

A Comparison of Flexible Prompt Fading and Constant Time Delay for Five Children with Autism

ERIC Educational Resources Information Center

Soluaga, Doris; Leaf, Justin B.; Taubman, Mitchell; McEachin, John; Leaf, Ron

2008-01-01

Given the increasing rates of autism, identifying prompting procedures that can assist in the development of more optimal learning opportunities for this population is critical. Extensive empirical research exists supporting the effectiveness of various prompting strategies. Constant time delay (CTD) is a highly implemented prompting procedure…

Development and Implementation of an Empirical Ionosphere Variability Model

NASA Technical Reports Server (NTRS)

Minow, Joesph I.; Almond, Deborah (Technical Monitor)

2002-01-01

Spacecraft designers and operations support personnel involved in space environment analysis for low Earth orbit missions require ionospheric specification and forecast models that provide not only average ionospheric plasma parameters for a given set of geophysical conditions but the statistical variations about the mean as well. This presentation describes the development of a prototype empirical model intended for use with the International Reference Ionosphere (IRI) to provide ionospheric Ne and Te variability. We first describe the database of on-orbit observations from a variety of spacecraft and ground based radars over a wide range of latitudes and altitudes used to obtain estimates of the environment variability. Next, comparison of the observations with the IRI model provide estimates of the deviations from the average model as well as the range of possible values that may correspond to a given IRI output. Options for implementation of the statistical variations in software that can be run with the IRI model are described. Finally, we provide example applications including thrust estimates for tethered satellites and specification of sunrise Ne, Te conditions required to support spacecraft charging issues for satellites with high voltage solar arrays.

Changing organization culture: data driven participatory evaluation and revision of wraparound implementation.

PubMed

Bertram, Rosalyn M; Schaffer, Pam; Charnin, Leia

2014-01-01

Family members and professionals in a Substance Abuse and Mental Health Services Administration Children's Mental Health Systems of Care Initiative in Houston, Texas conducted a participatory evaluation to examine wraparound implementation. Results guided systematic, theory-based program revisions. By focusing through empirically derived frameworks for implementation, the evaluation team identified and generated useful data sources to support and improve wraparound provision. Despite working with a more diverse population in which youth displayed more severe behaviors than in similar grants, after 18 months more families received service and outcomes improved as fidelity scores advanced above the national mean.

Implementing Lumberjacks and Black Swans Into Model-Based Tools to Support Human-Automation Interaction.

PubMed

Sebok, Angelia; Wickens, Christopher D

2017-03-01

The objectives were to (a) implement theoretical perspectives regarding human-automation interaction (HAI) into model-based tools to assist designers in developing systems that support effective performance and (b) conduct validations to assess the ability of the models to predict operator performance. Two key concepts in HAI, the lumberjack analogy and black swan events, have been studied extensively. The lumberjack analogy describes the effects of imperfect automation on operator performance. In routine operations, an increased degree of automation supports performance, but in failure conditions, increased automation results in more significantly impaired performance. Black swans are the rare and unexpected failures of imperfect automation. The lumberjack analogy and black swan concepts have been implemented into three model-based tools that predict operator performance in different systems. These tools include a flight management system, a remotely controlled robotic arm, and an environmental process control system. Each modeling effort included a corresponding validation. In one validation, the software tool was used to compare three flight management system designs, which were ranked in the same order as predicted by subject matter experts. The second validation compared model-predicted operator complacency with empirical performance in the same conditions. The third validation compared model-predicted and empirically determined time to detect and repair faults in four automation conditions. The three model-based tools offer useful ways to predict operator performance in complex systems. The three tools offer ways to predict the effects of different automation designs on operator performance.

An empirically based model for knowledge management in health care organizations.

PubMed

Sibbald, Shannon L; Wathen, C Nadine; Kothari, Anita

2016-01-01

Knowledge management (KM) encompasses strategies, processes, and practices that allow an organization to capture, share, store, access, and use knowledge. Ideal KM combines different sources of knowledge to support innovation and improve performance. Despite the importance of KM in health care organizations (HCOs), there has been very little empirical research to describe KM in this context. This study explores KM in HCOs, focusing on the status of current intraorganizational KM. The intention is to provide insight for future studies and model development for effective KM implementation in HCOs. A qualitative methods approach was used to create an empirically based model of KM in HCOs. Methods included (a) qualitative interviews (n = 24) with senior leadership to identify types of knowledge important in these roles plus current information-seeking behaviors/needs and (b) in-depth case study with leaders in new executive positions (n = 2). The data were collected from 10 HCOs. Our empirically based model for KM was assessed for face and content validity. The findings highlight the paucity of formal KM in our sample HCOs. Organizational culture, leadership, and resources are instrumental in supporting KM processes. An executive's knowledge needs are extensive, but knowledge assets are often limited or difficult to acquire as much of the available information is not in a usable format. We propose an empirically based model for KM to highlight the importance of context (internal and external), and knowledge seeking, synthesis, sharing, and organization. Participants who reviewed the model supported its basic components and processes, and potential for incorporating KM into organizational processes. Our results articulate ways to improve KM, increase organizational learning, and support evidence-informed decision-making. This research has implications for how to better integrate evidence and knowledge into organizations while considering context and the role of organizational processes.

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

NASA Astrophysics Data System (ADS)

Wickramasinghe, Vathsala; Gunawardena, Vathsala

2010-08-01

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

Incorporating video modeling into a school-based intervention for students with autism spectrum disorders.

PubMed

Wilson, Kaitlyn P

2013-01-01

Video modeling is an intervention strategy that has been shown to be effective in improving the social and communication skills of students with autism spectrum disorders, or ASDs. The purpose of this tutorial is to outline empirically supported, step-by-step instructions for the use of video modeling by school-based speech-language pathologists (SLPs) serving students with ASDs. This tutorial draws from the many reviews and meta-analyses of the video modeling literature that have been conducted over the past decade, presenting empirically supported considerations for school-based SLPs who are planning to incorporate video modeling into their service delivery for students with ASD. The 5 overarching procedural phases presented in this tutorial are (a) preparation, (b) recording of the video model, (c) implementation of the video modeling intervention, (d) monitoring of the student's response to the intervention, and (e) planning of the next steps. Video modeling is not only a promising intervention strategy for students with ASD, but it is also a practical and efficient tool that is well-suited to the school setting. This tutorial will facilitate school-based SLPs' incorporation of this empirically supported intervention into their existing strategies for intervention for students with ASD.

Chronic disease management: implementation and coordination of healthcare systems for depressed elderly persons.

PubMed

Severinsson, Elisabeth; Holm, Anne Lise

2014-12-01

The aim of this study was to evaluate the implementation of the research-based Chronic Care Model (CCM), discuss methods and summarise research recommendations for improving the care of depressed elderly persons. Interviews were conducted and state-of-the-art reviews employed. Three important areas emerged: (1) barriers to and facilitating factors in the implementation of the CCM; (2) the challenges involved in re-designing the delivery system and interdisciplinary team collaboration; and (3) empirical evidence pertaining to self-management support and how older persons manage to live with depressive ill-health. In conclusion, implementation research requires evidence-based knowledge, staff involvement and familiarity with the context in which development occurs.

Validity and reliability of the "German Utilization Questionnaire-Dissemination and Use of Research" to measure attitude, availability, and support toward implementation of research in nursing practice.

PubMed

Haslinger-Baumann, Elisabeth; Lang, Gert; Müller, Gerhard

2014-01-01

In nursing practice, research results have to undergo a systematic process of transformation. Currently in Austria, there is no empirical data available concerning the actual implementation of research results. An English validated questionnaire was translated into German and tested for validity and reliability. A survey of 178 registered nurses (n = 178) was conducted in a multicenter, quantitative, cross-sectional study in Austria in 2011. Cronbach's alpha values (.82-.92) were calculated for 4 variables ("use," "attitude," "availability," "support") after the reduction of 7 irrelevant items. Exploratory factor analysis was calculated with Kaiser-Meyer-Olkin (KMO) ranging from .78 to .92; the total variance ranged from 46% to 56%. A validated German questionnaire concerning the implementation of research results is now available for the nursing practice.

Long-Term Stability of Membership in a Wechsler Intelligence Scale for Children--Third Edition (WISC-III) Subtest Core Profile Taxonomy

ERIC Educational Resources Information Center

Borsuk, Ellen R.; Watkins, Marley W.; Canivez, Gary L.

2006-01-01

Although often applied in practice, clinically based cognitive subtest profile analysis has failed to achieve empirical support. Nonlinear multivariate subtest profile analysis may have benefits over clinically based techniques, but the psychometric properties of these methods must be studied prior to their implementation and interpretation. The…

Free/Libre Open Source Software Implementation in Schools: Evidence from the Field and Implications for the Future

ERIC Educational Resources Information Center

Lin, Yu-Wei; Zini, Enrico

2008-01-01

This empirical paper shows how free/libre open source software (FLOSS) contributes to mutual and collaborative learning in an educational environment. Unlike proprietary software, FLOSS allows extensive customisation of software to support the needs of local users better. This also allows users to participate more proactively in the development…

Mindfulness for Children and Youth: A Review of the Literature with an Argument for School-Based Implementation

ERIC Educational Resources Information Center

Rempel, Kim

2012-01-01

Interest in the use of mindfulness-based activities with children and youth is growing. The article evaluates empirical evidence related to the use of mindfulness-based activities to facilitate enhanced student learning and to support students' psychological, physiological, and social development. It also provides an overview of interventions that…

Training Addiction Counselors to Implement an Evidence-Based Intervention: Strategies for Increasing Organizational and Provider Acceptance

ERIC Educational Resources Information Center

Woo, Stephanie M.; Hepner, Kimberly A.; Gilbert, Elizabeth A.; Osilla, Karen Chan; Hunter, Sarah B.; Munoz, Ricardo F.; Watkins, Katherine E.

2013-01-01

One barrier to widespread public access to empirically supported treatments (ESTs) is the limited availability and high cost of professionals trained to deliver them. Our earlier work from 2 clinical trials demonstrated that front-line addiction counselors could be trained to deliver a manualized, group-based cognitive behavioral therapy (GCBT)…

Response to Intervention: Ready or Not? Or, from Wait-to-Fail to Watch-Them-Fail

ERIC Educational Resources Information Center

Reynolds, Cecil R.; Shaywitz, Sally E.

2009-01-01

Response to Intervention (RTI) models of diagnosis and intervention are being implemented rapidly throughout the schools. The purposes of invoking an RTI model for disabilities in the schools clearly are laudable, yet close examination reveals an unappreciated paucity of empirical support for RTI and an overly optimistic view of its practical,…

Track Model: A Proposal of an Interactive Exhibit to Learn Aerodynamics

ERIC Educational Resources Information Center

Sturm, Heike; Sturm, Gerd; Bogner, Franz X.

2011-01-01

Bird flight and lift in general is a complex subject which is also difficult to teach in a classroom. In order to support the teaching of this curriculum-based subject, an interactive exhibit to demonstrate aerodynamic aspects of objects has been developed, implemented and evaluated with 262 middle school students. The empirical evaluation…

The Empirical Relationship among Organisational Learning, Continuous Improvement and Performance Improvement

ERIC Educational Resources Information Center

Sun, Hongyi; Ho, Kario; Ni, Wenbin

2008-01-01

There are still many questions remain unanswered about the relationship between Organisational Learning (OL) and Continuous Improvement (CI). For example, how do OL and CI contribute to business performance? Are OL and CI equal? Do OL and CI support each other? Should OL and CI be implemented separately or together? If together, how to integrate…

Application of empirically supported treatments to clinical settings. In: Jelalian, E., Steele, R.G., editors. Handbook of Childhood and Adolescent Obesity

USDA-ARS?s Scientific Manuscript database

This book chapter identifies treatments for pediatric obesity that have been shown to be effective in research settings and discusses how these treatments can be implemented in an applied clinical setting. Behavior-based treatments have demonstrated the best outcomes. Commonly used behavioral strate...

Examining the association between implementation and outcomes : state-wide scale-up of school-wide positive behavior intervention and supports.

PubMed

Pas, Elise T; Bradshaw, Catherine P

2012-10-01

Although there is an established literature supporting the efficacy of a variety of prevention programs, there has been less empirical work on the translation of such research to everyday practice or when scaled-up state-wide. There is a considerable need for more research on factors that enhance implementation of programs and optimize outcomes, particularly in school settings. The current paper examines how the implementation fidelity of an increasingly popular and widely disseminated prevention model called, School-wide Positive Behavioral Interventions and Supports (SW-PBIS), relates to student outcomes within the context of a state-wide scale-up effort. Data come from a scale-up effort of SW-PBIS in Maryland; the sample included 421 elementary and middle schools trained in SW-PBIS. SW-PBIS fidelity, as measured by one of three fidelity measures, was found to be associated with higher math achievement, higher reading achievement, and lower truancy. School contextual factors were related to implementation levels and outcomes. Implications for scale-up efforts of behavioral and mental health interventions and measurement considerations are discussed.

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

PubMed

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

2014-04-14

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

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

PubMed Central

2014-01-01

Background In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS). Methods Participants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n = 229; k = 46 teams) or for a confirmatory factor analysis (n = 230; k = 47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample. Results The exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity. Conclusions The ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation. The ILS also holds promise as a tool for leader and organizational development to improve EBP implementation. PMID:24731295

Mentoring, Training and Support to Global Health Innovators: A Scoping Review

PubMed Central

Cho, Dan-Bi; Cole, Donald; Simiyu, Ken; Luong, Winnie; Neufeld, Vic

2013-01-01

Global health innovators must navigate substantial complexities to successfully develop, implement and sustain global health innovations with impact through application of an Integrated Innovation™ approach. We sought to examine the nature of the literature and evidence around mentoring, training and support of global health innovators. We conducted a scoping review searching eight databases with terms capturing different kinds of innovation and support. Assessment of relevance and mapping was completed by two reviewers, with interpretation by the review team. Twenty-eight relevant papers provided perspectives on fostering global health innovators and innovation. Fifteen included empirical data on supports to global health innovators involving a wide range of innovators. Eight included documentation of outcomes but without designs to determine effectiveness. The diverse mentoring, training and support activities included: business incubators, support organizations and centres for entrepreneurship, technology transfer and intellectual property management, internship programs for business skill development, initiatives to bridge industry and researchers, and platforms for South-led innovation for global health. We propose the cultivation of a pipeline of global health innovators to increase the number of appropriate, sustainable innovations with impact in global health. Further empirical work on how to effectively support global health innovators is needed. PMID:23985118

Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review.

PubMed

Novins, Douglas K; Green, Amy E; Legha, Rupinder K; Aarons, Gregory A

2013-10-01

Although there has been a dramatic increase in the number of evidence-based practices (EBPs) to improve child and adolescent mental health, the poor uptake of these EBPs has led to investigations of factors related to their successful dissemination and implementation. The purpose of this systematic review was to identify key findings from empirical studies examining the dissemination and implementation of EBPs for child and adolescent mental health. Of 14,247 citations initially identified, 73 articles drawn from 44 studies met inclusion criteria. The articles were classified by implementation phase (exploration, preparation, implementation, and sustainment) and specific implementation factors examined. These factors were divided into outer (i.e., system level) and inner (i.e., organizational level) contexts. Few studies used true experimental designs; most were observational. Of the many inner context factors that were examined in these studies (e.g., provider characteristics, organizational resources, leadership), fidelity monitoring and supervision had the strongest empirical evidence. Albeit the focus of fewer studies, implementation interventions focused on improving organizational climate and culture were associated with better intervention sustainment as well as child and adolescent outcomes. Outer contextual factors such as training and use of specific technologies to support intervention use were also important in facilitating the implementation process. The further development and testing of dissemination and implementation strategies is needed to more efficiently move EBPs into usual care. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Finding harmony so the music plays on: pragmatic trial design considerations to promote organizational sustainment of an empirically-supported behavior therapy.

PubMed

Hartzler, Bryan; Peavy, K Michelle; Jackson, T Ron; Carney, Molly

2016-01-22

Pragmatic trials of empirically-supported behavior therapies may inform clinical and policy decisions concerning therapy sustainment. This retrospective trial design paper describes and discusses pragmatic features of a hybrid type III implementation/effectiveness trial of a contingency management (CM) intervention at an opioid treatment program. Prior reporting (Hartzler et al., J Subst Abuse Treat 46:429-438, 2014; Hartzler, Subst Abuse Treat Prev Policy 10:30, 2015) notes success in recruiting program staff for voluntary participation, durable impacts of CM training on staff-level outcomes, provisional setting implementation of the intervention, documentation of clinical effectiveness, and post-trial sustainment of CM. Six pragmatic design features, and both scientific and practical bases for their inclusion in the trial, are presented: (1) a collaborative intervention design process, (2) voluntary recruitment of program staff for therapy training and implementation, (3) serial training outcome assessments, with quasi-experimental staff randomization to either single or multiple baseline assessment conditions, (4) designation of a 90-day period immediately after training in which the setting implemented the intervention on a provisional basis, (5) inclusive patient eligibility for receipt of the CM intervention, and (6) designation of two staff as local implementation leaders to oversee clinical/administrative issues in provisional implementation. Each pragmatic trial design feature is argued to have contributed to sustainment of CM. Contributions implicate the building of setting proprietorship for the CM intervention, culling of internal staff expertise in its delivery, iterative use of assessment methods that limited setting burden, documentation of setting-specific clinical effectiveness, expanded penetration of CM among staff during provisional implementation, and promotion of setting self-reliance in the oversight of sustainable implementation procedures. It is hoped this discussion offers ideas for how to impact local clinical and policy decisions via effective behavior therapy dissemination.

Information security requirements in patient-centred healthcare support systems.

PubMed

Alsalamah, Shada; Gray, W Alex; Hilton, Jeremy; Alsalamah, Hessah

2013-01-01

Enabling Patient-Centred (PC) care in modern healthcare requires the flow of medical information with the patient between different healthcare providers as they follow the patient's treatment plan. However, PC care threatens the stability of the balance of information security in the support systems since legacy systems fall short of attaining a security balance when sharing their information due to compromises made between its availability, integrity, and confidentiality. Results show that the main reason for this is that information security implementation in discrete legacy systems focused mainly on information confidentiality and integrity leaving availability a challenge in collaboration. Through an empirical study using domain analysis, observations, and interviews, this paper identifies a need for six information security requirements in legacy systems to cope with this situation in order to attain the security balance in systems supporting PC care implementation in modern healthcare.

The development of a scalable parallel 3-D CFD algorithm for turbomachinery. M.S. Thesis Final Report

NASA Technical Reports Server (NTRS)

Luke, Edward Allen

1993-01-01

Two algorithms capable of computing a transonic 3-D inviscid flow field about rotating machines are considered for parallel implementation. During the study of these algorithms, a significant new method of measuring the performance of parallel algorithms is developed. The theory that supports this new method creates an empirical definition of scalable parallel algorithms that is used to produce quantifiable evidence that a scalable parallel application was developed. The implementation of the parallel application and an automated domain decomposition tool are also discussed.

Teaching Note--"Social Work Serial": Using Video-Recorded Simulated Client Sessions to Teach Social Work Practice

ERIC Educational Resources Information Center

Asakura, Kenta; Bogo, Marion; Good, Bethany; Power, Roxanne

2018-01-01

Simulation, the use of trained actors as simulated clients, has gained empirical support as an effective teaching and assessment method in social work education. The associated costs involving the use of live simulation, however, often pose a barrier and prevent less resourced schools from implementing this pedagogical approach in the classroom.…

We Don't Train in Vain: A Dissemination Trial of Three Strategies of Training Clinicians in Cognitive-Behavioral Therapy

ERIC Educational Resources Information Center

Sholomskas, Diane E.; Syracuse-Siewert, Gia; Rounsaville, Bruce J.; Ball, Samuel A.; Nuro, Kathryn F.; Carroll, Kathleen M.

2005-01-01

There has been little research on the effectiveness of different training strategies or the impact of exposure to treatment manuals alone on clinicians' ability to effectively implement empirically supported therapies. Seventy-eight community-based clinicians were assigned to 1 of 3 training conditions: review of a cognitive-behavioral therapy…

A Comparative Study of the Empirical Relationship in Student Performance between Physics and Other STEM Subjects

NASA Astrophysics Data System (ADS)

Guerra, Maricela

The Next Generation Science Standards (NGSS) advocated by the National Research Council emphasize the connections among Science, Technology, Engineering, and Mathematics (STEM) disciplines. By design, NGSS is expected to replace the previous science education standards to enhance the quality of STEM education across the nation. To support this initiative, this investigation was conducted to fill a void in the research literature by developing an empirical indicator for the relationship of student performance across STEM subjects using a large-scale database from the Trends in Mathematics and Science Study (TIMSS). In particular, an innovative approach has been taken in this study to support the canonical correlation analysis of student plausible scores between physics and other STEM subjects at different grade levels and in a cross-country context. Results from this doctoral research revealed the need to strengthen the alignment between the intended, implemented, and attained curricula to support the integration of STEM disciplines in the United States.

Validation of the Implementation Leadership Scale (ILS) with Supervisors' Self-Ratings.

PubMed

Torres, Elisa M; Ehrhart, Mark G; Beidas, Rinad S; Farahnak, Lauren R; Finn, Natalie K; Aarons, Gregory A

2018-01-01

Although often discussed, there is a lack of empirical research on the role of leadership in the management and delivery of health services. The implementation leadership scale (ILS) assesses the degree to which leaders are knowledgeable, proactive, perseverant, and supportive during evidence-based practice (EBP) implementation. The purpose of this study was to examine the psychometric properties of the ILS for leaders' self-ratings using a sample of mental health clinic supervisors (N = 119). Supervisors (i.e., leaders) completed surveys including self-ratings of their implementation leadership. Confirmatory factor analysis, reliability, and validity of the ILS were evaluated. The ILS factor structure was supported in the sample of supervisors. Results demonstrated internal consistency reliability and validity. Cronbach alpha's ranged from 0.92 to 0.96 for the ILS subscales and 0.95 for the ILS overall scale. The factor structure replication and reliability of the ILS in a sample of supervisors demonstrates its applicability with employees across organizational levels.

Examining the role of implementation quality in school-based prevention using the PATHS curriculum. Promoting Alternative THinking Skills Curriculum.

PubMed

Kam, Chi-Ming; Greenberg, Mark T; Walls, Carla T

2003-03-01

In order for empirically validated school-based prevention programs to "go to scale," it is important to understand the processes underlying program dissemination. Data collected in effectiveness trials, especially those measuring the quality of program implementation and administrative support, are valuable in explicating important factors influencing implementation. This study describes findings regarding quality of implementation in a recent effectiveness trial conducted in a high-risk, American urban community. This delinquency prevention trial is a locally owned intervention, which used the Promoting Alternative THinking Skills Curriculum as its major program component. The intervention involved 350 first graders in 6 inner-city public schools. Three schools implemented the intervention and the other 3 were comparison schools from the same school district. Although intervention effects were not found for all the intervention schools, the intervention was effective in improving children's emotional competence and reducing their aggression in schools which effectively supported the intervention. This study, utilizing data from the 3 intervention schools (13 classrooms and 164 students), suggested that 2 factors contributed to the success of the intervention: (a) adequate support from school principals and (b) high degree of classroom implementation by teachers. These findings are discussed in light of the theory-driven models in program evaluation that emphasized the importance of the multiple factors influencing the implementation of school-based interventions.

The Carrot or the Stick? Evaluation of Education and Enforcement as Management Tools for Human-Wildlife Conflicts

PubMed Central

Baruch-Mordo, Sharon; Breck, Stewart W.; Wilson, Kenneth R.; Broderick, John

2011-01-01

Evidence-based decision-making is critical for implementing conservation actions, especially for human-wildlife conflicts, which have been increasing worldwide. Conservation practitioners recognize that long-term solutions should include altering human behaviors, and public education and enforcement of wildlife-related laws are two management actions frequently implemented, but with little empirical evidence evaluating their success. We used a system where human-black bear conflicts were common, to experimentally test the efficacy of education and enforcement in altering human behavior to better secure attractants (garbage) from bears. We conducted 3 experiments in Aspen CO, USA to evaluate: 1) on-site education in communal dwellings and construction sites, 2) Bear Aware educational campaign in residential neighborhoods, and 3) elevated law enforcement at two levels in the core business area of Aspen. We measured human behaviors as the response including: violation of local wildlife ordinances, garbage availability to bears, and change in use of bear-resistance refuse containers. As implemented, we found little support for education, or enforcement in the form of daily patrolling in changing human behavior, but found more support for proactive enforcement, i.e., dispensing warning notices. More broadly we demonstrated the value of gathering evidence before and after implementing conservation actions, and the dangers of measuring responses in the absence of ecological knowledge. We recommend development of more effective educational methods, application of proactive enforcement, and continued evaluation of tools by directly measuring change in human behavior. We provide empirical evidence adding to the conservation managers' toolbox, informing policy makers, and promoting solutions to human-wildlife conflicts. PMID:21264267

Changing the Context Is Important and Necessary, but Not Sufficient, for Reducing Adolescent Risky Sexual Behavior: A Reply to Steinberg (2015).

PubMed

Bryan, Angela D; Gillman, Arielle S; Hansen, Natasha S

2016-07-01

Starting school later, keeping adolescents busy with structured programming, and making free condoms available, as Steinberg (2015) suggests, are important and necessary steps, but they are simply not sufficient if the goal is reducing sexually transmitted infections and unplanned pregnancy. We agree that the current state of affairs, which in many schools involves sexuality education using programs that are not empirically supported, is unacceptable. However, abandoning sexuality education entirely would leave adolescents ill equipped to protect themselves. Despite the fact that current intervention technology is neither perfect nor optimally effective, there are empirically supported, school-based sexual risk reduction interventions that teach these skills and are readily available. In addition, even though we agree that structured afternoon programs for school-aged adolescents would reduce the opportunity for sexual risk behavior during the school years, such programs would not address the demographic reality of sexual risk that continues for adolescents and emerging adults far past the end of traditional secondary education. We believe Steinberg's suggestions are an excellent start and ought to be implemented. But complementary to this approach should be the use of existing empirically supported sexual risk reduction interventions and research into the development of even more effective interventions. © The Author(s) 2016.

Use of empirically supported interventions for psychopathology: can the participatory approach move us beyond the research-to-practice gap?

PubMed

Becker, Carolyn Black; Stice, Eric; Shaw, Heather; Woda, Susan

2009-04-01

Dissemination, or distribution, of empirically supported interventions (ESIs) for psychopathology remains a significant challenge. This paper reviews the principles of community-partnership research (CPR) and explores why CPR might improve distribution of psychological ESIs. Benefits of CPR include building trust, pooling resources and knowledge, and better serving a community by directly involving its members in the design and implementation of research. In addition, after establishing a community's trust using CPR, researchers are likely to be better positioned to partner with communities in the further distribution of ESIs via community networks. This paper reviews the case of dissonance-based eating disorder prevention interventions to provide an example of how CPR can facilitate the adoption and distribution of an ESI by a community, in this case, sororities. CPR also presents a number of challenges, however, because it is time consuming and does not always align with funding mechanisms and research designs used in randomized controlled trials. Further, CPR does not necessarily solve the challenge of training providers, though it may help with problem solving. Ultimately, we suggest that the benefits of CPR far outweigh the challenges, and hope that more researchers will adopt these practices so that more individuals can benefit from empirically supported psychological interventions.

Obesity prevention strategies: could food or soda taxes improve health?

PubMed

Encarnação, R; Lloyd-Williams, F; Bromley, H; Capewell, S

2016-03-01

Evidence shows that one of the main causes for rising obesity rates is excessive consumption of sugar, which is due in large part to the high sugar content of most soda and juice drinks and junk foods. Worryingly, UK and global populations are consuming increasing amounts of sugary drinks and junk foods (high in salt, sugar and saturated fats). However, there is raised public awareness, and parents in particular want something to be done to curb the alarming rise in childhood obesity. Population-wide policies (i.e. taxation, regulation, legislation, reformulation) consistently achieve greater public health gains than interventions and strategies targeted at individuals. Junk food and soda taxes are supported by increasing evidence from empirical and modelling studies. The strongest evidence base is for a tax on sugar sweetened beverages, but in order to effectively reduce consumption, that taxation needs to be at least 20%. Empirical data from a number of countries which have implemented a duty on sugar or sugary drinks shows rapid, substantial benefits. In the UK, increasing evidence from recent scientific reports consistently support substantial reductions in sugar consumption through comprehensive strategies which include a tax. Furthermore, there is increasing public support for such measures. A sugar sweetened beverages tax will happen in the UK so the question is not 'If?' but 'When?' this tax will be implemented. And, crucially, which nation will get there first? England, Ireland, Scotland or Wales?

Evidence implementation: Development of an online methodology from the knowledge-to-action model of knowledge translation.

PubMed

Lockwood, Craig; Stephenson, Matthew; Lizarondo, Lucylynn; van Den Hoek, Joan; Harrison, Margaret

2016-08-01

This paper describes an online facilitation for operationalizing the knowledge-to-action (KTA) model. The KTA model incorporates implementation planning that is optimally suited to the information needs of clinicians. The can-implement(©) is an evidence implementation process informed by the KTA model. An online counterpart, the can-implement.pro(©) , was developed to enable greater dissemination and utilization of the can-implement(©) process. The driver for this work was health professionals' need for facilitation that is iterative, informed by context and localized to the specific needs of users. The literature supporting this paper includes evaluation studies and theoretical concepts relevant to KTA model, evidence implementation and facilitation. Nursing and other health disciplines require a skill set and resources to successfully navigate the complexity of organizational requirements, inter-professional leadership and day-to-day practical management to implement evidence into clinical practice. The can-implement.pro(©) provides an accessible, inclusive system for evidence implementation projects. There is empirical support for evidence implementation informed by the KTA model, which in this phase of work has been developed for online uptake. Nurses and other clinicians seeking to implement evidence could benefit from the directed actions, planning advice and information embedded in the phases and steps of can-implement.pro(©) . © 2016 John Wiley & Sons Australia, Ltd.

Realising the Mass Public Benefit of Evidence-Based Psychological Therapies: The IAPT Program

PubMed Central

Clark, David M

2018-01-01

Empirically supported psychological therapies have been developed for many mental health conditions. However, in most countries only a small proportion of the public benefit from these advances. The English Improving Access to Psychological Therapies (IAPT) program aims to bridge the gap between research and practice by training over 10,500 new psychological therapists in empirically supported treatments and deploying them in new services for the treatment of depression and anxiety disorders. Currently IAPT treats over 560,000 patients per year, obtains clinical outcome data on 98.5% of these individuals and places this information in the public domain. Around 50% of patients treated in IAPT services recover and two-thirds show worthwhile benefits. The clinical and economic arguments on which IAPT is based are presented, along with details of the service model, how the program was implemented, and recent findings about service organization. Limitations and future directions are outlined. PMID:29350997

Empirically Supported Treatment’s Impact on Organizational Culture and Climate

PubMed Central

Patterson-Silver Wolf, David A.; Dulmus, Catherine N.; Maguin, Eugene

2012-01-01

Objectives With the continued push to implement empirically supported treatments (ESTs) into community-based organizations, it is important to investigate whether working condition disruptions occur during this process. While there are many studies investigating best practices and how to adopt them, the literature lacks studies investigating the working conditions in programs that currently use ESTs. Method This study compared the culture and climate scores of a large organization’s programs that use ESTs and those programs indicating no EST usage. Results Of the total 55 different programs (1,273 frontline workers), 27 programs used ESTs. Results indicate that the programs offering an EST had significantly more rigid and resistant cultures, compared to those without any ESTs. In regard to climate, programs offering an EST were significantly less engaged, less functional, and more stressed. Conclusion Outcomes indicate a significant disruption in organizational culture and climate for programs offering ESTs. PMID:23243379

Empirically Supported Treatment's Impact on Organizational Culture and Climate.

PubMed

Patterson-Silver Wolf, David A; Dulmus, Catherine N; Maguin, Eugene

2012-11-01

OBJECTIVES: With the continued push to implement empirically supported treatments (ESTs) into community-based organizations, it is important to investigate whether working condition disruptions occur during this process. While there are many studies investigating best practices and how to adopt them, the literature lacks studies investigating the working conditions in programs that currently use ESTs. METHOD: This study compared the culture and climate scores of a large organization's programs that use ESTs and those programs indicating no EST usage. RESULTS: Of the total 55 different programs (1,273 frontline workers), 27 programs used ESTs. Results indicate that the programs offering an EST had significantly more rigid and resistant cultures, compared to those without any ESTs. In regard to climate, programs offering an EST were significantly less engaged, less functional, and more stressed. CONCLUSION: Outcomes indicate a significant disruption in organizational culture and climate for programs offering ESTs.

Decision-support models for empiric antibiotic selection in Gram-negative bloodstream infections.

PubMed

MacFadden, D R; Coburn, B; Shah, N; Robicsek, A; Savage, R; Elligsen, M; Daneman, N

2018-04-25

Early empiric antibiotic therapy in patients can improve clinical outcomes in Gram-negative bacteraemia. However, the widespread prevalence of antibiotic-resistant pathogens compromises our ability to provide adequate therapy while minimizing use of broad antibiotics. We sought to determine whether readily available electronic medical record data could be used to develop predictive models for decision support in Gram-negative bacteraemia. We performed a multi-centre cohort study, in Canada and the USA, of hospitalized patients with Gram-negative bloodstream infection from April 2010 to March 2015. We analysed multivariable models for prediction of antibiotic susceptibility at two empiric windows: Gram-stain-guided and pathogen-guided treatment. Decision-support models for empiric antibiotic selection were developed based on three clinical decision thresholds of acceptable adequate coverage (80%, 90% and 95%). A total of 1832 patients with Gram-negative bacteraemia were evaluated. Multivariable models showed good discrimination across countries and at both Gram-stain-guided (12 models, areas under the curve (AUCs) 0.68-0.89, optimism-corrected AUCs 0.63-0.85) and pathogen-guided (12 models, AUCs 0.75-0.98, optimism-corrected AUCs 0.64-0.95) windows. Compared to antibiogram-guided therapy, decision-support models of antibiotic selection incorporating individual patient characteristics and prior culture results have the potential to increase use of narrower-spectrum antibiotics (in up to 78% of patients) while reducing inadequate therapy. Multivariable models using readily available epidemiologic factors can be used to predict antimicrobial susceptibility in infecting pathogens with reasonable discriminatory ability. Implementation of sequential predictive models for real-time individualized empiric antibiotic decision-making has the potential to both optimize adequate coverage for patients while minimizing overuse of broad-spectrum antibiotics, and therefore requires further prospective evaluation. Readily available epidemiologic risk factors can be used to predict susceptibility of Gram-negative organisms among patients with bacteraemia, using automated decision-making models. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Supporting Universal Prevention Programs: A Two-Phased Coaching Model

PubMed Central

Becker, Kimberly D.; Darney, Dana; Domitrovich, Celene; Keperling, Jennifer Pitchford; Ialongo, Nicholas S.

2013-01-01

Schools are adopting evidence-based programs designed to enhance students’ emotional and behavioral competencies at increasing rates (Hemmeter, Snyder, & Artman, 2011). At the same time, teachers express the need for increased support surrounding implementation of these evidence-based programs (Carter & Van Norman, 2010). Ongoing professional development in the form of coaching may enhance teacher skills and implementation (Noell et al., 2005; Stormont, Reinke, Newcomer, Darney, & Lewis, 2012). There exists a need for a coaching model that can be applied to a variety of teacher skill levels and one that guides coach decision-making about how best to support teachers. This article provides a detailed account of a two-phased coaching model with empirical support developed and tested with coaches and teachers in urban schools (Becker, Bradshaw, Domitrovich, & Ialongo, 2013). In the initial universal coaching phase, all teachers receive the same coaching elements regardless of their skill level. Then, in the tailored coaching phase, coaching varies according to the strengths and needs of each teacher. Specifically, more intensive coaching strategies are used only with teachers who need additional coaching supports whereas other teachers receive just enough support to consolidate and maintain their strong implementation. Examples of how coaches used the two-phased coaching model when working with teachers who were implementing two universal prevention programs (i.e., the PATHS® curriculum and PAX Good Behavior Game [PAX GBG]) provide illustrations of the application of this model. The potential reach of this coaching model extends to other school-based programs as well as other settings in which coaches partner with interventionists to implement evidence-based programs. PMID:23660973

Implementing shared decision making in routine mental health care

PubMed Central

Slade, Mike

2017-01-01

Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non‐maleficence. It is argued that SDM is “polyvalent”, a sociological concept which describes an idea commanding superficial but not deep agreement between disparate stakeholders. Implementing SDM in routine mental health services is as much a cultural as a technical problem. Three challenges are identified: creating widespread access to high‐quality decision support tools; integrating SDM with other recovery‐supporting interventions; and responding to cultural changes as patients develop the normal expectations of citizenship. Two approaches which may inform responses in the mental health system to these cultural changes – social marketing and the hospitality industry – are identified. PMID:28498575

Understanding Implementation of Complex Interventions in Primary Care Teams.

PubMed

Luig, Thea; Asselin, Jodie; Sharma, Arya M; Campbell-Scherer, Denise L

2018-01-01

The implementation of interventions to support practice change in primary care settings is complex. Pragmatic strategies, grounded in empiric data, are needed to navigate real-world challenges and unanticipated interactions with context that can impact implementation and outcomes. This article uses the example of the "5As Team" randomized control trial to explore implementation strategies to promote knowledge transfer, capacity building, and practice integration, and their interaction within the context of an interdisciplinary primary care team. We performed a qualitative evaluation of the implementation process of the 5As Team intervention study, a randomized control trial of a complex intervention in primary care. We conducted thematic analysis of field notes of intervention sessions, log books of the practice facilitation team members, and semistructured interviews with 29 interdisciplinary clinician participants. We used and further developed the Interactive Systems Framework for dissemination and implementation to interpret and structure findings. Three themes emerged that illuminate interactions between implementation processes, context, and outcomes: (1) facilitating team communication supported collective and individual sense-making and adoption of the innovation, (2) iterative evaluation of the implementation process and real-time feedback-driven adaptions of the intervention proved crucial for sustainable, context-appropriate intervention impact, (3) stakeholder engagement led to both knowledge exchange that contributes to local problem solving and to shaping a clinical context that is supportive to practice change. Our findings contribute pragmatic strategies that can help practitioners and researchers to navigate interactions between context, intervention, and implementation factors to increase implementation success. We further developed an implementation framework that includes sustained engagement with stakeholders, facilitation of team sense-making, and dynamic evaluation and intervention design as integral parts of complex intervention implementation. NCT01967797. 18 October 2013. © Copyright 2018 by the American Board of Family Medicine.

Leadership in evidence-based practice: a systematic review.

PubMed

Reichenpfader, Ursula; Carlfjord, Siw; Nilsen, Per

2015-01-01

This study aims to systematically review published empirical research on leadership as a determinant for the implementation of evidence-based practice (EBP) and to investigate leadership conceptualization and operationalization in this field. A systematic review with narrative synthesis was conducted. Relevant electronic bibliographic databases and reference lists of pertinent review articles were searched. To be included, a study had to involve empirical research and refer to both leadership and EBP in health care. Study quality was assessed with a structured instrument based on study design. A total of 17 studies were included. Leadership was mostly viewed as a modifier for implementation success, acting through leadership support. Yet, there was definitional imprecision as well as conceptual inconsistency, and studies seemed to inadequately address situational and contextual factors. Although referring to an organizational factor, the concept was mostly analysed at the individual or group level. The concept of leadership in implementation science seems to be not fully developed. It is unclear whether attempts to tap the concept of leadership in available instruments truly capture and measure the full range of the diverse leadership elements at various levels. Research in implementation science would benefit from a better integration of research findings from other disciplinary fields. Once a more mature concept has been established, researchers in implementation science could proceed to further elaborate operationalization and measurement. Although the relevance of leadership in implementation science has been acknowledged, the conceptual base of leadership in this field has received only limited attention.

Lost in translation? Moving contingency management and cognitive behavioral therapy into clinical practice.

PubMed

Carroll, Kathleen M

2014-10-01

In the treatment of addictions, the gap between the availability of evidence-based therapies and their limited implementation in practice has not yet been bridged. Two empirically validated behavioral therapies, contingency management (CM) and cognitive behavioral therapy (CBT), exemplify this challenge. Both have a relatively strong level of empirical support but each has weak and uneven adoption in clinical practice. This review highlights examples of how barriers to their implementation in practice have been addressed systematically, using the Stage Model of Behavioral Therapies Development as an organizing framework. For CM, barriers such as cost and ideology have been addressed through the development of lower-cost and other adaptations to make it more community friendly. For CBT, barriers such as relative complexity, lack of trained providers, and need for supervision have been addressed via conversion to standardized computer-assisted versions that can serve as clinician extenders. Although these and other modifications have rendered both interventions more disseminable, diffusion of innovation remains a complex, often unpredictable process. The existing specialty addiction-treatment system may require significant reforms to fully implement CBT and CM, particularly greater focus on definable treatment goals and performance-based outcomes. © 2014 New York Academy of Sciences.

Examining the Association Between Implementation and Outcomes

PubMed Central

Pas, Elise T.; Bradshaw, Catherine P.

2012-01-01

Although there is an established literature supporting the efficacy of a variety of prevention programs, there has been less empirical work on the tran of such research to everyday practice or when scaled-up state-wide. There is a considerable need for more research on factors that enhance implementation of programs and optimize outcomes, particularly in school settings. The current paper examines how the implementation fidelity of an increasingly popular and widely disseminated prevention model called, School-wide Positive Behavioral Interventions and Supports (SW-PBIS), relates to student outcomes within the context of a state-wide scale-up effort. Data come from a scale-up effort of SW-PBIS in Maryland; the sample included 421 elementary and middle schools trained in SW-PBIS. SW-PBIS fidelity, as measured by one of three fidelity measures, was found to be associated with higher math achievement, higher reading achievement, and lower truancy. School contextual factors were related to implementation levels and outcomes. Implications for scale-up efforts of behavioral and mental health interventions and measurement considerations are discussed. PMID:22836758

Examining the premises supporting the empirically supported intervention approach to social work practice.

PubMed

McBeath, Bowen; Briggs, Harold E; Aisenberg, Eugene

2010-10-01

Federal, state, and local policymakers and funders have increasingly organized human service delivery functions around the selection and implementation of empirically supported interventions (ESIs), under the expectation that service delivery through such intervention frameworks results in improvements in cost-effectiveness and system performance. This article examines the validity of four premises undergirding the ESI approach: ESIs are effective, relevant to common client problems and needs, culturally appropriate, and replicable and sustainable in community-based settings. In reviewing available literature, the authors found insufficient support for the uniform application of an ESI approach to social work practice in the human service sector, particularly as applied within agency contexts serving ethnic minority clients. The authors recommend that greater attention be devoted to the development and dissemination of social work interventions that respond to needs that are broadly understood and shared across diverse cultural groups, have proven clinical efficacy, and can be translated successfully for use across different agency and cultural environments. Such attention to the research and development function of the social work profession is increasingly necessary as policymakers and human service system architects require reduced costs and improved performance for programs serving historically oppressed client populations.

Supporting universal prevention programs: a two-phased coaching model.

PubMed

Becker, Kimberly D; Darney, Dana; Domitrovich, Celene; Keperling, Jennifer Pitchford; Ialongo, Nicholas S

2013-06-01

Schools are adopting evidence-based programs designed to enhance students' emotional and behavioral competencies at increasing rates (Hemmeter et al. in Early Child Res Q 26:96-109, 2011). At the same time, teachers express the need for increased support surrounding implementation of these evidence-based programs (Carter and Van Norman in Early Child Educ 38:279-288, 2010). Ongoing professional development in the form of coaching may enhance teacher skills and implementation (Noell et al. in School Psychol Rev 34:87-106, 2005; Stormont et al. 2012). There exists a need for a coaching model that can be applied to a variety of teacher skill levels and one that guides coach decision-making about how best to support teachers. This article provides a detailed account of a two-phased coaching model with empirical support developed and tested with coaches and teachers in urban schools (Becker et al. 2013). In the initial universal coaching phase, all teachers receive the same coaching elements regardless of their skill level. Then, in the tailored coaching phase, coaching varies according to the strengths and needs of each teacher. Specifically, more intensive coaching strategies are used only with teachers who need additional coaching supports, whereas other teachers receive just enough support to consolidate and maintain their strong implementation. Examples of how coaches used the two-phased coaching model when working with teachers who were implementing two universal prevention programs (i.e., the PATHS curriculum and PAX Good Behavior Game [PAX GBG]) provide illustrations of the application of this model. The potential reach of this coaching model extends to other school-based programs as well as other settings in which coaches partner with interventionists to implement evidence-based programs.

Supporting the Evaluation and Implementation of Musculoskeletal Models of Care: A Globally Informed Framework for Judging Readiness and Success.

PubMed

Briggs, Andrew M; Jordan, Joanne E; Jennings, Matthew; Speerin, Robyn; Bragge, Peter; Chua, Jason; Woolf, Anthony D; Slater, Helen

2017-04-01

To develop a globally informed framework to evaluate readiness for implementation and success after implementation of musculoskeletal models of care (MOCs). Three phases were undertaken: 1) a qualitative study with 27 Australian subject matter experts (SMEs) to develop a draft framework; 2) an eDelphi study with an international panel of 93 SMEs across 30 nations to evaluate face validity, and refine and establish consensus on the framework components; and 3) translation of the framework into a user-focused resource and evaluation of its acceptability with the eDelphi panel. A comprehensive evaluation framework was developed for judging the readiness and success of musculoskeletal MOCs. The framework consists of 9 domains, with each domain containing a number of themes underpinned by detailed elements. In the first Delphi round, scores of "partly agree" or "completely agree" with the draft framework ranged 96.7%-100%. In the second round, "essential" scores ranged 58.6%-98.9%, resulting in 14 of 34 themes being classified as essential. SMEs strongly agreed or agreed that the final framework was useful (98.8%), usable (95.1%), credible (100%) and appealing (93.9%). Overall, 96.3% strongly supported or supported the final structure of the framework as it was presented, while 100%, 96.3%, and 100% strongly supported or supported the content within the readiness, initiating implementation, and success streams, respectively. An empirically derived framework to evaluate the readiness and success of musculoskeletal MOCs was strongly supported by an international panel of SMEs. The framework provides an important internationally applicable benchmark for the development, implementation, and evaluation of musculoskeletal MOCs. © 2016, American College of Rheumatology.

Implementing Evidence-Based Practice: A Review of the Empirical Research Literature

ERIC Educational Resources Information Center

Gray, Mel; Joy, Elyssa; Plath, Debbie; Webb, Stephen A.

2013-01-01

The article reports on the findings of a review of empirical studies examining the implementation of evidence-based practice (EBP) in the human services. Eleven studies were located that defined EBP as a research-informed, clinical decision-making process and identified barriers and facilitators to EBP implementation. A thematic analysis of the…

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes.

PubMed

Moran, Anna M; Coyle, Julia; Pope, Rod; Boxall, Dianne; Nancarrow, Susan A; Young, Jennifer

2014-02-13

To identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts. This is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts. This review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme. Through a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts.

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

PubMed Central

2014-01-01

Objective To identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts. Design This is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts. Results This review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme. Conclusion Through a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts. PMID:24521004

The "PE coach" smartphone application: an innovative approach to improving implementation, fidelity, and homework adherence during prolonged exposure.

PubMed

Reger, Greg M; Hoffman, Julia; Riggs, David; Rothbaum, Barbara O; Ruzek, Josef; Holloway, Kevin M; Kuhn, Eric

2013-08-01

Prolonged exposure (PE) is an empirically supported treatment that is being disseminated broadly to providers in the Department of Veterans Affairs and Department of Defense. Innovative methods are needed to support the implementation, dissemination, and patient and provider adherence to PE. The PE Coach is a smartphone application (app) designed to mitigate barriers to PE implementation. PE Coach is installed on the patient's phone and includes a range of capabilities for use during the PE session and after each session to support the treatment. Functions include the ability to audio record treatment sessions onto the patient's device, to construct the in vivo hierarchy on the device, to record completed homework exercises, to review homework adherence, and to track symptom severity over time. The app also allows sessions and homework to be scheduled directly in the app, populating the device calendar with patient reminder notifications. In the final session, a visual display of symptom improvement and habituation to items on the in vivo hierarchy is presented. These capabilities may significantly improve convenience, provider implementation and adherence, and patient compliance with treatment. Future research is needed to test whether PE Coach is useful and effective. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies

PubMed Central

Wherton, Joseph; Papoutsi, Chrysanthi; Lynch, Jennifer; Hughes, Gemma; A'Court, Christine; Hinder, Susan; Fahy, Nick; Procter, Rob; Shaw, Sara

2017-01-01

Background Many promising technological innovations in health and social care are characterized by nonadoption or abandonment by individuals or by failed attempts to scale up locally, spread distantly, or sustain the innovation long term at the organization or system level. Objective Our objective was to produce an evidence-based, theory-informed, and pragmatic framework to help predict and evaluate the success of a technology-supported health or social care program. Methods The study had 2 parallel components: (1) secondary research (hermeneutic systematic review) to identify key domains, and (2) empirical case studies of technology implementation to explore, test, and refine these domains. We studied 6 technology-supported programs—video outpatient consultations, global positioning system tracking for cognitive impairment, pendant alarm services, remote biomarker monitoring for heart failure, care organizing software, and integrated case management via data sharing—using longitudinal ethnography and action research for up to 3 years across more than 20 organizations. Data were collected at micro level (individual technology users), meso level (organizational processes and systems), and macro level (national policy and wider context). Analysis and synthesis was aided by sociotechnically informed theories of individual, organizational, and system change. The draft framework was shared with colleagues who were introducing or evaluating other technology-supported health or care programs and refined in response to feedback. Results The literature review identified 28 previous technology implementation frameworks, of which 14 had taken a dynamic systems approach (including 2 integrative reviews of previous work). Our empirical dataset consisted of over 400 hours of ethnographic observation, 165 semistructured interviews, and 200 documents. The final nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework included questions in 7 domains: the condition or illness, the technology, the value proposition, the adopter system (comprising professional staff, patient, and lay caregivers), the organization(s), the wider (institutional and societal) context, and the interaction and mutual adaptation between all these domains over time. Our empirical case studies raised a variety of challenges across all 7 domains, each classified as simple (straightforward, predictable, few components), complicated (multiple interacting components or issues), or complex (dynamic, unpredictable, not easily disaggregated into constituent components). Programs characterized by complicatedness proved difficult but not impossible to implement. Those characterized by complexity in multiple NASSS domains rarely, if ever, became mainstreamed. The framework showed promise when applied (both prospectively and retrospectively) to other programs. Conclusions Subject to further empirical testing, NASSS could be applied across a range of technological innovations in health and social care. It has several potential uses: (1) to inform the design of a new technology; (2) to identify technological solutions that (perhaps despite policy or industry enthusiasm) have a limited chance of achieving large-scale, sustained adoption; (3) to plan the implementation, scale-up, or rollout of a technology program; and (4) to explain and learn from program failures. PMID:29092808

Against the empirical viability of the Deutsch-Wallace-Everett approach to quantum mechanics

NASA Astrophysics Data System (ADS)

Dawid, Richard; Thébault, Karim P. Y.

2014-08-01

The subjective Everettian approach to quantum mechanics presented by Deutsch and Wallace fails to constitute an empirically viable theory of quantum phenomena. The decision theoretic implementation of the Born rule realized in this approach provides no basis for rejecting Everettian quantum mechanics in the face of empirical data that contradicts the Born rule. The approach of Greaves and Myrvold, which provides a subjective implementation of the Born rule as well but derives it from empirical data rather than decision theoretic arguments, avoids the problem faced by Deutsch and Wallace and is empirically viable. However, there is good reason to cast doubts on its scientific value.

Partisan Politics or Public-Health Need? An empirical analysis of state choice during initial implementation of the Affordable Care Act.

PubMed

Mayer, Martin; Kenter, Robert; Morris, John C

2015-01-01

States' policy decisions regarding the Affordable Care Act (ACA) of 2010 have often been explained as predominantly, if not solely, partisan. Might rival explanations also apply? Using a cross-sectional 50-state regression model, we studied standard political variables coupled with public-health indicators. This work differs from existing research by employing a dependent variable of five additive measures of ACA support, examining the impact of both political and socioeconomic indicators on state policy decisions. Expanding on recent empirical studies with our more nuanced additive index of support measures, we found that same-party control of a state's executive and legislative branches was indeed by far the single best predictor of policy decisions. Public-health indicators, overwhelmed by partisan effect, did not sufficiently explain state policy choice. This result does not allay the concerns that health policy has become synonymous with health politics and that health politics now has little to do with health itself.

A systematic review of sensory-based treatments for children with disabilities.

PubMed

Barton, Erin E; Reichow, Brian; Schnitz, Alana; Smith, Isaac C; Sherlock, Daniel

2015-02-01

Sensory-based therapies are designed to address sensory processing difficulties by helping to organize and control the regulation of environmental sensory inputs. These treatments are increasingly popular, particularly with children with behavioral and developmental disabilities. However, empirical support for sensory-based treatments is limited. The purpose of this review was to conduct a comprehensive and methodologically sound evaluation of the efficacy of sensory-based treatments for children with disabilities. Methods for this review were registered with PROSPERO (CRD42012003243). Thirty studies involving 856 participants met our inclusion criteria and were included in this review. Considerable heterogeneity was noted across studies in implementation, measurement, and study rigor. The research on sensory-based treatments is limited due to insubstantial treatment outcomes, weak experimental designs, or high risk of bias. Although many people use and advocate for the use of sensory-based treatments and there is a substantial empirical literature on sensory-based treatments for children with disabilities, insufficient evidence exists to support their use. Copyright © 2014 Elsevier Ltd. All rights reserved.

Diffusion of school-based prevention programs in two urban districts: adaptations, rationales, and suggestions for change.

PubMed

Ozer, Emily J; Wanis, Maggie G; Bazell, Nickie

2010-03-01

The diffusion of school-based preventive interventions involves the balancing of high-fidelity implementation of empirically-supported programs with flexibility to permit local stakeholders to target the specific needs of their youth. There has been little systematic research that directly seeks to integrate research- and community-driven approaches to diffusion. The present study provides a primarily qualitative investigation of the initial roll-out of two empirically-supported substance and violence prevention programs in two urban school districts that serve a high proportion of low-income, ethnic minority youth. The predominant ethnic group in most of our study schools was Asian American, followed by smaller numbers of Latinos, African Americans, and European Americans. We examined the adaptations made by experienced health teachers as they implemented the programs, the elicitation of suggested adaptations to the curricula from student and teacher stakeholders, and the evaluation of the consistency of these suggested adaptations with the core components of the programs. Data sources include extensive classroom observations of curricula delivery and interviews with students, teachers, and program developers. All health teachers made adaptations, primarily with respect to instructional format, integration of real-life experiences into the curriculum, and supplementation with additional resources; pedagogical and class management issues were cited as the rationale for these changes. Students and teachers were equally likely to propose adaptations that met with the program developers' approval with respect to program theory and implementation logistics. Tensions between teaching practice and prevention science-as well as implications for future research and practice in school-based prevention-are considered.

Institutional ethics policies on medical end-of-life decisions: a literature review.

PubMed

Lemiengre, Joke; de Casterlé, Bernadette Dierckx; Van Craen, Katleen; Schotsmans, Paul; Gastmans, Chris

2007-10-01

The responsibility of healthcare administrators for handling ethically sensitive medical practices, such as medical end-of-life decisions (MELDs), within an institutional setting has been receiving more attention. The overall aim of this paper is to thoroughly examine the prevalence, content, communication, and implementation of written institutional ethics policies on MELDs by means of a literature review. Major databases (Pubmed, Cinahl, PsycINFO, Cochrane Library, FRANCIS, and Philosopher's Index) and reference lists were systematically searched for all relevant papers. Inclusion criteria for relevance were that the study was empirically based and that it focused on the prevalence, content, communication, or implementation of written institutional ethics policies concerning MELDs. Our search yielded 19 studies of American, Canadian, Dutch and Belgian origin. The majority of studies dealt with do-not-resuscitate (DNR) policies (prevalence: 10-89%). Only Dutch and Belgian studies dealt with policies on pain and symptom control (prevalence: 15-19%) and policies on euthanasia (prevalence: 30-79%). Procedural and technical aspects were a prime focus, while the defining of the specific roles of involved parties was unclear. Little attention was given to exploring ethical principles that question the ethical function of policies. In ethics policies on euthanasia, significant consideration was given to procedures that dealt with conscientious objections of physicians and nurses. Empirical studies about the implementation of ethics policies are scarce. With regard to providing support for physicians and nurses, DNR and euthanasia policies expressed support by primarily providing technical and procedural guidelines. Further research is needed whether and in which way written institutional ethics policies on MELDs could contribute to better end-of-life care.

Evidence Base Update for Autism Spectrum Disorder.

PubMed

Smith, Tristram; Iadarola, Suzannah

2015-01-01

This evidence base update examines the level of empirical support for interventions for children with autism spectrum disorder (ASD) younger than 5 years old. It focuses on research published since a previous review in this journal (Rogers & Vismara, 2008 ). We identified psychological or behavioral interventions that had been manualized and evaluated in either (a) experimental or quasi-experimental group studies or (b) systematic reviews of single-subject studies. We extracted data from all studies that met these criteria and were published after the previous review. Interventions were categorized across two dimensions. First, primary theoretical principles included applied behavior analysis (ABA), developmental social-pragmatic (DSP), or both. Second, practice elements included scope (comprehensive or focused), modality (individual intervention with the child, parent training, or classrooms), and intervention targets (e.g., spoken language or alternative and augmentative communication). We classified two interventions as well-established (individual, comprehensive ABA and teacher-implemented, focused ABA + DSP), 3 as probably efficacious (individual, focused ABA for augmentative and alternative communication; individual, focused ABA + DSP; and focused DSP parent training), and 5 as possibly efficacious (individual, comprehensive ABA + DSP; comprehensive ABA classrooms; focused ABA for spoken communication; focused ABA parent training; and teacher-implemented, focused DSP). The evidence base for ASD interventions has grown substantially since 2008. An increasing number of interventions have some empirical support; others are emerging as potentially efficacious. Priorities for future research include improving outcome measures, developing interventions for understudied ASD symptoms (e.g., repetitive behaviors), pinpointing mechanisms of action in interventions, and adapting interventions for implementation with fidelity by community providers.

The meaning and measurement of implementation climate

PubMed Central

2011-01-01

Background Climate has a long history in organizational studies, but few theoretical models integrate the complex effects of climate during innovation implementation. In 1996, a theoretical model was proposed that organizations could develop a positive climate for implementation by making use of various policies and practices that promote organizational members' means, motives, and opportunities for innovation use. The model proposes that implementation climate--or the extent to which organizational members perceive that innovation use is expected, supported, and rewarded--is positively associated with implementation effectiveness. The implementation climate construct holds significant promise for advancing scientific knowledge about the organizational determinants of innovation implementation. However, the construct has not received sufficient scholarly attention, despite numerous citations in the scientific literature. In this article, we clarify the meaning of implementation climate, discuss several measurement issues, and propose guidelines for empirical study. Discussion Implementation climate differs from constructs such as organizational climate, culture, or context in two important respects: first, it has a strategic focus (implementation), and second, it is innovation-specific. Measuring implementation climate is challenging because the construct operates at the organizational level, but requires the collection of multi-dimensional perceptual data from many expected innovation users within an organization. In order to avoid problems with construct validity, assessments of within-group agreement of implementation climate measures must be carefully considered. Implementation climate implies a high degree of within-group agreement in climate perceptions. However, researchers might find it useful to distinguish implementation climate level (the average of implementation climate perceptions) from implementation climate strength (the variability of implementation climate perceptions). It is important to recognize that the implementation climate construct applies most readily to innovations that require collective, coordinated behavior change by many organizational members both for successful implementation and for realization of anticipated benefits. For innovations that do not possess these attributes, individual-level theories of behavior change could be more useful in explaining implementation effectiveness. Summary This construct has considerable value in implementation science, however, further debate and development is necessary to refine and distinguish the construct for empirical use. PMID:21781328

The power of a collaborative relationship between technical assistance providers and community prevention teams: A correlational and longitudinal study

PubMed Central

Chilenski, Sarah M.; Perkins, Daniel F.; Olson, Jonathan; Hoffman, Lesa; Feinberg, Mark E.; Greenberg, Mark; Welsh, Janet; Crowley, D. Max; Spoth, Richard

2015-01-01

Background Historically, effectiveness of community collaborative prevention efforts has been mixed. Consequently, research has been undertaken to better understand the factors that support their effectiveness; theory and some related empirical research suggests that the provision of technical assistance is one important supporting factor. The current study examines one aspect of technical assistance that may be important in supporting coalition effectiveness, the collaborative relationship between the technical assistance provider and site lead implementer. Methods Four and one-half years of data were collected from technical assistance providers and prevention team members from the 14 community prevention teams involved in the PROSPER project. Results Spearman correlation analyses with longitudinal data show that the levels of the collaborative relationship during one phase of collaborative team functioning associated with characteristics of internal team functioning in future phases. Conclusions Results suggest that community collaborative prevention work should consider the collaborative nature of the technical assistance provider – prevention community team relationship when designing and conducting technical assistance activities, and it may be important to continually assess these dynamics to support high quality implementation. PMID:26476860

The anatomy of decision support during inpatient care provider order entry (CPOE): Empirical observations from a decade of CPOE experience at Vanderbilt

PubMed Central

Miller, Randolph A.; Waitman, Lemuel R.; Chen, Sutin; Rosenbloom, S. Trent

2006-01-01

The authors describe a pragmatic approach to the introduction of clinical decision support at the point of care, based on a decade of experience in developing and evolving Vanderbilt’s inpatient “WizOrder” care provider order entry (CPOE) system. The inpatient care setting provides a unique opportunity to interject CPOE-based decision support features that restructure clinical workflows, deliver focused relevant educational materials, and influence how care is delivered to patients. From their empirical observations, the authors have developed a generic model for decision support within inpatient CPOE systems. They believe that the model’s utility extends beyond Vanderbilt, because it is based on characteristics of end-user workflows and on decision support considerations that are common to a variety of inpatient settings and CPOE systems. The specific approach to implementing a given clinical decision support feature within a CPOE system should involve evaluation along three axes: what type of intervention to create (for which the authors describe 4 general categories); when to introduce the intervention into the user’s workflow (for which the authors present 7 categories), and how disruptive, during use of the system, the intervention might be to end-users’ workflows (for which the authors describe 6 categories). Framing decision support in this manner may help both developers and clinical end-users plan future alterations to their systems when needs for new decision support features arise. PMID:16290243

Implementation of inclusive education for children with intellectual and developmental disabilities in African countries: a scoping review.

PubMed

Okyere, Christiana; Aldersey, Heather Michelle; Lysaght, Rosemary; Sulaiman, Surajo Kamilu

2018-04-25

To advance understanding of practices that support inclusion of children with intellectual and developmental disabilities in inclusive education classrooms in Africa by conducting a review of the extant literature. Five academic databases were searched supplemented by a hand search of key journals and references of included studies. Two authors independently screened studies via a reference manager (Covidence) which allowed for blinding. A third author was consulted in cases of conflict. Thirty articles that provided empirical evidence of inclusive education implementation were included. Eight articles highlighted practices that support inclusion of children with intellectual and developmental disabilities. Using Bronfenbrenner's bioecological framework, findings revealed that inclusive education implementation is influenced by factors on the bio level, micro level, meso level, and macro level. Recommendations for promoting inclusive education implementation are provided. Inclusion goes beyond teachers and requires strong commitment of other stakeholders such as families and governments. To guarantee the smooth inclusion of children with special education needs and particularly with intellectual and developmental disabilities, a set of practices validated through rigorous research as supportive and unique and that can be universal to Africa is wise. Implications for rehabilitation A number of strategies were identified that can improve the classroom inclusion of children with intellectual and developmental disabilities. Development of policies that support such strategies could improve implementation. Inclusion goes beyond teachers. Rehabilitation professionals (i.e. occupational therapists) and educational professionals should partner to identify practical solutions to the challenges of creating inclusive environments for children with special education needs. Committing more resources and time towards the development and implementation of special education policies can advance the successful inclusion of children with special education needs.

Relational systems change: implementing a model of change in integrating services for women with substance abuse and mental health disorders and histories of trauma.

PubMed

Markoff, Laurie S; Finkelstein, Norma; Kammerer, Nina; Kreiner, Peter; Prost, Carol A

2005-01-01

This article describes the "relational systems change" model developed by the Institute for Health and Recovery, and the implementation of the model in Massachusetts from 1998-2002 to facilitate systems change to support the delivery of integrated and trauma-informed services for women with co-occurring substance abuse and mental health disorders and histories of violence and empirical evidence of resulting systems changes. The federally funded Women Embracing Life and Living (WELL) Project utilized relational strategies to facilitate systems change within and across 3 systems levels: local treatment providers, community (or region), and state. The WELL Project demonstrates that a highly collaborative, inclusive, and facilitated change process can effect services integration within agencies (intra-agency), strengthen integration within a regional network of agencies (interagency), and foster state support for services integration.

An empirical identification and categorisation of training best practices for ERP implementation projects

NASA Astrophysics Data System (ADS)

Esteves, Jose Manuel

2014-11-01

Although training is one of the most cited critical success factors in Enterprise Resource Planning (ERP) systems implementations, few empirical studies have attempted to examine the characteristics of management of the training process within ERP implementation projects. Based on the data gathered from a sample of 158 respondents across four stakeholder groups involved in ERP implementation projects, and using a mixed method design, we have assembled a derived set of training best practices. Results suggest that the categorised list of ERP training best practices can be used to better understand training activities in ERP implementation projects. Furthermore, the results reveal that the company size and location have an impact on the relevance of training best practices. This empirical study also highlights the need to investigate the role of informal workplace trainers in ERP training activities.

Towards generic online multicriteria decision support in patient-centred health care.

PubMed

Dowie, Jack; Kjer Kaltoft, Mette; Salkeld, Glenn; Cunich, Michelle

2015-10-01

To introduce a new online generic decision support system based on multicriteria decision analysis (MCDA), implemented in practical and user-friendly software (Annalisa©). All parties in health care lack a simple and generic way to picture and process the decisions to be made in pursuit of improved decision making and more informed choice within an overall philosophy of person- and patient-centred care. The MCDA-based system generates patient-specific clinical guidance in the form of an opinion as to the merits of the alternative options in a decision, which are all scored and ranked. The scores for each option combine, in a simple expected value calculation, the best estimates available now for the performance of those options on patient-determined criteria, with the individual patient's preferences, expressed as importance weightings for those criteria. The survey software within which the Annalisa file is embedded (Elicia©) customizes and personalizes the presentation and inputs. Principles relevant to the development of such decision-specific MCDA-based aids are noted and comparisons with alternative implementations presented. The necessity to trade-off practicality (including resource constraints) with normative rigour and empirical complexity, in both their development and delivery, is emphasized. The MCDA-/Annalisa-based decision support system represents a prescriptive addition to the portfolio of decision-aiding tools available online to individuals and clinicians interested in pursuing shared decision making and informed choice within a commitment to transparency in relation to both the evidence and preference bases of decisions. Some empirical data establishing its usability are provided. © 2013 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Traffic load spectra for implementing and using the mechanistic-empirical pavement design guide in Georgia.

DOT National Transportation Integrated Search

2014-02-01

The GDOT is preparing for implementation of the Mechanistic-Empirical Pavement Design : Guide (MEPDG). As part of this preparation, a statewide traffic load spectra program is being : developed for gathering truck axle loading data. This final report...

Learning practice: a new model of health visitor intervention to drive outcomes.

PubMed

Ebeid, Ann

2012-03-01

Although there is a body of literature related to how hospital nurses develop skill, judgement or expertise there is little empirical work that focuses on understanding and developing health visiting expertise. The aims of this paper are: to identify a typology of health visitor skills, knowledge and cognition in use and the nature of health visitor expertise; to present an expert model of practice as a practice learning tool; to locate this model in context of my 2007 empirical research. This explored the problems of families and children in need and how they were supported by health visitors. This new practice model is timely in view of the need to train more health visitors, educators and practice facilitators as set out in the Health Visitor Implementation Plan.

Modelling innovation performance of European regions using multi-output neural networks

PubMed Central

Henriques, Roberto

2017-01-01

Regional innovation performance is an important indicator for decision-making regarding the implementation of policies intended to support innovation. However, patterns in regional innovation structures are becoming increasingly diverse, complex and nonlinear. To address these issues, this study aims to develop a model based on a multi-output neural network. Both intra- and inter-regional determinants of innovation performance are empirically investigated using data from the 4th and 5th Community Innovation Surveys of NUTS 2 (Nomenclature of Territorial Units for Statistics) regions. The results suggest that specific innovation strategies must be developed based on the current state of input attributes in the region. Thus, it is possible to develop appropriate strategies and targeted interventions to improve regional innovation performance. We demonstrate that support of entrepreneurship is an effective instrument of innovation policy. We also provide empirical support that both business and government R&D activity have a sigmoidal effect, implying that the most effective R&D support should be directed to regions with below-average and average R&D activity. We further show that the multi-output neural network outperforms traditional statistical and machine learning regression models. In general, therefore, it seems that the proposed model can effectively reflect both the multiple-output nature of innovation performance and the interdependency of the output attributes. PMID:28968449

Modelling innovation performance of European regions using multi-output neural networks.

PubMed

Hajek, Petr; Henriques, Roberto

2017-01-01

Regional innovation performance is an important indicator for decision-making regarding the implementation of policies intended to support innovation. However, patterns in regional innovation structures are becoming increasingly diverse, complex and nonlinear. To address these issues, this study aims to develop a model based on a multi-output neural network. Both intra- and inter-regional determinants of innovation performance are empirically investigated using data from the 4th and 5th Community Innovation Surveys of NUTS 2 (Nomenclature of Territorial Units for Statistics) regions. The results suggest that specific innovation strategies must be developed based on the current state of input attributes in the region. Thus, it is possible to develop appropriate strategies and targeted interventions to improve regional innovation performance. We demonstrate that support of entrepreneurship is an effective instrument of innovation policy. We also provide empirical support that both business and government R&D activity have a sigmoidal effect, implying that the most effective R&D support should be directed to regions with below-average and average R&D activity. We further show that the multi-output neural network outperforms traditional statistical and machine learning regression models. In general, therefore, it seems that the proposed model can effectively reflect both the multiple-output nature of innovation performance and the interdependency of the output attributes.

Mechanistic-empirical Pavement Design Guide Implementation

DOT National Transportation Integrated Search

2010-06-01

The recently introduced Mechanistic-Empirical Pavement Design Guide (MEPDG) and associated computer software provides a state-of-practice mechanistic-empirical highway pavement design methodology. The MEPDG methodology is based on pavement responses ...

Methodological Reflections on the Contribution of Qualitative Research to the Evaluation of Clinical Ethics Support Services.

PubMed

Wäscher, Sebastian; Salloch, Sabine; Ritter, Peter; Vollmann, Jochen; Schildmann, Jan

2017-05-01

This article describes a process of developing, implementing and evaluating a clinical ethics support service intervention with the goal of building up a context-sensitive structure of minimal clinical-ethics in an oncology department without prior clinical ethics structure. Scholars from different disciplines have called for an improvement in the evaluation of clinical ethics support services (CESS) for different reasons over several decades. However, while a lot has been said about the concepts and methodological challenges of evaluating CESS up to the present time, relatively few empirical studies have been carried out. The aim of this article is twofold. On the one hand, it describes a process of development, modifying and evaluating a CESS intervention as part of the ETHICO research project, using the approach of qualitative-formative evaluation. On the other hand, it provides a methodological analysis which specifies the contribution of qualitative empirical methods to the (formative) evaluation of CESS. We conclude with a consideration of the strengths and limitations of qualitative evaluation research with regards to the evaluation and development of context sensitive CESS. We further discuss our own approach in contrast to rather traditional consult or committee models. © 2017 John Wiley & Sons Ltd.

Using ERP and WfM Systems for Implementing Business Processes: An Empirical Study

NASA Astrophysics Data System (ADS)

Aversano, Lerina; Tortorella, Maria

Software systems mainly considered from enterprises for dealing with a business process automation belong to the following two categories: Workflow Management Systems (WfMS) and Enterprise Resource Planning (ERP) systems. The wider diffusion of ERP systems tends to favourite this solution, but there are several limitations of most ERP systems for automating business processes. This paper reports an empirical study aiming at comparing the ability of implementing business processes of ERP systems and WfMSs. Two different case studies have been considered in the empirical study. It evaluates and analyses the correctness and completeness of the process models implemented by using ERP and WfM systems.

Interdisciplinary training to build an informatics workforce for precision medicine

PubMed Central

Williams, Marc S.; Ritchie, Marylyn D.; Payne, Philip R.O.

2015-01-01

The proposed Precision Medicine Initiative has the potential to transform medical care in the future through a shift from interventions based on evidence from population studies and empiric response to ones that account for a range of individual factors that more reliably predict response and outcomes for the patient. Many things are needed to realize this vision, but one of the most critical is an informatics workforce that has broad interdisciplinary training in basic science, applied research and clinical implementation. Current approaches to informatics training do not support this requirement. We present a collaborative model of training that has the potential to produce a workforce prepared for the challenges of implementing precision medicine. PMID:27054076

Challenges in the management of support and care programmes for child-headed households in South Africa.

PubMed

Human, Sarie P; van Rensburg, Gisela H

2011-10-01

The present study reports on data collected in a larger study on 'A situational analysis of child-headed households in South Africa'. The purpose of this study was to explore the management and control of available and required services, resources and safety nets for children in child-headed households. The significance of having a better understanding of the challenges, limitations but importance for government structures to manage and control programmes will enhance the implementation and maintenance of focused and sustainable support structures and programmes which will effectively address the needs of child-headed households. An exploratory and descriptive, quantitative survey was conducted to provide information on government structures at a national level and the nine provinces in South Africa. The population consisted of the Departments of Social Development, Education, Health and Agriculture, at both national and provincial levels. The main findings included a lack of clarity regarding the concept and definition of a child-headed household, lack of empirical data, a diversity of needs and challenges in terms of location and geographical distribution of available infrastructure and support systems; programmes that are not inclusive and integrated; and contradictions in the stipulations and implementation of existing policies and capacity and human resources shortages. It was concluded that the magnitude, uniqueness and complexity of the phenomenon necessitate effective and sound scientific management principles. This is achieved by providing legal clarity of the concept; developing relevant policies and ensuring effective implementation thereof; rigorous monitoring and evaluation based on comprehensive empirical data; and protecting the rights and safety of these children and ensuring an enabling environment for all stakeholders to address needs and challenges. The role of the nurse manager is to ensure a holistic approach to children living in child-headed households by acting as a facilitator, advocate, leader, coordinator and consultant. © 2011 Blackwell Publishing Ltd.

The NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester: combining empirical, theoretical and experiential evidence to design and evaluate a large-scale implementation strategy.

PubMed

Harvey, Gill; Fitzgerald, Louise; Fielden, Sandra; McBride, Anne; Waterman, Heather; Bamford, David; Kislov, Roman; Boaden, Ruth

2011-08-23

In response to policy recommendations, nine National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were established in England in 2008, aiming to create closer working between the health service and higher education and narrow the gap between research and its implementation in practice. The Greater Manchester (GM) CLAHRC is a partnership between the University of Manchester and twenty National Health Service (NHS) trusts, with a five-year mission to improve healthcare and reduce health inequalities for people with cardiovascular conditions. This paper outlines the GM CLAHRC approach to designing and evaluating a large-scale, evidence- and theory-informed, context-sensitive implementation programme. The paper makes a case for embedding evaluation within the design of the implementation strategy. Empirical, theoretical, and experiential evidence relating to implementation science and methods has been synthesised to formulate eight core principles of the GM CLAHRC implementation strategy, recognising the multi-faceted nature of evidence, the complexity of the implementation process, and the corresponding need to apply approaches that are situationally relevant, responsive, flexible, and collaborative. In turn, these core principles inform the selection of four interrelated building blocks upon which the GM CLAHRC approach to implementation is founded. These determine the organizational processes, structures, and roles utilised by specific GM CLAHRC implementation projects, as well as the approach to researching implementation, and comprise: the Promoting Action on Research Implementation in Health Services (PARIHS) framework; a modified version of the Model for Improvement; multiprofessional teams with designated roles to lead, facilitate, and support the implementation process; and embedded evaluation and learning. Designing and evaluating a large-scale implementation strategy that can cope with and respond to the local complexities of implementing research evidence into practice is itself complex and challenging. We present an argument for adopting an integrative, co-production approach to planning and evaluating the implementation of research into practice, drawing on an eclectic range of evidence sources.

Managing maritime automobile terminals: an approach toward decision-support model for higher productivity

NASA Astrophysics Data System (ADS)

Beškovnik, Bojan; Twrdy, Elen

2011-12-01

The article describes actions and strategies to obtain higher productivity on maritime automobile terminals. The main focus is on elaboration of efficient and effective organizational structure to model and implement short-term, mid-term and long-term strategies. In addition, with an empiric approach we combined the analyses of current findings in important scientific papers and our acknowledgments in practical research of north Adriatic maritime automobile terminals. The main goal is to propose actions towards increasing system's productivity. Based on our research of the north Adriatic maritime automobile terminals and with Lambert's model an in-deep analysis of limiting factors, user's expectations and possibilities for productivity increase has been performed. Moreover, with our acknowledgments a three-level decision-support model is presented. With an adequate model implementation it is possible to efficiently develop and implement different strategies of productivity measurement and productivity increase, especially in the fields of internal transport productivity, entrance/exit truck gates operations and wagon manipulations. According to our observation a significant increase might be achieved in all three fields.

Looking Forward: The Promise of Widespread Implementation of Parent Training Programs

PubMed Central

Forgatch, Marion S.; Patterson, Gerald R.; Gewirtz, Abigail H.

2013-01-01

Over the past quarter century a body of parent training programs has been developed and validated as effective in reducing child behavior problems, but few of these have made their way into routine practice. This article describes the long and winding road of implementation as applied to children's mental health. Adopting Rogers' (1995) diffusion framework and Fixsen and colleagues' implementation framework (Fixsen, Naoom, Blase, Friedman, & Wallace, 2005), we review more than a decade of research on the implementation of Parent Management Training – Oregon Model (PMTO®). Data from US and international PMTO implementations are used to illustrate the payoffs and the challenges of making empirically supported interventions routine practice in the community. Technological advances that break down barriers to communication across distances, the availability of efficacious programs suitable for implementation, and the urgent need for high quality mental health care provide strong rationales for prioritizing attention to implementation. Over the next quarter of a century, the challenge is to reduce the prevalence of children's psychopathology by creating science-based delivery systems to reach families in need, everywhere. PMID:24443650

GIS Teacher Training: Empirically-Based Indicators of Effectiveness

ERIC Educational Resources Information Center

Höhnle, Steffen; Fögele, Janis; Mehren, Rainer; Schubert, Jan Christoph

2016-01-01

In spite of various actions, the implementation of GIS (geographic information systems) in German schools is still very low. In the presented research, teaching experts as well as teaching novices were presented with empirically based constraints for implementation stemming from an earlier survey. In the process of various group discussions, the…

Preparation for implementation of the mechanistic-empirical pavement design guide in Michigan : part 1 - HMA mixture characterization.

DOT National Transportation Integrated Search

2013-03-01

This is the final report of the Part 1 (HMA Mixture Characterization) of the Preparation for Implementation of the Mechanistic-Empirical Pavement Design Guide in Michigan project. The main objectives of the Part 1 were (i) to conduct a literatu...

From data to wisdom: quality improvement strategies supporting large-scale implementation of evidence-based services.

PubMed

Daleiden, Eric L; Chorpita, Bruce F

2005-04-01

The Hawaii Department of Health Child and Adolescent Mental Health Division has explored various strategies to promote widespread use of empirical evidence to improve the quality of services and outcomes for youth. This article describes a core set of clinical decisions and how several general and local evidence bases may inform those decisions. Multiple quality improvement strategies are illustrated in the context of a model that outlines four phases of evidence: data, information, knowledge, and wisdom.

Increasing access to learning for the adult basic education learner with learning disabilities: evidence-based accommodation research.

PubMed

Gregg, Noel

2012-01-01

Accommodating adult basic education (ABE) learners with learning disabilities (LD) is common practice across many instructional, testing, and work settings. However, the results from this literature search indicate that very few empirically based studies are available to support or reject the effectiveness of a great deal of accommodation implementation. In addition, in light of the profound changes to literacy taking place in today's digital, networked, and multimodal world, technology is redefining traditional concepts of accessibility and accommodation.

Participatory Evaluation of a Community Mobilization Effort to Enroll Wyandotte County, Kansas, Residents Through the Affordable Care Act

PubMed Central

Sepers, Charles E.; McKain, Wesley

2015-01-01

Successful implementation of the Affordable Care Act (ACA) depends on the capacity of local communities to mobilize for action. Yet the literature offers few systematic investigations of what communities are doing to ensure support for enrollment. In this empirical case study, we report implementation and outcomes of Enroll Wyandotte, a community mobilization effort to facilitate enrollment through the ACA in Wyandotte County, Kansas. We describe mobilization activities during the first round of open enrollment in coverage under the ACA (October 1, 2013–March 31, 2014), including the unfolding of community and organizational changes (e.g., new enrollment sites) and services provided to assist enrollment over time. The findings show an association between implementation measures and newly created accounts under the ACA (the primary outcome). PMID:25905820

Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies.

PubMed

Greenhalgh, Trisha; Wherton, Joseph; Papoutsi, Chrysanthi; Lynch, Jennifer; Hughes, Gemma; A'Court, Christine; Hinder, Susan; Fahy, Nick; Procter, Rob; Shaw, Sara

2017-11-01

Many promising technological innovations in health and social care are characterized by nonadoption or abandonment by individuals or by failed attempts to scale up locally, spread distantly, or sustain the innovation long term at the organization or system level. Our objective was to produce an evidence-based, theory-informed, and pragmatic framework to help predict and evaluate the success of a technology-supported health or social care program. The study had 2 parallel components: (1) secondary research (hermeneutic systematic review) to identify key domains, and (2) empirical case studies of technology implementation to explore, test, and refine these domains. We studied 6 technology-supported programs-video outpatient consultations, global positioning system tracking for cognitive impairment, pendant alarm services, remote biomarker monitoring for heart failure, care organizing software, and integrated case management via data sharing-using longitudinal ethnography and action research for up to 3 years across more than 20 organizations. Data were collected at micro level (individual technology users), meso level (organizational processes and systems), and macro level (national policy and wider context). Analysis and synthesis was aided by sociotechnically informed theories of individual, organizational, and system change. The draft framework was shared with colleagues who were introducing or evaluating other technology-supported health or care programs and refined in response to feedback. The literature review identified 28 previous technology implementation frameworks, of which 14 had taken a dynamic systems approach (including 2 integrative reviews of previous work). Our empirical dataset consisted of over 400 hours of ethnographic observation, 165 semistructured interviews, and 200 documents. The final nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework included questions in 7 domains: the condition or illness, the technology, the value proposition, the adopter system (comprising professional staff, patient, and lay caregivers), the organization(s), the wider (institutional and societal) context, and the interaction and mutual adaptation between all these domains over time. Our empirical case studies raised a variety of challenges across all 7 domains, each classified as simple (straightforward, predictable, few components), complicated (multiple interacting components or issues), or complex (dynamic, unpredictable, not easily disaggregated into constituent components). Programs characterized by complicatedness proved difficult but not impossible to implement. Those characterized by complexity in multiple NASSS domains rarely, if ever, became mainstreamed. The framework showed promise when applied (both prospectively and retrospectively) to other programs. Subject to further empirical testing, NASSS could be applied across a range of technological innovations in health and social care. It has several potential uses: (1) to inform the design of a new technology; (2) to identify technological solutions that (perhaps despite policy or industry enthusiasm) have a limited chance of achieving large-scale, sustained adoption; (3) to plan the implementation, scale-up, or rollout of a technology program; and (4) to explain and learn from program failures. ©Trisha Greenhalgh, Joseph Wherton, Chrysanthi Papoutsi, Jennifer Lynch, Gemma Hughes, Christine A'Court, Susan Hinder, Nick Fahy, Rob Procter, Sara Shaw. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.11.2017.

Automation and decision support in interactive consumer products.

PubMed

Sauer, J; Rüttinger, B

2007-06-01

This article presents two empirical studies (n = 30, n = 48) that are concerned with different forms of automation in interactive consumer products. The goal of the studies was to evaluate the effectiveness of two types of automation: perceptual augmentation (i.e. supporting users' information acquisition and analysis); and control integration (i.e. supporting users' action selection and implementation). Furthermore, the effectiveness of on-product information (i.e. labels attached to product) in supporting automation design was evaluated. The findings suggested greater benefits for automation in control integration than in perceptual augmentation alone, which may be partly due to the specific requirements of consumer product usage. If employed appropriately, on-product information can be a helpful means of information conveyance. The article discusses the implications of automation design in interactive consumer products while drawing on automation models from the work environment.

Use of Evidence in the Implementation of Social Programs: A Qualitative Study from Chile.

PubMed

Flores, Rodrigo; Naranjo, Carola; Hein, Andreas

2016-01-01

Through this qualitative, empirical study the authors aim to explore and describe the sources of knowledge that are used to guide intervention practice by social workers in Chile. Particular attention was paid to factors that may facilitate or hinder the use of research-based evidence to guide social interventions design, implementation, and outcome evaluation. In order to explore these issues, 25 semi-structured interviews with social workers from Chilean social service non-profit organizations were conducted. The main findings suggest that social workers do not use research-based evidence to support their social interventions due to various personal organizational constraints (e.g., lack of time, lack of access to resources for disseminating evidence, lack of English command). In addition, no evaluation processes of social programs which will support evidence-based effectiveness could be found. One key barrier to support use of evidence and evidence production may be related to the fact that most non-governmental organizations maintain a hierarchical and vertical relationship with state agencies (program design, oversight, and funding) for social program development.

The use and application of assistive technology to promote literacy in early childhood: a systematic review.

PubMed

Burne, Brian; Knafelc, Valerie; Melonis, Maureen; Heyn, Patricia C

2011-01-01

The Individuals with Disabilities Act was implemented in 1975 to assure that all children aged 0-21 years old have access and the right to an equal education. However, young children with disabilities continue to need additional support to meet the reading readiness standards as outlined in The No Child Left Behind legislation (2004). Although all children benefit from readiness skills, it is essential for children with special needs. With the technology boom of the past decade, assistive technology (AT) has been used increasingly to enhance emerging literacy skills. In order to identify current trends in the use of AT as a means to enhance emergent literacy skills in young children with disabilities, a systematic review of the literature was undertaken. The findings from this review support the scarcity of empirical research demonstrating the benefit of AT to promote emergent literacy with young children with disabilities. We also found a need for evidence supporting education approaches for the proper use of AT in early childhood literacy as well as little family knowledge regarding the implementation and instructional use of AT.

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

PubMed

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

2014-01-01

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

Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

PubMed Central

2013-01-01

Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and identifying emerging areas of research. Conclusions As of 2012, the updated theoretical rationale and emerging evidence suggest potential benefits to delivering patient decision aids on the Internet. However, additional research is needed to identify best practices and quality metrics for Internet-based development, evaluation, and dissemination, particularly in the areas of interactivity, multimedia components, socially-generated information, and implementation strategies. PMID:24625064

Development and Validation of the Controller Acceptance Rating Scale (CARS): Results of Empirical Research

NASA Technical Reports Server (NTRS)

Lee, Katharine K.; Kerns, Karol; Bone, Randall

2001-01-01

The measurement of operational acceptability is important for the development, implementation, and evolution of air traffic management decision support tools. The Controller Acceptance Rating Scale was developed at NASA Ames Research Center for the development and evaluation of the Passive Final Approach Spacing Tool. CARS was modeled after a well-known pilot evaluation rating instrument, the Cooper-Harper Scale, and has since been used in the evaluation of the User Request Evaluation Tool, developed by MITRE's Center for Advanced Aviation System Development. In this paper, we provide a discussion of the development of CARS and an analysis of the empirical data collected with CARS to examine construct validity. Results of intraclass correlations indicated statistically significant reliability for the CARS. From the subjective workload data that were collected in conjunction with the CARS, it appears that the expected set of workload attributes was correlated with the CARS. As expected, the analysis also showed that CARS was a sensitive indicator of the impact of decision support tools on controller operations. Suggestions for future CARS development and its improvement are also provided.

A Sociocognitive Perspective of Women's Participation in Physics: Improving Accessibility throughout the Pipeline

NASA Astrophysics Data System (ADS)

Kelly, Angela

2017-01-01

Sociopsychological theories and empirical research provide a framework for exploring causal pathways and targeted interventions to increase the representation of women in post-secondary physics. Women earned only 19.7 percent of physics undergraduate degrees in 2012 (APS, 2015). This disparity has been attributed to a variety of factors, including chilly classroom climates, gender-based stereotypes, persistent self-doubt, and a lack of role models in physics departments. The theoretical framework for this research synthesis is based upon several psychological theories of sociocognitive behavior and is derived from three general constructs: 1) self-efficacy and self-concept; 2) expectancy value and planned behavior; and 3) motivation and self-determination. Recent studies have suggested that the gender discrepancy in physics participation may be alleviated by applying interventions derived from social cognitive research. These interventions include social and familial support, welcoming and collaborative classroom environments, critical feedback, and identification with a malleable view of intelligence. This research provides empirically supported mechanisms for university stakeholders to implement reforms that will increase women's participation in physics.

Going Global: A Model for Evaluating Empirically Supported Family-Based Interventions in New Contexts.

PubMed

Sundell, Knut; Ferrer-Wreder, Laura; Fraser, Mark W

2014-06-01

The spread of evidence-based practice throughout the world has resulted in the wide adoption of empirically supported interventions (ESIs) and a growing number of controlled trials of imported and culturally adapted ESIs. This article is informed by outcome research on family-based interventions including programs listed in the American Blueprints Model and Promising Programs. Evidence from these controlled trials is mixed and, because it is comprised of both successful and unsuccessful replications of ESIs, it provides clues for the translation of promising programs in the future. At least four explanations appear plausible for the mixed results in replication trials. One has to do with methodological differences across trials. A second deals with ambiguities in the cultural adaptation process. A third explanation is that ESIs in failed replications have not been adequately implemented. A fourth source of variation derives from unanticipated contextual influences that might affect the effects of ESIs when transported to other cultures and countries. This article describes a model that allows for the differential examination of adaptations of interventions in new cultural contexts. © The Author(s) 2012.

A comparison of a modified sequential oral sensory approach to an applied behavior-analytic approach in the treatment of food selectivity in children with autism spectrum disorder.

PubMed

Peterson, Kathryn M; Piazza, Cathleen C; Volkert, Valerie M

2016-09-01

Treatments of pediatric feeding disorders based on applied behavior analysis (ABA) have the most empirical support in the research literature (Volkert & Piazza, 2012); however, professionals often recommend, and caregivers often use, treatments that have limited empirical support. In the current investigation, we compared a modified sequential oral sensory approach (M-SOS; Benson, Parke, Gannon, & Muñoz, 2013) to an ABA approach for the treatment of the food selectivity of 6 children with autism. We randomly assigned 3 children to ABA and 3 children to M-SOS and compared the effects of treatment in a multiple baseline design across novel, healthy target foods. We used a multielement design to assess treatment generalization. Consumption of target foods increased for children who received ABA, but not for children who received M-SOS. We subsequently implemented ABA with the children for whom M-SOS was not effective and observed a potential treatment generalization effect during ABA when M-SOS preceded ABA. © 2016 Society for the Experimental Analysis of Behavior.

Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems

PubMed Central

Slade, Mike; Amering, Michaela; Farkas, Marianne; Hamilton, Bridget; O'Hagan, Mary; Panther, Graham; Perkins, Rachel; Shepherd, Geoff; Tse, Samson; Whitley, Rob

2014-01-01

An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses (“abuses”) of the concept of recovery: recovery is the latest model; recovery does not apply to “my” patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship. PMID:24497237

The power of a collaborative relationship between technical assistance providers and community prevention teams: A correlational and longitudinal study.

PubMed

Chilenski, Sarah M; Perkins, Daniel F; Olson, Jonathan; Hoffman, Lesa; Feinberg, Mark E; Greenberg, Mark; Welsh, Janet; Crowley, D Max; Spoth, Richard

2016-02-01

Historically, effectiveness of community collaborative prevention efforts has been mixed. Consequently, research has been undertaken to better understand the factors that support their effectiveness; theory and some related empirical research suggests that the provision of technical assistance is one important supporting factor. The current study examines one aspect of technical assistance that may be important in supporting coalition effectiveness, the collaborative relationship between the technical assistance provider and site lead implementer. Four and one-half years of data were collected from technical assistance providers and prevention team members from the 14 community prevention teams involved in the PROSPER project. Spearman correlation analyses with longitudinal data show that the levels of the collaborative relationship during one phase of collaborative team functioning associated with characteristics of internal team functioning in future phases. Results suggest that community collaborative prevention work should consider the collaborative nature of the technical assistance provider - prevention community team relationship when designing and conducting technical assistance activities, and it may be important to continually assess these dynamics to support high quality implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Schema therapy for borderline personality disorder: a comprehensive review of its empirical foundations, effectiveness and implementation possibilities.

PubMed

Sempértegui, Gabriela A; Karreman, Annemiek; Arntz, Arnoud; Bekker, Marrie H J

2013-04-01

Borderline personality disorder is a serious psychiatric disorder for which the effectiveness of the current pharmacotherapeutical and psychotherapeutic approaches has shown to be limited. In the last decades, schema therapy has increased in popularity as a treatment of borderline personality disorder; however, systematic evaluation of both effectiveness and empirical evidence for the theoretical background of the therapy is limited. This literature review comprehensively evaluates the current empirical status of schema therapy for borderline personality disorder. We first described the theoretical framework and reviewed its empirical foundations. Next, we examined the evidence regarding effectiveness and implementability. We found evidence for a considerable number of elements of Young's schema model; however, the strength of the results varies and there are also mixed results and some empirical blanks in the theory. The number of studies on effectiveness is small, but reviewed findings suggest that schema therapy is a promising treatment. In Western-European societies, the therapy could be readily implemented as a cost-effective strategy with positive economic consequences. Copyright © 2012 Elsevier Ltd. All rights reserved.

Adolescent preventive health and team-games-tournaments: five decades of evidence for an empirically based paradigm.

PubMed

Wodarski, John S; Feit, Marvin D

2011-01-01

The problematic behaviors of teenagers and the subsequent negative consequences are extensive and well documented: unwanted pregnancy, substance abuse, violent behavior, depression, and social and psychological consequences of unemployment. In this article, the authors review an approach that uses a cooperative learning, empirically based intervention that employs peers as teachers. This intervention of choice is Teams-Games-Tournaments (TGT), a paradigm backed by five decades of empirical support. The application of TGT in preventive health programs incorporates elements in common with other prevention programs that are based on a public health orientation and constitute the essential components of health education, that is, skills training and practice in applying skills. The TGT intervention supports the idea that children and adolescents from various socioeconomic classes, between the ages of 8 and 18 and in classrooms or groups ranging in size from 4 to 17 members, can work together for one another. TGT has been applied successfully in such diverse areas as adolescent development, sexuality education, psychoactive substance abuse education, anger control, coping with depression and suicide, nutrition, comprehensive employment preparation, and family intervention. This article reviews the extensive research on TGT using examples of successful projects in substance abuse, violence, and nutrition. Issues are raised that relate to the implementation of preventive health strategies for adolescents, including cognitive aspects, social and family networks, and intervention components.

Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation.

PubMed

Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R; Hurlburt, Michael S

2015-01-16

Leadership is important in the implementation of innovation in business, health, and allied health care settings. Yet there is a need for empirically validated organizational interventions for coordinated leadership and organizational development strategies to facilitate effective evidence-based practice (EBP) implementation. This paper describes the initial feasibility, acceptability, and perceived utility of the Leadership and Organizational Change for Implementation (LOCI) intervention. A transdisciplinary team of investigators and community stakeholders worked together to develop and test a leadership and organizational strategy to promote effective leadership for implementing EBPs. Participants were 12 mental health service team leaders and their staff (n = 100) from three different agencies that provide mental health services to children and families in California, USA. Supervisors were randomly assigned to the 6-month LOCI intervention or to a two-session leadership webinar control condition provided by a well-known leadership training organization. We utilized mixed methods with quantitative surveys and qualitative data collected via surveys and a focus group with LOCI trainees. Quantitative and qualitative analyses support the LOCI training and organizational strategy intervention in regard to feasibility, acceptability, and perceived utility, as well as impact on leader and supervisee-rated outcomes. The LOCI leadership and organizational change for implementation intervention is a feasible and acceptable strategy that has utility to improve staff-rated leadership for EBP implementation. Further studies are needed to conduct rigorous tests of the proximal and distal impacts of LOCI on leader behaviors, implementation leadership, organizational context, and implementation outcomes. The results of this study suggest that LOCI may be a viable strategy to support organizations in preparing for the implementation and sustainment of EBP.

LEVERAGING TECHNOLOGY TO ENHANCE ADDICTION TREATMENT AND RECOVERY

PubMed Central

Marsch, Lisa A.

2012-01-01

Technology such as the Internet and mobile phones offers considerable promise for affecting the assessment, prevention, and treatment of and recovery from substance use disorders. Technology may enable entirely new models of behavioral health care within and outside of formal systems of care. This article reviews the promise of technology-based therapeutic tools for affecting the quality and reach of addiction treatment and recovery support systems, as well as the empirical support to date for this approach. Potential models for implementing technology-based interventions targeting substance use disorders are described. Opportunities to optimize the effectiveness and impact of technology-based interventions targeting addiction and recovery, along with outstanding research needs, are discussed. PMID:22873192

Promoting postconventional morality: the adequacy of Kohlberg's aim.

PubMed

Wonderly, D M; Kupfersmid, J H

1980-01-01

Lawrence Kohlberg has advocated the implementation of programs in the public schools designed to raise the general level of moral reasoning. His contention is that the attainment of Postconventional moral reasoning is associated with optimal personal and social adjustment. Growing concern about the violence and disintegration of American society has led to public and private support for such programs. Because intervention into the moral education of children in a democratic society raises serious social/political questions, it seems appropriate to consider the relevance of the Kohlberg hypothesis. In this paper, the twin issues of philosophic adequacy and empirical evidence are examined. In neither respect does the cognitive-developmentalist position find the support essential to a recommendation for its use.

Leveraging technology to enhance addiction treatment and recovery.

PubMed

Marsch, Lisa A

2012-01-01

Technology such as the Internet and mobile phones offers considerable promise for affecting the assessment, prevention, and treatment of and recovery from substance use disorders. Technology may enable entirely new models of behavioral health care within and outside of formal systems of care. This article reviews the promise of technology-based therapeutic tools for affecting the quality and reach of addiction treatment and recovery support systems, as well as the empirical support to date for this approach. Potential models for implementing technology-based interventions targeting substance use disorders are described. Opportunities to optimize the effectiveness and impact of technology-based interventions targeting addiction and recovery, along with outstanding research needs, are discussed.

An international model for staffing maternal and child health research: the use of undergraduate students.

PubMed

Wallis, Anne Baber; Chereches, Răzvan; Oprescu, Florin; Brînzaniuc, Alexandra; Dungy, Claibourne I

2007-09-01

Constrained resources in Central and Eastern Europe limit the capacity of local and national health ministries to study breastfeeding practices or implement evidence-based breastfeeding support programs. This paper describes an innovative model for studying an important maternal and child health (MCH) problem by training undergraduate students to strengthen local capacity for research. An international team of researchers from Romania and the United States designed a study conducted at Babeş-Bolyai University and two academic maternity hospitals in Cluj-Napoca, Romania. The objectives were to (1) spark interest in breastfeeding research among undergraduates, (2) develop empirical knowledge about breastfeeding, and (3) train a team of undergraduate students to collect, manage, and enter study data. A team of carefully selected undergraduate students was trained in survey design, data collection, data entry, and interviewing skills. Internet technology was used to facilitate communication and to transfer data. The project resulted in a trained cadre of undergraduate students able to conduct survey research on breastfeeding practices with skills ranging from questionnaire design and implementation to descriptive data analysis. Empirical data obtained from the study will be used for student projects, to stimulate new breastfeeding support policies and programs, and to apply for research grants. Undergraduate students in developing countries in Central and Eastern Europe are a valuable, untapped resource for expanding MCH capacity. We recommend adoption of this cost-effective approach to foster high-quality MCH research.

Processes, contexts, and rationale for disinvestment: a protocol for a critical interpretive synthesis.

PubMed

Wilson, Michael G; Ellen, Moriah E; Lavis, John N; Grimshaw, Jeremy M; Moat, Kaelan A; Shemer, Joshua; Sullivan, Terry; Garner, Sarah; Goeree, Ron; Grilli, Roberto; Peffer, Justin; Samra, Kevin

2014-12-11

Practical solutions are needed to support the appropriate use of available health system resources as countries are continually pressured to 'do more with less' in health care. Increasingly, health systems and organizations are exploring the reassessment of possibly obsolete, inefficient, or ineffective health system resources and potentially redirecting funds to those that are more effective and efficient. Such processes are often referred to as 'disinvestment'. Our objective is to gain further understanding about: 1) whether how and under what conditions health systems decide to pursue disinvestment; 2) how health systems have chosen to undertake disinvestment; and 3) how health systems have implemented their disinvestment approach. We will use a critical interpretive synthesis (CIS) approach, to develop a theoretical framework based on insights drawn from a range of relevant sources. We will conduct systematic searches of databases as well as purposive searches to identify literature to fill conceptual gaps that may emerge during our inductive process of synthesis and analysis. Two independent reviewers will assess search results for relevance and conceptually map included references. We will include all empirical and non-empirical articles that focus on disinvestment at a system level. We will then extract key findings from a purposive sample of articles using frameworks related to government agendas, policy development and implementation, and health system contextual factors and then synthesize and integrate the findings to develop a framework about our core areas of interest. Lastly, we will convene a stakeholder dialogue with Canadian and international policymakers and other stakeholders to solicit targeted feedback about the framework (e.g., by identifying any gaps in the literature that we may want to revisit before finalizing it) and deliberating about barriers for developing and implementing approaches to disinvestment, strategies to address these barriers and about next steps that could be taken by different constituencies. Disinvestment is an emerging field and there is a need for evidence to inform the prioritization, development, and implementation of strategies in different contexts. Our CIS and the framework developed through it will support the actions of those involved in the prioritization, development, and implementation of disinvestment initiatives. PROSPERO CRD42014013204.

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

Pedagogising the University: On Higher Education Policy Implementation and Its Effects on Social Relations

ERIC Educational Resources Information Center

Stavrou, Sophia

2016-01-01

This paper aims at providing a theoretical and empirical discussion on the concept of pedagogisation which derives from the hypothesis of a new era of "totally pedagogised society" in Basil Bernstein's work. The article is based on empirical research on higher education policy, with a focus on the implementation of curriculum change…

Application of the migration models implemented in the decision system MOIRA-PLUS to assess the long term behaviour of (137)Cs in water and fish of the Baltic Sea.

PubMed

Monte, Luigi

2014-08-01

This work presents and discusses the results of an application of the contaminant migration models implemented in the decision support system MOIRA-PLUS to simulate the time behaviour of the concentrations of (137)Cs of Chernobyl origin in water and fish of the Baltic Sea. The results of the models were compared with the extensive sets of highly reliable empirical data of radionuclide contamination available from international databases and covering a period of, approximately, twenty years. The model application involved three main phases: a) the customisation performed by using hydrological, morphometric and water circulation data obtained from the literature; b) a blind test of the model results, in the sense that the models made use of default values of the migration parameters to predict the dynamics of the contaminant in the environmental components; and c) the adjustment of the model parameter values to improve the agreement of the predictions with the empirical data. The results of the blind test showed that the models successfully predicted the empirical contamination values within the expected range of uncertainty of the predictions (confidence level at 68% of approximately a factor 2). The parameter adjustment can be helpful for the assessment of the fluxes of water circulating among the main sub-basins of the Baltic Sea, substantiating the usefulness of radionuclides to trace the movement of masses of water in seas. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assisted-living spaces for end-users with complex needs: a proposed implementation and delivery model.

PubMed

Linskell, Jeremy; Bouamrane, Matt-Mouley

2012-09-01

An assisted living space (ALS) is a technology-enabled environment designed to allow people with complex health or social care needs to remain, and live independently, in their own home for longer. However, many challenges remain in order to deliver usable systems acceptable to a diverse range of stakeholders, including end-users, and their families and carers, as well as health and social care services. ALSs need to support activities of daily-living while allowing end-users to maintain important social connections. They must be dynamic, flexible and adaptable living environments. In this article, we provide an overview of the technological landscape of assisted-living technology (ALT) and recent policies to promote an increased adoption of ALT in Scotland. We discuss our experiences in implementing technology-supported ALSs and emphasise key lessons. Finally, we propose an iterative and pragmatic user-centred implementation model for delivering ALSs in complex-needs scenarios. This empirical model is derived from our past ALS implementations. The proposed model allows project stakeholders to identify requirements, allocate tasks and responsibilities, and identify appropriate technological solutions for the delivery of functional ALS systems. The model is generic and makes no assumptions on needs or technology solutions, nor on the technical knowledge, skills and experience of the stakeholders involved in the ALS design process.

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2010 CFR

2010-07-01

... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life... empirical tools should be used to support the life safety equivalency evaluation? 102-80.120 Section 102-80...

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2011 CFR

2011-01-01

... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life... empirical tools should be used to support the life safety equivalency evaluation? 102-80.120 Section 102-80...

The effectiveness of consultation for clinicians learning to deliver motivational interviewing with fidelity.

PubMed

Barac, Raluca; Kimber, Melissa; Johnson, Sabine; Barwick, Melanie

2018-06-08

Despite the emerging literature documenting gains in clinician competence following consultation, little empirical work has examined consultation as an implementation strategy. To this end, the present study examined consultation in the context of implementing motivational interviewing in four community child and youth mental health organizations. We used qualitative methods with a dual goal: to describe the consultation process and to explore trainees' perspectives on consultation. Participants included 22 clinicians and 9 supervisors who received monthly, group, phone-based consultation for seven months following training in motivational interviewing. Analyses showed that consultation was perceived as effective because it helped to "keep motivational interviewing alive," fulfilled a profound learning function through collaboration and connection with others, and served as protected time for reflection on practice change. Our findings contribute to a body of knowledge about consultation elements that appear to be effective when implementing research-supported interventions in child and youth mental health.

An empirical study of multidimensional fidelity of COMPASS consultation.

PubMed

Wong, Venus; Ruble, Lisa A; McGrew, John H; Yu, Yue

2018-06-01

Consultation is essential to the daily practice of school psychologists (National Association of School Psychologist, 2010). Successful consultation requires fidelity at both the consultant (implementation) and consultee (intervention) levels. We applied a multidimensional, multilevel conception of fidelity (Dunst, Trivette, & Raab, 2013) to a consultative intervention called the Collaborative Model for Promoting Competence and Success (COMPASS) for students with autism. The study provided 3 main findings. First, multidimensional, multilevel fidelity is a stable construct and increases over time with consultation support. Second, mediation analyses revealed that implementation-level fidelity components had distant, indirect effects on student Individualized Education Program (IEP) outcomes. Third, 3 fidelity components correlated with IEP outcomes: teacher coaching responsiveness at the implementation level, and teacher quality of delivery and student responsiveness at the intervention levels. Implications and future directions are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Validation of the theoretical domains framework for use in behaviour change and implementation research.

PubMed

Cane, James; O'Connor, Denise; Michie, Susan

2012-04-24

An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of clinical situations. This study tests the validity of this framework. Validity was investigated by behavioural experts sorting 112 unique theoretical constructs using closed and open sort tasks. The extent of replication was tested by Discriminant Content Validation and Fuzzy Cluster Analysis. There was good support for a refinement of the framework comprising 14 domains of theoretical constructs (average silhouette value 0.29): 'Knowledge', 'Skills', 'Social/Professional Role and Identity', 'Beliefs about Capabilities', 'Optimism', 'Beliefs about Consequences', 'Reinforcement', 'Intentions', 'Goals', 'Memory, Attention and Decision Processes', 'Environmental Context and Resources', 'Social Influences', 'Emotions', and 'Behavioural Regulation'. The refined Theoretical Domains Framework has a strengthened empirical base and provides a method for theoretically assessing implementation problems, as well as professional and other health-related behaviours as a basis for intervention development.

Implementation outcomes of Multidimensional Family Therapy-Detention to Community: a reintegration program for drug-using juvenile detainees.

PubMed

Liddle, Howard A; Dakof, Gayle A; Henderson, Craig; Rowe, Cindy

2011-06-01

Responding to urgent calls for effective interventions to address young offenders' multiple and interconnected problems, a new variant of an existing empirically-validated intervention for drug-using adolescents, Multidimensional Family Therapy (MDFT)-Detention to Community (DTC) was tested in a two-site controlled trial. This article (a) outlines the rationale and protocol basics of the MDFT-DTC intervention, a program for substance-using juvenile offenders that links justice and substance abuse treatment systems to facilitate adolescents' post-detention community reintegration; (b) presents implementation outcomes, including fidelity, treatment engagement and retention rates, amount of services received, treatment satisfaction, and substance abuse-juvenile justice system collaboration outcomes; and (c) details the implementation and sustainability challenges in a cross-system (substance abuse treatment and juvenile justice) adolescent intervention. Findings support the effectiveness of the MDFT-DTC intervention, and the need to develop a full implementation model in which transfer and dissemination issues could be explored more fully, and tested experimentally.

North Dakota implementation of mechanistic-empirical pavement design guide (MEPDG).

DOT National Transportation Integrated Search

2014-12-01

North Dakota currently designs roads based on the AASHTO Design Guide procedure, which is based on : the empirical findings of the AASHTO Road Test of the late 1950s. However, limitations of the current : empirical approach have prompted AASHTO to mo...

Implementing and Sustaining Team-Based Telecare for Bipolar Disorder: Lessons Learned from a Model-Guided, Mixed Methods Analysis.

PubMed

Bauer, Mark S; Krawczyk, Lois; Tuozzo, Kathy; Frigand, Cara; Holmes, Sally; Miller, Christopher J; Abel, Erica; Osser, David N; Franz, Aleda; Brandt, Cynthia; Rooney, Meghan; Fleming, Jerry; Smith, Eric; Godleski, Linda

2018-01-01

Telemental health interventions have empirical support from clinical trials and structured demonstration projects. However, their implementation and sustainability under less structured clinical conditions are not well demonstrated. We conducted a follow-up analysis of the implementation and sustainability of a clinical video teleconference-based collaborative care model for individuals with bipolar disorder treated in the Department of Veterans Affairs to (a) characterize the extent of implementation and sustainability of the program after its establishment and (b) identify barriers and facilitators to implementation and sustainability. We conducted a mixed methods program evaluation, assessing quantitative aspects of implementation according to the Reach, Efficacy, Adoption, Implementation, and Maintenance implementation framework. We conducted qualitative analysis of semistructured interviews with 16 of the providers who submitted consults, utilizing the Integrated Promoting Action on Research Implementation in the Health Services implementation framework. The program demonstrated linear growth in sites (n = 35) and consults (n = 915) from late 2011 through mid-2016. Site-based analysis indicated statistically significant sustainability beyond the first year of operation. Qualitative analysis identified key facilitators, including consult content, ease of use via electronic health record, and national infrastructure. Barriers included availability of telehealth space, equipment, and staff at the sites, as well as the labor-intensive nature of scheduling. The program achieved continuous growth over almost 5 years due to (1) successfully filling a need perceived by providers, (2) developing in a supportive context, and (3) receiving effective facilitation by national and local infrastructure. Clinical video teleconference-based interventions, even multicomponent collaborative care interventions for individuals with complex mental health conditions, can grow vigorously under appropriate conditions.

Implementation of a Computerized Decision Support System to Improve the Appropriateness of Antibiotic Therapy Using Local Microbiologic Data

PubMed Central

Rodriguez-Maresca, Manuel; Sorlozano, Antonio; Grau, Magnolia; Rodriguez-Castaño, Rocio; Ruiz-Valverde, Andres; Gutierrez-Fernandez, Jose

2014-01-01

A prospective quasi-experimental study was undertaken in 218 patients with suspicion of nosocomial infection hospitalized in a polyvalent ICU where a new electronic device (GERB) has been designed for antibiotic prescriptions. Two GERB-based applications were developed to provide local resistance maps (LRMs) and preliminary microbiological reports with therapeutic recommendation (PMRTRs). Both applications used the data in the Laboratory Information System of the Microbiology Department to report on the optimal empiric therapeutic option, based on the most likely susceptibility profile of the microorganisms potentially responsible for infection in patients and taking into account the local epidemiology of the hospital department/unit. LRMs were used for antibiotic prescription in 20.2% of the patients and PMRTRs in 78.2%, and active antibiotics against the finally identified bacteria were prescribed in 80.0% of the former group and 82.4% of the latter. When neither LMRs nor PMRTRs were considered for empiric treatment prescription, only around 40% of the antibiotics prescribed were active. Hence, the percentage appropriateness of the empiric antibiotic treatments was significantly higher when LRM or PMRTR guidelines were followed rather than other criteria. LRMs and PMRTRs applications are dynamic, highly accessible, and readily interpreted instruments that contribute to the appropriateness of empiric antibiotic treatments. PMID:25197643

Taking Innovation To Scale In Primary Care Practices: The Functions Of Health Care Extension.

PubMed

Ono, Sarah S; Crabtree, Benjamin F; Hemler, Jennifer R; Balasubramanian, Bijal A; Edwards, Samuel T; Green, Larry A; Kaufman, Arthur; Solberg, Leif I; Miller, William L; Woodson, Tanisha Tate; Sweeney, Shannon M; Cohen, Deborah J

2018-02-01

Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. Seven regional grantee cooperatives provided the foundational elements of health care extension-technological and quality improvement support, practice capacity building, and linking with community resources-to more than two hundred primary care practices in each region. This article describes how the cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement support to primary care practices. With investment, health care extension may be an effective platform for federal and state quality improvement efforts to create economies of scale and provide practices with more robust and coordinated support services.

Family-based treatment of eating disorders in adolescents: current insights

PubMed Central

Rienecke, Renee D

2017-01-01

Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT) has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment. PMID:28615982

Family-based treatment of eating disorders in adolescents: current insights.

PubMed

Rienecke, Renee D

2017-01-01

Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT) has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment.

Taking Innovation To Scale In Primary Care Practices: The Functions Of Health Care Extension

PubMed Central

Ono, Sarah S.; Crabtree, Benjamin F.; Hemler, Jennifer R.; Balasubramanian, Bijal A.; Edwards, Samuel T.; Green, Larry A.; Kaufman, Arthur; Solberg, Leif I.; Miller, William L.; Woodson, Tanisha Tate; Sweeney, Shannon M.; Cohen, Deborah J.

2018-01-01

Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. Seven regional grantee cooperatives provided the foundational elements of health care extension—technological and quality improvement support, practice capacity building, and linking with community resources—to more than two hundred primary care practices in each region. This article describes how the cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement support to primary care practices. With investment, health care extension may be an effective platform for federal and state quality improvement efforts to create economies of scale and provide practices with more robust and coordinated support services. PMID:29401016

Systematic evaluation of implementation fidelity of complex interventions in health and social care

PubMed Central

2010-01-01

Background Evaluation of an implementation process and its fidelity can give insight into the 'black box' of interventions. However, a lack of standardized methods for studying fidelity and implementation process have been reported, which might be one reason for the fact that few prior studies in the field of health service research have systematically evaluated interventions' implementation processes. The aim of this project is to systematically evaluate implementation fidelity and possible factors influencing fidelity of complex interventions in health and social care. Methods A modified version of The Conceptual Framework for Implementation Fidelity will be used as a conceptual model for the evaluation. The modification implies two additional moderating factors: context and recruitment. A systematic evaluation process was developed. Multiple case study method is used to investigate implementation of three complex health service interventions. Each case will be investigated in depth and longitudinally, using both quantitative and qualitative methods. Discussion This study is the first attempt to empirically test The Conceptual Framework for Implementation Fidelity. The study can highlight mechanism and factors of importance when implementing complex interventions. Especially the role of the moderating factors on implementation fidelity can be clarified. Trial Registration Supported Employment, SE, among people with severe mental illness -- a randomized controlled trial: NCT00960024. PMID:20815872

Developing the Autism Model of Implementation for Autism spectrum disorder community providers: study protocol

PubMed Central

2012-01-01

Background Currently, 1 out of 88 children are diagnosed with an autism spectrum disorder (ASD), and the estimated cost for treatment services is $126 billion annually. Typically, ASD community providers (ASD-CPs) provide services to children with any severity of ASD symptoms using a combination of various treatment paradigms, some with an evidence-base and some without. When evidence-based practices (EBPs) are successfully implemented by ASD-CPs, they can result in positive outcomes. Despite this promise, EBPs are often implemented unsuccessfully and other treatments used by ASD-CPs lack supportive evidence, especially for school-age children with ASD. While it is not well understood why ASD-CPs are not implementing EBPs, organizational and individual characteristics likely play a role. As a response to this need and to improve the lives of children with ASD and their families, this study aims to develop and test the feasibility and acceptability of the Autism Model of Implementation (AMI) to support the implementation of EBPs by ASD-CPs. Methods/design An academic-community collaboration developed to partner with ASD-CPs will facilitate the development of the AMI, a process specifically for use by ASD community-based agencies. Using a mixed methods approach, the project will assess agency and individual factors likely to facilitate or hinder implementing EBPs in this context; develop the AMI to address identified barriers and facilitators; and pilot test the AMI to examine its feasibility and acceptability using a specific EBP to treat anxiety disorders in school-age children with ASD. Discussion The AMI will represent a data-informed approach to facilitate implementation of EBPs by ASD-CPs by providing an implementation model specifically developed for this context. This study is designed to address the real-world implications of EBP implementation in ASD community-based agencies. In doing so, the AMI will help to provide children with ASD the best and most effective services in their own community. Moreover, the proposed study will positively impact the field of implementation science by providing an empirically supported and tested model of implementation to facilitate the identification, adoption, and use of EBPs. PMID:22963616

The use of the coping power program to treat a 10-year-old girl with disruptive behaviors.

PubMed

Lochman, John E; Boxmeyer, Caroline; Powell, Nicole; Wojnaroski, Mary; Yaros, Anna

2007-01-01

This article describes the successful application of the Coping Power program by school-based clinicians to address a 10-year-old girl's disruptive behavior symptoms. Coping Power is an empirically supported cognitive-behavioral program for children at risk for serious conduct problems and their parents. The following case study illustrates the core features of the Coping Power child and parent components while describing the use of assessment data and clinical decision making during the implementation of a manualized intervention.

A Service Design Thinking Approach for Stakeholder-Centred eHealth.

PubMed

Lee, Eunji

2016-01-01

Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

Implementing community-based provider participation in research: an empirical study.

PubMed

Teal, Randall; Bergmire, Dawn M; Johnston, Matthew; Weiner, Bryan J

2012-05-08

Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute's (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation. Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness.

A modified theoretical framework to assess implementation fidelity of adaptive public health interventions.

PubMed

Pérez, Dennis; Van der Stuyft, Patrick; Zabala, Maríadel Carmen; Castro, Marta; Lefèvre, Pierre

2016-07-08

One of the major debates in implementation research turns around fidelity and adaptation. Fidelity is the degree to which an intervention is implemented as intended by its developers. It is meant to ensure that the intervention maintains its intended effects. Adaptation is the process of implementers or users bringing changes to the original design of an intervention. Depending on the nature of the modifications brought, adaptation could either be potentially positive or could carry the risk of threatening the theoretical basis of the intervention, resulting in a negative effect on expected outcomes. Adaptive interventions are those for which adaptation is allowed or even encouraged. Classical fidelity dimensions and conceptual frameworks do not address the issue of how to adapt an intervention while still maintaining its effectiveness. We support the idea that fidelity and adaptation co-exist and that adaptations can impact either positively or negatively on the intervention's effectiveness. For adaptive interventions, research should answer the question how an adequate fidelity-adaptation balance can be reached. One way to address this issue is by looking systematically at the aspects of an intervention that are being adapted. We conducted fidelity research on the implementation of an empowerment strategy for dengue prevention in Cuba. In view of the adaptive nature of the strategy, we anticipated that the classical fidelity dimensions would be of limited use for assessing adaptations. The typology we used in the assessment-implemented, not-implemented, modified, or added components of the strategy-also had limitations. It did not allow us to answer the question which of the modifications introduced in the strategy contributed to or distracted from outcomes. We confronted our empirical research with existing literature on fidelity, and as a result, considered that the framework for implementation fidelity proposed by Carroll et al. in 2007 could potentially meet our concerns. We propose modifications to the framework to assess both fidelity and adaptation. The modified Carroll et al.'s framework we propose may permit a comprehensive assessment of the implementation fidelity-adaptation balance required when implementing adaptive interventions, but more empirical research is needed to validate it.

Attending unintended transformations of health care infrastructure

PubMed Central

Wentzer, Helle; Bygholm, Ann

2007-01-01

Introduction Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes. PMID:18043725

Writing-to-learn in undergraduate science education: a community-based, conceptually driven approach.

PubMed

Reynolds, Julie A; Thaiss, Christopher; Katkin, Wendy; Thompson, Robert J

2012-01-01

Despite substantial evidence that writing can be an effective tool to promote student learning and engagement, writing-to-learn (WTL) practices are still not widely implemented in science, technology, engineering, and mathematics (STEM) disciplines, particularly at research universities. Two major deterrents to progress are the lack of a community of science faculty committed to undertaking and applying the necessary pedagogical research, and the absence of a conceptual framework to systematically guide study designs and integrate findings. To address these issues, we undertook an initiative, supported by the National Science Foundation and sponsored by the Reinvention Center, to build a community of WTL/STEM educators who would undertake a heuristic review of the literature and formulate a conceptual framework. In addition to generating a searchable database of empirically validated and promising WTL practices, our work lays the foundation for multi-university empirical studies of the effectiveness of WTL practices in advancing student learning and engagement.

Education Improves Public Health and Promotes Health Equity.

PubMed

Hahn, Robert A; Truman, Benedict I

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. © The Author(s) 2015.

Education Improves Public Health and Promotes Health Equity

PubMed Central

Hahn, Robert A.; Truman, Benedict I.

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health – an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. PMID:25995305

Defining the external implementation context: an integrative systematic literature review.

PubMed

Watson, Dennis P; Adams, Erin L; Shue, Sarah; Coates, Heather; McGuire, Alan; Chesher, Jeremy; Jackson, Joanna; Omenka, Ogbonnaya I

2018-03-27

Proper implementation of evidence-based interventions is necessary for their full impact to be realized. However, the majority of research to date has overlooked facilitators and barriers existing outside the boundaries of the implementing organization(s). Better understanding and measurement of the external implementation context would be particularly beneficial in light of complex health interventions that extend into and interact with the larger environment they are embedded within. We conducted a integrative systematic literature review to identify external context constructs likely to impact implementation of complex evidence-based interventions. The review process was iterative due to our goal to inductively develop the identified constructs. Data collection occurred in four primary stages: (1) an initial set of key literature across disciplines was identified and used to inform (2) journal and (3) author searches that, in turn, informed the design of the final (4) database search. Additionally, (5) we conducted citation searches of relevant literature reviews identified in each stage. We carried out an inductive thematic content analysis with the goal of developing homogenous, well-defined, and mutually exclusive categories. We identified eight external context constructs: (1) professional influences, (2) political support, (3) social climate, (4) local infrastructure, (5) policy and legal climate, (6) relational climate, (7) target population, and (8) funding and economic climate. This is the first study to our knowledge to use a systematic review process to identify empirically observed external context factors documented to impact implementation. Comparison with four widely-utilized implementation frameworks supports the exhaustiveness of our review process. Future work should focus on the development of more stringent operationalization and measurement of these external constructs.

Quantum optimization for training support vector machines.

PubMed

Anguita, Davide; Ridella, Sandro; Rivieccio, Fabio; Zunino, Rodolfo

2003-01-01

Refined concepts, such as Rademacher estimates of model complexity and nonlinear criteria for weighting empirical classification errors, represent recent and promising approaches to characterize the generalization ability of Support Vector Machines (SVMs). The advantages of those techniques lie in both improving the SVM representation ability and yielding tighter generalization bounds. On the other hand, they often make Quadratic-Programming algorithms no longer applicable, and SVM training cannot benefit from efficient, specialized optimization techniques. The paper considers the application of Quantum Computing to solve the problem of effective SVM training, especially in the case of digital implementations. The presented research compares the behavioral aspects of conventional and enhanced SVMs; experiments in both a synthetic and real-world problems support the theoretical analysis. At the same time, the related differences between Quadratic-Programming and Quantum-based optimization techniques are considered.

Attachment-Based Family Therapy: A Review of the Empirical Support.

PubMed

Diamond, Guy; Russon, Jody; Levy, Suzanne

2016-09-01

Attachment-based family therapy (ABFT) is an empirically supported treatment designed to capitalize on the innate, biological desire for meaningful and secure relationships. The therapy is grounded in attachment theory and provides an interpersonal, process-oriented, trauma-focused approach to treating adolescent depression, suicidality, and trauma. Although a process-oriented therapy, ABFT offers a clear structure and road map to help therapists quickly address attachment ruptures that lie at the core of family conflict. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanism of change. This article provides an overview of the clinical model and the existing empirical support for ABFT. © 2016 Family Process Institute.

Familiarizing Students with the Empirically Supported Treatment Approaches for Childhood Problems.

ERIC Educational Resources Information Center

Wilkins, Victoria; Chambliss, Catherine

The clinical research literature exploring the efficacy of particular treatment approaches is reviewed with the intent to facilitate the training of counseling students. Empirically supported treatments (ESTs) is defined operationally as evidence-based treatments following the listing of empirically validated psychological treatments reported by…

What we know and what we need to learn about the treatment of dissociative disorders.

PubMed

Brand, Bethany L

2012-01-01

In this editorial, I briefly review research design issues and the current treatment research for dissociative disorders (DD), discuss the limitations and challenges of conducting treatment studies for patients with DD, and conclude by describing what I see as the first wave and second wave in the field of dissociation. Insurers and federally funded programs are increasingly requiring that treatment be empirically supported in order for treatment to be reimbursed. For example, psychoanalysis will no longer be reimbursed in The Netherlands because of what is perceived as a lack of empirical support. Other countries have also established standards about the treatments that have sufficient empirical support to merit government payment. I believe it is only a matter of time before it is common for patients with DD to be required to seek out empirically supported treatment if they want treatment to be reimbursed. We need to financially support treatment studies in order to develop a more solid empirical basis for the treatment of DD.

The Faculty Costs to Educate a Biomedical Sciences Graduate Student

PubMed Central

Smolka, Adam J.; Halushka, Perry V.; Garrett-Mayer, Elizabeth

2015-01-01

Academic medical centers nationwide face numerous fiscal challenges resulting from implementation of restructured healthcare delivery models, contracting state support for higher education, and increased competition for federal and other sources of biomedical research funding. In pursuing greater accountability and transparency in its fiscal operations, the Medical University of South Carolina (MUSC) has implemented a responsibility centers management budgetary model, which requires all MUSC colleges to be eventually self-sustaining financially. Graduate schools in the biomedical sciences are particularly vulnerable in the face of these challenges, depending traditionally as they do on financial support from training grant tuition, occasional medical school tuition and medical practice plan revenues, graduate college–based revenue-generating programs, and faculty payment of PhD tuition. The revenue streams are often insufficient to support PhD training programs, and supplemental financial support is required from the institution. In the context of a college of graduate studies, estimates of the cost of educating a graduate student become a significant necessity. This study presents a readily applicable model of empirically estimating the faculty salary costs that may provide a basis for budgetary planning that will help to sustain a biomedical sciences graduate school’s commitment to its teaching, research, and service mission goals. PMID:25673355

Supported employment for persons with serious mental illness: current status and future directions.

PubMed

Mueser, K T; McGurk, S R

2014-06-01

The individual placement and supported (IPS) model of supported employment is the most empirically validated model of vocational rehabilitation for persons with schizophrenia or another serious mental illness. Over 18 randomized controlled trials have been conducted throughout the world demonstrating the effectiveness of supported employment at improving competitive work compared to other vocational programs: IPS supported employment is defined by the following principles: 1) inclusion of all clients who want to work; 2) integration of vocational and clinical services; 3) focus on competitive employment; 4) rapid job search and no required prevocational skills training; 5) job development by the employment specialist; 6) attention to client preferences about desired work and disclosure of mental illness to prospective employers; 7) benefits counseling; and 8) follow-along supports after a job is obtained. Supported employment has been successfully implemented in a wide range of cultural and clinical populations, although challenges to implementation are also encountered. Common challenges are related to problems such as the failure to access technical assistance, system issues, negative beliefs and attitudes of providers, funding restrictions, and poor leadership. These challenges can be overcome by tapping expertise in IPS supported employment, including standardized and tested models of training and consultation. Efforts are underway to increase the efficiency of training methods for supported employment and the overall program, and to improve its effectiveness for those clients who do not benefit. Progress in IPS supported employment offers people with a serious mental illness realistic hope for achieving their work goals, and taking greater control over their lives. Copyright © 2014. Published by Elsevier Masson SAS.

Moving towards a new vision: implementation of a public health policy intervention.

PubMed

Valaitis, Ruta; MacDonald, Marjorie; Kothari, Anita; O'Mara, Linda; Regan, Sandra; Garcia, John; Murray, Nancy; Manson, Heather; Peroff-Johnston, Nancy; Bursey, Gayle; Boyko, Jennifer

2016-05-17

Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public's health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced their implementation. This paper explores policy implementation in two exemplar public health programs -chronic disease prevention and sexually-transmitted infection prevention - in Ontario, Canada. It examines public health service providers', managers' and senior managements' perspectives on the process of implementation of the Ontario Public Health Standards 2008 and factors influencing implementation. Public health staff from six health units representing rural, remote, large and small urban settings were included. We conducted 21 focus groups and 18 interviews between 2010 (manager and staff focus groups) and 2011 (senior management interviews) involving 133 participants. Research assistants coded transcripts and researchers reviewed these; the research team discussed and resolved discrepancies. To facilitate a breadth of perspectives, several team members helped interpret the findings. An integrated knowledge translation approach was used, reflected by the inclusion of academics as well as decision-makers on the team and as co-authors. Front line service providers often were unaware of the new policies but managers and senior management incorporated them in operational and program planning. Some participants were involved in policy development or provided feedback prior to their launch. Implementation was influenced by many factors that aligned with Greenhalgh and colleagues' empirically-based Diffusion of Innovations in Service Organizations Framework. Factors and related components that were most clearly linked to the OPHS policy implementation were: attributes of the innovation itself; adoption by individuals; diffusion and dissemination; the outer context - interorganizational networks and collaboration; the inner setting - implementation processes and routinization; and, linkage at the design and implementation stage. Multiple factors influenced public health policy implementation. Results provide empirical support for components of Greenhalgh et al's framework and suggest two additional components - the role of external organizational collaborations and partnerships as well as planning processes in influencing implementation. These are important to consider by government and public health organizations when promoting new or revised public health policies as they evolve over time. A successful policy implementation process in Ontario has helped to move public health towards the new vision.

Study on Language Rehabilitation for Aphasia.

PubMed

Yu, Zeng-Zhi; Jiang, Shu-Jun; Jia, Zi-Shan; Xiao, Hong-Yu; Zhou, Mei-Qi

2017-06-20

The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015. Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based. The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full. Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians' first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine. At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia.

Managing IT service management implementation complexity: from the perspective of the Warfield Version of systems science

NASA Astrophysics Data System (ADS)

Wan, Jiangping; Jones, James D.

2013-11-01

The Warfield version of systems science supports a wide variety of application areas, and is useful to practitioners who use the work program of complexity (WPOC) tool. In this article, WPOC is applied to information technology service management (ITSM) for managing the complexity of projects. In discussing the application of WPOC to ITSM, we discuss several steps of WPOC. The discovery step of WPOC consists of a description process and a diagnosis process. During the description process, 52 risk factors are identified, which are then narrowed to 20 key risk factors. All of this is done by interviews and surveys. Root risk factors (the most basic risk factors) consist of 11 kinds of common 'mindbugs' which are selected from an interpretive structural model. This is achieved by empirical analysis of 25 kinds of mindbugs. (A lesser aim of this research is to affirm that these mindbugs developed from a Western mindset have corresponding relevance in a completely different culture: the Peoples Republic of China.) During the diagnosis process, the relationships among the root risk factors in the implementation of the ITSM project are identified. The resolution step of WPOC consists of a design process and an implementation process. During the design process, issues related to the ITSM application are compared to both e-Government operation and maintenance, and software process improvement. The ITSM knowledge support structure is also designed at this time. During the implementation process, 10 keys to the successful implementation of ITSM projects are identified.

Economic instruments for obesity prevention: results of a scoping review and modified Delphi survey.

PubMed

Faulkner, Guy E J; Grootendorst, Paul; Nguyen, Van Hai; Andreyeva, Tatiana; Arbour-Nicitopoulos, Kelly; Auld, M Christopher; Cash, Sean B; Cawley, John; Donnelly, Peter; Drewnowski, Adam; Dubé, Laurette; Ferrence, Roberta; Janssen, Ian; Lafrance, Jeffrey; Lakdawalla, Darius; Mendelsen, Rena; Powell, Lisa M; Traill, W Bruce; Windmeijer, Frank

2011-10-06

Comprehensive, multi-level approaches are required to address obesity. One important target for intervention is the economic domain. The purpose of this study was to synthesize existing evidence regarding the impact of economic policies targeting obesity and its causal behaviours (diet, physical activity), and to make specific recommendations for the Canadian context. Arksey and O'Malley's (2005) methodological framework for conducting scoping reviews was adopted for this study and this consisted of two phases: 1) a structured literature search and review, and 2) consultation with experts in the research field through a Delphi survey and an in-person expert panel meeting in April 2010. Two key findings from the scoping review included 1) consistent evidence that weight outcomes are responsive to food and beverage prices. The debate on the use of food taxes and subsidies to address obesity should now shift to how best to address practical issues in designing such policies; and 2) very few studies have examined the impact of economic instruments to promote physical activity and clear policy recommendations cannot be made at this time. Delphi survey findings emphasised the relatively modest impact any specific economic instrument would have on obesity independently. Based on empirical evidence and expert opinion, three recommendations were supported. First, to create and implement an effective health filter to review new and current agricultural polices to reduce the possibility that such policies have a deleterious impact on population rates of obesity. Second, to implement a caloric sweetened beverage tax. Third, to examine how to implement fruit and vegetable subsidies targeted at children and low income households. In terms of economic interventions, shifting from empirical evidence to policy recommendation remains challenging. Overall, the evidence is not sufficiently strong to provide clear policy direction. Additionally, the nature of the experiments needed to provide definitive evidence supporting certain policy directions is likely to be complex and potentially unfeasible. However, these are not reasons to take no action. It is likely that policies need to be implemented in the face of an incomplete evidence base.

Economic instruments for obesity prevention: results of a scoping review and modified delphi survey

PubMed Central

2011-01-01

Background Comprehensive, multi-level approaches are required to address obesity. One important target for intervention is the economic domain. The purpose of this study was to synthesize existing evidence regarding the impact of economic policies targeting obesity and its causal behaviours (diet, physical activity), and to make specific recommendations for the Canadian context. Methods Arksey and O'Malley's (2005) methodological framework for conducting scoping reviews was adopted for this study and this consisted of two phases: 1) a structured literature search and review, and 2) consultation with experts in the research field through a Delphi survey and an in-person expert panel meeting in April 2010. Results Two key findings from the scoping review included 1) consistent evidence that weight outcomes are responsive to food and beverage prices. The debate on the use of food taxes and subsidies to address obesity should now shift to how best to address practical issues in designing such policies; and 2) very few studies have examined the impact of economic instruments to promote physical activity and clear policy recommendations cannot be made at this time. Delphi survey findings emphasised the relatively modest impact any specific economic instrument would have on obesity independently. Based on empirical evidence and expert opinion, three recommendations were supported. First, to create and implement an effective health filter to review new and current agricultural polices to reduce the possibility that such policies have a deleterious impact on population rates of obesity. Second, to implement a caloric sweetened beverage tax. Third, to examine how to implement fruit and vegetable subsidies targeted at children and low income households. Conclusions In terms of economic interventions, shifting from empirical evidence to policy recommendation remains challenging. Overall, the evidence is not sufficiently strong to provide clear policy direction. Additionally, the nature of the experiments needed to provide definitive evidence supporting certain policy directions is likely to be complex and potentially unfeasible. However, these are not reasons to take no action. It is likely that policies need to be implemented in the face of an incomplete evidence base. PMID:21978599

Using a knowledge utilization framework to explore how findings from one study can be applied to other nursing contexts.

PubMed

Olsen, P R; Bradbury-Jones, C

2013-09-01

To discuss the complexities of moving research into practice and through a case example, explore how empirical findings from one specific study could be applied to nursing in other contexts. The processes of moving research findings into practice are complex and multidimensional. In this paper, an innovative approach to social support, network-focused nursing (NFN), is used as a case example to illustrate these complexities. Social support is associated with better recovery and survival after illness and based on this, a NFN programme was developed in a Danish oncology youth unit. Subsequently, a research study was undertaken to investigate the programme and based on the findings, the concept NFN was developed. A knowledge utilization framework is used to explore how empirical findings from the NFN study could be applied to nursing more generally. Aligned with this, the specific considerations for implementing NFN are explicated. Strong leadership, education, management support and effective communication are critical factors for research utilization. Moving research into practice requires openness to new ideas. Nursing and healthcare policies therefore need to support environments in which creativity and innovation can flourish. NFN was developed in teenager and young adult cancer care, but its principles may be transferable to other clinical environments. It is important that nurse managers and policy makers ensure that support and education are available to nurses to facilitate moving research into practice. Moreover, resources need to be considered, particularly in countries where financial and organizational infrastructures may be weak. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.

Develop a Model Component

NASA Technical Reports Server (NTRS)

Ensey, Tyler S.

2013-01-01

During my internship at NASA, I was a model developer for Ground Support Equipment (GSE). The purpose of a model developer is to develop and unit test model component libraries (fluid, electrical, gas, etc.). The models are designed to simulate software for GSE (Ground Special Power, Crew Access Arm, Cryo, Fire and Leak Detection System, Environmental Control System (ECS), etc. .) before they are implemented into hardware. These models support verifying local control and remote software for End-Item Software Under Test (SUT). The model simulates the physical behavior (function, state, limits and 110) of each end-item and it's dependencies as defined in the Subsystem Interface Table, Software Requirements & Design Specification (SRDS), Ground Integrated Schematic (GIS), and System Mechanical Schematic.(SMS). The software of each specific model component is simulated through MATLAB's Simulink program. The intensiv model development life cycle is a.s follows: Identify source documents; identify model scope; update schedule; preliminary design review; develop model requirements; update model.. scope; update schedule; detailed design review; create/modify library component; implement library components reference; implement subsystem components; develop a test script; run the test script; develop users guide; send model out for peer review; the model is sent out for verifictionlvalidation; if there is empirical data, a validation data package is generated; if there is not empirical data, a verification package is generated; the test results are then reviewed; and finally, the user. requests accreditation, and a statement of accreditation is prepared. Once each component model is reviewed and approved, they are intertwined together into one integrated model. This integrated model is then tested itself, through a test script and autotest, so that it can be concluded that all models work conjointly, for a single purpose. The component I was assigned, specifically, was a fluid component, a discrete pressure switch. The switch takes a fluid pressure input, and if the pressure is greater than a designated cutoff pressure, the switch would stop fluid flow.

The implementation of mindfulness in healthcare systems: a theoretical analysis.

PubMed

Demarzo, M M P; Cebolla, A; Garcia-Campayo, J

2015-01-01

Evidence regarding the efficacy of mindfulness-based interventions (MBIs) is increasing exponentially; however, there are still challenges to their integration in healthcare systems. Our goal is to provide a conceptual framework that addresses these challenges in order to bring about scholarly dialog and support health managers and practitioners with the implementation of MBIs in healthcare. This is an opinative narrative review based on theoretical and empirical data that address key issues in the implementation of mindfulness in healthcare systems, such as the training of professionals, funding and costs of interventions, cost effectiveness and innovative delivery models. We show that even in the United Kingdom, where mindfulness has a high level of implementation, there is a high variability in the access to MBIs. In addition, we discuss innovative approaches based on "complex interventions," "stepped-care" and "low intensity-high volume" concepts that may prove fruitful in the development and implementation of MBIs in national healthcare systems, particularly in Primary Care. In order to better understand barriers and opportunities for mindfulness implementation in healthcare systems, it is necessary to be aware that MBIs are "complex interventions," which require innovative approaches and delivery models to implement these interventions in a cost-effective and accessible way. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinic-Based Mobile Health Decision Support to Enhance Adult Epilepsy Self-Management: An Intervention Mapping Approach.

PubMed

Shegog, Ross; Begley, Charles E

2017-01-01

Epilepsy is a neurological disorder involving recurrent seizures. It affects approximately 5 million people in the U.S. To optimize their quality of life people with epilepsy are encouraged to engage in self-management (S-M) behaviors. These include managing their treatment (e.g., adhering to anti-seizure medication and clinical visit schedules), managing their seizures (e.g., responding to seizure episodes), managing their safety (e.g., monitoring and avoiding environmental seizure triggers), and managing their co-morbid conditions (e.g., anxiety, depression). The clinic-based Management Information Decision Support Epilepsy Tool (MINDSET) is a decision-support system founded on theory and empirical evidence. It is designed to increase awareness by adult patients (≥18 years) and their health-care provider regarding the patient's epilepsy S-M behaviors, facilitate communication during the clinic visit to prioritize S-M goals and strategies commensurate with the patient's needs, and increase the patient's self-efficacy to achieve those goals. The purpose of this paper is to describe the application of intervention mapping (IM) to develop, implement, and formatively evaluate the clinic-based MINDSET prototype and in developing implementation and evaluation plans. Deliverables comprised a logic model of the problem (IM Step 1); matrices of program objectives (IM Step 2); a program planning document comprising scope, sequence, theory-based methods, and practical strategies (IM Step 3); a functional MINDSET program prototype (IM Step 4); plans for implementation (IM Step 5); and evaluation (IM Step 6). IM provided a logical and systematic approach to developing and evaluating clinic-based decision support toward epilepsy S-M.

A scoping review of personalisation in the UK: approaches to social work and people with learning disabilities.

PubMed

Sims, David; Cabrita Gulyurtlu, Sandra S

2014-01-01

There have been rapid developments in personalisation of health and social care in the UK over the past 5 years to develop a more flexible model of provision based upon greater choice and control for service users. This has been important for people with learning disabilities who are often dependent on others such as social workers to support their autonomy and independence. This article discusses a study carried out to explore the impact of personalisation on people with learning disabilities and the role of social workers to support this. A scoping review of the UK literature from 1996 to 2011 was conducted. It was found that there has not been a significant amount of empirical research in this area. Some studies, such as reports by InControl, have suggested that when implemented well, personalisation can have a positive impact on the lives of people with learning disabilities. Other literature highlighted the limitations and critiques of personalisation. Without the right support to manage budgets and autonomy, people with learning disabilities could be left vulnerable. In respect of the social workers, the finding of the review was that there was a lack of guidance on how to implement personalisation and a perceived threat to their traditional practice role, resulting in barriers to implementation. Although the literature emphasises the need for choice, control and autonomy in personalisation, the conclusion of this study is that more research needs to be carried out into how professional roles fit into and can support this process. © 2013 John Wiley & Sons Ltd.

Towards a resilience management framework for complex enterprise systems upgrade implementation

NASA Astrophysics Data System (ADS)

Teoh, Say Yen; Yeoh, William; Zadeh, Hossein Seif

2017-05-01

The lack of knowledge of how resilience management supports enterprise system (ES) projects accounts for the failure of firms to leverage their investments in costly ES implementations. Using a structured-pragmatic-situational (SPS) case study research approach, this paper reports on an investigation into the resilience management of a large utility company as it implemented an ES upgrade. Drawing on the literature and on the case study findings, we developed a process-based resilience management framework that involves three strategies (developing situation awareness, demystifying threats, and executing restoration plans) and four organisational capabilities that transform resilience management concepts into practices. We identified the crucial phases of ES upgrade implementation and developed indicators for how different strategies and capabilities of resilience management can assist managers at different stages of an ES upgrade. This research advances the state of existing knowledge by providing specific and verifiable propositions for attaining a state of resilience, the knowledge being grounded in the empirical reality of a case study. Moreover, the framework offers ES practitioners a roadmap to better identify appropriate responses and levels of preparedness.

GPU-accelerated Tersoff potentials for massively parallel Molecular Dynamics simulations

NASA Astrophysics Data System (ADS)

Nguyen, Trung Dac

2017-03-01

The Tersoff potential is one of the empirical many-body potentials that has been widely used in simulation studies at atomic scales. Unlike pair-wise potentials, the Tersoff potential involves three-body terms, which require much more arithmetic operations and data dependency. In this contribution, we have implemented the GPU-accelerated version of several variants of the Tersoff potential for LAMMPS, an open-source massively parallel Molecular Dynamics code. Compared to the existing MPI implementation in LAMMPS, the GPU implementation exhibits a better scalability and offers a speedup of 2.2X when run on 1000 compute nodes on the Titan supercomputer. On a single node, the speedup ranges from 2.0 to 8.0 times, depending on the number of atoms per GPU and hardware configurations. The most notable features of our GPU-accelerated version include its design for MPI/accelerator heterogeneous parallelism, its compatibility with other functionalities in LAMMPS, its ability to give deterministic results and to support both NVIDIA CUDA- and OpenCL-enabled accelerators. Our implementation is now part of the GPU package in LAMMPS and accessible for public use.

Empirical Analysis of Optical Attenuator Performance in Quantum Key Distribution Systems Using a Particle Model

DTIC Science & Technology

2012-03-01

EMPIRICAL ANALYSIS OF OPTICAL ATTENUATOR PERFORMANCE IN QUANTUM KEY DISTRIBUTION SYSTEMS USING A...DISTRIBUTION IS UNLIMITED AFIT/GCS/ENG/12-01 EMPIRICAL ANALYSIS OF OPTICAL ATTENUATOR PERFORMANCE IN QUANTUM KEY DISTRIBUTION SYSTEMS USING ...challenging as the complexity of actual implementation specifics are considered. Two components common to most quantum key distribution

Pressure ulcers: implementation of evidence-based nursing practice.

PubMed

Clarke, Heather F; Bradley, Chris; Whytock, Sandra; Handfield, Shannon; van der Wal, Rena; Gundry, Sharon

2005-03-01

A 2-year project was carried out to evaluate the use of multi-component, computer-assisted strategies for implementing clinical practice guidelines. This paper describes the implementation of the project and lessons learned. The evaluation and outcomes of implementing clinical practice guidelines to prevent and treat pressure ulcers will be reported in a separate paper. The prevalence and incidence rates of pressure ulcers, coupled with the cost of treatment, constitute a substantial burden for our health care system. It is estimated that treating a pressure ulcer can increase nursing time up to 50%, and that treatment costs per ulcer can range from US$10,000 to $86,000, with median costs of $27,000. Although evidence-based guidelines for prevention and optimum treatment of pressure ulcers have been developed, there is little empirical evidence about the effectiveness of implementation strategies. The study was conducted across the continuum of care (primary, secondary and tertiary) in a Canadian urban Health Region involving seven health care organizations (acute, home and extended care). Trained surveyors (Registered Nurses) determined the prevalence and incidence of pressure ulcers among patients in these organizations. The use of a computerized decision-support system assisted staff to select optimal, evidence-based care strategies, record information and analyse individual and aggregate data. Evaluation indicated an increase in knowledge relating to pressure ulcer prevention, treatment strategies, resources required, and the role of the interdisciplinary team. Lack of visible senior nurse leadership; time required to acquire computer skills and to implement new guidelines; and difficulties with the computer system were identified as barriers. There is a need for a comprehensive, supported and sustained approach to implementation of evidence-based practice for pressure ulcer prevention and treatment, greater understanding of organization-specific barriers, and mechanisms for addressing the barriers.

Prep-ME Software Implementation and Enhancement

DOT National Transportation Integrated Search

2017-09-01

Highway agencies across the United States are moving from empirical design procedures towards the mechanistic-empirical (ME) based pavement design. Even though the Pavement ME Design presents a new paradigm shift with several dramatic improvements, i...

Calibrating the mechanistic-empirical pavement design guide for Kansas.

DOT National Transportation Integrated Search

2015-04-01

The Kansas Department of Transportation (KDOT) is moving toward the implementation of the new American : Association of State Highway and Transportation Officials (AASHTO) Mechanistic-Empirical Pavement Design Guide (MEPDG) : for pavement design. The...

Use of qualitative environmental and phenotypic variables in the context of allele distribution models: detecting signatures of selection in the genome of Lake Victoria cichlids.

PubMed

Joost, Stéphane; Kalbermatten, Michael; Bezault, Etienne; Seehausen, Ole

2012-01-01

When searching for loci possibly under selection in the genome, an alternative to population genetics theoretical models is to establish allele distribution models (ADM) for each locus to directly correlate allelic frequencies and environmental variables such as precipitation, temperature, or sun radiation. Such an approach implementing multiple logistic regression models in parallel was implemented within a computing program named MATSAM: . Recently, this application was improved in order to support qualitative environmental predictors as well as to permit the identification of associations between genomic variation and individual phenotypes, allowing the detection of loci involved in the genetic architecture of polymorphic characters. Here, we present the corresponding methodological developments and compare the results produced by software implementing population genetics theoretical models (DFDIST: and BAYESCAN: ) and ADM (MATSAM: ) in an empirical context to detect signatures of genomic divergence associated with speciation in Lake Victoria cichlid fishes.

Transition of care for patients with type 1 diabetes mellitus from pediatric to adult health care systems

PubMed Central

Glick, Bethany; Kamboj, Manmohan K.

2017-01-01

Planning for the transition from pediatric to adult healthcare is broadly understood to be beneficial to the quality of care of patients with chronic illness. Due to the level of self-care that is necessary in the maintenance of most chronic diseases, it is important that pediatric settings can offer support during a time when adolescents are beginning to take more responsibility in all areas of their lives. Lack of supportive resources for adolescents with chronic conditions often results in both decreased access to care and impaired health and function likely leading to increased medical costs later. Additionally, fundamental differences in health care delivery exist between pediatric and adult care settings. There is limited empiric data and information on best practices in transition care. In this article we address the importance of bridging pediatric and adult care settings and highlight the challenges and successes of the implementation of the young adult transition clinic program for patients with type 1 diabetes at our facility. We provide recommendations for further research and program implementation with the transition population. PMID:29184818

Scaling up Evidence-based Practices for Children and Families in New York State: Towards Evidence-based Policies on Implementation for State Mental Health Systems

PubMed Central

Hoagwood, Kimberly Eaton; Olin, S. Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M.; Woodlock, Kristin M.; Hogan, Michael

2014-01-01

Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling-out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518

MIRO: A debugging tool for CLIPS incorporating historical Rete networks

NASA Technical Reports Server (NTRS)

Tuttle, Sharon M.; Eick, Christoph F.

1994-01-01

At the last CLIPS conference, we discussed our ideas for adding a temporal dimension to the Rete network used to implement CLIPS. The resulting historical Rete network could then be used to store 'historical' information about a run of a CLIPS program, to aid in debugging. MIRO, a debugging tool for CLIPS built on top of CLIPS, incorporates such a historical Rete network and uses it to support its prototype question-answering capability. By enabling CLIPS users to directly ask debugging-related questions about the history of a program run, we hope to reduce the amount of single-stepping and program tracing required to debug a CLIPS program. In this paper, we briefly describe MIRO's architecture and implementation, and the current question-types that MIRO supports. These question-types are further illustrated using an example, and the benefits of the debugging tool are discussed. We also present empirical results that measure the run-time and partial storage overhead of MIRO, and discuss how MIRO may also be used to study various efficiency aspects of CLIPS programs.

Gas Bearing Implementation of Small Cryocooler Compressor

NASA Astrophysics Data System (ADS)

Kuo, D. T.; Loc, A. S.; Hanes, M.

2006-04-01

In order to reduce the life-cycle cost of systems that use cryocoolers, it is necessary to extend the operating life of the cooler beyond what is currently available for tactical military applications. Several approaches have been used to increase life such as flexure bearing and gas bearing support. It was determined that a gas bearing system offered a novel and cost effective approach for our products. This paper presents the implementation of a gas bearing system into the miniature cryocooler compressor. The theoretical analyses used to design the gas bearing system will be discussed and empirical data comparing the performance between the baseline and gas bearing coolers will be presented. A life test program is being undertaken to verify the life characteristics of the gas bearing cooler and the results will be summarized and published at a later date.

Identifying governance strategies that effectively support ecosystem services, resource sustainability, and biodiversity

PubMed Central

Kenward, R. E.; Whittingham, M. J.; Arampatzis, S.; Manos, B. D.; Hahn, T.; Terry, A.; Simoncini, R.; Alcorn, J.; Bastian, O.; Donlan, M.; Elowe, K.; Franzén, F.; Karacsonyi, Z.; Larsson, M.; Manou, D.; Navodaru, I.; Papadopoulou, O.; Papathanasiou, J.; von Raggamby, A.; Sharp, R. J. A.; Söderqvist, T.; Soutukorva, Å.; Vavrova, L.; Aebischer, N. J.; Leader-Williams, N.; Rutz, C.

2011-01-01

Conservation scientists, national governments, and international conservation groups seek to devise, and implement, governance strategies that mitigate human impact on the environment. However, few studies to date have systematically investigated the performance of different systems of governance in achieving successful conservation outcomes. Here, we use a newly-developed analytic framework to conduct analyses of a suite of case studies, linking different governance strategies to standardized scores for delivering ecosystem services, achieving sustainable use of natural resources, and conserving biodiversity, at both local and international levels. Our results: (i) confirm the benefits of adaptive management; and (ii) reveal strong associations for the role of leadership. Our work provides a critical step toward implementing empirically justified governance strategies that are capable of improving the management of human-altered environments, with benefits for both biodiversity and people. PMID:21402916

Empirical Analysis of Green Supply Chain Management Practices in Indian Automobile Industry

NASA Astrophysics Data System (ADS)

Luthra, S.; Garg, D.; Haleem, A.

2014-04-01

Environmental sustainability and green environmental issues have an increasing popularity among researchers and supply chain practitioners. An attempt has been made to identify and empirically analyze green supply chain management (GSCM) practices in Indian automobile industry. Six main GSCM practices (having 37 sub practices) and four expected performance outcomes (having 16 performances) have been identified by implementing GSCM practices from literature review. Questionnaire based survey has been made to validate these practices and performance outcomes. 123 complete questionnaires were collected from Indian automobile organizations and used for empirical analysis of GSCM practices in Indian automobile industry. Descriptive statistics have been used to know current implementation status of GSCM practices in Indian automobile industry and multiple regression analysis has been carried out to know the impact on expected organizational performance outcomes by current GSCM practices adopted by Indian automobile industry. The results of study suggested that environmental, economic, social and operational performances improve with the implementation of GSCM practices. This paper may play an important role to understand various GSCM implementation issues and help practicing managers to improve their performances in the supply chain.

Health care workers and their needs: the forgotten shadow of AIM research.

PubMed

Lillehaug, S I; Lajoie, S

1998-01-01

The field of AI in Medicine (AIM) seems to have accepted that decision support is, and will be, needed within most medical domains. As society calls for cost-effectiveness, and human expertise or expert guidance are not always available, decision support systems (DSSs) are proposed as the solutions. These solutions, however, do not necessarily correspond with the basic needs of their targeted users. We will show this through a review of the literature related to health care workers and the various factors that have an influence on their performances. Furthermore, we will use these empirical findings to argue that the AIM community must go beyond its decision support philosophy, whereby the gaps in human expertise are filled in by the computer. In the future, joint emphasis must be placed on decision support and the promotion towards independent and self-sufficient problem solving. In order to implement this paradigm change, the AIM community will have to incorporate findings from the research discipline of AI in Education.

Sensory modulation intervention and behaviour support modification for the treatment of severe aggression in Huntington's disease. A single case experimental design.

PubMed

Fisher, Caroline A; Brown, Anahita

2017-09-01

Aggression is common in Huntington's disease. However, at present there are no standard guidelines for managing aggression in Huntington's sufferers due to a lack of empirical research. This paper presents a case study of the treatment of very high levels of aggression with sensory modulation and behaviour support intervention in a Huntington's sufferer. The client exhibited a range of aggressive behaviours, including physical aggression to people, furniture and objects, and verbal aggression. Following an eight week baseline phase, five weeks of sensory modulation intervention were employed. A behaviour support plan was then implemented as an adjunct to the sensory intervention, with aggressive behaviour systematically audited for a further 11 weeks. The results indicate a significant reduction in reported levels of aggression during the combined sensory modulation and behaviour support phase, compared to both the baseline and the sensory modulation therapy alone phases. This case study highlights the efficacy non-pharmacological interventions may have for reducing aggression in HD.

Mobile Autonomous Sensing Unit (MASU): A Framework That Supports Distributed Pervasive Data Sensing

PubMed Central

Medina, Esunly; Lopez, David; Meseguer, Roc; Ochoa, Sergio F.; Royo, Dolors; Santos, Rodrigo

2016-01-01

Pervasive data sensing is a major issue that transverses various research areas and application domains. It allows identifying people’s behaviour and patterns without overwhelming the monitored persons. Although there are many pervasive data sensing applications, they are typically focused on addressing specific problems in a single application domain, making them difficult to generalize or reuse. On the other hand, the platforms for supporting pervasive data sensing impose restrictions to the devices and operational environments that make them unsuitable for monitoring loosely-coupled or fully distributed work. In order to help address this challenge this paper present a framework that supports distributed pervasive data sensing in a generic way. Developers can use this framework to facilitate the implementations of their applications, thus reducing complexity and effort in such an activity. The framework was evaluated using simulations and also through an empirical test, and the obtained results indicate that it is useful to support such a sensing activity in loosely-coupled or fully distributed work scenarios. PMID:27409617

Implementation and local calibration of the MEPDG transfer functions in Wyoming.

DOT National Transportation Integrated Search

2015-11-01

The Wyoming Department of Transportation (WYDOT) currently uses the empirical AASHTO Design for Design of : Pavement Structures as their standard pavement design procedure. WYDOT plans to transition to the Mechanistic : Empirical Pavement Design Guid...

Mechanistic-empirical pavement design guide calibration for pavement rehabilitation.

DOT National Transportation Integrated Search

2013-01-01

The Oregon Department of Transportation (ODOT) is in the process of implementing the recently introduced AASHTO : Mechanistic-Empirical Pavement Design Guide (MEPDG) for new pavement sections. The majority of pavement work : conducted by ODOT involve...

Calibrating the mechanistic-empirical pavement design guide for Kansas : [technical summary].

DOT National Transportation Integrated Search

2015-04-01

The Kansas Department of Transportation (KDOT) is moving toward the implementation : of the new American Association of State Highway and Transportation Officials : (AASHTO) Mechanistic-Empirical Pavement Design Guide (MEPDG) for pavement : design. T...

Implementation of Evidence-Based Practice From a Learning Perspective.

PubMed

Nilsen, Per; Neher, Margit; Ellström, Per-Erik; Gardner, Benjamin

2017-06-01

For many nurses and other health care practitioners, implementing evidence-based practice (EBP) presents two interlinked challenges: acquisition of EBP skills and adoption of evidence-based interventions and abandonment of ingrained non-evidence-based practices. The purpose of this study to describe two modes of learning and use these as lenses for analyzing the challenges of implementing EBP in health care. The article is theoretical, drawing on learning and habit theory. Adaptive learning involves a gradual shift from slower, deliberate behaviors to faster, smoother, and more efficient behaviors. Developmental learning is conceptualized as a process in the "opposite" direction, whereby more or less automatically enacted behaviors become deliberate and conscious. Achieving a more EBP depends on both adaptive and developmental learning, which involves both forming EBP-conducive habits and breaking clinical practice habits that do not contribute to realizing the goals of EBP. From a learning perspective, EBP will be best supported by means of adaptive learning that yields a habitual practice of EBP such that it becomes natural and instinctive to instigate EBP in appropriate contexts by means of seeking out, critiquing, and integrating research into everyday clinical practice as well as learning new interventions best supported by empirical evidence. However, the context must also support developmental learning that facilitates disruption of existing habits to ascertain that the execution of the EBP process or the use of evidence-based interventions in routine practice is carefully and consciously considered to arrive at the most appropriate response. © 2017 Sigma Theta Tau International.

Identifying Conditions That Support Causal Inference in Observational Studies in Education: Empirical Evidence from within Study Comparisons

ERIC Educational Resources Information Center

Hallberg, Kelly

2013-01-01

This dissertation is a collection of three papers that employ empirical within study comparisons (WSCs) to identify conditions that support causal inference in observational studies. WSC studies empirically estimate the extent to which a given observational study reproduces the result of a randomized clinical trial (RCT) when both share the same…

Implementing community-based provider participation in research: an empirical study

PubMed Central

2012-01-01

Background Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. Methods We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. Results The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation. Conclusion Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness. PMID:22568935

The standard of healthcare accreditation standards: a review of empirical research underpinning their development and impact

PubMed Central

2012-01-01

Background Healthcare accreditation standards are advocated as an important means of improving clinical practice and organisational performance. Standard development agencies have documented methodologies to promote open, transparent, inclusive development processes where standards are developed by members. They assert that their methodologies are effective and efficient at producing standards appropriate for the health industry. However, the evidence to support these claims requires scrutiny. The study’s purpose was to examine the empirical research that grounds the development methods and application of healthcare accreditation standards. Methods A multi-method strategy was employed over the period March 2010 to August 2011. Five academic health research databases (Medline, Psych INFO, Embase, Social work abstracts, and CINAHL) were interrogated, the websites of 36 agencies associated with the study topic were investigated, and a snowball search was undertaken. Search criteria included accreditation research studies, in English, addressing standards and their impact. Searching in stage 1 initially selected 9386 abstracts. In stage 2, this selection was refined against the inclusion criteria; empirical studies (n = 2111) were identified and refined to a selection of 140 papers with the exclusion of clinical or biomedical and commentary pieces. These were independently reviewed by two researchers and reduced to 13 articles that met the study criteria. Results The 13 articles were analysed according to four categories: overall findings; standards development; implementation issues; and impact of standards. Studies have only occurred in the acute care setting, predominately in 2003 (n = 5) and 2009 (n = 4), and in the United States (n = 8). A multidisciplinary focus (n = 9) and mixed method approach (n = 11) are common characteristics. Three interventional studies were identified, with the remaining 10 studies having research designs to investigate clinical or organisational impacts. No study directly examined standards development or other issues associated with their progression. Only one study noted implementation issues, identifying several enablers and barriers. Standards were reported to improve organisational efficiency and staff circumstances. However, the impact on clinical quality was mixed, with both improvements and a lack of measurable effects recorded. Conclusion Standards are ubiquitous within healthcare and are generally considered to be an important means by which to improve clinical practice and organisational performance. However, there is a lack of robust empirical evidence examining the development, writing, implementation and impacts of healthcare accreditation standards. PMID:22995152

The standard of healthcare accreditation standards: a review of empirical research underpinning their development and impact.

PubMed

Greenfield, David; Pawsey, Marjorie; Hinchcliff, Reece; Moldovan, Max; Braithwaite, Jeffrey

2012-09-20

Healthcare accreditation standards are advocated as an important means of improving clinical practice and organisational performance. Standard development agencies have documented methodologies to promote open, transparent, inclusive development processes where standards are developed by members. They assert that their methodologies are effective and efficient at producing standards appropriate for the health industry. However, the evidence to support these claims requires scrutiny. The study's purpose was to examine the empirical research that grounds the development methods and application of healthcare accreditation standards. A multi-method strategy was employed over the period March 2010 to August 2011. Five academic health research databases (Medline, Psych INFO, Embase, Social work abstracts, and CINAHL) were interrogated, the websites of 36 agencies associated with the study topic were investigated, and a snowball search was undertaken. Search criteria included accreditation research studies, in English, addressing standards and their impact. Searching in stage 1 initially selected 9386 abstracts. In stage 2, this selection was refined against the inclusion criteria; empirical studies (n = 2111) were identified and refined to a selection of 140 papers with the exclusion of clinical or biomedical and commentary pieces. These were independently reviewed by two researchers and reduced to 13 articles that met the study criteria. The 13 articles were analysed according to four categories: overall findings; standards development; implementation issues; and impact of standards. Studies have only occurred in the acute care setting, predominately in 2003 (n = 5) and 2009 (n = 4), and in the United States (n = 8). A multidisciplinary focus (n = 9) and mixed method approach (n = 11) are common characteristics. Three interventional studies were identified, with the remaining 10 studies having research designs to investigate clinical or organisational impacts. No study directly examined standards development or other issues associated with their progression. Only one study noted implementation issues, identifying several enablers and barriers. Standards were reported to improve organisational efficiency and staff circumstances. However, the impact on clinical quality was mixed, with both improvements and a lack of measurable effects recorded. Standards are ubiquitous within healthcare and are generally considered to be an important means by which to improve clinical practice and organisational performance. However, there is a lack of robust empirical evidence examining the development, writing, implementation and impacts of healthcare accreditation standards.

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

PubMed

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

2018-05-10

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

Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework.

PubMed

Lemiengre, Joke; Dierckx de Casterlé, Bernadette; Schotsmans, Paul; Gastmans, Chris

2014-05-01

As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones-law, care and ethics-constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice.

Enhanced methods for determining operational capabilities and support costs of proposed space systems

NASA Technical Reports Server (NTRS)

Ebeling, Charles

1993-01-01

This report documents the work accomplished during the first two years of research to provide support to NASA in predicting operational and support parameters and costs of proposed space systems. The first year's research developed a methodology for deriving reliability and maintainability (R & M) parameters based upon the use of regression analysis to establish empirical relationships between performance and design specifications and corresponding mean times of failure and repair. The second year focused on enhancements to the methodology, increased scope of the model, and software improvements. This follow-on effort expands the prediction of R & M parameters and their effect on the operations and support of space transportation vehicles to include other system components such as booster rockets and external fuel tanks. It also increases the scope of the methodology and the capabilities of the model as implemented by the software. The focus is on the failure and repair of major subsystems and their impact on vehicle reliability, turn times, maintenance manpower, and repairable spares requirements. The report documents the data utilized in this study, outlines the general methodology for estimating and relating R&M parameters, presents the analyses and results of application to the initial data base, and describes the implementation of the methodology through the use of a computer model. The report concludes with a discussion on validation and a summary of the research findings and results.

Implementation of the AASHTO mechanistic-empirical pavement design guide for Colorado.

DOT National Transportation Integrated Search

2000-01-01

The objective of this project was to integrate the American Association of State Highway and Transportation Officials (AASHTO) Mechanistic-Empirical Pavement Design Guide, Interim Edition: A Manual of Practice and its accompanying software into the d...

Development and Pilot of the Caregiver Strategies Inventory.

PubMed

Kirby, Anne V; Little, Lauren M; Schultz, Beth; Watson, Linda R; Zhang, Wanqing; Baranek, Grace T

2016-01-01

Children with autism spectrum disorder often demonstrate unusual behavioral responses to sensory stimuli (i.e., sensory features). To manage everyday activities, caregivers may implement strategies to address these features during family routines. However, investigation of specific strategies used by caregivers is limited by the lack of empirically developed measures. In this study, we describe the development and pilot results of the Caregiver Strategies Inventory (CSI), a supplement to the Sensory Experiences Questionnaire Version 3.0 (SEQ 3.0; Baranek, 2009) that measures caregivers' strategies in response to their children's sensory features. Three conceptually derived and empirically grounded strategy types were tested: cognitive-behavioral, sensory-perceptual, and avoidance. Results indicated that the CSI demonstrated good internal consistency and that strategy use was related to child age and cognition. Moreover, parent feedback after completing the CSI supported its utility and social validity. The CSI may be used alongside the SEQ 3.0 to facilitate a family-centered approach to assessment and intervention planning. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Group interventions for patients with cancer and HIV disease: part IV. Clinical and policy recommendations.

PubMed

Leszcz, Molyn; Sherman, Allen; Mosier, Julie; Burlingame, Gary M; Cleary, Trish; Ulman, Kathleen Hubbs; Simonton, Stephanie; Latif, Umaira; Strauss, Bernhard; Hazelton, Lara

2004-10-01

Group interventions have assumed a growing role in primary prevention and supportive care for cancer and HIV disease. Earlier sections of this Special Report examined empirical findings for these interventions and provided recommendations for future research. The current section offers brief recommendations for service providers, policymakers, and stakeholders. Group services now occupy an increasingly prominent place in primary prevention programs and medical settings. In previous sections of this Special Report (Sherman, Leszcz et al., 2004; Sherman, Mosier et al., 2004a, 2004b) we examined the efficacy of different group interventions at different phases of cancer or HIV disease, considered characteristics of the intervention and the participants that might influence outcomes, and discussed mechanisms of action. Methodological challenges and priorities for future research were highlighted. In this, the final section, we offer brief recommendations for service providers, policymakers, and other stakeholders. We consider some of the barriers that constrain use of empirically-based group interventions and note how these programs might be implemented more widely and effectively.

Writing-to-Learn in Undergraduate Science Education: A Community-Based, Conceptually Driven Approach

PubMed Central

Reynolds, Julie A.; Thaiss, Christopher; Katkin, Wendy; Thompson, Robert J.

2012-01-01

Despite substantial evidence that writing can be an effective tool to promote student learning and engagement, writing-to-learn (WTL) practices are still not widely implemented in science, technology, engineering, and mathematics (STEM) disciplines, particularly at research universities. Two major deterrents to progress are the lack of a community of science faculty committed to undertaking and applying the necessary pedagogical research, and the absence of a conceptual framework to systematically guide study designs and integrate findings. To address these issues, we undertook an initiative, supported by the National Science Foundation and sponsored by the Reinvention Center, to build a community of WTL/STEM educators who would undertake a heuristic review of the literature and formulate a conceptual framework. In addition to generating a searchable database of empirically validated and promising WTL practices, our work lays the foundation for multi-university empirical studies of the effectiveness of WTL practices in advancing student learning and engagement. PMID:22383613

Measuring and modelling the quality of 40 post-disaster mental health and psychosocial support programmes.

PubMed

Dückers, Michel L A; Thormar, Sigridur B; Juen, Barbara; Ajdukovic, Dean; Newlove-Eriksson, Lindy; Olff, Miranda

2018-01-01

Disasters can have an enormous impact on the health and well-being of those affected. Internationally, governments and service providers are often challenged to address complex psychosocial problems. Ideally, the potentially broad range of support activities include a coherent, high-quality mental health and psychosocial support (MHPSS) programme. We present a theory-driven quantitative analysis of the quality of 40 MHPSS programmes, mostly implemented in European disaster settings. The objective is to measure quality domains recognized as relevant in the literature and to empirically test associations. During the EU project "Operationalizing Psychosocial Support in Crisis" (OPSIC) an evaluation survey was designed and developed for this purpose and completed by 40 MHPSS programme coordinators involved in different mass emergencies and disasters. We analysed the survey data in two steps. Firstly, we used the data to operationalize quality domains of a MHPSS programme, tested constructs and assessed their internal consistency reliability. A total of 26 out of 44 survey items clustered into three of the four domains identified within the theoretical framework: "planning and delivery system" (Cronbach's alpha 0.82); "general evaluation criteria" (Cronbach's alpha 0.82); and "essential psychosocial principles" (Cronbach's alpha 0.75). "Measures and interventions applied", theoretically a potential fourth domain, could not be confirmed to empirically cluster together. Secondly, several models with associations between domains and measures and interventions were tested and compared. The model with the best fit suggests that in MHPSS programmes with a higher planning and delivery systems score, a larger number of measures and interventions from evidence-informed guidelines are applied. In such programmes, coordinators are more positive about general evaluation criteria and the realization of essential psychosocial principles. Moreover, the analyses showed that some measures and interventions are more likely to be applied in programmes with more evolved planning and delivery systems, yet for most measures and interventions the likelihood of being applied is not linked to planning and delivery system status, nor to coordinator perceptions concerning psychosocial principles and evaluation criteria. Further research is necessary to validate and expand the findings and to learn more about success factors and obstacles for MHPSS programme implementation.

The effect of Fisher information matrix approximation methods in population optimal design calculations.

PubMed

Strömberg, Eric A; Nyberg, Joakim; Hooker, Andrew C

2016-12-01

With the increasing popularity of optimal design in drug development it is important to understand how the approximations and implementations of the Fisher information matrix (FIM) affect the resulting optimal designs. The aim of this work was to investigate the impact on design performance when using two common approximations to the population model and the full or block-diagonal FIM implementations for optimization of sampling points. Sampling schedules for two example experiments based on population models were optimized using the FO and FOCE approximations and the full and block-diagonal FIM implementations. The number of support points was compared between the designs for each example experiment. The performance of these designs based on simulation/estimations was investigated by computing bias of the parameters as well as through the use of an empirical D-criterion confidence interval. Simulations were performed when the design was computed with the true parameter values as well as with misspecified parameter values. The FOCE approximation and the Full FIM implementation yielded designs with more support points and less clustering of sample points than designs optimized with the FO approximation and the block-diagonal implementation. The D-criterion confidence intervals showed no performance differences between the full and block diagonal FIM optimal designs when assuming true parameter values. However, the FO approximated block-reduced FIM designs had higher bias than the other designs. When assuming parameter misspecification in the design evaluation, the FO Full FIM optimal design was superior to the FO block-diagonal FIM design in both of the examples.

Building a bonfire that remains stoked: sustainment of a contingency management intervention developed through collaborative design.

PubMed

Hartzler, Bryan

2015-08-06

Community dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use. The adaptability of contingency management renders it an exemplary therapy to model this collaborative design process. At conclusion of an implementation/effectiveness hybrid trial conducted at an opiate treatment program, a group elicitation interview was conducted with the setting's five managerial staff to cull qualitative impressions of a collaboratively-designed contingency management intervention after 90 days of provisional implementation in the setting. Two independent raters reviewed the audio-recording and conducted a phenomenological narrative analysis, extracting themes and selecting excerpts to correspond with innovation attributes (i.e., relative advantage, compatibility, complexity, trialability, observability) of a well-known implementation science framework. This qualitative analysis suggested the intervention was regarded as: (1) cost-effective and clinically useful relative to prior practices, (2) a strong fit with existing service structure and staffing resources, (3) procedurally uncomplicated, with staff consistently implementing it as intended, (4) providing site-specific data to sufficiently inform decisions about its sustainment, and (5) offering palpable benefits to staff-patient interactions. The current work complements prior reports of positive implementation outcomes and intervention effectiveness for the parent trial, mapping qualitative managerial accounts of this contingency management intervention to a set of attributes thought to influence the speed and effectiveness with which an innovative practice is disseminated. Findings support the incorporation of collaborative design processes in future efforts to transport contingency management to the addiction treatment community.

A traffic data plan for mechanistic-empirical pavement designs (2002 pavement design guide).

DOT National Transportation Integrated Search

2003-01-01

The Virginia Department of Transportation (VDOT) is preparing to implement the mechanistic-empirical pavement design methodology being developed under the National Cooperative Research Program's Project 1-37A, commonly referred to as the 2002 Pavemen...

Verification and implementation of set-up empirical models in pile design : research project capsule.

DOT National Transportation Integrated Search

2016-08-01

The primary objectives of this research include: performing static and dynamic load tests on : newly instrumented test piles to better understand the set-up mechanism for individual soil : layers, verifying or recalibrating previously developed empir...

Mechanistic-empirical design, implementation, and monitoring for flexible pavements : a project summary.

DOT National Transportation Integrated Search

2014-05-01

This document is a summary of tasks performed for Project ICT-R27-060. : Mechanistic-empirical (M-E)based flexible pavement design concepts and procedures were : developed in previous Illinois Cooperative Highway Research Program projects (IHR-510...

It’s Personal: Biology Instructors Prioritize Personal Evidence over Empirical Evidence in Teaching Decisions

PubMed Central

Andrews, Tessa C.; Lemons, Paula P.

2015-01-01

Despite many calls for undergraduate biology instructors to incorporate active learning into lecture courses, few studies have focused on what it takes for instructors to make this change. We sought to investigate the process of adopting and sustaining active-learning instruction. As a framework for our research, we used the innovation-decision model, a generalized model of how individuals adopt innovations. We interviewed 17 biology instructors who were attempting to implement case study teaching and conducted qualitative text analysis on interview data. The overarching theme that emerged from our analysis was that instructors prioritized personal experience—rather than empirical evidence—in decisions regarding case study teaching. We identified personal experiences that promote case study teaching, such as anecdotal observations of student outcomes, and those that hinder case study teaching, such as insufficient teaching skills. By analyzing the differences between experienced and new case study instructors, we discovered that new case study instructors need support to deal with unsupportive colleagues and to develop the skill set needed for an active-learning classroom. We generated hypotheses that are grounded in our data about effectively supporting instructors in adopting and sustaining active-learning strategies. We also synthesized our findings with existing literature to tailor the innovation-decision model. PMID:25713092

The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs.

PubMed

McGurk, Susan R; Mueser, Kim T; Watkins, Melanie A; Dalton, Carline M; Deutsch, Heather

2017-03-01

Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The implementation of integrated care: the empirical validation of the Development Model for Integrated Care

PubMed Central

2011-01-01

Background Integrated care is considered as a strategy to improve the delivery, efficiency, client outcomes and satisfaction rates of health care. To integrate the care from multiple providers into a coherent client-focused service, a large number of activities and agreements have to be implemented like streamlining information flows and patient transfers. The Development Model for Integrated care (DMIC) describes nine clusters containing in total 89 elements that contribute to the integration of care. We have empirically validated this model in practice by assessing the relevance, implementation and plans of the elements in three integrated care service settings in The Netherlands: stroke, acute myocardial infarct (AMI), and dementia. Methods Based on the DMIC, a survey was developed for integrated care coordinators. We invited all Dutch stroke and AMI-services, as well as the dementia care networks to participate, of which 84 did (response rate 83%). Data were collected on relevance, presence, and year of implementation of the 89 elements. The data analysis was done by means of descriptive statistics, Chi Square, ANOVA and Kruskal-Wallis H tests. Results The results indicate that the integrated care practice organizations in all three care settings rated the nine clusters and 89 elements of the DMIC as highly relevant. The average number of elements implemented was 50 ± 18, 42 ± 13, and 45 ± 22 for stroke, acute myocardial infarction, and dementia care services, respectively. Although the dementia networks were significantly younger, their numbers of implemented elements were comparable to those of the other services. The analyses of the implementation timelines showed that the older integrated care services had fewer plans for further implementation than the younger ones. Integrated care coordinators stated that the DMIC helped them to assess their integrated care development in practice and supported them in obtaining ideas for expanding their integrated care activities. Conclusions Although the patient composites and the characteristics of the 84 participating integrated care services differed considerably, the results confirm that the clusters and the vast majority of DMIC elements are relevant to all three groups. Therefore, the DMIC can serve as a general quality management tool for integrated care. Applying the model in practice can help in steering further implementations as well as the development of new integrated care practices. PMID:21801428

The implementation of integrated care: the empirical validation of the Development Model for Integrated care.

PubMed

Minkman, Mirella M N; Vermeulen, Robbert P; Ahaus, Kees T B; Huijsman, Robbert

2011-07-30

Integrated care is considered as a strategy to improve the delivery, efficiency, client outcomes and satisfaction rates of health care. To integrate the care from multiple providers into a coherent client-focused service, a large number of activities and agreements have to be implemented like streamlining information flows and patient transfers. The Development Model for Integrated care (DMIC) describes nine clusters containing in total 89 elements that contribute to the integration of care. We have empirically validated this model in practice by assessing the relevance, implementation and plans of the elements in three integrated care service settings in The Netherlands: stroke, acute myocardial infarct (AMI), and dementia. Based on the DMIC, a survey was developed for integrated care coordinators. We invited all Dutch stroke and AMI-services, as well as the dementia care networks to participate, of which 84 did (response rate 83%). Data were collected on relevance, presence, and year of implementation of the 89 elements. The data analysis was done by means of descriptive statistics, Chi Square, ANOVA and Kruskal-Wallis H tests. The results indicate that the integrated care practice organizations in all three care settings rated the nine clusters and 89 elements of the DMIC as highly relevant. The average number of elements implemented was 50 ± 18, 42 ± 13, and 45 ± 22 for stroke, acute myocardial infarction, and dementia care services, respectively. Although the dementia networks were significantly younger, their numbers of implemented elements were comparable to those of the other services. The analyses of the implementation timelines showed that the older integrated care services had fewer plans for further implementation than the younger ones. Integrated care coordinators stated that the DMIC helped them to assess their integrated care development in practice and supported them in obtaining ideas for expanding their integrated care activities. Although the patient composites and the characteristics of the 84 participating integrated care services differed considerably, the results confirm that the clusters and the vast majority of DMIC elements are relevant to all three groups. Therefore, the DMIC can serve as a general quality management tool for integrated care. Applying the model in practice can help in steering further implementations as well as the development of new integrated care practices.

An exploration of self-management support in the context of palliative nursing: a modified concept analysis

PubMed Central

2014-01-01

Background The role of self-management is often ambiguous, yet, it is an important area in clinical practice for palliative nurses. A clear conceptual understanding, however, of what it represents is lacking. Method This paper reports an analysis of the concept of self-management support in palliative nursing. Avant and Walker’s method was used to guide this concept analysis. A search of electronic databases (1990–2013), use of internet search engines and supplementary hand searching produced an international data set of reviews, empirical research, editorials, protocols and guidelines. Results Based on the analysis self-management support in palliative nursing has been defined as assessing, planning, and implementing appropriate care to enable the patient to live until they die and supporting the patient to be given the means to master or deal with their illness or their effects of their illness themselves. Conclusions Clarity with the concept of self-management support and palliative nursing could enable nurses to provide more patient and family centred care to people facing life threatening illnesses. PMID:25120381

The methodological quality of guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia: A systematic review.

PubMed

Ambaras Khan, R; Aziz, Z

2018-05-02

Clinical practice guidelines serve as a framework for physicians to make decisions and to support best practice for optimizing patient care. However, if the guidelines do not address all the important components of optimal care sufficiently, the quality and validity of the guidelines can be reduced. The objectives of this study were to systematically review current guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), evaluate their methodological quality and highlight the similarities and differences in their recommendations for empirical antibiotic and antibiotic de-escalation strategies. This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Electronic databases including MEDLINE, CINAHL, PubMed and EMBASE were searched up to September 2017 for relevant guidelines. Other databases such as NICE, Scottish Intercollegiate Guidelines Network (SIGN) and the websites of professional societies were also searched for relevant guidelines. The quality and reporting of included guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) instrument. Six guidelines were eligible for inclusion in our review. Among 6 domains of AGREE-II, "clarity of presentation" scored the highest (80.6%), whereas "applicability" scored the lowest (11.8%). All the guidelines supported the antibiotic de-escalation strategy, whereas the majority of the guidelines (5 of 6) recommended that empirical antibiotic therapy should be implemented in accordance with local microbiological data. All the guidelines suggested that for early-onset HAP/VAP, therapy should start with a narrow spectrum empirical antibiotic such as penicillin or cephalosporins, whereas for late-onset HAP/VAP, the guidelines recommended the use of a broader spectrum empirical antibiotic such as the penicillin extended spectrum carbapenems and glycopeptides. Expert guidelines promote the judicious use of antibiotics and prevent antibiotic overuse. The quality and validity of available HAP/VAP guidelines would be enhanced by improving their adherence to accepted best practice for the management of HAP and VAP. © 2018 John Wiley & Sons Ltd.

Facilitating large-scale implementation of evidence based health care: insider accounts from a co-operative inquiry.

PubMed

Waterman, Heather; Boaden, Ruth; Burey, Lorraine; Howells, Brook; Harvey, Gill; Humphreys, John; Rothwell, Katy; Spence, Michael

2015-02-13

Facilitators are known to be influential in the implementation of evidence-based health care (EBHC). However, little evidence exists on what it is that they do to support the implementation process. This research reports on how knowledge transfer associates (KTAs) working as part of the UK National Institute for Health Research 'Collaboration for Leadership in Applied Health Research and Care' for Greater Manchester (GM CLAHRC) facilitated the implementation of EBHC across several commissioning and provider health care agencies. A prospective co-operative inquiry with eight KTAs was carried out comprising of 11 regular group meetings where they reflected critically on their experiences. Twenty interviews were also conducted with other members of the GM CLAHRC Implementation Team to gain their perspectives of the KTAs facilitation role and process. There were four phases to the facilitation of EBHC on a large scale: (1) Assisting with the decision on what EBHC to implement, in this phase, KTAs pulled together people and disparate strands of information to facilitate a decision on which EBHC should be implemented; (2) Planning of the implementation of EBHC, in which KTAs spent time gathering additional information and going between key people to plan the implementation; (3) Coordinating and implementing EBHC when KTAs recruited general practices and people for the implementation of EBHC; and (4) Evaluating the EBHC which required the KTAs to set up (new) systems to gather data for analysis. Over time, the KTAs demonstrated growing confidence and skills in aspects of facilitation: research, interpersonal communication, project management and change management skills. The findings provide prospective empirical data on the large scale implementation of EBHC in primary care and community based organisations focusing on resources and processes involved. Detailed evidence shows facilitation is context dependent and that 'one size does not fits all'. Co-operative inquiry was a useful method to enhance KTAs learning. The evidence shows that facilitators need tailored support and education, during the process of implementation to provide them with a well-rounded skill-set. Our study was not designed to demonstrate how facilitators contribute to patient health outcomes thus further prospective research is required.

State Fall Prevention Coalitions as Systems Change Agents: An Emphasis on Policy.

PubMed

Schneider, Ellen C; Smith, Matthew Lee; Ory, Marcia G; Altpeter, Mary; Beattie, Bonita Lynn; Scheirer, Mary Ann; Shubert, Tiffany E

2016-03-01

Falls among older adults are an escalating public health issue, which requires a multidisciplinary and multilevel approach to affect systems change to effectively address this problem. The National Council on Aging established the Falls Free® Initiative, enfolding and facilitating statewide Fall Prevention Coalitions. Fall Free® activities included developing the State Policy Toolkit for Advancing Falls Prevention to promote sustainable change by supporting the dissemination and adoption of evidence-based strategies. To (1) determine if the policies being implemented were recommended and supported by the Toolkit, (2) identify the perceived barriers and facilitators to implementing policies, and (3) identify Coalitions' current and future fall prevention policy activities. A 63-item online survey was distributed to State Coalition Leads. Descriptive statistics (frequencies and counts) were used to describe Coalition characteristics and activities. Coalitions had several similarities, and varied greatly in their number of member organizations and members as well as meeting frequencies. Key activities included building partnerships, disseminating programs, and pursuing at least one of the eight National Council on Aging-recommended policy goals. The most commonly reported facilitator was active support from the Coalition Leads, whereas the lack of funding was the most cited barrier. This study serves as the first national census of empirical evidence regarding Falls Coalitions' composition, goals, and activities. Results indicate that Coalitions are actively pursuing evidence-based policies but could benefit from additional technical assistance and resources. Findings support the value of Toolkit recommendations by documenting what is feasible and being implemented. Knowledge about facilitators and barriers will inform future efforts to foster sustainable systems change in states with active Coalitions and encourage Coalitions in other states. © 2015 Society for Public Health Education.

Ontological approach for safe and effective polypharmacy prescription

PubMed Central

Grando, Adela; Farrish, Susan; Boyd, Cynthia; Boxwala, Aziz

2012-01-01

The intake of multiple medications in patients with various medical conditions challenges the delivery of medical care. Initial empirical studies and pilot implementations seem to indicate that generic safe and effective multi-drug prescription principles could be defined and reused to reduce adverse drug events and to support compliance with medical guidelines and drug formularies. Given that ontologies are known to provide well-principled, sharable, setting-independent and machine-interpretable declarative specification frameworks for modeling and reasoning on biomedical problems, we explore here their use in the context of multi-drug prescription. We propose an ontology for modeling drug-related knowledge and a repository of safe and effective generic prescription principles. To test the usability and the level of granularity of the developed ontology-based specification models and heuristic we implemented a tool that computes the complexity of multi-drug treatments, and a decision aid to check the safeness and effectiveness of prescribed multi-drug treatments. PMID:23304299

Guidelines for Implementing NCHRP 1-37A M-E Design Procedures in Ohio : Volume 1 -- Summary of Findings, Implementation Plan, and Next Steps

DOT National Transportation Integrated Search

2009-11-01

Highway agencies across the nation are moving towards implementation of the new AASHTO Mechanistic-Empirical Pavement Design Guide (MEPDG) for pavement design. The benefits of implementing the MEPDG for routine use in Ohio includes (1) achieving more...

Mechanistic-Empirical (M-E) Design Implementation & Monitoring for Flexible Pavements : 2018 PROJECT SUMMARY

DOT National Transportation Integrated Search

2018-06-01

This document is a summary of the tasks performed for Project ICT-R27-149-1. Mechanistic-empirical (M-E)based flexible pavement design concepts and procedures were previously developed in Illinois Cooperative Highway Research Program projects IHR-...

Layer moduli of Nebraska pavements for the new Mechanistic-Empirical Pavement Design Guide (MEPDG).

DOT National Transportation Integrated Search

2010-12-01

As a step-wise implementation effort of the Mechanistic-Empirical Pavement Design Guide (MEPDG) for the design : and analysis of Nebraska flexible pavement systems, this research developed a database of layer moduli dynamic : modulus, creep compl...

An empirical analysis of strategy implementation process and performance of construction companies

NASA Astrophysics Data System (ADS)

Zaidi, F. I.; Zawawi, E. M. A.; Nordin, R. M.; Ahnuar, E. M.

2018-02-01

Strategy implementation is known as action stage where it is to be considered as the most difficult stage in strategic planning. Strategy implementation can influence the whole texture of a company including its performance. The aim of this research is to provide the empirical relationship between strategy implementation process and performance of construction companies. This research establishes the strategy implementation process and how it influences the performance of construction companies. This research used quantitative method approached via questionnaire survey. Respondents were G7 construction companies in Klang Valley, Selangor. Pearson correlation analysis indicate a strong positive relationship between strategy implementation process and construction companies’ performance. The most importance part of strategy implementation process is to provide sufficient training for employees which directly influence the construction companies’ profit growth and employees’ growth. This research results will benefit top management in the construction companies to conduct strategy implementation in their companies. This research may not reflect the whole construction industry in Malaysia. Future research may be resumed to small and medium grades contractors and perhaps in other areas in Malaysia.

QoS enabled dissemination of managed information objects in a publish-subscribe-query information broker

NASA Astrophysics Data System (ADS)

Loyall, Joseph P.; Carvalho, Marco; Martignoni, Andrew, III; Schmidt, Douglas; Sinclair, Asher; Gillen, Matthew; Edmondson, James; Bunch, Larry; Corman, David

2009-05-01

Net-centric information spaces have become a necessary concept to support information exchange for tactical warfighting missions using a publish-subscribe-query paradigm. To support dynamic, mission-critical and time-critical operations, information spaces require quality of service (QoS)-enabled dissemination (QED) of information. This paper describes the results of research we are conducting to provide QED information exchange in tactical environments. We have developed a prototype QoS-enabled publish-subscribe-query information broker that provides timely delivery of information needed by tactical warfighters in mobile scenarios with time-critical emergent targets. This broker enables tailoring and prioritizing of information based on mission needs and responds rapidly to priority shifts and unfolding situations. This paper describes the QED architecture, prototype implementation, testing infrastructure, and empirical evaluations we have conducted based on our prototype.

[Personalised treatment of disorders in the use of alcohol and nicotine].

PubMed

Dom, G; van den Brink, W; Schellekens, A

There is an increasing interest in personalised treatment based on the individual characteristics of the patient in the field of addiction care. To summarise the present state of staging and profiling possibilities within addiction care. A literature review highlighting the current scientific findings and proposing a theoretical model. There are currently an insufficient number of studies to allow for a fully data driven model. However, research identifying biomarkers is growing and some clinically implementable findings can be put forward. a personalised approach in addiction care holds promise. There is an urgent need for better and larger datasets to empirically support models aimed for clinical use.

Social workers and delivery of evidence-based psychosocial treatments for substance use disorders.

PubMed

Wells, Elizabeth A; Kristman-Valente, Allison N; Peavy, K Michelle; Jackson, T Ron

2013-01-01

Social workers encounter individuals with substance use disorders (SUDs) in a variety of settings. With changes in health care policy and a movement toward integration of health and behavioral health services, social workers will play an increased role vis-á-vis SUD. As direct service providers, administrators, care managers, and policy makers, they will select, deliver, or advocate for delivery of evidence-based SUD treatment practices. This article provides an overview of effective psychosocial SUD treatment approaches. In addition to describing the treatments, the article discusses empirical support, populations for whom the treatments are known to be efficacious, and implementation issues.

Empirically-supported and non-empirically supported therapies for bulimia nervosa: retrospective patient ratings

PubMed Central

2013-01-01

Background Empirically supported therapies for bulimia nervosa include cognitive behaviour therapy and interpersonal therapy. Whilst these treatments have been shown to be effective in multiple randomised controlled trials, little research has investigated how they are perceived by patients who receive them. This study investigated whether empirically-supported psychological therapies (ESTs) are associated with superior self-rated treatment outcomes in clients with Bulimia Nervosa (BN). Results 98 adults who had received psychological therapy for BN in the United Kingdom completed a questionnaire which retrospectively assessed the specific contents of their psychological therapy and self-rated treatment outcomes. Around half the sample, fifty three participants reported receiving an EST. Fifty of these received Cognitive Behaviour Therapy (CBT) and three Interpersonal Therapy (IPT). Where therapy met expert criteria for Cognitive Behaviour Therapy for Bulimia Nervosa (CBT-BN, an EST) participants reported superior treatment outcomes than those who appeared to receive non-specialist cognitive-behavioural therapy. However, self-rated treatment outcomes were similar overall between those whose therapy met criteria for ESTs and those whose therapy did not. Conclusions The findings offer tentative support for the perceived helpfulness of CBT-BN as evaluated in controlled research trials. Cognitive-behavioural therapies for BN, as they are delivered in the UK, may not necessarily be perceived as more beneficial by clients with BN than psychological therapies which currently have less empirical support. PMID:24999419

Empirical performance of the multivariate normal universal portfolio

NASA Astrophysics Data System (ADS)

Tan, Choon Peng; Pang, Sook Theng

2013-09-01

Universal portfolios generated by the multivariate normal distribution are studied with emphasis on the case where variables are dependent, namely, the covariance matrix is not diagonal. The moving-order multivariate normal universal portfolio requires very long implementation time and large computer memory in its implementation. With the objective of reducing memory and implementation time, the finite-order universal portfolio is introduced. Some stock-price data sets are selected from the local stock exchange and the finite-order universal portfolio is run on the data sets, for small finite order. Empirically, it is shown that the portfolio can outperform the moving-order Dirichlet universal portfolio of Cover and Ordentlich[2] for certain parameters in the selected data sets.

Phoneme restoration and empirical coverage of interactive activation and adaptive resonance models of human speech processing

PubMed Central

Magnuson, James S.

2015-01-01

Grossberg and Kazerounian [(2011). J. Acoust. Soc. Am. 130, 440–460] present a model of sequence representation for spoken word recognition, the cARTWORD model, which simulates essential aspects of phoneme restoration. Grossberg and Kazerounian also include simulations with the TRACE model presented by McClelland and Elman [(1986). Cognit. Psychol. 18, 1–86] that seem to indicate that TRACE cannot simulate phoneme restoration. Grossberg and Kazerounian also claim cARTWORD should be preferred to TRACE because of TRACE's implausible approach to sequence representation (reduplication of time-specific units) and use of non-modulatory feedback (i.e., without position-specific bottom-up support). This paper responds to Grossberg and Kazerounian first with TRACE simulations that account for phoneme restoration when appropriately constructed noise is used (and with minor changes to TRACE phoneme definitions), then reviews the case for reduplicated units and feedback as implemented in TRACE, as well as TRACE's broad and deep coverage of empirical data. Finally, it is argued that cARTWORD is not comparable to TRACE because cARTWORD cannot represent sequences with repeated elements, has only been implemented with small phoneme and lexical inventories, and has been applied to only one phenomenon (phoneme restoration). Without evidence that cARTWORD captures a similar range and detail of human spoken language processing as alternative models, it is premature to prefer cARTWORD to TRACE. PMID:25786959

Empire matters: implications for pastoral care.

PubMed

LaMothe, Ryan

2007-01-01

In this essay, I argue that the American Empire matters for pastoral care. I begin with a discussion of the meaning of empire and the particular historical roots and characteristics of the American Empire. From this, I contend that the American Empire matters because the United States has had a long history of expansionist aims, which has been couched in idealized secular discourse as well as ensconced in theo-political discourse. These discourses, which have, implicitly or explicitly, supported foreign policies and actions aimed at political, economic, and military dominion, are joined to an empire psyche. This empire psyche and the actions of U.S. governments are matters for pastoral care because of a) the various physical, psychological, and spiritual harms that attend hubris, greed, entitlement, and the quest for hegemony, and b) the theological contradictions inherent in Christian discourse that supports the American Empire. These consequences and contradictions serve as reasons why pastoral theologians and caregivers ought to bring these matters to public reflection and conversation. I conclude with a brief depiction of possible pastoral actions given the reality of the American Empire.

EMPIRE: A code for nuclear astrophysics

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

Palumbo, A.

The nuclear reaction code EMPIRE is presented as a useful tool for nuclear astrophysics. EMPIRE combines a variety of the reaction models with a comprehensive library of input parameters providing a diversity of options for the user. With exclusion of the directsemidirect capture all reaction mechanisms relevant to the nuclear astrophysics energy range of interest are implemented in the code. Comparison to experimental data show consistent agreement for all relevant channels.

Creating Community Responsibility for Child Protection: Possibilities and Challenges

PubMed Central

Daro, Deborah; Dodge, Kenneth A.

2013-01-01

Summary Deborah Daro and Kenneth Dodge observe that efforts to prevent child abuse have historically focused on directly improving the skills of parents who are at risk for or engaged in maltreatment. But, as experts increasingly recognize that negative forces within a community can overwhelm even well-intentioned parents, attention is shifting toward creating environments that facilitate a parent’s ability to do the right thing. The most sophisticated and widely used community prevention programs, say Daro and Dodge, emphasize the reciprocal interplay between individual-family behavior and broader neighborhood, community, and cultural contexts. The authors examine five different community prevention efforts, summarizing for each both the theory of change and the empirical evidence concerning its efficacy. Each program aims to enhance community capacity by expanding formal and informal resources and establishing a normative cultural context capable of fostering collective responsibility for positive child development. Over the past ten years, researchers have explored how neighborhoods influence child development and support parenting. Scholars are still searching for agreement on the most salient contextual factors and on how to manipulate these factors to increase the likelihood parents will seek out, find, and effectively use necessary and appropriate support. The current evidence base for community child abuse prevention, observe Daro and Dodge, offers both encouragement and reason for caution. Although theory and empirical research suggest that intervention at the neighborhood level is likely to prevent child maltreatment, designing and implementing a high-quality, multifaceted community prevention initiative is expensive. Policy makers must consider the trade-offs in investing in strategies to alter community context and those that expand services for known high-risk individuals. The authors conclude that if the concept of community prevention is to move beyond the isolated examples examined in their article, additional conceptual and empirical work is needed to garner support from public institutions, community-based stakeholders, and local residents. PMID:19719023

Evolution of the empirical and theoretical foundations of eyewitness identification reform.

PubMed

Clark, Steven E; Moreland, Molly B; Gronlund, Scott D

2014-04-01

Scientists in many disciplines have begun to raise questions about the evolution of research findings over time (Ioannidis in Epidemiology, 19, 640-648, 2008; Jennions & Møller in Proceedings of the Royal Society, Biological Sciences, 269, 43-48, 2002; Mullen, Muellerleile, & Bryan in Personality and Social Psychology Bulletin, 27, 1450-1462, 2001; Schooler in Nature, 470, 437, 2011), since many phenomena exhibit decline effects-reductions in the magnitudes of effect sizes as empirical evidence accumulates. The present article examines empirical and theoretical evolution in eyewitness identification research. For decades, the field has held that there are identification procedures that, if implemented by law enforcement, would increase eyewitness accuracy, either by reducing false identifications, with little or no change in correct identifications, or by increasing correct identifications, with little or no change in false identifications. Despite the durability of this no-cost view, it is unambiguously contradicted by data (Clark in Perspectives on Psychological Science, 7, 238-259, 2012a; Clark & Godfrey in Psychonomic Bulletin & Review, 16, 22-42, 2009; Clark, Moreland, & Rush, 2013; Palmer & Brewer in Law and Human Behavior, 36, 247-255, 2012), raising questions as to how the no-cost view became well-accepted and endured for so long. Our analyses suggest that (1) seminal studies produced, or were interpreted as having produced, the no-cost pattern of results; (2) a compelling theory was developed that appeared to account for the no-cost pattern; (3) empirical results changed over the years, and subsequent studies did not reliably replicate the no-cost pattern; and (4) the no-cost view survived despite the accumulation of contradictory empirical evidence. Theories of memory that were ruled out by early data now appear to be supported by data, and the theory developed to account for early data now appears to be incorrect.

A theory of planned behaviour-based analysis of TIMSS 2011 to determine factors influencing inquiry teaching practices in high-performing countries

NASA Astrophysics Data System (ADS)

Pongsophon, Pongprapan; Herman, Benjamin C.

2017-07-01

Given the abundance of literature describing the strong relationship between inquiry-based teaching and student achievement, more should be known about the factors impacting science teachers' classroom inquiry implementation. This study utilises the theory of planned behaviour to propose and validate a causal model of inquiry-based teaching through analysing data relating to high-performing countries retrieved from the 2011 Trends in International Mathematics and Science Study assessments. Data analysis was completed through structural equation modelling using a polychoric correlation matrix for data input and diagonally weighted least squares estimation. Adequate fit of the full model to the empirical data was realised. The model demonstrates that the extent the teachers participated in academic collaborations was positively related to their occupational satisfaction, confidence in teaching inquiry, and classroom inquiry practices. Furthermore, the teachers' confidence with implementing inquiry was positively related to their classroom inquiry implementation and occupational satisfaction. However, perceived student-generated constraints demonstrated a negative relationship with the teachers' confidence with implementing inquiry and occupational satisfaction. Implications from this study include supporting teachers through promoting collaborative opportunities that facilitate inquiry-based practices and occupational satisfaction.

Empirically Based Myths: Astrology, Biorhythms, and ATIs.

ERIC Educational Resources Information Center

Ragsdale, Ronald G.

1980-01-01

A myth may have an empirical basis through chance occurrence; perhaps Aptitude Treatment Interactions (ATIs) are in this category. While ATIs have great utility in describing, planning, and implementing instruction, few disordinal interactions have been found. Article suggests narrowing of ATI research with replications and estimates of effect…

Decision blocks: A tool for automating decision making in CLIPS

NASA Technical Reports Server (NTRS)

Eick, Christoph F.; Mehta, Nikhil N.

1991-01-01

The human capability of making complex decision is one of the most fascinating facets of human intelligence, especially if vague, judgemental, default or uncertain knowledge is involved. Unfortunately, most existing rule based forward chaining languages are not very suitable to simulate this aspect of human intelligence, because of their lack of support for approximate reasoning techniques needed for this task, and due to the lack of specific constructs to facilitate the coding of frequently reoccurring decision block to provide better support for the design and implementation of rule based decision support systems. A language called BIRBAL, which is defined on the top of CLIPS, for the specification of decision blocks, is introduced. Empirical experiments involving the comparison of the length of CLIPS program with the corresponding BIRBAL program for three different applications are surveyed. The results of these experiments suggest that for decision making intensive applications, a CLIPS program tends to be about three times longer than the corresponding BIRBAL program.

Organizational Readiness for Change and Opinions toward Treatment Innovations

PubMed Central

Fuller, Bret E.; Rieckmann, Traci; Nunes, Edward V.; Miller, Michael; Arfken, Cynthia; Edmundson, Eldon; McCarty, Dennis

2007-01-01

Program administrators and staff in treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) completed surveys to characterize participating programs and practitioners. A two-level random effects regression model assessed the influence of Organizational Readiness for Change (ORC) and organizational attributes on opinions toward the use of four evidence-based practices (manualized treatments, medication, integrated mental health services, and motivational incentives) and practices with less empirical support (confrontation and noncompliance discharge). The ORC Scales suggested greater support for evidence-based practices in programs where staff perceived more program need for improvement, better Internet access, higher levels of peer influence, more opportunities for professional growth, a stronger sense of organizational mission and more organizational stress. Support for confrontation and noncompliance discharge, in contrast, was strong when staff saw less opportunity for professional growth, weaker peer influence, less Internet access, and perceived less organizational stress. The analysis provides evidence of the ORC’s utility in assessing agency strengths and needs during the implementation of evidence-based practices. PMID:17434708

The Ethical, Legal, and Social Implications Program of the National Human Genome Research Institute: reflections on an ongoing experiment.

PubMed

McEwen, Jean E; Boyer, Joy T; Sun, Kathie Y; Rothenberg, Karen H; Lockhart, Nicole C; Guyer, Mark S

2014-01-01

For more than 20 years, the Ethical, Legal, and Social Implications (ELSI) Program of the National Human Genome Research Institute has supported empirical and conceptual research to anticipate and address the ethical, legal, and social implications of genomics. As a component of the agency that funds much of the underlying science, the program has always been an experiment. The ever-expanding number of issues the program addresses and the relatively low level of commitment on the part of other funding agencies to support such research make setting priorities especially challenging. Program-supported studies have had a significant impact on the conduct of genomics research, the implementation of genomic medicine, and broader public policies. The program's influence is likely to grow as ELSI research, genomics research, and policy development activities become increasingly integrated. Achieving the benefits of increased integration while preserving the autonomy, objectivity, and intellectual independence of ELSI investigators presents ongoing challenges and new opportunities.

Re-evaluation of Yellowstone grizzly bear population dynamics not supported by empirical data: response to Doak & Cutler

USGS Publications Warehouse

van Manen, Frank T.; Ebinger, Michael R.; Haroldson, Mark A.; Harris, Richard B.; Higgs, Megan D.; Cherry, Steve; White, Gary C.; Schwartz, Charles C.

2014-01-01

Doak and Cutler critiqued methods used by the Interagency Grizzly Bear Study Team (IGBST) to estimate grizzly bear population size and trend in the Greater Yellowstone Ecosystem. Here, we focus on the premise, implementation, and interpretation of simulations they used to support their arguments. They argued that population increases documented by IGBST based on females with cubs-of-the-year were an artifact of increased search effort. However, we demonstrate their simulations were neither reflective of the true observation process nor did their results provide statistical support for their conclusion. They further argued that survival and reproductive senescence should be incorporated into population projections, but we demonstrate their choice of extreme mortality risk beyond age 20 and incompatible baseline fecundity led to erroneous conclusions. The conclusions of Doak and Cutler are unsubstantiated when placed within the context of a thorough understanding of the data, study system, and previous research findings and publications.

Greening the work force in Brazilian hotels: the role of environmental training.

PubMed

Dias-Angelo, Fernanda; Jabbour, Charbel J C; Calderaro, José Armando

2014-01-01

Organizations are increasingly required to reduce their environmental impact through the adoption of environmental management, which requires the support of human resource practices. The objective of this study is to determine whether human resource management practices, especially training, are supporting environmental management practices at four hotels located in Brazil. This research is qualitative, based on the analysis of four hotels in Brazil. Based on the systematized empirical evidence collected from four hotels (Hotels A, B, C, and D), it can be concluded that: (1) human resource management is still not fully aligned with environmental objectives at the hotels studied; (2) only Hotel B has implemented environmental management practices and aligned with human resource management in a more developed manner, which may indicate that these two variables of analysis could have interrelations; (3) environmental training as a human resource management practice was verified in all hotels analyzed. The greening of human resources practices is not fully aligned with environmental objectives in the hotels studied. If these hotels really wish to "go green," environmental training will be necessary. Hotel stakeholders play a major role in implementing the greening of the hotel industry.

Stakeholders' views on the routine use of n-of-1 trials to improve clinical care and to make resource allocation decisions for drug use.

PubMed

Nikles, Jane; Mitchell, Geoffrey K; Clavarino, Alexandra; Yelland, Michael J; Del Mar, Christopher B

2010-03-01

N-of-1 trials are empirical formal tests using a within-patient randomised, double-blind, cross-over comparison of drug and placebo (or another drug), which we adapted to study individual patients' responses as a clinical tool to guide clinical management. We administered semi-structured interviews to gauge stakeholder perspectives on the possibility of using routine n-of-1 trials for this purpose. Stakeholders included government and non-government health care sector, and patient, clinician and consumer, organisations. Stakeholders supported more widespread implementation of n-of-1 trials, in a targeted fashion, with some caveats. Barriers to their widespread implementation included constraints on doctors' time, doctors' acceptance, drug company acceptance, patient willingness, and cost. Strategies for overcoming barriers included conditional Pharmaceutical Benefits Scheme listing if cost-effective. There was little consensus on which model of n-of-1 trial implementation would be most effective. We discuss different approaches to addressing the several concerns raised to enable widespread introduction of n-of-1 trials into routine clinical practice as a decision tool.

Validation of the theoretical domains framework for use in behaviour change and implementation research

PubMed Central

2012-01-01

Background An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of clinical situations. This study tests the validity of this framework. Methods Validity was investigated by behavioural experts sorting 112 unique theoretical constructs using closed and open sort tasks. The extent of replication was tested by Discriminant Content Validation and Fuzzy Cluster Analysis. Results There was good support for a refinement of the framework comprising 14 domains of theoretical constructs (average silhouette value 0.29): ‘Knowledge’, ‘Skills’, ‘Social/Professional Role and Identity’, ‘Beliefs about Capabilities’, ‘Optimism’, ‘Beliefs about Consequences’, ‘Reinforcement’, ‘Intentions’, ‘Goals’, ‘Memory, Attention and Decision Processes’, ‘Environmental Context and Resources’, ‘Social Influences’, ‘Emotions’, and ‘Behavioural Regulation’. Conclusions The refined Theoretical Domains Framework has a strengthened empirical base and provides a method for theoretically assessing implementation problems, as well as professional and other health-related behaviours as a basis for intervention development. PMID:22530986

E-learning in engineering education: a theoretical and empirical study of the Algerian higher education institution

NASA Astrophysics Data System (ADS)

Benchicou, Soraya; Aichouni, Mohamed; Nehari, Driss

2010-06-01

Technology-mediated education or e-learning is growing globally both in scale and delivery capacity due to the large diffusion of the ubiquitous information and communication technologies (ICT) in general and the web technologies in particular. This statement has not yet been fully supported by research, especially in developing countries such as Algeria. The purpose of this paper was to identify directions for addressing the needs of academics in higher education institutions in Algeria in order to adopt the e-learning approach as a strategy to improve quality of education. The paper will report results of an empirical study that measures the readiness of the Algerian higher education institutions towards the implementation of ICT in the educational process and the attitudes of faculty members towards the application of the e-learning approach in engineering education. Three main objectives were targeted, namely: (a) to provide an initial evaluation of faculty members' attitudes and perceptions towards web-based education; (b) reporting on their perceived requirements for implementing e-learning in university courses; (c) providing an initial input for a collaborative process of developing an institutional strategy for e-learning. Statistical analysis of the survey results indicates that the Algerian higher education institution, which adopted the Licence - Master and Doctorate educational system, is facing a big challenge to take advantage of emerging technological innovations and the advent of e-learning to further develop its teaching programmes and to enhance the quality of education in engineering fields. The successful implementation of this modern approach is shown to depend largely on a set of critical success factors that would include: 1. The extent to which the institution will adopt a formal and official e-learning strategy. 2. The extent to which faculty members will adhere and adopt this strategy and develop ownership of the various measures in the context of their teaching and research responsibilities. 3. The extent to which the university will offer adequate support in terms of training, software platform administration, online resource development and impact monitoring and assessment.

Information sharing model in supporting implementation of e-procurement service: Case of Bandung city

NASA Astrophysics Data System (ADS)

Ramantoko, Gadang; Irawan, Herry

2017-10-01

This research examines the factors influencing the Information Sharing Model in Supporting Implementation of e-Procurement Services: Case of Bandung City in its early maturity stage. The early maturity of information sharing stage was determined using e-Government Maturity Stage Conceptual Framework from Estevez. Bandung City e-Procurement Information Sharing system was categorized at stage 1 in Estevez' model where the concern was mainly on assessing the benefit and risk of implementing the system. The Authors were using DeLone & McLean (D&M) Information System Success model to study benefit and risk of implementing the system in Bandung city. The model was then empirically tested by employing survey data that was collected from the available 40 listed supplier firms. D&M's model adjusted by Klischewski's description was introducing Information Quality, System Quality, and Service Quality as independent variable; Usability and User Satisfaction as intermediate dependent variable; and Perceived Net Benefit as final dependent variable. The findings suggested that, all of the predictors in D&M's model significantly influenced the net perceived benefit of implementing the e-Procurement system in the early maturity stage. The theoretical contribution of this research suggested that D&M's model might find useful in modeling complex information technology successfulness such as the one used in e-Procurement service. This research could also have implications for policy makers (LPSE) and system providers (LKPP) following the introduction of the service. However, the small number of respondent might be considered limitation of the study. The model needs to be further tested using larger number of respondents by involving the population of the firms in extended boundary/municipality area around Bandung.

Facts and values in psychotherapy-A critique of the empirical reduction of psychotherapy within evidence-based practice.

PubMed

Berg, Henrik; Slaattelid, Rasmus

2017-10-01

This paper addresses an implicit presupposition in research-supported psychological treatments and evidence-based practice in psychology. It argues that the notion of research-supported psychological treatments is based on a reductive conceptualisation of psychotherapy. Research-supported psychological treatments hinge upon an empirical reduction where psychotherapy schools become conceptualized as mere collections of empirical propositions. However, this paper argues that the different psychotherapy schools have distinct ethoses that are constituted by normative claims. Consequently, the evaluation of the different psychotherapy schools and the practice of psychotherapy should include the underlying normative claims of these ethoses. © 2017 John Wiley & Sons, Ltd.

Exploring the nature and impact of leadership on the local implementation of the Productive Ward Releasing Time to Care.

PubMed

Morrow, Elizabeth; Robert, Glenn; Maben, Jill

2014-01-01

The purpose of this paper is to explore the nature and impact of leadership in relation to the local implementation of quality improvement interventions in health care organisations. Using empirical data from two studies of the implementation of The Productive Ward: Releasing Time to Care in English hospitals, the paper explores leadership in relation to local implementation. Data were attained from in-depth interviews with senior managers, middle managers and frontline staff (n = 79) in 13 NHS hospital case study sites. Framework Approach was used to explore staff views and to identify themes about leadership. Four overall themes were identified: different leadership roles at multiple levels of the organisation, experiences of "good and bad" leadership styles, frontline staff having a sense of permission to lead change, leader's actions to spread learning and sustain improvements. This paper offers useful perspectives in understanding informal, emergent, developmental or shared "new" leadership because it emphasises that health care structures, systems and processes influence and shape interactions between the people who work within them. The framework of leadership processes developed could guide implementing organisations to achieve leadership at multiple levels, use appropriate leadership roles, styles and behaviours at different levels and stages of implementation, value and provide support for meaningful staff empowerment, and enable leader's boundary spanning activities to spread learning and sustain improvements.

Guidelines for Implementing NCHRP 1-37A M-E Design Procedures in Ohio : Volume 3 -- Sensitivity Analysis

DOT National Transportation Integrated Search

2009-11-01

The new Mechanistic-Empirical Pavement Design Guide (NCHRP 1-37A and 1-40D) is based on fundamental engineering principles and is far more comprehensive than the current empirical AASHTO Design Guide developed for conditions more than 40 years previo...

The effect of environmental factors on the implementation of the Mechanistic-empirical pavement design guide (MEPDG).

DOT National Transportation Integrated Search

2011-07-01

Current pavement design based on the AASHTO Design Guide uses an empirical approach from the results of the AASHO Road Test conducted in 1958. To address some of the limitations of the original design guide, AASHTO developed a new guide: Mechanistic ...

Integration of least angle regression with empirical Bayes for multi-locus genome-wide association studies

USDA-ARS?s Scientific Manuscript database

Multi-locus genome-wide association studies has become the state-of-the-art procedure to identify quantitative trait loci (QTL) associated with traits simultaneously. However, implementation of multi-locus model is still difficult. In this study, we integrated least angle regression with empirical B...

A cross-national comparison of incident reporting systems implemented in German and Swiss hospitals.

PubMed

Manser, Tanja; Imhof, Michael; Lessing, Constanze; Briner, Matthias

2017-06-01

This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM). We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices. The survey was originally sent to 2136 hospitals in Germany and Switzerland. Persons responsible for CRM in 622 hospitals completed the survey (response rate 29%). None. Differences between IRS in German and Swiss hospitals were assessed using Chi2, Fisher's Exact and Freeman-Halton-Tests, as appropriate. To explore interrelations between IRS characteristics and context factors (i.e. hospital and CRM characteristics) we computed Cramer's V. Comparing participating hospitals across countries, Swiss hospitals had implemented IRS earlier, more frequently and more often provided introductory IRS training systematically. German hospitals had more frequently systematically implemented standardized procedures for event analyses. IRS characteristics were significantly associated with hospital characteristics such as hospital type as well as with CRM characteristics such as existence of strategic CRM objectives and of a dedicated position for central CRM coordination. This study contributes to an improved understanding of differences in the way IRS are set up in two European countries and explores related context factors. This opens up new possibilities for empirically informed, strategic interventions to further improve dissemination of IRS and thus support hospitals in their efforts to move patient safety forward. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The Empirically Supported Status of Acceptance and Commitment Therapy: An Update

ERIC Educational Resources Information Center

Smout, Matthew F.; Hayes, Louise; Atkins, Paul W. B.; Klausen, Jessica; Duguid, James E.

2012-01-01

Acceptance and commitment therapy (ACT) is a transdiagnostic cognitive behavioural therapy that predominantly teaches clients acceptance and mindfulness skills, as well as values clarification and enactment skills. Australian treatment guideline providers have been cautious in recognising ACT as empirically supported. This article reviews evidence…

Comparison of Traditional and Trial-Based Methodologies for Conducting Functional Analyses

ERIC Educational Resources Information Center

LaRue, Robert H.; Lenard, Karen; Weiss, Mary Jane; Bamond, Meredith; Palmieri, Mark; Kelley, Michael E.

2010-01-01

Functional analysis represents a sophisticated and empirically supported functional assessment procedure. While these procedures have garnered considerable empirical support, they are often underused in clinical practice. Safety risks resulting from the evocation of maladaptive behavior and the length of time required to conduct functional…

Improving Education in Medical Statistics: Implementing a Blended Learning Model in the Existing Curriculum

PubMed Central

Milic, Natasa M.; Trajkovic, Goran Z.; Bukumiric, Zoran M.; Cirkovic, Andja; Nikolic, Ivan M.; Milin, Jelena S.; Milic, Nikola V.; Savic, Marko D.; Corac, Aleksandar M.; Marinkovic, Jelena M.; Stanisavljevic, Dejana M.

2016-01-01

Background Although recent studies report on the benefits of blended learning in improving medical student education, there is still no empirical evidence on the relative effectiveness of blended over traditional learning approaches in medical statistics. We implemented blended along with on-site (i.e. face-to-face) learning to further assess the potential value of web-based learning in medical statistics. Methods This was a prospective study conducted with third year medical undergraduate students attending the Faculty of Medicine, University of Belgrade, who passed (440 of 545) the final exam of the obligatory introductory statistics course during 2013–14. Student statistics achievements were stratified based on the two methods of education delivery: blended learning and on-site learning. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course. Results Mean exam scores for the blended learning student group were higher than for the on-site student group for both final statistics score (89.36±6.60 vs. 86.06±8.48; p = 0.001) and knowledge test score (7.88±1.30 vs. 7.51±1.36; p = 0.023) with a medium effect size. There were no differences in sex or study duration between the groups. Current grade point average (GPA) was higher in the blended group. In a multivariable regression model, current GPA and knowledge test scores were associated with the final statistics score after adjusting for study duration and learning modality (p<0.001). Conclusion This study provides empirical evidence to support educator decisions to implement different learning environments for teaching medical statistics to undergraduate medical students. Blended and on-site training formats led to similar knowledge acquisition; however, students with higher GPA preferred the technology assisted learning format. Implementation of blended learning approaches can be considered an attractive, cost-effective, and efficient alternative to traditional classroom training in medical statistics. PMID:26859832

Improving Education in Medical Statistics: Implementing a Blended Learning Model in the Existing Curriculum.

PubMed

Milic, Natasa M; Trajkovic, Goran Z; Bukumiric, Zoran M; Cirkovic, Andja; Nikolic, Ivan M; Milin, Jelena S; Milic, Nikola V; Savic, Marko D; Corac, Aleksandar M; Marinkovic, Jelena M; Stanisavljevic, Dejana M

2016-01-01

Although recent studies report on the benefits of blended learning in improving medical student education, there is still no empirical evidence on the relative effectiveness of blended over traditional learning approaches in medical statistics. We implemented blended along with on-site (i.e. face-to-face) learning to further assess the potential value of web-based learning in medical statistics. This was a prospective study conducted with third year medical undergraduate students attending the Faculty of Medicine, University of Belgrade, who passed (440 of 545) the final exam of the obligatory introductory statistics course during 2013-14. Student statistics achievements were stratified based on the two methods of education delivery: blended learning and on-site learning. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course. Mean exam scores for the blended learning student group were higher than for the on-site student group for both final statistics score (89.36±6.60 vs. 86.06±8.48; p = 0.001) and knowledge test score (7.88±1.30 vs. 7.51±1.36; p = 0.023) with a medium effect size. There were no differences in sex or study duration between the groups. Current grade point average (GPA) was higher in the blended group. In a multivariable regression model, current GPA and knowledge test scores were associated with the final statistics score after adjusting for study duration and learning modality (p<0.001). This study provides empirical evidence to support educator decisions to implement different learning environments for teaching medical statistics to undergraduate medical students. Blended and on-site training formats led to similar knowledge acquisition; however, students with higher GPA preferred the technology assisted learning format. Implementation of blended learning approaches can be considered an attractive, cost-effective, and efficient alternative to traditional classroom training in medical statistics.

Sustaining Fidelity Following the Nationwide PMTO™ Implementation in Norway

PubMed Central

Forgatch, Marion S.; DeGarmo, David S.

2011-01-01

This report describes three studies from the nationwide Norwegian implementation of Parent Management Training – Oregon Model (PMTO™), an empirically supported treatment for families of children with behavior problems (Forgatch and Patterson 2010). Separate stages of the implementation were evaluated using a fidelity measure based on direct observation of intervention sessions. Study 1 assessed growth in fidelity observed early, mid, and late in the training of a group of practitioners. We hypothesized increased fidelity and decreased variability in practice. Study 2 evaluated method fidelity over the course of three generations of practitioners trained in PMTO. Generation 1 (G1) was trained by the PMTO developer/purveyors; Generation 2 (G2) was trained by selected G1 Norwegian trainers; and Generation 3 (G3) was trained by G1 and G2 trainers. We hypothesized decrease in fidelity with each generation. Study 3 tested the predictive validity of fidelity in a cross-cultural replication, hypothesizing that higher fidelity scores would correlate with improved parenting practices observed in parent-child interactions before and after treatment. In Study 1, trainees' performance improved and became more homogeneous as predicted. In Study 2, a small decline in fidelity followed the transfer from the purveyor trainers to Norwegian trainers in G2, but G3 scores were equivalent to those attained by G1. Thus, the hypothesis was not fully supported. Finally, the FIMP validity model replicated; PMTO fidelity significantly contributed to improvements in parenting practices from pre- to post-treatment. The data indicate that PMTO was transferred successfully to Norwegian implementation with sustained fidelity and cross-cultural generalization. PMID:21671090

Neural Correlates of Intentional Communication

PubMed Central

Noordzij, Matthijs L.; Newman-Norlund, Sarah E.; de Ruiter, Jan Peter; Hagoort, Peter; Levinson, Stephen C.; Toni, Ivan

2010-01-01

We know a great deal about the neurophysiological mechanisms supporting instrumental actions, i.e., actions designed to alter the physical state of the environment. In contrast, little is known about our ability to select communicative actions, i.e., actions directly designed to modify the mental state of another agent. We have recently provided novel empirical evidence for a mechanism in which a communicator selects his actions on the basis of a prediction of the communicative intentions that an addressee is most likely to attribute to those actions. The main novelty of those findings was that this prediction of intention recognition is cerebrally implemented within the intention recognition system of the communicator, is modulated by the ambiguity in meaning of the communicative acts, and not by their sensorimotor complexity. The characteristics of this predictive mechanism support the notion that human communicative abilities are distinct from both sensorimotor and linguistic processes. PMID:21151781

How stakeholder participation can contribute to systematic reviews of complex interventions

PubMed Central

Harris, J; Croot, L; Thompson, J; Springett, J

2016-01-01

Although patient and public involvement in research is a requirement for research funding in many countries, the knowledge base for how to effectively involve people—and evidence of the effectiveness of involvement—is weak. This article describes how methods used in participatory health research were used to involve patients, clients, providers and community health workers across all stages of a realist review. Sustained involvement enabled better identification of the components of the complex intervention of community-based peer support. It also challenged assumptions of how peer support is constructed, leading the review team to question whether the process of designing and implementing interventions has more influence on effectiveness than previously recognised in empirical studies. We conclude with a discussion on when sustained involvement should be used, and the challenges of incorporating it into the traditional researcher-led approach to systematic reviews. PMID:26475921

Inadequate Evidence for Multiple Intelligences, Mozart Effect, and Emotional Intelligence Theories

ERIC Educational Resources Information Center

Waterhouse, Lynn

2006-01-01

I (Waterhouse, 2006) argued that, because multiple intelligences, the Mozart effect, and emotional intelligence theories have inadequate empirical support and are not consistent with cognitive neuroscience findings, these theories should not be applied in education. Proponents countered that their theories had sufficient empirical support, were…

Perceived Social Support and Subjective States in Urban Adolescent Girls.

ERIC Educational Resources Information Center

Procidano, Mary E.; And Others

While prospective investigations of social support, coping, and stress are accumulating, there is relatively little empirical knowledge regarding how these variables are related to each other among adolescents, and virtually no empirical knowledge regarding their relationship to subjective states in that population. This study examined the…

Familiarizing Students with the Empirically Supported Treatment Approaches for Psychophysiological Disorders and Chronic Pain.

ERIC Educational Resources Information Center

Wilkins, Victoria; Chambliss, Catherine

In training counseling students, it is increasingly important to acquaint them with the clinical research literature exploring the efficacy of particular treatments. This review of empirically supported treatments (EST's) concerning psychophysiological disorders and chronic pain is intended to facilitate the educational process. EST's, or…

Description of an Intensive Dialectical Behavior Therapy Program for Multidiagnostic Clients with Eating Disorders

ERIC Educational Resources Information Center

Federici, Anita; Wisniewski, Lucene; Ben-Porath, Denise

2012-01-01

The authors describe an intensive outpatient dialectical behavior therapy (DBT) program for multidiagnostic clients with eating disorders who had not responded adequately to standard, empirically supported treatments for eating disorders. The program integrates DBT with empirically supported cognitive behavior therapy approaches that are well…

Using Mental Health Consultation to Decrease Disruptive Behaviors in Preschoolers: Adapting an Empirically-Supported Intervention

ERIC Educational Resources Information Center

Williford, Amanda P.; Shelton, Terri L.

2008-01-01

Background: This study examined the effectiveness of an adaptation of an empirically-supported intervention delivered using mental health consultation to preschoolers who displayed elevated disruptive behaviors. Method: Ninety-six preschoolers, their teachers, and their primary caregivers participated. Children in the intervention group received…

Identifying Empirically Supported Treatments for Phobic Avoidance in Individuals with Intellectual Disabilities

ERIC Educational Resources Information Center

Jennett, Heather K.; Hagopian, Louis P.

2008-01-01

This paper reviews the literature regarding the treatment of phobic avoidance in individuals with intellectual disabilities. Criteria for classifying interventions as empirically supported, developed by the American Psychological Association (APA) Division 12 Task Force on Promotion and Dissemination of Psychological Procedures, were used. For…

Modelling public support for wildland fire policy

Treesearch

J.D. Absher; J.J. Vaske

2007-01-01

Theoretically grounded explanations of wildland fire policy can be improved by empirically documenting the causal influences of support for (or opposition to) management alternatives. This chapter proposes a model based on the specificity principle (i.e. correspondence between measured variables to empirically examine four common wildland fire policies in relation to...

A Survey of Graduate Training in Empirically Supported and Manualized Treatments: A Preliminary Report

ERIC Educational Resources Information Center

Karekla, Maria; Lundgren, Jennifer D.; Forsyth, John P.

2004-01-01

The promotion and dissemination of empirically supported (ESTs) and manualized therapies are important, albeit controversial, developments within clinical science and practice. To date, studies evaluating training opportunities and attitudes about such treatments at the graduate, predoctoral internship, and postdoctoral levels have focused on the…

Attachment-based family therapy for depressed and suicidal adolescents: theory, clinical model and empirical support.

PubMed

Ewing, E Stephanie Krauthamer; Diamond, Guy; Levy, Suzanne

2015-01-01

Attachment-Based Family Therapy (ABFT) is a manualized family-based intervention designed for working with depressed adolescents, including those at risk for suicide, and their families. It is an empirically informed and supported treatment. ABFT has its theoretical underpinnings in attachment theory and clinical roots in structural family therapy and emotion focused therapies. ABFT relies on a transactional model that aims to transform the quality of adolescent-parent attachment, as a means of providing the adolescent with a more secure relationship that can support them during challenging times generally, and the crises related to suicidal thinking and behavior, specifically. This article reviews: (1) the theoretical foundations of ABFT (attachment theory, models of emotional development); (2) the ABFT clinical model, including training and supervision factors; and (3) empirical support.

Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England.

PubMed

Ovseiko, Pavel V; O'Sullivan, Catherine; Powell, Susan C; Davies, Stephen M; Buchan, Alastair M

2014-11-08

Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N = 17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the central mandate by HIEC leaders to serve their local needs. These findings augur well for Academic Health Science Networks, which pick up the mantle of large-scale, cross-sector collaborations for health and innovation. This study also highlights that a supportive policy environment and sufficient time would be crucial to the successful implementation of new cross-sector health collaborations.

A scoping study to identify opportunities to advance the ethical implementation and scale-up of HIV treatment as prevention: priorities for empirical research.

PubMed

Knight, Rod; Small, Will; Pakula, Basia; Thomson, Kimberly; Shoveller, Jean

2014-07-03

Despite the evidence showing the promise of HIV treatment as prevention (TasP) in reducing HIV incidence, a variety of ethical questions surrounding the implementation and "scaling up" of TasP have been articulated by a variety of stakeholders including scientists, community activists and government officials. Given the high profile and potential promise of TasP in combatting the global HIV epidemic, an explicit and transparent research priority-setting process is critical to inform ongoing ethical discussions pertaining to TasP. We drew on the Arksey and O'Malley framework for conducting scoping review studies as well as systematic approaches to identifying empirical and theoretical gaps within ethical discussions pertaining to population-level intervention implementation and scale up. We searched the health science database PubMed to identify relevant peer-reviewed articles on ethical and implementation issues pertaining to TasP. We included English language articles that were published after 2009 (i.e., after the emergence of causal evidence within this field) by using search terms related to TasP. Given the tendency for much of the criticism and support of TasP to occur outside the peer-reviewed literature, we also included grey literature in order to provide a more exhaustive representation of how the ethical discussions pertaining to TasP have and are currently taking place. To identify the grey literature, we systematically searched a set of search engines, databases, and related webpages for keywords pertaining to TasP. Three dominant themes emerged in our analysis with respect to the ethical questions pertaining to TasP implementation and scale-up: (a) balancing individual- and population-level interests; (b) power relations within clinical practice and competing resource demands within health care systems; (c) effectiveness considerations and socio-structural contexts of HIV treatment experiences within broader implementation contexts. Ongoing research and normative deliberation is required in order to successfully and ethically scale-up TasP within the continuum of HIV care models. Based on the results of this scoping review, we identify several ethical and implementation dimensions that hold promise for informing the process of scaling up TasP and that could benefit from new research.

A scoping study to identify opportunities to advance the ethical implementation and scale-up of HIV treatment as prevention: priorities for empirical research

PubMed Central

2014-01-01

Background Despite the evidence showing the promise of HIV treatment as prevention (TasP) in reducing HIV incidence, a variety of ethical questions surrounding the implementation and “scaling up” of TasP have been articulated by a variety of stakeholders including scientists, community activists and government officials. Given the high profile and potential promise of TasP in combatting the global HIV epidemic, an explicit and transparent research priority-setting process is critical to inform ongoing ethical discussions pertaining to TasP. Methods We drew on the Arksey and O’Malley framework for conducting scoping review studies as well as systematic approaches to identifying empirical and theoretical gaps within ethical discussions pertaining to population-level intervention implementation and scale up. We searched the health science database PubMed to identify relevant peer-reviewed articles on ethical and implementation issues pertaining to TasP. We included English language articles that were published after 2009 (i.e., after the emergence of causal evidence within this field) by using search terms related to TasP. Given the tendency for much of the criticism and support of TasP to occur outside the peer-reviewed literature, we also included grey literature in order to provide a more exhaustive representation of how the ethical discussions pertaining to TasP have and are currently taking place. To identify the grey literature, we systematically searched a set of search engines, databases, and related webpages for keywords pertaining to TasP. Results Three dominant themes emerged in our analysis with respect to the ethical questions pertaining to TasP implementation and scale-up: (a) balancing individual- and population-level interests; (b) power relations within clinical practice and competing resource demands within health care systems; (c) effectiveness considerations and socio-structural contexts of HIV treatment experiences within broader implementation contexts. Conclusion Ongoing research and normative deliberation is required in order to successfully and ethically scale-up TasP within the continuum of HIV care models. Based on the results of this scoping review, we identify several ethical and implementation dimensions that hold promise for informing the process of scaling up TasP and that could benefit from new research. PMID:24994501

Testing the Relation between Fidelity of Implementation and Student Outcomes in Math

ERIC Educational Resources Information Center

Crawford, Lindy; Carpenter, Dick M., II; Wilson, Mary T.; Schmeister, Megan; McDonald, Marilee

2012-01-01

The relation between fidelity of implementation and student outcomes in a computer-based middle school mathematics curriculum was measured empirically. Participants included 485 students and 23 teachers from 11 public middle schools across seven states. Implementation fidelity was defined using two constructs: fidelity to structure and fidelity to…

Cognitive-Behavioral Couple Therapies: Review of the Evidence for the Treatment of Relationship Distress, Psychopathology, and Chronic Health Conditions.

PubMed

Fischer, Melanie S; Baucom, Donald H; Cohen, Matthew J

2016-09-01

Cognitive-behavioral couple therapy (CBCT) is an approach to assisting couples that has strong empirical support for alleviating relationship distress. This paper provides a review of the empirical status of CBCT along with behavioral couple therapy (BCT), as well as the evidence for recent applications of CBCT principles to couple-based interventions for individual psychopathology and medical conditions. Several meta-analyses and major reviews have confirmed the efficacy of BCT and CBCT across trials in the United States, Europe, and Australia, and there is little evidence to support differential effectiveness of various forms of couple therapy derived from behavioral principles. A much smaller number of effectiveness studies have shown that successful implementation in community settings is possible, although effect sizes tend to be somewhat lower than those evidenced in randomized controlled trials. Adapted for individual problems, cognitive-behavioral couple-based interventions appear to be at least as effective as individual cognitive behavioral therapy (CBT) across a variety of psychological disorders, and often more effective, especially when partners are substantially involved in treatment. In addition, couple-based interventions tend to have the unique added benefit of improving relationship functioning. Findings on couple-based interventions for medical conditions are more varied and more complex to interpret given the greater range of target outcomes (psychological, relational, and medical variables). © 2016 Family Process Institute.

The science experience: The relationship between an inquiry-based science program and student outcomes

NASA Astrophysics Data System (ADS)

Poderoso, Charie

Science education reforms in U.S. schools emphasize the importance of students' construction of knowledge through inquiry. Organizations such as the National Science Foundation (NSF), the National Research Council (NRC), and the American Association for the Advancement of Science (AAAS) have demonstrated a commitment to searching for solutions and renewed efforts to improve science education. One suggestion for science education reform in U.S. schools was a transition from traditional didactic, textbook-based to inquiry-based instructional programs. While inquiry has shown evidence for improved student learning in science, what is needed is empirical evidence of those inquiry-based practices that affect student outcomes in a local context. This study explores the relationship between instructional programs and curricular changes affecting student outcomes in the Santa Ana Unified District (SAUSD): It provides evidence related to achievement and attitudes. SAUSD employs two approaches to teaching in the middle school science classrooms: traditional and inquiry-based approaches. The Leadership and Assistance for Science Education Reform (LASER) program is an inquiry-based science program that utilizes resources for implementation of the University of California Berkeley's Lawrence Hall of Science Education for Public Understanding Program (SEPUP) to support inquiry-based teaching and learning. Findings in this study provide empirical support related to outcomes of seventh-grade students, N = 328, in the LASER and traditional science programs in SAUSD.

Landscape genetics for the empirical assessment of resistance surfaces: the European pine marten (Martes martes) as a target-species of a regional ecological network.

PubMed

Ruiz-González, Aritz; Gurrutxaga, Mikel; Cushman, Samuel A; Madeira, María José; Randi, Ettore; Gómez-Moliner, Benjamin J

2014-01-01

Coherent ecological networks (EN) composed of core areas linked by ecological corridors are being developed worldwide with the goal of promoting landscape connectivity and biodiversity conservation. However, empirical assessment of the performance of EN designs is critical to evaluate the utility of these networks to mitigate effects of habitat loss and fragmentation. Landscape genetics provides a particularly valuable framework to address the question of functional connectivity by providing a direct means to investigate the effects of landscape structure on gene flow. The goals of this study are (1) to evaluate the landscape features that drive gene flow of an EN target species (European pine marten), and (2) evaluate the optimality of a regional EN design in providing connectivity for this species within the Basque Country (North Spain). Using partial Mantel tests in a reciprocal causal modeling framework we competed 59 alternative models, including isolation by distance and the regional EN. Our analysis indicated that the regional EN was among the most supported resistance models for the pine marten, but was not the best supported model. Gene flow of pine marten in northern Spain is facilitated by natural vegetation, and is resisted by anthropogenic landcover types and roads. Our results suggest that the regional EN design being implemented in the Basque Country will effectively facilitate gene flow of forest dwelling species at regional scale.

Preventing behavioural and emotional problems in children who have a developmental disability: a public health approach.

PubMed

Mazzucchelli, Trevor G; Sanders, Matthew R

2011-01-01

Children with developmental disabilities are at substantially greater risk of developing emotional and behavioural problems compared to their typically developing peers. While the quality of parenting that children receive has a major effect on their development, empirically supported parenting programs reach relatively few parents. A recent trend in parenting intervention research has been the adoption of a public health approach to improve the quality of parenting at a population level. This has involved delivering parenting interventions on a large scale and in a cost-effective manner. Such trials have been demonstrated to reduce negative parenting practices, prevent child maltreatment, and reduce child behavioural and emotional problems. However, these trials have been restricted to parents of children who are developing typically. This paper explores the rational for the extension of a population health approach to parenting interventions for children with developmental disabilities. It is argued that a population-based implementation and evaluation trial of an empirically supported system of interventions is needed to determine whether this approach is viable and can have a positive impact on parents and their children in a disability context. The Stepping Stones Triple P--Positive Parenting Program is presented as an example of a parenting intervention that satisfies the requirements for such a trial. Tasks and challenges of such a trial are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

The "Creative Right Brain" Revisited: Individual Creativity and Associative Priming in the Right Hemisphere Relate to Hemispheric Asymmetries in Reward Brain Function.

PubMed

Aberg, Kristoffer Carl; Doell, Kimberly C; Schwartz, Sophie

2017-10-01

The idea that creativity resides in the right cerebral hemisphere is persistent in popular science, but has been widely frowned upon by the scientific community due to little empirical support. Yet, creativity is believed to rely on the ability to combine remote concepts into novel and useful ideas, an ability which would depend on associative processing in the right hemisphere. Moreover, associative processing is modulated by dopamine, and asymmetries in dopamine functionality between hemispheres may imbalance the expression of their implemented cognitive functions. Here, by uniting these largely disconnected concepts, we hypothesize that relatively less dopamine function in the right hemisphere boosts creativity by releasing constraining effects of dopamine on remote associations. Indeed, participants with reduced neural responses in the dopaminergic system of the right hemisphere (estimated by functional MRI in a reward task with positive and negative feedback), displayed higher creativity (estimated by convergent and divergent tasks), and increased associative processing in the right hemisphere (estimated by a lateralized lexical decision task). Our findings offer unprecedented empirical support for a crucial and specific contribution of the right hemisphere to creativity. More importantly our study provides a comprehensive view on potential determinants of human creativity, namely dopamine-related activity and associative processing. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Evidence-based treatment of attention deficit/hyperactivity disorder in a preschool-age child: a case study.

PubMed

Verduin, Timothy L; Abikoff, Howard; Kurtz, Steven M S

2008-04-01

This case study illustrates a behavioral treatment of "Peter," a 4-year-old male with attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder. Multiple evidence-based treatment procedures were implemented, affording the opportunity to explore issues common to the clinical application of empirically supported interventions. Among the strategies utilized were behavioral parent training, school consultation and behavioral training of educators, school-based contingency management, and a behavioral daily report card. Numerous issues are discussed, including the limited evidence regarding interventions for preschool-age children with ADHD, factors influencing treatment planning and sequencing, collaboration with schools and parents, and evidence-based assessment of treatment gains.

How can the impact of PACS on inpatient length of hospital stay be established?

NASA Astrophysics Data System (ADS)

Bryan, Stirling; Muris, Nicole; Keen, Justin; Weatherburn, Gwyneth C.; Buxton, Martin J.

1994-05-01

Many have argued that the introduction of a large-scale PACS system into a hospital will bring about reductions in the length of inpatient hospital stays. There is currently no convicting empirical evidence to support such claims. As part of the independent evaluation exercise being undertaken alongside the Hammersmith Hospital PACS implementation, an assessment is being made of the impact of PACS on length of stay for selected patient groups. This paper reports the general research methods being employed to undertake this assessment and provides some baseline results from the analysis of total hip replacement patients and total knee replacement patients treated prior to the introduction of PACS.

Education for sustainability and environmental education in National Geoparks. EarthCaching - a new method?

NASA Astrophysics Data System (ADS)

Zecha, Stefanie; Regelous, Anette

2017-04-01

National Geoparks are restricted areas incorporating educational resources of great importance in promoting education for sustainable development, mobilizing knowledge inherent to the EarthSciences. Different methods can be used to implement the education of sustainability. Here we present possibilities for National Geoparks to support sustainability focusing on new media and EarthCaches based on the data set of the "EarthCachers International EarthCaching" conference in Goslar in October 2015. Using an empirical study designed by ourselves we collected actual information about the environmental consciousness of Earthcachers. The data set was analyzed using SPSS and statistical methods. Here we present the results and their consequences for National Geoparks.

Ottawa Model of Implementation Leadership and Implementation Leadership Scale: mapping concepts for developing and evaluating theory-based leadership interventions.

PubMed

Gifford, Wendy; Graham, Ian D; Ehrhart, Mark G; Davies, Barbara L; Aarons, Gregory A

2017-01-01

Leadership in health care is instrumental to creating a supportive organizational environment and positive staff attitudes for implementing evidence-based practices to improve patient care and outcomes. The purpose of this study is to demonstrate the alignment of the Ottawa Model of Implementation Leadership (O-MILe), a theoretical model for developing implementation leadership, with the Implementation Leadership Scale (ILS), an empirically validated tool for measuring implementation leadership. A secondary objective is to describe the methodological process for aligning concepts of a theoretical model with an independently established measurement tool for evaluating theory-based interventions. Modified template analysis was conducted to deductively map items of the ILS onto concepts of the O-MILe. An iterative process was used in which the model and scale developers (n=5) appraised the relevance, conceptual clarity, and fit of each ILS items with the O-MILe concepts through individual feedback and group discussions until consensus was reached. All 12 items of the ILS correspond to at least one O-MILe concept, demonstrating compatibility of the ILS as a measurement tool for the O-MILe theoretical constructs. The O-MILe provides a theoretical basis for developing implementation leadership, and the ILS is a compatible tool for measuring leadership based on the O-MILe. Used together, the O-MILe and ILS provide an evidence- and theory-based approach for developing and measuring leadership for implementing evidence-based practices in health care. Template analysis offers a convenient approach for determining the compatibility of independently developed evaluation tools to test theoretical models.

Ottawa Model of Implementation Leadership and Implementation Leadership Scale: mapping concepts for developing and evaluating theory-based leadership interventions

PubMed Central

Gifford, Wendy; Graham, Ian D; Ehrhart, Mark G; Davies, Barbara L; Aarons, Gregory A

2017-01-01

Purpose Leadership in health care is instrumental to creating a supportive organizational environment and positive staff attitudes for implementing evidence-based practices to improve patient care and outcomes. The purpose of this study is to demonstrate the alignment of the Ottawa Model of Implementation Leadership (O-MILe), a theoretical model for developing implementation leadership, with the Implementation Leadership Scale (ILS), an empirically validated tool for measuring implementation leadership. A secondary objective is to describe the methodological process for aligning concepts of a theoretical model with an independently established measurement tool for evaluating theory-based interventions. Methods Modified template analysis was conducted to deductively map items of the ILS onto concepts of the O-MILe. An iterative process was used in which the model and scale developers (n=5) appraised the relevance, conceptual clarity, and fit of each ILS items with the O-MILe concepts through individual feedback and group discussions until consensus was reached. Results All 12 items of the ILS correspond to at least one O-MILe concept, demonstrating compatibility of the ILS as a measurement tool for the O-MILe theoretical constructs. Conclusion The O-MILe provides a theoretical basis for developing implementation leadership, and the ILS is a compatible tool for measuring leadership based on the O-MILe. Used together, the O-MILe and ILS provide an evidence- and theory-based approach for developing and measuring leadership for implementing evidence-based practices in health care. Template analysis offers a convenient approach for determining the compatibility of independently developed evaluation tools to test theoretical models. PMID:29355212

Psychiatric Advance Directives and Social Workers: An Integrative Review

PubMed Central

Van Dorn, Richard A.; Scheyett, Anna; Swanson, Jeffrey W.; Swartz, Marvin S.

2013-01-01

Psychiatric Advance Directives (PADs) are legal documents that allow individuals to express their wishes for future psychiatric care and to authorize a legally appointed proxy to make decisions on their behalf during incapacitating crises. PADs are viewed as an alternative to the coercive interventions that sometimes accompany mental health crises for persons with mental illness. Insofar as coercive interventions can abridge clients’ autonomy and self-determination -- values supported by the Profession’s Code of Ethics -- social workers have a vested interest in finding ways to reduce coercion and increase autonomy and self-determination in their practice. However, PADs are also viewed as having the potential to positively affect a variety of other clinical outcomes, including but not limited to treatment engagement, treatment satisfaction, and working alliance. This article reviews the clinical and legal history of PADs and empirical evidence for their implementation and effectiveness. Despite what should be an inherent interest in PADs, and the fact that laws authorizing PADs have proliferated in the past decade, there is little theoretical or empirical research in the social work literature. PMID:20408357

Complex contagion process in spreading of online innovation

PubMed Central

Karsai, Márton; Iñiguez, Gerardo; Kaski, Kimmo; Kertész, János

2014-01-01

Diffusion of innovation can be interpreted as a social spreading phenomenon governed by the impact of media and social interactions. Although these mechanisms have been identified by quantitative theories, their role and relative importance are not entirely understood, as empirical verification has so far been hindered by the lack of appropriate data. Here we analyse a dataset recording the spreading dynamics of the world's largest Voice over Internet Protocol service to empirically support the assumptions behind models of social contagion. We show that the rate of spontaneous service adoption is constant, the probability of adoption via social influence is linearly proportional to the fraction of adopting neighbours, and the rate of service termination is time-invariant and independent of the behaviour of peers. By implementing the detected diffusion mechanisms into a dynamical agent-based model, we are able to emulate the adoption dynamics of the service in several countries worldwide. This approach enables us to make medium-term predictions of service adoption and disclose dependencies between the dynamics of innovation spreading and the socio-economic development of a country. PMID:25339685

Reproducible Computing: a new Technology for Statistics Education and Educational Research

NASA Astrophysics Data System (ADS)

Wessa, Patrick

2009-05-01

This paper explains how the R Framework (http://www.wessa.net) and a newly developed Compendium Platform (http://www.freestatistics.org) allow us to create, use, and maintain documents that contain empirical research results which can be recomputed and reused in derived work. It is illustrated that this technological innovation can be used to create educational applications that can be shown to support effective learning of statistics and associated analytical skills. It is explained how a Compendium can be created by anyone, without the need to understand the technicalities of scientific word processing (L style="font-variant: small-caps">ATEX) or statistical computing (R code). The proposed Reproducible Computing system allows educational researchers to objectively measure key aspects of the actual learning process based on individual and constructivist activities such as: peer review, collaboration in research, computational experimentation, etc. The system was implemented and tested in three statistics courses in which the use of Compendia was used to create an interactive e-learning environment that simulated the real-world process of empirical scientific research.

Augmented reality in medical education?

PubMed

Kamphuis, Carolien; Barsom, Esther; Schijven, Marlies; Christoph, Noor

2014-09-01

Learning in the medical domain is to a large extent workplace learning and involves mastery of complex skills that require performance up to professional standards in the work environment. Since training in this real-life context is not always possible for reasons of safety, costs, or didactics, alternative ways are needed to achieve clinical excellence. Educational technology and more specifically augmented reality (AR) has the potential to offer a highly realistic situated learning experience supportive of complex medical learning and transfer. AR is a technology that adds virtual content to the physical real world, thereby augmenting the perception of reality. Three examples of dedicated AR learning environments for the medical domain are described. Five types of research questions are identified that may guide empirical research into the effects of these learning environments. Up to now, empirical research mainly appears to focus on the development, usability and initial implementation of AR for learning. Limited review results reflect the motivational value of AR, its potential for training psychomotor skills and the capacity to visualize the invisible, possibly leading to enhanced conceptual understanding of complex causality.

Improving the Standards-Based Management-Recognition initiative to provide high-quality, equitable maternal health services in Malawi: an implementation research protocol.

PubMed

Mumtaz, Zubia; Salway, Sarah; Nyagero, Josephat; Osur, Joachim; Chirwa, Ellen; Kachale, Fannie; Saunders, Duncan

2016-01-01

The Government of Malawi is seeking evidence to improve implementation of its flagship quality of care improvement initiative-the Standards Based Management-Recognition for Reproductive Health (SBM-R(RH)). This implementation study will assess the quality of maternal healthcare in facilities where the SBM-R(RH) initiative has been employed, identify factors that support or undermine effectiveness of the initiative and develop strategies to further enhance its operation. Data will be collected in 4 interlinked modules using quantitative and qualitative research methods. Module 1 will develop the programme theory underlying the SBM-R(RH) initiative, using document review and in-depth interviews with policymakers and programme managers. Module 2 will quantitatively assess the quality and equity of maternal healthcare provided in facilities where the SBM-R(RH) initiative has been implemented, using the Malawi Integrated Performance Standards for Reproductive Health. Module 3 will conduct an organisational ethnography to explore the structures and processes through which SBM-R(RH) is currently operationalised. Barriers and facilitators will be identified. Module 4 will involve coordinated co-production of knowledge by researchers, policymakers and the public, to identify and test strategies to improve implementation of the initiative. The research outcomes will provide empirical evidence of strategies that will enhance the facilitators and address the barriers to effective implementation of the initiative. It will also contribute to the theoretical advances in the emerging science of implementation research.

How Should Remote Clinical Monitoring Be Used to Treat Alcohol Use Disorders?: Initial Findings From an Expert Round Table Discussion.

PubMed

Gordon, Alan; Jaffe, Adi; McLellan, A Thomas; Richardson, Gary; Skipper, Gregory; Sucher, Michel; Tirado, Carlos F; Urschel, Harold C

Scientific evidence combined with new health insurance coverage now enable a chronic illness management approach to the treatment of alcohol use disorders (AUDs), including regular monitoring of blood alcohol content (BAC), as a useful indicator of disease control. Recent technical advances now permit many different types of remote, real-time monitoring of BAC. However, there is no body of research to empirically guide clinicians in how to maximize the clinical potential of remote BAC monitoring.As an initial step in guiding and supporting such research, the manufacturer of one remote BAC monitoring system sponsored a group of experienced clinicians and clinical researchers to discuss 8 issues that generally affect remote, clinical BAC monitoring of "adults in outpatient AUD treatment."The expert panel unanimously agreed that remote BAC monitoring for at least 12 months during and after the outpatient treatment of AUD was a clinically viable deterrent to relapse. There was also consensus that positive test results (ie, recent alcohol use) should lead to intensified care and monitoring. However, there was no agreement on specific types of clinical intensification after a positive test. The panel agreed that sharing positive and negative test results with members of the patient support group was helpful in reinforcing abstinence, yet they noted many practical issues regarding information sharing that remain concerning. Significant differences within the panel on several important clinical issues underline the need for more clinical and implementation research to produce empirically-supported guidelines for the use of remote BAC monitoring in AUD treatment.

How Should Remote Clinical Monitoring Be Used to Treat Alcohol Use Disorders?: Initial Findings From an Expert Round Table Discussion

PubMed Central

Gordon, Alan; Jaffe, Adi; McLellan, A. Thomas; Richardson, Gary; Skipper, Gregory; Sucher, Michel; Tirado, Carlos F.; Urschel, Harold C.

2017-01-01

Scientific evidence combined with new health insurance coverage now enable a chronic illness management approach to the treatment of alcohol use disorders (AUDs), including regular monitoring of blood alcohol content (BAC), as a useful indicator of disease control. Recent technical advances now permit many different types of remote, real-time monitoring of BAC. However, there is no body of research to empirically guide clinicians in how to maximize the clinical potential of remote BAC monitoring. As an initial step in guiding and supporting such research, the manufacturer of one remote BAC monitoring system sponsored a group of experienced clinicians and clinical researchers to discuss 8 issues that generally affect remote, clinical BAC monitoring of “adults in outpatient AUD treatment.” The expert panel unanimously agreed that remote BAC monitoring for at least 12 months during and after the outpatient treatment of AUD was a clinically viable deterrent to relapse. There was also consensus that positive test results (ie, recent alcohol use) should lead to intensified care and monitoring. However, there was no agreement on specific types of clinical intensification after a positive test. The panel agreed that sharing positive and negative test results with members of the patient support group was helpful in reinforcing abstinence, yet they noted many practical issues regarding information sharing that remain concerning. Significant differences within the panel on several important clinical issues underline the need for more clinical and implementation research to produce empirically-supported guidelines for the use of remote BAC monitoring in AUD treatment. PMID:28157829

Hospital nurses' wellbeing at work: a theoretical model.

PubMed

Utriainen, Kati; Ala-Mursula, Leena; Kyngäs, Helvi

2015-09-01

To develop a theoretical model of hospital nurses' wellbeing at work. The concept of wellbeing at work is presented without an exact definition and without considering different contents. A model was developed in a deductive manner and empirical data collected from nurses (n = 233) working in a university hospital. Explorative factor analysis was used. The main concepts were: patients' experience of high-quality care; assistance and support among nurses; nurses' togetherness and cooperation; fluent practical organisation of work; challenging and meaningful work; freedom to express diverse feelings in the work community; well-conducted everyday nursing; status related to the work itself; fair and supportive leadership; opportunities for professional development; fluent communication with other professionals; and being together with other nurses in an informal way. Themes included: collegial relationships; enhancing high-quality patient care; supportive and fair leadership; challenging, meaningful and well organised work; and opportunities for professional development. Object-dependent wellbeing was supported. Managers should focus on strengthening the positive aspect of wellbeing at work, focusing on providing fluently organised work practices, fair and supportive leadership and togetherness while allowing nurses to implement their own ideas and promote the experience of meaningfulness. © 2014 John Wiley & Sons Ltd.

Implementation of the MEPDG for flexible pavements in Idaho.

DOT National Transportation Integrated Search

2012-05-01

This study was conducted to assist the Idaho Transportation Department (ITD) in the implementation of the Mechanistic-Empirical Pavement Design Guide (MEPDG) for flexible pavements. The main research work in this study focused on establishing a mater...

Theoretical Implementations of Various Mobile Applications Used in English Language Learning

ERIC Educational Resources Information Center

Small, Melissa

2014-01-01

This review of the theoretical framework for Mastery Learning Theory and Sense of Community theories is provided in conjunction with a review of the literature for mobile technology in relation to language learning. Although empirical research is minimal for mobile phone technology as an aid for language learning, the empirical research that…

A Review of Empirical Evidence on Scaffolding for Science Education

ERIC Educational Resources Information Center

Lin, Tzu-Chiang; Hsu, Ying-Shao; Lin, Shu-Sheng; Changlai, Maio-Li; Yang, Kun-Yuan; Lai, Ting-Ling

2012-01-01

This content analysis of articles in the Social Science Citation Index journals from 1995 to 2009 was conducted to provide science educators with empirical evidence regarding the effects of scaffolding on science learning. It clarifies the definition, design, and implementation of scaffolding in science classrooms and research studies. The results…

Empirical Histograms in Item Response Theory with Ordinal Data

ERIC Educational Resources Information Center

Woods, Carol M.

2007-01-01

The purpose of this research is to describe, test, and illustrate a new implementation of the empirical histogram (EH) method for ordinal items. The EH method involves the estimation of item response model parameters simultaneously with the approximation of the distribution of the random latent variable (theta) as a histogram. Software for the EH…

The Role of Empirical Evidence in Modeling Speech Segmentation

ERIC Educational Resources Information Center

Phillips, Lawrence

2015-01-01

Choosing specific implementational details is one of the most important aspects of creating and evaluating a model. In order to properly model cognitive processes, choices for these details must be made based on empirical research. Unfortunately, modelers are often forced to make decisions in the absence of relevant data. My work investigates the…

Sending Scholarship Students Abroad in Ottoman Empire

ERIC Educational Resources Information Center

Kulaç, Onur; Özgür, Hüseyin

2017-01-01

The implementation of sending scholarship students abroad that started in the 19th century by Sultan Selim III in Ottoman Empire continued during the period of other Sultans became a significant reference point for the abroad scholarship policy of Turkey. The students that were firstly sent abroad especially for military training, were sent to…

Preparation for implementation of the mechanistic-empirical pavement design guide in Michigan, part 3 : local calibration and validation of the pavement-ME performance models.

DOT National Transportation Integrated Search

2014-11-01

The main objective of Part 3 was to locally calibrate and validate the mechanistic-empirical pavement : design guide (Pavement-ME) performance models to Michigan conditions. The local calibration of the : performance models in the Pavement-ME is a ch...

Lean practices for quality results: a case illustration.

PubMed

Hwang, Pauline; Hwang, David; Hong, Paul

2014-01-01

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific organisations and inter-organisational networks. Healthcare managers are adopting business practices that improve efficiency and productivity while ensuring their healthcare mission and guaranteeing that customer values are achieved. Shared understanding about complex goals (e.g. reducing waste and enhancing customer value) at the front-end is crucial for implementing successful lean practices. In particular, this study shows that nursing practices, which are both labour intensive and technology enabled, are good candidates for lean practice.

Women's autonomy and reproductive health care utilisation: empirical evidence from Tajikistan.

PubMed

Kamiya, Yusuke

2011-10-01

Women's autonomy is widely considered to be a key to improving maternal health in developing countries, whereas there is no consistent empirical evidence to support this claim. This paper examines whether or not and how women's autonomy within the household affects the use of reproductive health care, using a household survey data from Tajikistan. Estimation is performed by the bivariate probit model whereby woman's use of health services and the level of women's autonomy are recursively and simultaneously determined. The data is from a sample of women aged 15-49 from the Tajikistan Living Standard Measurement Survey 2007. Women's autonomy as measured by women's decision-making on household financial matters increase the likelihood that a woman receives antenatal and delivery care, whilst it has a negative effect on the probability of attending to four or more antenatal consultations. The hypothesis that women's autonomy and reproductive health care utilisation are independently determined is rejected for most of the estimation specifications, indicating the importance of taking into account the endogenous nature of women's autonomy when assessing its effect on health care use. The empirical results reconfirm the assertion that women's status within the household is closely linked to reproductive health care utilisation in developing countries. Policymakers therefore need not only to implement not only direct health interventions but also to focus on broader social policies which address women's empowerment. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2014 CFR

2014-01-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life...

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2013 CFR

2013-07-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life...

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2012 CFR

2012-01-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life...

Familiarizing Students with the Empirically Supported Treatment Approaches for Substance Abuse Problems.

ERIC Educational Resources Information Center

Wilkins, Victoria; Chambliss, Catherine

When training counseling students, it is important to familiarize them with the clinical research literature exploring the efficacy of particular treatments. The bulk of the document is comprised of a review of empirically supported treatments (ESTs). ESTs or evidence-based treatments are grounded in studies recommended by the American…

A Literature Review of Gaming in Education. Research Report

ERIC Educational Resources Information Center

McClarty, Katie Larsen; Orr, Aline; Frey, Peter M.; Dolan, Robert P.; Vassileva, Victoria; McVay, Aaron

2012-01-01

The use of simulations and digital games in learning and assessment is expected to increase over the next several years. Although there is much theoretical support for the benefits of digital games in learning and education, there is mixed empirical support. This research report provides an overview of the theoretical and empirical evidence behind…

Diversifying Theory and Science: Expanding the Boundaries of Empirically Supported Interventions in School Psychology.

ERIC Educational Resources Information Center

Kratochwill, Thomas R.; Stoiber, Karen Callan

2000-01-01

Developmental psychopathology and principles advance in Hughes' target article can be useful to promote development, evaluation, and application of empirically supported interventions (ESIs), but embracing a pathological framework is extremely limited given the diversity in theoretical approaches relevant to school-based ESIs. Argues that in order…

An Exploration of Students' Perceptions of Empirically Supported Treatments: The Significance of Gender and Ethnicity

ERIC Educational Resources Information Center

Simons, Lori; Giorgio, Tina; Houston, Hank; Jacobucci, Ray

2007-01-01

A secondary analysis of a quasi-experimental study was conducted to evaluate differences in students 'perceptions of empirically supported treatments (ESTS) randomized to experimental (n= 10) and attention-control (n= 10) manual-based therapy interventions. The results indicated that attitudinal changes took place for both groups. The results…

Resource efficiency and culture--workplace training for small and medium-sized enterprises.

PubMed

Bliesner, Anna; Liedtke, Christa; Rohn, Holger

2014-05-15

Although there are already some qualification offers available for enterprises to support resource efficiency innovations, the high potentials that can be identified especially for small and medium sized enterprises (SMEs) have not been activated until now. As successful change lies in the hands of humans, the main aim of vocational education has to be the promotion of organisational and cultural changes in the enterprises. As there is already a small but increasing number of enterprises that perform very well in resource efficiency innovations one question arises: What are typical characteristics of those enterprises? Leaning on a good-practice approach, the project "ResourceCulture" is going to prove or falsify the hypothesis that enterprises being successful with resource efficiency innovations have a specific culture of trust, which substantially contributes to innovation processes, or even initially enables them. Detailed empirical field research will light up which correlations between resource efficiency, innovation and cultures of trust can be found and will offer important aspects for the improvement of management instruments and qualification concepts for workplace training. The project seizes qualification needs that were likewise mentioned by enterprises and consultants, regarding the implementation of resource efficiency. This article - based on first empirical field research results - derives preliminary indications for the design of the qualification module for the target groups resource efficiency consultants and managers. On this basis and in order to implement "ResourceCulture" conceptual and methodological starting points for workplace training are outlined. Copyright © 2013 Elsevier B.V. All rights reserved.

Risks, Outcomes, and Evidence-Based Interventions for Girls in the US Juvenile Justice System.

PubMed

Leve, Leslie D; Chamberlain, Patricia; Kim, Hyoun K

2015-09-01

The proportion of the juvenile justice population that comprises females is increasing, yet few evidence-based models have been evaluated and implemented with girls in the juvenile justice system. Although much is known about the risk and protective factors for girls who participate in serious delinquency, significant gaps in the research base hamper the development and implementation of theoretically based intervention approaches. In this review, we first summarize the extant empirical work about the predictors and sequelae of juvenile justice involvement for girls. Identified risk and protective factors that correspond to girls' involvement in the juvenile justice system have been shown to largely parallel those of boys, although exposure rates and magnitudes of association sometimes differ by sex. Second, we summarize findings from empirically validated, evidence-based interventions for juvenile justice-involved youths that have been tested with girls. The interventions include Functional Family Therapy, Multisystemic Therapy, Multidimensional Family Therapy, and Treatment Foster Care Oregon (formerly known as Multidimensional Treatment Foster Care). We conclude that existing evidence-based practices appear to be effective for girls. However, few studies have been sufficiently designed to permit conclusions about whether sex-specific interventions would yield any better outcomes for girls than would interventions that already exist for both sexes and that have a strong base of evidence to support them. Third, we propose recommendations for feasible, cost-efficient next steps to advance the research and intervention agendas for this under-researched and underserved population of highly vulnerable youths.

Measuring and modelling the quality of 40 post-disaster mental health and psychosocial support programmes

PubMed Central

Thormar, Sigridur B.; Juen, Barbara; Ajdukovic, Dean; Newlove-Eriksson, Lindy; Olff, Miranda

2018-01-01

Disasters can have an enormous impact on the health and well-being of those affected. Internationally, governments and service providers are often challenged to address complex psychosocial problems. Ideally, the potentially broad range of support activities include a coherent, high-quality mental health and psychosocial support (MHPSS) programme. We present a theory-driven quantitative analysis of the quality of 40 MHPSS programmes, mostly implemented in European disaster settings. The objective is to measure quality domains recognized as relevant in the literature and to empirically test associations. During the EU project “Operationalizing Psychosocial Support in Crisis” (OPSIC) an evaluation survey was designed and developed for this purpose and completed by 40 MHPSS programme coordinators involved in different mass emergencies and disasters. We analysed the survey data in two steps. Firstly, we used the data to operationalize quality domains of a MHPSS programme, tested constructs and assessed their internal consistency reliability. A total of 26 out of 44 survey items clustered into three of the four domains identified within the theoretical framework: “planning and delivery system” (Cronbach’s alpha 0.82); “general evaluation criteria” (Cronbach’s alpha 0.82); and “essential psychosocial principles” (Cronbach’s alpha 0.75). “Measures and interventions applied”, theoretically a potential fourth domain, could not be confirmed to empirically cluster together. Secondly, several models with associations between domains and measures and interventions were tested and compared. The model with the best fit suggests that in MHPSS programmes with a higher planning and delivery systems score, a larger number of measures and interventions from evidence-informed guidelines are applied. In such programmes, coordinators are more positive about general evaluation criteria and the realization of essential psychosocial principles. Moreover, the analyses showed that some measures and interventions are more likely to be applied in programmes with more evolved planning and delivery systems, yet for most measures and interventions the likelihood of being applied is not linked to planning and delivery system status, nor to coordinator perceptions concerning psychosocial principles and evaluation criteria. Further research is necessary to validate and expand the findings and to learn more about success factors and obstacles for MHPSS programme implementation. PMID:29489888

Characteristics and Differences of Lifelong Learning Policy Implementation for the Elderly in Thailand

ERIC Educational Resources Information Center

Dhirathiti, Nopraenue S.; Pichitpatja, Pojjana

2018-01-01

The study examined the process of policy implementation of lifelong learning for the elderly in Thailand, covering four main regions within the country. The study empirically compared inputs, processes, outputs, and outcomes of policy implementation in the north, south, northeast, and central regions of Thailand and captured the rigor of policy…

Implementation Fidelity of MyTeachingPartner Literacy and Language Activities: Association with Preschoolers' Language and Literacy Growth

ERIC Educational Resources Information Center

Hamre, Bridget K.; Justice, Laura M.; Pianta, Robert C.; Kilday, Carolyn; Sweeney, Beverly; Downer, Jason T.; Leach, Allison

2010-01-01

There is surprisingly little empirical research examining issues of fidelity of implementation within the early childhood education literature. In the MyTeachingPartner project, 154 teachers were provided with materials to implement a supplemental classroom curriculum addressing six aspects of literacy and language development. The present study…

Improved Design of Tunnel Supports : Volume 5 : Empirical Methods in Rock Tunneling -- Review and Recommendations

DOT National Transportation Integrated Search

1980-06-01

Volume 5 evaluates empirical methods in tunneling. Empirical methods that avoid the use of an explicit model by relating ground conditions to observed prototype behavior have played a major role in tunnel design. The main objective of this volume is ...

Development and validation of measures to assess prevention and control of AMR in hospitals.

PubMed

Flanagan, Mindy; Ramanujam, Rangaraj; Sutherland, Jason; Vaughn, Thomas; Diekema, Daniel; Doebbeling, Bradley N

2007-06-01

The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. To develop and validate a measurement scale for assessing hospitals' efforts to implement recommended AMR prevention and control measures. Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. : Four hundred forty-eight infection control professionals participated (67% response rate). Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. "Derivation" and "validation" samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

Characterization and effectiveness of pay-for-performance in ophthalmology: a systematic review.

PubMed

Herbst, Tim; Emmert, Martin

2017-06-05

To identify, characterize and compare existing pay-for-performance approaches and their impact on the quality of care and efficiency in ophthalmology. A systematic evidence-based review was conducted. English, French and German written literature published between 2000 and 2015 were searched in the following databases: Medline (via PubMed), NCBI web site, Scopus, Web of Knowledge, Econlit and the Cochrane Library. Empirical as well as descriptive articles were included. Controlled clinical trials, meta-analyses, randomized controlled studies as well as observational studies were included as empirical articles. Systematic characterization of identified pay-for-performance approaches (P4P approaches) was conducted according to the "Model for Implementing and Monitoring Incentives for Quality" (MIMIQ). Methodological quality of empirical articles was assessed according to the Critical Appraisal Skills Programme (CASP) checklists. Overall, 13 relevant articles were included. Eleven articles were descriptive and two articles included empirical analyses. Based on these articles, four different pay-for-performance approaches implemented in the United States were identified. With regard to quality and incentive elements, systematic comparison showed numerous differences between P4P approaches. Empirical studies showed isolated cost or quality effects, while a simultaneous examination of these effects was missing. Research results show that experiences with pay-for-performance approaches in ophthalmology are limited. Identified approaches differ with regard to quality and incentive elements restricting comparability. Two empirical studies are insufficient to draw strong conclusions about the effectiveness and efficiency of these approaches.

Strengthening population health interventions: developing the CollaboraKTion Framework for Community-Based Knowledge Translation.

PubMed

Jenkins, Emily K; Kothari, Anita; Bungay, Vicky; Johnson, Joy L; Oliffe, John L

2016-08-30

Much of the research and theorising in the knowledge translation (KT) field has focused on clinical settings, providing little guidance to those working in community settings. In this study, we build on previous research in community-based KT by detailing the theory driven and empirically-informed CollaboraKTion framework. A case study design and ethnographic methods were utilised to gain an in-depth understanding of the processes for conducting a community-based KT study as a means to distilling the CollaboraKTion framework. Drawing on extensive field notes describing fieldwork observations and interactions as well as evidence from the participatory research and KT literature, we detail the processes and steps undertaken in this community-based KT study as well as their rationale and the challenges encountered. In an effort to build upon existing knowledge, Kitson and colleagues' co-KT framework, which provides guidance for conducting KT aimed at addressing population-level health, was applied as a coding structure to inform the current analysis. This approach was selected because it (1) supported the application of an existing community-based KT framework to empirical data and (2) provided an opportunity to contribute to the theory and practice gaps in the community-based KT literature through an inductively derived empirical example. Analysis revealed that community-based KT is an iterative process that can be viewed as comprising five overarching processes: (1) contacting and connecting; (2) deepening understandings; (3) adapting and applying the knowledge base; (4) supporting and evaluating continued action; and (5) transitioning and embedding as well as several key elements within each of these processes (e.g. building on existing knowledge, establishing partnerships). These empirically informed theory advancements in KT and participatory research traditions are summarised in the CollaboraKTion framework. We suggest that community-based KT researchers place less emphasis on enhancing uptake of specific interventions and focus on collaboratively identifying and creating changes to the contextual factors that influence health outcomes. The CollaboraKTion framework can be used to guide the development, implementation and evaluation of contextually relevant, evidence-informed initiatives aimed at improving population health, amid providing a foundation to leverage future research and practice in this emergent KT area.

Implementation of the Exception from Informed Consent Regulations in a Large Multicenter Emergency Clinical Trials Network; the RAMPART Experience

PubMed Central

Silbergleit, Robert; Biros, Michelle H.; Harney, Deneil; Dickert, Neal; Baren, Jill

2012-01-01

Clinical trials investigating therapies for acutely and critically ill and injured patients in the earliest phases of treatment often can only be performed under regulations allowing for exception from informed consent (EFIC) for emergency research. Implementation of these regulations in multicenter clinical trials involves special challenges and opportunities. The Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART), the first EFIC trial conducted by the Neurological Emergencies Treatment Trials (NETT) network, combined centralized resources and coordination with retention of local control and flexibility to facilitate compliance with the EFIC regulations. Specific methods used by the NETT included common tools for community consultation and public disclosure, sharing of experiences and knowledge, and reporting of aggregate results. Tracking of community consultation and public disclosure activities and feedback facilitates empirical research on EFIC methods in the network and supports quality improvements for future NETT trials. The NETT model used in RAMPART demonstrates how EFIC may be effectively performed in established clinical trial networks. PMID:22506949

The impact of eHealth on the quality and safety of health care: a systematic overview.

PubMed

Black, Ashly D; Car, Josip; Pagliari, Claudia; Anandan, Chantelle; Cresswell, Kathrin; Bokun, Tomislav; McKinstry, Brian; Procter, Rob; Majeed, Azeem; Sheikh, Aziz

2011-01-18

There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment strategies are lacking. There is a large gap between the postulated and empirically demonstrated benefits of eHealth technologies. In addition, there is a lack of robust research on the risks of implementing these technologies and their cost-effectiveness has yet to be demonstrated, despite being frequently promoted by policymakers and "techno-enthusiasts" as if this was a given. In the light of the paucity of evidence in relation to improvements in patient outcomes, as well as the lack of evidence on their cost-effectiveness, it is vital that future eHealth technologies are evaluated against a comprehensive set of measures, ideally throughout all stages of the technology's life cycle. Such evaluation should be characterised by careful attention to socio-technical factors to maximise the likelihood of successful implementation and adoption.

Models of Human Information Requirements: "When Reasonable Aiding Systems Disagree"

NASA Technical Reports Server (NTRS)

Corker, Kevin; Pisanich, Gregory; Shafto, Michael (Technical Monitor)

1994-01-01

Aircraft flight management and Air Traffic Control (ATC) automation are under development to maximize the economy of flight and to increase the capacity of the terminal area airspace while maintaining levels of flight safety equal to or better than current system performance. These goals are being realized by the introduction of flight management automation aiding and operations support systems on the flight deck and by new developments of ATC aiding systems that seek to optimize scheduling of aircraft while potentially reducing required separation and accounting for weather and wake vortex turbulence. Aiding systems on both the flight deck and the ground operate through algorithmic functions on models of the aircraft and of the airspace. These models may differ from each other as a result of variations in their models of the immediate environment. The resultant flight operations or ATC commands may differ in their response requirements (e.g. different preferred descent speeds or descent initiation points). The human operators in the system must then interact with the automation to reconcile differences and resolve conflicts. We have developed a model of human performance including cognitive functions (decision-making, rule-based reasoning, procedural interruption recovery and forgetting) that supports analysis of the information requirements for resolution of flight aiding and ATC conflicts. The model represents multiple individuals in the flight crew and in ATC. The model is supported in simulation on a Silicon Graphics' workstation using Allegro Lisp. Design guidelines for aviation automation aiding systems have been developed using the model's specification of information and team procedural requirements. Empirical data on flight deck operations from full-mission flight simulation are provided to support the model's predictions. The paper describes the model, its development and implementation, the simulation test of the model predictions, and the empirical validation process. The model and its supporting data provide a generalizable tool that is being expanded to include air/ground compatibility and ATC crew interactions in air traffic management.

Feasibility of an Empirically Based Program for Parents of Preschoolers with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Dababnah, Sarah; Parish, Susan L.

2016-01-01

This article reports on the feasibility of implementing an existing empirically based program, "The Incredible Years," tailored to parents of young children with autism spectrum disorder. Parents raising preschool-aged children (aged 3-6?years) with autism spectrum disorder (N?=?17) participated in a 15-week pilot trial of the…

Preparation of the implementation plan of AASHTO Mechanistic-Empirical Pavement Design Guide (M-EPDG) in Connecticut : Phase II : expanded sensitivity analysis and validation with pavement management data.

DOT National Transportation Integrated Search

2017-02-08

The study re-evaluates distress prediction models using the Mechanistic-Empirical Pavement Design Guide (MEPDG) and expands the sensitivity analysis to a wide range of pavement structures and soils. In addition, an extensive validation analysis of th...

Increasing Functional Communication in Non-Speaking Preschool Children: Comparison of PECS and VOCA

ERIC Educational Resources Information Center

Bock, Stacey Jones; Stoner, Julia B.; Beck, Ann R.; Hanley, Laurie; Prochnow, Jessica

2005-01-01

For individuals who have complex communication needs and for the interventionists who work with them, the collection of empirically derived data that support the use of an intervention approach is critical. The purposes of this study were to continue building an empirically derived base of support for, and to compare the relative effectiveness of…

Identifying Empirically Supported Treatments for Pica in Individuals with Intellectual Disabilities

ERIC Educational Resources Information Center

Hagopian, Louis P.; Rooker, Griffin W.; Rolider, Natalie U.

2011-01-01

The purpose of the current study was to critically examine the existing literature on the treatment of pica displayed by individuals with intellectual disabilities. Criteria for empirically supported treatments as described by Divisions 12 and 16 of APA, and adapted for studies employing single-case designs were used to review this body of…

Cognitive Behaviour Therapy in Schools: The Role of Educational Psychology in the Dissemination of Empirically Supported Interventions

ERIC Educational Resources Information Center

Pugh, John

2010-01-01

Educational psychology has recently experienced something of a revival in the provision of psychological therapy. This revival has aligned with general developments in evidence-based psychology. A product of this has been more frequent delivery of empirically supported therapies in practice settings, for example, anxiety reduction programmes in…

Do Master's in Social Work Programs Teach Empirically Supported Interventions? A Survey of Deans and Directors

ERIC Educational Resources Information Center

Woody, Jane D.; D'Souza, Henry J.; Dartman, Rebecca

2006-01-01

Objective: A questionnaire to examine efforts toward the teaching of empirically supported interventions (ESI) was mailed to the 165 deans and directors of Council on Social Work Education-accredited Master's in social work (MSW) programs; 66 (40%) responded. Method: Questions included program characteristics and items assessing both faculty and…

Evaluating the Validity of Systematic Reviews to Identify Empirically Supported Treatments

ERIC Educational Resources Information Center

Slocum, Timothy A.; Detrich, Ronnie; Spencer, Trina D.

2012-01-01

The "best available evidence" is one of the three basic inputs into evidence-based practice. This paper sets out a framework for evaluating the quality of systematic reviews that are intended to identify empirically supported interventions as a way of summarizing the best available evidence. The premise of this paper is that the process of…

Social and Interpersonal Factors Relating to Adolescent Suicidality: A Review of the Literature

PubMed Central

King, Cheryl A.; Merchant, Christopher R.

2009-01-01

This article reviews the empirical literature concerning social and interpersonal variables as risk factors for adolescent suicidality (suicidal ideation, suicidal behavior, death by suicide. It also describes major social constructs in theories of suicide and the extent to which studies support their importance to adolescent suicidality. PsychINFO and PubMed searches were conducted for empirical studies focused on family and friend support, social isolation, peer victimization, physical/sexual abuse, or emotional neglect as these relate to adolescent suicidality. Empirical findings converge in documenting the importance of multiple social and interpersonal factors to adolescent suicidality. Research support for the social constructs in several major theories of suicide is summarized and research challenges are discussed. PMID:18576200

Empirical knowledge engine of local governance Senegalese artisanal fisheries Empirical knowledge engine of local governance Senegalese artisanal fisheries

NASA Astrophysics Data System (ADS)

Mbaye, A.

2016-02-01

Fishery resources has always been an administrative management faced with the supposed irrationality of artisanal fishermen and the state has always had a monopoly over such management. The state rules well established, synonyms of denial local populations knowledge on management, and expropriation of their fisheries territories, came into conflict with the existing rules thus weakening the traditional management system.However, aware of the threats to their survival because of the limitations of state rules and technicist perception of management, some populations of fishermen tried to organize and implement management measures.These measures are implemented on the basis of their own knowledge of the environmentsThis is the case in Kayar, Nianing, Bétenty, where local management initiatives began to bear fruit despite some difficulties.These examples of successful local management have prompted the Senegalese administration to have more consideration for the knowledge and know-how of fishermen and to be open to co-management of the fisheries resource. his communication shows how this is implemented new co-management approach in the governance of the Senegalese artisanal fisheries through the consideration of empirical knowledge of fishermen.

Methodological support for the further abstraction of and philosophical examination of empirical findings in the context of caring science.

PubMed

Lindberg, Elisabeth; Österberg, Sofia A; Hörberg, Ulrica

2016-01-01

Phenomena in caring science are often complex and laden with meanings. Empirical research with the aim of capturing lived experiences is one way of revealing the complexity. Sometimes, however, results from empirical research need to be further discussed. One way is to further abstract the result and/or philosophically examine it. This has previously been performed and presented in scientific journals and doctoral theses, contributing to a greater understanding of phenomena in caring science. Although the intentions in many of these publications are laudable, the lack of methodological descriptions as well as a theoretical and systematic foundation can contribute to an ambiguity concerning how the results have emerged during the analysis. The aim of this paper is to describe the methodological support for the further abstraction of and/or philosophical examination of empirical findings. When trying to systematize the support procedures, we have used a reflective lifeworld research (RLR) approach. Based on the assumptions in RLR, this article will present methodological support for a theoretical examination that can include two stages. In the first stage, data from several (two or more) empirical results on an essential level are synthesized into a general structure. Sometimes the analysis ends with the general structure, but sometimes there is a need to proceed further. The second stage can then be a philosophical examination, in which the general structure is discussed in relation to a philosophical text, theory, or concept. It is important that the theories are brought in as the final stage after the completion of the analysis. Core dimensions of the described methodological support are, in accordance with RLR, openness, bridling, and reflection. The methodological support cannot be understood as fixed stages, but rather as a guiding light in the search for further meanings.

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

PubMed

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

2012-01-01

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

Health information technology and dynamic capabilities.

PubMed

Leung, Ricky C

2012-01-01

Health information technology (HIT) purports to increase quality and efficiency in health care organizations. However, health care organizations are situated in constantly changing environments. They need dynamic capabilities to implement HIT effectively. This article builds on the dynamic capabilities perspective and generates propositions about implementing HIT in dynamic environments. Specifically, I identify the (1) the necessary resources and capabilities for organizations to implement HIT; (2) the organizational capabilities and benefits that can be enhanced by HIT; and (3) the similarities and differences between three distinct forms of HIT. I synthesized the literature on dynamic capabilities and HIT to identify dynamic capabilities that are associated with (1) electronic medical records, (2) telemedicine, and (3) social media. In addition, I discuss the benefits of these HITs for improving the dynamic capabilities of health care organizations. PROPOSITIONS/FINDINGS: This article generates three sets of propositions that can be tested empirically. First, I am concerned with how organizational size and human resources affect successful implementation of HIT. In addition, I argue that three technology-specific factors--hospital type, medical specialty, and socially desirable technical features--may affect the implementation of HIT. To cope with constantly changing environmental pressures, health administrators need to deploy, modify, and/or acquire organizational resources skillfully. Practitioners need to identify dynamic capabilities to support specific forms of HIT and understand how HIT enables health care organizations in turn. The concept of evolutionary fitness in the dynamic capabilities perspective may be developed to measure HIT implementation.

The Examination of the Effects of Writing Strategy-Based Procedural Facilitative Environments on Students' English Foreign Language Writing Anxiety Levels

PubMed Central

Tsiriotakis, Ioanna K.; Vassilaki, Eleni; Spantidakis, Ioannis; Stavrou, Nektarios A. M.

2017-01-01

Empirical studies have shown that anxiety and negative emotion can hinder language acquisition. The present study implemented a writing instructional model so as to investigate its effects on the writing anxiety levels of English Foreign Language learners. The study was conducted with 177 participants, who were administered the Second Language Writing Anxiety Inventory (SLWAI; Cheng, 2004) that assesses somatic, cognitive and behavioral anxiety, both at baseline and following the implementation of a writing instructional model. The hypothesis stated that the participant's writing anxiety levels would lessen following the provision of a writing strategy-based procedural facilitative environment that fosters cognitive apprenticeship. The initial hypothesis was supported by the findings. Specifically, in the final measurement statistical significant differences appeared where participants in the experimental group showed notable lower mean values of the three factors of anxiety, a factor that largely can be attributed to the content of the intervention program applied to this specific group. The findings validate that Foreign Language writing anxiety negatively effects Foreign Language learning and performance. The findings also support the effectiveness of strategy-based procedural facilitative writing environments that foster cognitive apprenticeship, so as to enhance language skill development and reduce feelings of Foreign Language writing anxiety. PMID:28119658

Effects of Sectoral Diversity on Community Coalition Processes and Outcomes.

PubMed

Brown, Louis D; Wells, Rebecca; Jones, Eric C; Chilenski, Sarah Meyer

2017-07-01

Collaboration with diverse partners is challenging but essential for the implementation of prevention programs and policies. Increased communication with partners from diverse sectors may help community coalitions overcome the challenges that diversity presents. We examined these issues empirically in a study of 17 substance use prevention coalitions in Mexico. Building on coalition and workgroup literatures, we hypothesized that sectoral diversity would improve outcomes but undermine coalition processes. Conversely, we expected uniformly positive effects from higher levels of intersectoral communication. Data are from a 2015 survey of 211 members within the 17 community coalitions. Regression models used sectoral diversity and intersectoral communication to predict coalition processes (cohesion, leader-member communication, efficiency) and outcomes (community support, community improvement, sustainability planning). Sectoral diversity was negatively associated with coalition processes and was not associated with coalition outcomes. Intersectoral communication was positively associated with two of the three measures of coalition outcomes but not associated with coalition processes. Our findings concur with those from prior research indicating that sectoral diversity may undermine coalition processes. However, more communication between sectors may facilitate the coalition outcomes of community support and sustainability planning. Skilled team leaders and participatory decision making may also help coalitions promote intersectoral communication, thereby engaging diverse community sectors to implement preventive interventions and actualize sustained public health impact.

The Examination of the Effects of Writing Strategy-Based Procedural Facilitative Environments on Students' English Foreign Language Writing Anxiety Levels.

PubMed

Tsiriotakis, Ioanna K; Vassilaki, Eleni; Spantidakis, Ioannis; Stavrou, Nektarios A M

2016-01-01

Empirical studies have shown that anxiety and negative emotion can hinder language acquisition. The present study implemented a writing instructional model so as to investigate its effects on the writing anxiety levels of English Foreign Language learners. The study was conducted with 177 participants, who were administered the Second Language Writing Anxiety Inventory (SLWAI; Cheng, 2004) that assesses somatic, cognitive and behavioral anxiety, both at baseline and following the implementation of a writing instructional model. The hypothesis stated that the participant's writing anxiety levels would lessen following the provision of a writing strategy-based procedural facilitative environment that fosters cognitive apprenticeship. The initial hypothesis was supported by the findings. Specifically, in the final measurement statistical significant differences appeared where participants in the experimental group showed notable lower mean values of the three factors of anxiety, a factor that largely can be attributed to the content of the intervention program applied to this specific group. The findings validate that Foreign Language writing anxiety negatively effects Foreign Language learning and performance. The findings also support the effectiveness of strategy-based procedural facilitative writing environments that foster cognitive apprenticeship, so as to enhance language skill development and reduce feelings of Foreign Language writing anxiety.

The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study.

PubMed

Aarons, Gregory A; Green, Amy E; Trott, Elise; Willging, Cathleen E; Torres, Elisa M; Ehrhart, Mark G; Roesch, Scott C

2016-11-01

If evidence-based interventions (EBIs) are not sustained, investments are wasted and public health impact is limited. Leadership has been suggested as a key determinant of implementation and sustainment; however, little empirical work has examined this factor. This mixed-methods study framed using the Exploration, Preparation, Implementation, Sustainment (EPIS) conceptual framework examines leadership in both the outer service system context and inner organizational context in eleven system-wide implementations of the same EBI across two U.S. states and 87 counties. Quantitative data at the outer context (i.e., system) and inner context (i.e., team) levels demonstrated that leadership predicted future sustainment and differentiated between sites with full, partial, or no sustainment. In the outer context positive sustainment leadership was characterized as establishing a project's mission and vision, early and continued planning for sustainment, realistic project plans, and having alternative strategies for project survival. Inner context frontline transformational leadership predicted sustainment while passive-avoidant leadership predicted non-sustainment. Qualitative results found that sustainment was associated with outer context leadership characterized by engagement in ongoing supportive EBI championing, marketing to stakeholders; persevering in these activities; taking action to institutionalize the EBI with funding, contracting, and system improvement plans; and fostering ongoing collaboration between stakeholders at state and county, and community stakeholder levels. For frontline leadership the most important activities included championing the EBI and providing practical support for service providers. There was both convergence and expansion that identified unique contributions of the quantitative and qualitative methods. Greater attention to leadership in both the outer system and inner organizational contexts is warranted to enhance EBI implementation and sustainment.

The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study

PubMed Central

Aarons, Gregory A.; Green, Amy E.; Trott, Elise; Willging, Cathleen E.; Torres, Elisa M.; Ehrhart, Mark G.; Roesch, Scott C.

2017-01-01

If evidence-based interventions (EBIs) are not sustained, investments are wasted and public health impact is limited. Leadership has been suggested as a key determinant of implementation and sustainment; however, little empirical work has examined this factor. This mixed-methods study framed using the Exploration, Preparation, Implementation, Sustainment (EPIS) conceptual framework examines leadership in both the outer service system context and inner organizational context in eleven system-wide implementations of the same EBI across two U.S. states and 87 counties. Quantitative data at the outer context (i.e., system) and inner context (i.e., team) levels demonstrated that leadership predicted future sustainment and differentiated between sites with full, partial, or no sustainment. In the outer context positive sustainment leadership was characterized as establishing a project’s mission and vision, early and continued planning for sustainment, realistic project plans, and having alternative strategies for project survival. Inner context frontline transformational leadership predicted sustainment while passive-avoidant leadership predicted non-sustainment. Qualitative results found that sustainment was associated with outer context leadership characterized by engagement in ongoing supportive EBI championing, marketing to stakeholders; persevering in these activities; taking action to institutionalize the EBI with funding, contracting, and system improvement plans; and fostering ongoing collaboration between stakeholders at state and county, and community stakeholder levels. For frontline leadership the most important activities included championing the EBI and providing practical support for service providers. There was both convergence and expansion that identified unique contributions of the quantitative and qualitative methods. Greater attention to leadership in both the outer system and inner organizational contexts is warranted to enhance EBI implementation and sustainment. PMID:27439504

A Praxeological Perspective for the Design and Implementation of a Digital Role-Play Game

ERIC Educational Resources Information Center

Sanchez, Eric; Monod-Ansaldi, Réjane; Vincent, Caroline; Safadi-Katouzian, Sina

2017-01-01

This paper draws on an empirical work dedicated to discussing a theoretical model for design-based research. The context of our study is a research project for the design, the implementation and the analysis of Insectophagia, a digital role-play game implemented in secondary schools. The model presented in this paper aims at conceptualizing…

An Empirical Examination of Fear Appeal's Effect on Behavioral Intention to Comply with Anti-Spyware Software Information Security Recommendations among College Students

ERIC Educational Resources Information Center

Brown, David A.

2017-01-01

Information security is a concern for managers implementing protection measures. Implementing information security measures requires communicating both the reason and remediation for the protection measure. Examining how an anti-spyware security communication affects an individual's intention to implement a protection measure could help improve…

Accelerating Translation of Physical Activity and Cancer Survivorship Research into Practice: Recommendations for a More Integrated and Collaborative Approach

PubMed Central

Phillips, Siobhan M.; Alfano, Catherine M.; Perna, Frank M.; Glasgow, Russell E.

2015-01-01

Physical activity has been deemed safe and effective in reducing many negative side effects of treatment for cancer survivors and promoting better overall health. However, most of this research has focused on highly controlled randomized trials and little of this research has been translated into care or policy for survivors. The purpose of the present paper is to present a research agenda for the field to accelerate the dissemination and implementation of empirically-supported physical activity interventions into care. We provide rationale for the role of basic, behavioral, clinical implementation and population scientists in moving this science forward and call for a more coordinated effort across different phases of research. In addition, we provide key strategies and examples for ongoing and future studies using the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance) framework and pose recommendations for collaborations between researchers and stakeholders to enhance the integration of this research into policy and practice. Overall, we recommend that physical activity and cancer survivorship research employ additional study designs, include relevant stakeholders and be more collaborative, integrated, contextual, and representative in terms of both setting and participants. PMID:24599577

Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India.

PubMed

Mohanan, Manoj; Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos

2017-05-01

To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme - the World Health Partners' Sky Program. We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers' performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. The programme did not significantly improve health-care providers' knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up.

Integrated primary care: an inclusive three-world view through process metrics and empirical discrimination.

PubMed

Miller, Benjamin F; Mendenhall, Tai J; Malik, Alan D

2009-03-01

Integrating behavioral health services within the primary care setting drives higher levels of collaborative care, and is proving to be an essential part of the solution for our struggling American healthcare system. However, justification for implementing and sustaining integrated and collaborative care has shown to be a formidable task. In an attempt to move beyond conflicting terminology found in the literature, we delineate terms and suggest a standardized nomenclature. Further, we maintain that addressing the three principal worlds of healthcare (clinical, operational, financial) is requisite in making sense of the spectrum of available implementations and ultimately transitioning collaborative care into the mainstream. Using a model that deconstructs process metrics into factors/barriers and generalizes behavioral health provider roles into major categories provides a framework to empirically discriminate between implementations across specific settings. This approach offers practical guidelines for care sites implementing integrated and collaborative care and defines a research framework to produce the evidence required for the aforementioned clinical, operational and financial worlds of this important movement.

National laboratory-based surveillance system for antimicrobial resistance: a successful tool to support the control of antimicrobial resistance in the Netherlands.

PubMed

Altorf-van der Kuil, Wieke; Schoffelen, Annelot F; de Greeff, Sabine C; Thijsen, Steven Ft; Alblas, H Jeroen; Notermans, Daan W; Vlek, Anne Lm; van der Sande, Marianne Ab; Leenstra, Tjalling

2017-11-01

An important cornerstone in the control of antimicrobial resistance (AMR) is a well-designed quantitative system for the surveillance of spread and temporal trends in AMR. Since 2008, the Dutch national AMR surveillance system, based on routine data from medical microbiological laboratories (MMLs), has developed into a successful tool to support the control of AMR in the Netherlands. It provides background information for policy making in public health and healthcare services, supports development of empirical antibiotic therapy guidelines and facilitates in-depth research. In addition, participation of the MMLs in the national AMR surveillance network has contributed to sharing of knowledge and quality improvement. A future improvement will be the implementation of a new semantic standard together with standardised data transfer, which will reduce errors in data handling and enable a more real-time surveillance. Furthermore, the scientific impact and the possibility of detecting outbreaks may be amplified by merging the AMR surveillance database with databases from selected pathogen-based surveillance programmes containing patient data and genotypic typing data.

National laboratory-based surveillance system for antimicrobial resistance: a successful tool to support the control of antimicrobial resistance in the Netherlands

PubMed Central

Altorf-van der Kuil, Wieke; Schoffelen, Annelot F; de Greeff, Sabine C; Thijsen, Steven FT; Alblas, H Jeroen; Notermans, Daan W; Vlek, Anne LM; van der Sande, Marianne AB; Leenstra, Tjalling

2017-01-01

An important cornerstone in the control of antimicrobial resistance (AMR) is a well-designed quantitative system for the surveillance of spread and temporal trends in AMR. Since 2008, the Dutch national AMR surveillance system, based on routine data from medical microbiological laboratories (MMLs), has developed into a successful tool to support the control of AMR in the Netherlands. It provides background information for policy making in public health and healthcare services, supports development of empirical antibiotic therapy guidelines and facilitates in-depth research. In addition, participation of the MMLs in the national AMR surveillance network has contributed to sharing of knowledge and quality improvement. A future improvement will be the implementation of a new semantic standard together with standardised data transfer, which will reduce errors in data handling and enable a more real-time surveillance. Furthermore, the scientific impact and the possibility of detecting outbreaks may be amplified by merging the AMR surveillance database with databases from selected pathogen-based surveillance programmes containing patient data and genotypic typing data. PMID:29162208

An Analysis of Functional Communication Training as an Empirically Supported Treatment for Problem Behavior Displayed by Individuals with Intellectual Disabilities

ERIC Educational Resources Information Center

Kurtz, Patricia F.; Boelter, Eric W.; Jarmolowicz, David P.; Chin, Michelle D.; Hagopian, Louis P.

2011-01-01

This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force,…

Use of Evidence-Based Practice Resources and Empirically Supported Treatments for Posttraumatic Stress Disorder among University Counseling Center Psychologists

ERIC Educational Resources Information Center

Juel, Morgen Joray

2012-01-01

In the present study, an attempt was made to determine the degree to which psychologists at college and university counseling centers (UCCs) utilized empirically supported treatments with their posttraumatic stress disorder (PTSD) clients. In addition, an attempt was made to determine how frequently UCC psychologists utilized a number of…

Empirically Supported Psychotherapy in Social Work Training Programs: Does the Definition of Evidence Matter?

ERIC Educational Resources Information Center

Bledsoe, Sarah E.; Weissman, Myrna M.; Mullen, Edward J.; Ponniah, Kathryn; Gameroff, Marc J.; Verdeli, Helen; Mufson, Laura; Fitterling, Heidi; Wickramaratne, Priya

2007-01-01

Objectives: A national survey finds that 62% of social work programs do not require didactic and clinical supervision in any empirically supported psychotherapy (EST). The authors report the results of analysis of national survey data using two alternative classifications of EST to determine if the results are because of the definition of EST used…

Instructional Supports for Students with Special Education Needs in French as a Second Language Education: A Review of Canadian Empirical Literature

ERIC Educational Resources Information Center

Mady, Callie; Muhling, Stefanie

2017-01-01

With the view to responding to a call for information on instructional supports for students with special education needs (SSEN) in French as a second language (FSL) education, this article reviews the empirical literature from three Canadian contexts: core French, intensive French and French immersion. More specifically, we developed this…

Implementing Geographical Key Concepts: Design of a Symbiotic Teacher Training Course Based on Empirical and Theoretical Evidence

ERIC Educational Resources Information Center

Fögele, Janis; Mehren, Rainer

2015-01-01

A central desideratum for the professionalization of qualified teachers is an improved practice of further teacher education. The present work constitutes a course of in-service training, which is built upon both a review of empirical findings concerning the efficacy of in-service training courses for teachers and theoretical assumptions about the…

Issues in Implementation of Coeducation in Turkish Education System: A Historical Research on 1869 Statute on General Education

ERIC Educational Resources Information Center

Kamer, Selman Tunay

2017-01-01

Though the Imperial Edict of Gülhane, which is regarded as the real beginning of modernization in the Ottoman Empire, does not contain any direct article on education, "Tanzimat" (Reorganization of the Ottoman Empire) and the process following it directly affected the education system in the country. The boards formed and the regulations…

Retaining the Value of PV at High Penetration Workshop

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

Kurtz, Sarah; Bolen, Michael

PV prices have dropped and are now attractive without incentives for peaking applications in some locations. Modeling suggests and, empirically, some regions demonstrate that as PV penetration increases its value decreases, predominantly due to a decrease in energy and capacity value. It is not apparent what technologies and price may be needed for PV to supply tens of percent of electricity in the most economically efficient manner. A 1-day workshop was co-sponsored by EPRI and NREL with support from ASU. A dozen presentations and discussions introduced how the interplay of various technologies impact the value of PV, identified technical challengesmore » and gaps impeding implementation, and discussed future R&D needs and opportunities.« less

Comparative study of internet cloud and cloudlet over wireless mesh networks for real-time applications

NASA Astrophysics Data System (ADS)

Khan, Kashif A.; Wang, Qi; Luo, Chunbo; Wang, Xinheng; Grecos, Christos

2014-05-01

Mobile cloud computing is receiving world-wide momentum for ubiquitous on-demand cloud services for mobile users provided by Amazon, Google etc. with low capital cost. However, Internet-centric clouds introduce wide area network (WAN) delays that are often intolerable for real-time applications such as video streaming. One promising approach to addressing this challenge is to deploy decentralized mini-cloud facility known as cloudlets to enable localized cloud services. When supported by local wireless connectivity, a wireless cloudlet is expected to offer low cost and high performance cloud services for the users. In this work, we implement a realistic framework that comprises both a popular Internet cloud (Amazon Cloud) and a real-world cloudlet (based on Ubuntu Enterprise Cloud (UEC)) for mobile cloud users in a wireless mesh network. We focus on real-time video streaming over the HTTP standard and implement a typical application. We further perform a comprehensive comparative analysis and empirical evaluation of the application's performance when it is delivered over the Internet cloud and the cloudlet respectively. The study quantifies the influence of the two different cloud networking architectures on supporting real-time video streaming. We also enable movement of the users in the wireless mesh network and investigate the effect of user's mobility on mobile cloud computing over the cloudlet and Amazon cloud respectively. Our experimental results demonstrate the advantages of the cloudlet paradigm over its Internet cloud counterpart in supporting the quality of service of real-time applications.

Disorders without borders: current and future directions in the meta-structure of mental disorders.

PubMed

Carragher, Natacha; Krueger, Robert F; Eaton, Nicholas R; Slade, Tim

2015-03-01

Classification is the cornerstone of clinical diagnostic practice and research. However, the extant psychiatric classification systems are not well supported by research evidence. In particular, extensive comorbidity among putatively distinct disorders flags an urgent need for fundamental changes in how we conceptualize psychopathology. Over the past decade, research has coalesced on an empirically based model that suggests many common mental disorders are structured according to two correlated latent dimensions: internalizing and externalizing. We review and discuss the development of a dimensional-spectrum model which organizes mental disorders in an empirically based manner. We also touch upon changes in the DSM-5 and put forward recommendations for future research endeavors. Our review highlights substantial empirical support for the empirically based internalizing-externalizing model of psychopathology, which provides a parsimonious means of addressing comorbidity. As future research goals, we suggest that the field would benefit from: expanding the meta-structure of psychopathology to include additional disorders, development of empirically based thresholds, inclusion of a developmental perspective, and intertwining genomic and neuroscience dimensions with the empirical structure of psychopathology.

Real-time video streaming in mobile cloud over heterogeneous wireless networks

NASA Astrophysics Data System (ADS)

Abdallah-Saleh, Saleh; Wang, Qi; Grecos, Christos

2012-06-01

Recently, the concept of Mobile Cloud Computing (MCC) has been proposed to offload the resource requirements in computational capabilities, storage and security from mobile devices into the cloud. Internet video applications such as real-time streaming are expected to be ubiquitously deployed and supported over the cloud for mobile users, who typically encounter a range of wireless networks of diverse radio access technologies during their roaming. However, real-time video streaming for mobile cloud users across heterogeneous wireless networks presents multiple challenges. The network-layer quality of service (QoS) provision to support high-quality mobile video delivery in this demanding scenario remains an open research question, and this in turn affects the application-level visual quality and impedes mobile users' perceived quality of experience (QoE). In this paper, we devise a framework to support real-time video streaming in this new mobile video networking paradigm and evaluate the performance of the proposed framework empirically through a lab-based yet realistic testing platform. One particular issue we focus on is the effect of users' mobility on the QoS of video streaming over the cloud. We design and implement a hybrid platform comprising of a test-bed and an emulator, on which our concept of mobile cloud computing, video streaming and heterogeneous wireless networks are implemented and integrated to allow the testing of our framework. As representative heterogeneous wireless networks, the popular WLAN (Wi-Fi) and MAN (WiMAX) networks are incorporated in order to evaluate effects of handovers between these different radio access technologies. The H.264/AVC (Advanced Video Coding) standard is employed for real-time video streaming from a server to mobile users (client nodes) in the networks. Mobility support is introduced to enable continuous streaming experience for a mobile user across the heterogeneous wireless network. Real-time video stream packets are captured for analytical purposes on the mobile user node. Experimental results are obtained and analysed. Future work is identified towards further improvement of the current design and implementation. With this new mobile video networking concept and paradigm implemented and evaluated, results and observations obtained from this study would form the basis of a more in-depth, comprehensive understanding of various challenges and opportunities in supporting high-quality real-time video streaming in mobile cloud over heterogeneous wireless networks.

Toward a Culture of Consequences: Performance-Based Accountability Systems for Public Services.

PubMed

Stecher, Brian M; Camm, Frank; Damberg, Cheryl L; Hamilton, Laura S; Mullen, Kathleen J; Nelson, Christopher; Sorensen, Paul; Wachs, Martin; Yoh, Allison; Zellman, Gail L; Leuschner, Kristin J; Camm, Frank; Stecher, Brian M

2012-01-01

Performance-based accountability systems (PBASs), which link incentives to measured performance as a means of improving services to the public, have gained popularity. While PBASs can vary widely across sectors, they share three main components: goals, incentives, and measures. Research suggests that PBASs influence provider behaviors, but little is known about PBAS effectiveness at achieving performance goals or about government and agency experiences. This study examines nine PBASs that are drawn from five sectors: child care, education, health care, public health emergency preparedness, and transportation. In the right circumstances, a PBAS can be an effective strategy for improving service delivery. Optimum circumstances include having a widely shared goal, unambiguous observable measures, meaningful incentives for those with control over the relevant inputs and processes, few competing interests, and adequate resources to design, implement, and operate the PBAS. However, these conditions are rarely fully realized, so it is difficult to design and implement PBASs that are uniformly effective. PBASs represent a promising policy option for improving the quality of service-delivery activities in many contexts. The evidence supports continued experimentation with and adoption of this approach in appropriate circumstances. Even so, PBAS design and its prospects for success depend on the context in which it will operate. Also, ongoing system evaluation and monitoring are integral components of a PBAS; they inform refinements that improve system functioning over time. Empirical evidence of the effects of performance-based public management is scarce. This article also describes a framework used to evaluate a PBAS. Such a system identifies individuals or organizations that must change their behavior for the performance of an activity to improve, chooses an implicit or explicit incentive structure to motivate these organizations or individuals to change, and then chooses performance measures tailored to inform the incentive structure appropriately. The study focused on systems in the child care, education, health care, public health emergency preparedness, and transportation sectors, mainly in the United States. Analysts could use this framework to seek empirical information in other sectors and other parts of the world. Additional empirical information could help refine existing PBASs and, more broadly, improve decisions on where to initiate new PBASs, how to implement them, and then how to design, manage, and refine them over time.

Guidelines for Adapting Manualized Interventions for New Target Populations: A Step-Wise Approach Using Anger Management as a Model

PubMed Central

Goldstein, Naomi E. S.; Kemp, Kathleen A.; Leff, Stephen S.; Lochman, John E.

2014-01-01

The use of manual-based interventions tends to improve client outcomes and promote replicability. With an increasingly strong link between funding and the use of empirically supported prevention and intervention programs, manual development and adaptation have become research priorities. As a result, researchers and scholars have generated guidelines for developing manuals from scratch, but there are no extant guidelines for adapting empirically supported, manualized prevention and intervention programs for use with new populations. Thus, this article proposes step-by-step guidelines for the manual adaptation process. It also describes two adaptations of an extensively researched anger management intervention to exemplify how an empirically supported program was systematically and efficiently adapted to achieve similar outcomes with vastly different populations in unique settings. PMID:25110403

Supporting Evidence-Informed Teaching in Biomedical and Health Professions Education Through Knowledge Translation: An Interdisciplinary Literature Review.

PubMed

Tractenberg, Rochelle E; Gordon, Morris

2017-01-01

Phenomenon: The purpose of "systematic" reviews/reviewers of medical and health professions educational research is to identify best practices. This qualitative article explores the question of whether systematic reviews can support "evidence informed" teaching and contrasts traditional systematic reviewing with a knowledge translation (KT) approach to this objective. Degrees of freedom analysis (DOFA) is used to examine the alignment of systematic review methods with educational research and the pedagogical strategies and approaches that might be considered with a decision-making framework developed to support valid assessment. This method is also used to explore how KT can be used to inform teaching and learning. The nature of educational research is not compatible with most (11/14) methods for systematic review. The inconsistency of systematic reviewing with the nature of educational research impedes both the identification and implementation of "best-evidence" pedagogy and teaching. This is primarily because research questions that do support the purposes of review do not support educational decision making. By contrast to systematic reviews of the literature, both a DOFA and KT are fully compatible with informing teaching using evidence. A DOFA supports the translation of theory to a specific teaching or learning case, so could be considered a type of KT. The DOFA results in a test of alignment of decision options with relevant educational theory, and KT leads to interventions in teaching or learning that can be evaluated. Examples of how to structure evaluable interventions are derived from a KT approach that are simply not available from a systematic review. Insights: Systematic reviewing of current empirical educational research is not suitable for deriving or supporting best practices in education. However, both "evidence-informed" and scholarly approaches to teaching can be supported as KT projects, which are inherently evaluable and can generate actionable evidence about whether the decision or intervention worked for students, instructors, and the institution. A DOFA can also support evidence- and theory-informed teaching to develop an understanding of what works, why, and for whom. Thus KT, but not systematic reviewing, can support decision making around pedagogy (and pedagogical innovation) that can also inform new teaching and learning initiatives; it can also point to new avenues of empirical research in education that are informed by, and can inform, theory.

Masks in Pedagogical Practice

ERIC Educational Resources Information Center

Roy, David

2016-01-01

In Drama Education mask work is undertaken and presented as both a methodology and knowledge base. There are numerous workshops and journal articles available for teachers that offer knowledge or implementation of mask work. However, empirical examination of the context or potential implementation of masks as a pedagogical tool remains…

A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture.

PubMed

Cramm, Jane M; Strating, Mathilde M H; Bal, Roland; Nieboer, Anna P

2013-04-01

Teams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. Each QI team member received a questionnaire by mail within one week after the second (2-3 months post-implementation of the collaborative = T0) and final conference (12 months post-implementation = T1). A total of 859 (out of 1161) respondents filled in the questionnaire at T0 and 541 at T1 (47% response). A total of 307 team members filled in the questionnaire at both T0 and T1. We measured innovative culture, respondent characteristics (age, gender, education), perceived team effectiveness, organizational support, and management support. Two-tailed paired t-tests showed that innovative culture was slightly but significantly lower at T1 compared to T0 (12 months and 2-3 months after the start of the collaborative, respectively). Univariate analyses revealed that perceived effectiveness, organizational and management support were significantly related to innovative culture at T1 (all at p ≤ 0.001). Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Landscape Genetics for the Empirical Assessment of Resistance Surfaces: The European Pine Marten (Martes martes) as a Target-Species of a Regional Ecological Network

PubMed Central

Ruiz-González, Aritz; Gurrutxaga, Mikel; Cushman, Samuel A.; Madeira, María José; Randi, Ettore; Gómez-Moliner, Benjamin J.

2014-01-01

Coherent ecological networks (EN) composed of core areas linked by ecological corridors are being developed worldwide with the goal of promoting landscape connectivity and biodiversity conservation. However, empirical assessment of the performance of EN designs is critical to evaluate the utility of these networks to mitigate effects of habitat loss and fragmentation. Landscape genetics provides a particularly valuable framework to address the question of functional connectivity by providing a direct means to investigate the effects of landscape structure on gene flow. The goals of this study are (1) to evaluate the landscape features that drive gene flow of an EN target species (European pine marten), and (2) evaluate the optimality of a regional EN design in providing connectivity for this species within the Basque Country (North Spain). Using partial Mantel tests in a reciprocal causal modeling framework we competed 59 alternative models, including isolation by distance and the regional EN. Our analysis indicated that the regional EN was among the most supported resistance models for the pine marten, but was not the best supported model. Gene flow of pine marten in northern Spain is facilitated by natural vegetation, and is resisted by anthropogenic landcover types and roads. Our results suggest that the regional EN design being implemented in the Basque Country will effectively facilitate gene flow of forest dwelling species at regional scale. PMID:25329047

Using antibiograms to improve antibiotic prescribing in skilled nursing facilities.

PubMed

Furuno, Jon P; Comer, Angela C; Johnson, J Kristie; Rosenberg, Joseph H; Moore, Susan L; MacKenzie, Thomas D; Hall, Kendall K; Hirshon, Jon Mark

2014-10-01

Antibiograms have effectively improved antibiotic prescribing in acute-care settings; however, their effectiveness in skilled nursing facilities (SNFs) is currently unknown. To develop SNF-specific antibiograms and identify opportunities to improve antibiotic prescribing. Cross-sectional and pretest-posttest study among residents of 3 Maryland SNFs. Antibiograms were created using clinical culture data from a 6-month period in each SNF. We also used admission clinical culture data from the acute care facility primarily associated with each SNF for transferred residents. We manually collected all data from medical charts, and antibiograms were created using WHONET software. We then used a pretest-posttest study to evaluate the effectiveness of an antibiogram on changing antibiotic prescribing practices in a single SNF. Appropriate empirical antibiotic therapy was defined as an empirical antibiotic choice that sufficiently covered the infecting organism, considering antibiotic susceptibilities. We reviewed 839 patient charts from SNF and acute care facilities. During the initial assessment period, 85% of initial antibiotic use in the SNFs was empirical, and thus only 15% of initial antibiotics were based on culture results. Fluoroquinolones were the most frequently used empirical antibiotics, accounting for 54.5% of initial prescribing instances. Among patients with available culture data, only 35% of empirical antibiotic prescribing was determined to be appropriate. In the single SNF in which we evaluated antibiogram effectiveness, prevalence of appropriate antibiotic prescribing increased from 32% to 45% after antibiogram implementation; however, this was not statistically significant ([Formula: see text]). Implementation of antibiograms may be effective in improving empirical antibiotic prescribing in SNFs.

A Family-Centered Positive Behavior Support Approach to the Amelioration of Food Refusal Behavior: An Empirical Case Study

ERIC Educational Resources Information Center

Binnendyk, Lauren; Lucyshyn, Joseph M.

2009-01-01

The purpose of this study was to evaluate the effectiveness of a family-centered positive behavior support approach to the amelioration of food refusal behavior in a child with autism. The study was conducted with the child and his family in their home. It employed an empirical case study design with one meal routine: snack time. Following…

Computer implemented empirical mode decomposition method, apparatus, and article of manufacture for two-dimensional signals

NASA Technical Reports Server (NTRS)

Huang, Norden E. (Inventor)

2001-01-01

A computer implemented method of processing two-dimensional physical signals includes five basic components and the associated presentation techniques of the results. The first component decomposes the two-dimensional signal into one-dimensional profiles. The second component is a computer implemented Empirical Mode Decomposition that extracts a collection of Intrinsic Mode Functions (IMF's) from each profile based on local extrema and/or curvature extrema. The decomposition is based on the direct extraction of the energy associated with various intrinsic time scales in the profiles. In the third component, the IMF's of each profile are then subjected to a Hilbert Transform. The fourth component collates the Hilbert transformed IMF's of the profiles to form a two-dimensional Hilbert Spectrum. A fifth component manipulates the IMF's by, for example, filtering the two-dimensional signal by reconstructing the two-dimensional signal from selected IMF(s).

Adaptive Educational Hypermedia Accommodating Learning Styles: A Content Analysis of Publications from 2000 to 2011

ERIC Educational Resources Information Center

Akbulut, Yavuz; Cardak, Cigdem Suzan

2012-01-01

Implementing instructional interventions to accommodate learner differences has received considerable attention. Among these individual difference variables, the empirical evidence regarding the pedagogical value of learning styles has been questioned, but the research on the issue continues. Recent developments in Web-based implementations have…

An Evaluation of Strategies for Training Staff to Implement the Picture Exchange Communication System

ERIC Educational Resources Information Center

Barnes, Clarissa S.; Dunning, Johnna L.; Rehfeldt, Ruth Anne

2011-01-01

The picture exchange communication system (PECS) is a functional communication system frequently used with individuals diagnosed with autism spectrum disorders who experience severe language delays (Frost & Bondy, 2002). Few empirical investigations have evaluated strategies for training direct care staff how to effectively implement PECS with…

A Contingent Analysis of the Relationship between IS Implementation Strategies and IS Success.

ERIC Educational Resources Information Center

Kim, Sang-Hoon; Lee, Jinjoo

1991-01-01

Considers approaches to dealing with user attitudes toward newly implemented information systems (IS), and suggests that behavioral management strategies relevant to IS fall into three categories: (1) empirical/rational; (2) normative/reeducative; and (3) power/coercive, based on "planned change" theories. An integrative contingent model…

Graphic Narratives: Cognitive and Pedagogical Choices for Implementation in the English Language Arts Classroom

ERIC Educational Resources Information Center

Dulaney, Margaret Anne

2012-01-01

There is little empirical research that investigates the implementation of graphic narratives into the English language arts classroom, subsequently leading to misperceptions and misconceptions about their educative uses. Despite sequential arts' long history, graphic narratives continue to experience a marginalized existence within the…

The influence of sleep and activity patterns on fatigue in women with HIV/AIDS.

PubMed

Lee, K A; Portillo, C J; Miramontes, H

2001-01-01

The cause of HIV-related fatigue is most likely multifactorial. When presented as a chief complaint, clinicians often include an assessment of stress level, depression, anemia, infection, and amount of sleep and activity. The empirical bases for these evaluations vary in their validity and implementation in clinical practice, but the basis for evaluating adequate amounts of sleep and activity currently lacks empirical research. The purpose of this study was to describe HIV seropositive women's sleep and activity patterns related to their fatigue experience. Sleep and activity were assessed with wrist actigraphy to obtain objective measures of total sleep time, number of awakenings, and sleep efficiency, as well as level of daytime activity, 24-hour activity rhythm, and naps. This sample of 100 women with HIV/AIDS averaged only 6.5 hours of sleep at night, and 45% of the sample napped. CD4 cell counts were unrelated to sleep and fatigue measures. Compared to the low-fatigue group, the women with high fatigue had significantly more difficulty falling asleep, more awakenings from nighttime sleep, poorer daytime functioning, and a higher frequency of depressive symptoms. Findings from this study provide clinicians with empirically based support for detailed clinical evaluations of sleep and activity patterns, as well as anxiety and depression, in clients who complain of fatigue. Findings also provide data for potential interventions to improve sleep and activity in persons living with HIV/AIDS and to reduce fatigue and depressive symptoms.

Role of Statistical Random-Effects Linear Models in Personalized Medicine.

PubMed

Diaz, Francisco J; Yeh, Hung-Wen; de Leon, Jose

2012-03-01

Some empirical studies and recent developments in pharmacokinetic theory suggest that statistical random-effects linear models are valuable tools that allow describing simultaneously patient populations as a whole and patients as individuals. This remarkable characteristic indicates that these models may be useful in the development of personalized medicine, which aims at finding treatment regimes that are appropriate for particular patients, not just appropriate for the average patient. In fact, published developments show that random-effects linear models may provide a solid theoretical framework for drug dosage individualization in chronic diseases. In particular, individualized dosages computed with these models by means of an empirical Bayesian approach may produce better results than dosages computed with some methods routinely used in therapeutic drug monitoring. This is further supported by published empirical and theoretical findings that show that random effects linear models may provide accurate representations of phase III and IV steady-state pharmacokinetic data, and may be useful for dosage computations. These models have applications in the design of clinical algorithms for drug dosage individualization in chronic diseases; in the computation of dose correction factors; computation of the minimum number of blood samples from a patient that are necessary for calculating an optimal individualized drug dosage in therapeutic drug monitoring; measure of the clinical importance of clinical, demographic, environmental or genetic covariates; study of drug-drug interactions in clinical settings; the implementation of computational tools for web-site-based evidence farming; design of pharmacogenomic studies; and in the development of a pharmacological theory of dosage individualization.

Modeling the Innovation-Decision Process: Dissemination and Adoption of a Motivational Interviewing Preparatory Procedure in Addiction Outpatient Clinics

PubMed Central

Walitzer, Kimberly S.; Dermen, Kurt H.; Barrick, Christopher; Shyhalla, Kathleen

2015-01-01

Widespread adoption of empirically-supported treatment innovations has the potential to improve effectiveness of treatment received by individuals with substance use disorders. However, the process of disseminating such innovations has been complex, slow, and difficult. We empirically describe the dissemination and adoption of a treatment innovation – an alcohol-treatment preparatory therapeutic procedure based on motivational interviewing (MI) – in the context of Rogers’ (2003) five stages of innovation-decision process (knowledge, persuasion, decision, implementation and confirmation). To this end, 145 randomly-chosen outpatient addiction treatment clinics in New York State received an onsite visit from a project trainer delivering one of three randomly-assigned dissemination intensities: a 15-minute, a half-day or a full-day presentation. Across these clinics, 141 primary administrators and 837 clinicians completed questionnaires assessing aspects of five innovation-decision stages. At each clinic, questionnaire administration occurred immediately pre- and post-dissemination, as well as one and six months after dissemination. Consistent with Rogers’ theory, earlier stages of the innovation-decision process predicted later stages. As hypothesized, dissemination intensity predicted clinicians’ post-dissemination knowledge. Clinician baseline characteristics (including gender, pre-dissemination knowledge regarding the MI preparatory technique, education, case load, beliefs regarding the nature of alcohol problems, and beliefs and behavior with regard to therapeutic style) predicted knowledge and persuasion stage variables. One baseline clinic characteristic (i.e., clinic mean beliefs and behavior regarding an MI-consistent therapeutic style) predicted implementation stage variables. Findings suggest that dissemination strategies should accommodate clinician and clinic characteristics. PMID:25934460

Risks, Outcomes, and Evidence-based Interventions for Girls in the U.S. Juvenile Justice System

PubMed Central

Leve, Leslie D.; Chamberlain, Patricia; Kim, Hyoun K.

2015-01-01

The proportion of the juvenile justice population that is comprised of females is increasing, yet few evidence-based models have been evaluated and implemented with girls in the juvenile justice system. Although much is known about the risk and protective factors for girls who participate in serious delinquency, significant gaps in the research base hamper the development and implementation of theoretically based intervention approaches. In this review, we first summarize the extant empirical work about the predictors and sequelae of juvenile justice involvement for girls. Identified risk and protective factors that correspond to girls’ involvement in the juvenile justice system have been shown to largely parallel those of boys, although exposure rates and magnitudes of association sometimes differ by sex. Second, we summarize findings from empirically validated, evidence-based interventions for juvenile justice–involved youths that have been tested with girls. The interventions include Functional Family Therapy, Multisystemic Therapy, Multidimensional Family Therapy, and Treatment Foster Care Oregon (formerly known as Multidimensional Treatment Foster Care). We conclude that existing evidence-based practices appear to be effective for girls. However, few studies have been sufficiently designed to permit conclusions about whether sex-specific interventions would yield any better outcomes for girls than would interventions that already exist for both sexes and that have a strong base of evidence to support them. Third, we propose recommendations for feasible, cost-efficient next steps to advance the research and intervention agendas for this under-researched, under-served population of highly vulnerable youths. PMID:26119215

Obesity prevention programs and policies: practitioner and policy-maker perceptions of feasibility and effectiveness.

PubMed

Cleland, Verity; McNeilly, Briohny; Crawford, David; Ball, Kylie

2013-09-01

The aims of this study were to map obesity prevention activity being implemented by government, non-government, and community-based organizations; to determine practitioner and policy-maker perceptions of the feasibility and effectiveness of a range of evidence-based obesity prevention strategies; and to determine practitioner and policy-maker perceptions of preferred settings for obesity prevention strategies. This study involved a cross-sectional survey of 304 public health practitioners and policy-makers from government, non-government, and community organizations across Victoria, Australia. Participants reported their organizations' current obesity prevention programs and policies, their own perceptions of the feasibility and effectiveness of strategies to prevent obesity and their preferred settings for obesity prevention. Thirty-nine percent had an obesity prevention policy, and 92% were implementing obesity prevention programs. The most common programs focused on education, skill-building, and increasing access to healthy eating/physical activity opportunities. School curriculum-based initiatives, social support for physical activity, and family-based programs were considered the most effective strategies, whereas curriculum-based initiatives, active after-school programs, and providing access to and information about physical activity facilities were deemed the most feasible strategies. Schools were generally perceived as the most preferred setting for obesity prevention. Many organizations had obesity prevention programs, but far fewer had obesity prevention policies. Current strategies and those considered feasible and effective are often mismatched with the empirical literature. Systems to ensure better alignment between researchers, practitioners, and policy-makers, and identifying effective methods of translating empirical evidence into practice and policy are required. Copyright © 2012 The Obesity Society.

Selecting informative subsets of sparse supermatrices increases the chance to find correct trees.

PubMed

Misof, Bernhard; Meyer, Benjamin; von Reumont, Björn Marcus; Kück, Patrick; Misof, Katharina; Meusemann, Karen

2013-12-03

Character matrices with extensive missing data are frequently used in phylogenomics with potentially detrimental effects on the accuracy and robustness of tree inference. Therefore, many investigators select taxa and genes with high data coverage. Drawbacks of these selections are their exclusive reliance on data coverage without consideration of actual signal in the data which might, thus, not deliver optimal data matrices in terms of potential phylogenetic signal. In order to circumvent this problem, we have developed a heuristics implemented in a software called mare which (1) assesses information content of genes in supermatrices using a measure of potential signal combined with data coverage and (2) reduces supermatrices with a simple hill climbing procedure to submatrices with high total information content. We conducted simulation studies using matrices of 50 taxa × 50 genes with heterogeneous phylogenetic signal among genes and data coverage between 10-30%. With matrices of 50 taxa × 50 genes with heterogeneous phylogenetic signal among genes and data coverage between 10-30% Maximum Likelihood (ML) tree reconstructions failed to recover correct trees. A selection of a data subset with the herein proposed approach increased the chance to recover correct partial trees more than 10-fold. The selection of data subsets with the herein proposed simple hill climbing procedure performed well either considering the information content or just a simple presence/absence information of genes. We also applied our approach on an empirical data set, addressing questions of vertebrate systematics. With this empirical dataset selecting a data subset with high information content and supporting a tree with high average boostrap support was most successful if information content of genes was considered. Our analyses of simulated and empirical data demonstrate that sparse supermatrices can be reduced on a formal basis outperforming the usually used simple selections of taxa and genes with high data coverage.

Academic dishonesty in nursing schools: an empirical investigation.

PubMed

McCabe, Donald L

2009-11-01

Academic dishonesty, whether in the form of plagiarism or cheating on tests, has received renewed attention in the past few decades as pervasive use of the Internet and a presumed deterioration of ethics in the current generation of students has led some, perhaps many, to conclude that academic dishonesty is reaching epidemic proportions. What is lacking in many cases, including in the nursing profession, is empirical support of these trends. This article attempts to provide some of that empirical data and supports the conclusion that cheating is a significant issue in all disciplines today, including nursing. Some preliminary policy implications are also considered. Copyright 2009, SLACK Incorporated.

Impact of a clinical pathway on appropriate empiric vancomycin use in cancer patients with febrile neutropenia.

PubMed

Vicente, Mildred; Al-Nahedh, Mohammad; Parsad, Sandeep; Knoebel, Randall W; Pisano, Jennifer; Pettit, Natasha N

2017-12-01

Objectives Febrile neutropenia management guidelines recommend the use of vancomycin as part of an empiric antimicrobial regimen when specific criteria are met. Often, vancomycin use among patients with febrile neutropenia is not indicated and may be over utilized for this indication. We sought to evaluate the impact of implementing a febrile neutropenia clinical pathway on empiric vancomycin use for febrile neutropenia and to identify predictors of vancomycin use when not indicated. Methods Adult febrile neutropenia patients who received initial therapy with an anti-pseudomonal beta-lactam with or without vancomycin were identified before (June 2008 to November 2010) and after (June 2012 to June 2013) pathway implementation. Patients were assessed for appropriateness of therapy based on whether the patient received vancomycin consistent with guideline recommendations. Using a comorbidity index used for risk assessment in high risk hematology/oncology patients, we evaluated whether specific comorbidities are associated with inappropriate vancomycin use in the setting of febrile neutropenia. Results A total of 206 patients were included in the pre-pathway time period with 35.9% of patients receiving vancomycin therapy that was inconsistent with the pathway. A total of 131 patients were included in the post-pathway time period with 11.4% of patients receiving vancomycin inconsistent with the pathway ( p = 0.001). None of the comorbidities assessed, nor the comorbidity index score were found to be predictors of vancomycin use inconsistent with guideline recommendations. Conclusion Our study has demonstrated that implementation of a febrile neutropenia pathway can significantly improve adherence to national guideline recommendations with respect to empiric vancomycin utilization for febrile neutropenia.

Severity assessment scores to guide empirical use of antibiotics in community acquired pneumonia.

PubMed

Singanayagam, Aran; Chalmers, James D

2013-10-01

Severity assessment scores were first developed to predict the 30 day mortality in community acquired pneumonia; however, several guidelines have extended their use to guide empirical antibiotic prescription decisions. This approach has theoretical advantages because a decrease in broad-spectrum antibiotic treatment in low-risk patients might reduce antibiotic-related side-effects, and to give broad-spectrum therapy to patients at higher risk of death is intuitive. However, evidence in support of this approach is not clear. In particular, the British Thoracic Society guidelines suggest withholding a macrolide from patients with low CURB 65 scores, despite evidence that these patients have a higher frequency of atypical pathogens than do those with a higher severity of pneumonia. Severity scores do not perform well in some groups and might overestimate disease severity in elderly people, leading to inappropriate broad-spectrum treatment to those at high risk of complications such as Clostridium difficile infection. In this Review, we discuss the evidence for antibiotic prescribing guided by severity score and suggest that more evidence of effect and implementation is needed before this approach can be universally adopted. Copyright © 2013 Elsevier Ltd. All rights reserved.

How Can We Make the Pain Go Away? Public Policies to Manage Pain at the End of Life

PubMed Central

Imhof, Sara; Kaskie, Brian

2011-01-01

The continued undertreatment of pain at the end of life is a substantive public health problem that has not been resolved through increased public awareness, the issuance of clinical guidance for providers, or expanded organizational commitments. In this forum, we illuminate the role of public policies in promoting pain management. We review federal and state policies and consider empirical evaluations that compared the quality of state policies and the factors that contributed to their formation. We resolve that any organized interest in improving end-of-life care should begin by focusing on the development and expansion of those state policies that support the provision of evidence-based medicine for reducing the amount of pain an individual experiences at the end of life. Although empirical research is needed to determine which particular aspects of state pain policy are most critical and how these policies can be implemented most effectively, any organized effort that advances state medical board activity or another state policy would appear to be making an important step toward making the pain at the end of life go away. PMID:18728292

ICT and OTs: a model of information and communication technology acceptance and utilisation by occupational therapists.

PubMed

Schaper, Louise K; Pervan, Graham P

2007-06-01

There is evidence to suggest that health professionals are reluctant to accept and utilise information and communication technologies (ICT) and concern is growing within health informatics research that this is contributing to the lag in adoption and utilisation of ICT across the health sector. Technology acceptance research within the field of information systems has been limited in its application to health and there is a concurrent need to develop and gain empirical support for models of technology acceptance within health and to examine acceptance and utilisation issues amongst health professionals to improve the success of information system implementation in this arena. This paper outlines a project that examines ICT acceptance and utilisation by Australian occupational therapists. It describes the theoretical basis behind the development of a research model and the methodology being employed to empirically validate the model using substantial quantitative, qualitative and longitudinal data. Preliminary results from Phase II of the study are presented. The theoretical significance of this work is that it uses a thoroughly constructed research model, with potentially the largest sample size ever tested, to extend technology acceptance research into the health sector.

Complex contagion process in spreading of online innovation.

PubMed

Karsai, Márton; Iñiguez, Gerardo; Kaski, Kimmo; Kertész, János

2014-12-06

Diffusion of innovation can be interpreted as a social spreading phenomenon governed by the impact of media and social interactions. Although these mechanisms have been identified by quantitative theories, their role and relative importance are not entirely understood, as empirical verification has so far been hindered by the lack of appropriate data. Here we analyse a dataset recording the spreading dynamics of the world's largest Voice over Internet Protocol service to empirically support the assumptions behind models of social contagion. We show that the rate of spontaneous service adoption is constant, the probability of adoption via social influence is linearly proportional to the fraction of adopting neighbours, and the rate of service termination is time-invariant and independent of the behaviour of peers. By implementing the detected diffusion mechanisms into a dynamical agent-based model, we are able to emulate the adoption dynamics of the service in several countries worldwide. This approach enables us to make medium-term predictions of service adoption and disclose dependencies between the dynamics of innovation spreading and the socio-economic development of a country. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

A review of risk perceptions and other factors that influence flood mitigation behavior.

PubMed

Bubeck, P; Botzen, W J W; Aerts, J C J H

2012-09-01

In flood risk management, a shift can be observed toward more integrated approaches that increasingly address the role of private households in implementing flood damage mitigation measures. This has resulted in a growing number of studies into the supposed positive relationship between individual flood risk perceptions and mitigation behavior. Our literature review shows, however, that, actually, this relationship is hardly observed in empirical studies. Two arguments are provided as an explanation. First, on the basis of protection motivation theory, a theoretical framework is discussed suggesting that individuals' high-risk perceptions need to be accompanied by coping appraisal to result in a protective response. Second, it is pointed out that possible feedback from already-adopted mitigation measures on risk perceptions has hardly been considered by current studies. In addition, we also provide a review of factors that drive precautionary behavior other than risk perceptions. It is found that factors such as coping appraisal are consistently related to mitigation behavior. We conclude, therefore, that the current focus on risk perceptions as a means to explain and promote private flood mitigation behavior is not supported on either theoretical or empirical grounds. © 2012 Society for Risk Analysis.

Human interaction as environmental enrichment for pair-housed wolves and wolf-dog crosses.

PubMed

Mehrkam, Lindsay R; Verdi, Nicolle T; Wynne, Clive D L

2014-01-01

Private nonhuman animal sanctuaries are often financially limited in their ability to implement traditional environmental enrichment strategies. One possible solution may be to provide socialized animals with human interaction sessions. However, the merit of human interaction as enrichment has received little empirical attention to date. The present study aimed to evaluate whether human interaction could be enriching for socialized, pair-housed wolves and wolf-dog crosses at a private sanctuary. Observations of each subject were conducted in a reversal design to measure species-typical affiliation, activity levels, and aberrant behaviors when caretakers were both present and absent. The results demonstrate significantly higher levels of conspecific-directed affiliation and activity levels and reduced aberrant behavior when human interaction was available. Social play also increased when caregivers were present, supporting the hypothesis that play among conspecifics may be maintained by positive changes in an animal's environment. The potential for human interaction to be established as a scientifically validated, cost-effective enrichment strategy is supported by these findings.

Support Vector Data Descriptions and k-Means Clustering: One Class?

PubMed

Gornitz, Nico; Lima, Luiz Alberto; Muller, Klaus-Robert; Kloft, Marius; Nakajima, Shinichi

2017-09-27

We present ClusterSVDD, a methodology that unifies support vector data descriptions (SVDDs) and k-means clustering into a single formulation. This allows both methods to benefit from one another, i.e., by adding flexibility using multiple spheres for SVDDs and increasing anomaly resistance and flexibility through kernels to k-means. In particular, our approach leads to a new interpretation of k-means as a regularized mode seeking algorithm. The unifying formulation further allows for deriving new algorithms by transferring knowledge from one-class learning settings to clustering settings and vice versa. As a showcase, we derive a clustering method for structured data based on a one-class learning scenario. Additionally, our formulation can be solved via a particularly simple optimization scheme. We evaluate our approach empirically to highlight some of the proposed benefits on artificially generated data, as well as on real-world problems, and provide a Python software package comprising various implementations of primal and dual SVDD as well as our proposed ClusterSVDD.

Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector.

PubMed

Gordeev, Vladimir S; Pavlova, Milena; Groot, Wim

2011-10-01

This paper reviews the empirical evidence on the outcomes of the financial reforms in the Russian public healthcare sector. A systematic literature review identified 37 relevant publications that presented empirical evidence on changes in quality, equity, efficiency and sustainability in public healthcare provision due to the Russian public healthcare financial reforms. Evidence suggests that there are substantial inter-regional inequalities across income groups both in terms of financing and access to public healthcare services. There are large efficiency differences between regions, along with inter-regional variations in payment and reimbursement mechanisms. Informal and quasi-formal payments deteriorate access to public healthcare services and undermine the overall financing sustainability. The public healthcare sector is still underfinanced, although the implementation of health insurance gave some premises for future increases of efficiency. Overall, the available empirical data are not sufficient for an evidence-based evaluation of the reforms. More studies on the quality, equity, efficiency and sustainability impact of the reforms are needed. Future reforms should focus on the implementation of cost-efficiency and cost-control mechanisms; provide incentives for better allocation and distribution of resources; tackle problems in equity in access and financing; implement a system of quality controls; and stimulate healthy competition between insurance companies. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Investigating the roots of successful IT adoption processes - an empirical study exploring the shared awareness-knowledge of Directors of Nursing and Chief Information Officers.

PubMed

Liebe, J D; Hüsers, J; Hübner, U

2016-01-27

The majority of health IT adoption research focuses on the later stages of the IT adoption process: namely on the implementation phase. The first stage, however, which is defined as the knowledge-stage, remains widely unobserved. Following Rogers' Diffusion of Innovation Theory (DOI) this paper presents a research framework to examine the possible lack of shared IT awareness-knowledge, i.e. an information gradient, of two crucial stakeholders, the Chief Information Officer (CIO) and the Director of Nursing (DoN). This study shall answer the following research questions: (1.) Does this gradient exist? (2.) Which direction does it have? (3.) Are certain health IT (HIT) attributes associated with a potential gradient? (4.) Which determinants of diffusion go along with this gradient? Results of two surveys that focused on the topic "IT support of clinical workflows" from the viewpoint of CIOs and DoNs with corresponding datasets from 75 hospitals were used in a secondary data analysis. The gradient was operationalised by measuring the disagreement of CIOs and DoNs on the availability and implementation status of 29 IT functions. HIT attributes tested were relevance and market penetration of the IT functions, determinants of diffusion were inter-professional leadership and IT service density. The analysis revealed a significant disagreement on the availability of 9 out of 29 HIT functions. In 23 HIT functions, the CIOs reported a higher implementation status than the DoNs, which pointed to a trend for a unidirectional gradient. The disagreement was significantly lower when the relevance of the IT function was high. Both determinants of diffusion correlated significantly negative with the degree of disagreement. This is the first study to empirically examine shared awareness-knowledge of two IT-stakeholders that are crucial for triggering IT adoption on the frontline level in hospitals. It could be shown that a gradient and thus a lack of shared awareness-knowledge existed and was associated with certain factors. In conclusion, hospitals should implement improved cooperation between IT staff and clinicians and IT service density when establishing the prerequisites for successful IT adoption processes.

An exploratory analysis for Lean and Six Sigma implementation in hospitals: Together is better?

PubMed

Lee, Jung Young; McFadden, Kathleen L; Gowen, Charles R

Despite the increasing interest for Lean and Six Sigma implementations in hospitals, there has been little empirical evidence that goes beyond descriptive case studies to address the current status and the effectiveness of the implementations. The aim of this study was to explore existing patterns of Lean and Six Sigma implementation in U.S. hospitals and compare the performance of the different patterns. We collected data from 215 U.S. hospitals via a survey that includes measurement items developed from related literature. Using the cross-sectional data, we conducted a cluster analysis, followed by t tests, chi-square tests, and regression analyses for cluster verification. The cluster analysis identifies two clusters, a Moderate Six Sigma group and a Lean Six Sigma group. Results show that the Lean Six Sigma group outperforms the Moderate Six Sigma group across many performance dimensions: responsiveness capability, patient safety, and possibly cost saving. In addition, the Lean Six Sigma group tends to be composed of larger, private teaching hospitals located in more urban areas, and they employ more resources for quality improvement. Our research contributes to the quality management literature by supporting the possible complementary relationship between Lean and Six Sigma in hospitals. Our study encourages practitioners and managers to pay more attention to Lean implementation. Although Lean seems to be conducted in a limited fashion in many hospitals, it should be expanded and combined with Six Sigma for better results.

Cross-cultural comparison of concrete recycling decision-making and implementation in construction industry.

PubMed

Tam, Vivian W Y; Tam, Leona; Le, Khoa N

2010-02-01

Waste management is pressing very hard with alarming signals in construction industry. Concrete waste constituents major proportions of construction and demolition waste of 81% in Australia. To minimize concrete waste generated from construction activities, recycling concrete waste is one of the best methods to conserve the environment. This paper investigates concrete recycling implementation in construction. Japan is a leading country in recycling concrete waste, which has been implementing 98% recycling and using it for structural concrete applications. Hong Kong is developing concrete recycling programs for high-grade applications. Australia is making relatively slow progress in implementing concrete recycling in construction. Therefore, empirical studies in Australia, Hong Kong, and Japan were selected in this paper. A questionnaire survey and structured interviews were conducted. Power spectrum was used for analysis. It was found that "increasing overall business competitiveness and strategic business opportunities" was considered as the major benefit for concrete recycling from Hong Kong and Japanese respondents, while "rising concrete recycling awareness such as selecting suitable resources, techniques and training and compliance with regulations" was considered as the major benefit from Australian respondents. However, "lack of clients' support", "increase in management cost" and "increase in documentation workload, such as working documents, procedures and tools" were the major difficulties encountered from Australian, Hong Kong, and Japanese respondents, respectively. To improve the existing implementation, "inclusion of concrete recycling evaluation in tender appraisal" and "defining clear legal evaluation of concrete recycling" were major recommendations for Australian and Hong Kong, and Japanese respondents, respectively.

Research-Based Implementation of Peer Instruction: A Literature Review

PubMed Central

Vickrey, Trisha; Rosploch, Kaitlyn; Rahmanian, Reihaneh; Pilarz, Matthew; Stains, Marilyne

2015-01-01

Current instructional reforms in undergraduate science, technology, engineering, and mathematics (STEM) courses have focused on enhancing adoption of evidence-based instructional practices among STEM faculty members. These practices have been empirically demonstrated to enhance student learning and attitudes. However, research indicates that instructors often adapt rather than adopt practices, unknowingly compromising their effectiveness. Thus, there is a need to raise awareness of the research-based implementation of these practices, develop fidelity of implementation protocols to understand adaptations being made, and ultimately characterize the true impact of reform efforts based on these practices. Peer instruction (PI) is an example of an evidence-based instructional practice that consists of asking students conceptual questions during class time and collecting their answers via clickers or response cards. Extensive research has been conducted by physics and biology education researchers to evaluate the effectiveness of this practice and to better understand the intricacies of its implementation. PI has also been investigated in other disciplines, such as chemistry and computer science. This article reviews and summarizes these various bodies of research and provides instructors and researchers with a research-based model for the effective implementation of PI. Limitations of current studies and recommendations for future empirical inquiries are also provided. PMID:25713095

Implementation of guidelines for management of possible multidrug-resistant pneumonia in intensive care: an observational, multicentre cohort study.

PubMed

Kett, Daniel H; Cano, Ennie; Quartin, Andrew A; Mangino, Julie E; Zervos, Marcus J; Peyrani, Paula; Cely, Cynthia M; Ford, Kimbal D; Scerpella, Ernesto G; Ramirez, Julio A

2011-03-01

The American Thoracic Society and Infectious Diseases Society of America provide guidelines for management of hospital-acquired, ventilator-associated, and health-care-associated pneumonias, consisting of empirical antibiotic regimens for patients at risk for multidrug-resistant pathogens. We aimed to improve compliance with these guidelines and assess outcomes. We implemented a performance-improvement initiative in four academic medical centres in the USA with protocol-based education and prospective observation of outcomes. Patients were assessed for severity of illness and followed up until death, hospital discharge, or day 28. We included patients in intensive-care units who were at risk for multidrug-resistant pneumonia and were treated empirically. 303 patients at risk for multidrug-resistant pneumonia were treated empirically, and prescribed treatment was guideline compliant in 129 patients and non-compliant in 174 patients. 44 (34%) patients died before 28 days in the compliance group and 35 (20%) died in the non-compliance group. Five patients in the compliance group and seven in the non-compliance group were lost to follow-up after day 14. Kaplan-Meier estimated survival to 28 days was 65% in the compliance group and 79% in the non-compliance group (p=0·0042). This difference persisted after adjustment for severity of illness. Median length of stay and duration of mechanical ventilation did not differ between groups. Compliance failures included non-use of dual treatment for Gram-negative pathogens in 154 patients and absence of meticillin-resistant Staphylococcus aureus coverage in 24 patients. For patients in whom pathogens were subsequently identified, empirical treatment was active in 79 (81%) of 97 of patients receiving compliant therapy compared with 109 (85%) of 128 of patients receiving non-compliant therapy. Because adherence with empirical treatment was associated with increased mortality, we recommend a randomised trial be done before further implementation of these guidelines. Pfizer, US Medical. Copyright © 2011 Elsevier Ltd. All rights reserved.

In-network adaptation of SHVC video in software-defined networks

NASA Astrophysics Data System (ADS)

Awobuluyi, Olatunde; Nightingale, James; Wang, Qi; Alcaraz Calero, Jose Maria; Grecos, Christos

2016-04-01

Software Defined Networks (SDN), when combined with Network Function Virtualization (NFV) represents a paradigm shift in how future networks will behave and be managed. SDN's are expected to provide the underpinning technologies for future innovations such as 5G mobile networks and the Internet of Everything. The SDN architecture offers features that facilitate an abstracted and centralized global network view in which packet forwarding or dropping decisions are based on application flows. Software Defined Networks facilitate a wide range of network management tasks, including the adaptation of real-time video streams as they traverse the network. SHVC, the scalable extension to the recent H.265 standard is a new video encoding standard that supports ultra-high definition video streams with spatial resolutions of up to 7680×4320 and frame rates of 60fps or more. The massive increase in bandwidth required to deliver these U-HD video streams dwarfs the bandwidth requirements of current high definition (HD) video. Such large bandwidth increases pose very significant challenges for network operators. In this paper we go substantially beyond the limited number of existing implementations and proposals for video streaming in SDN's all of which have primarily focused on traffic engineering solutions such as load balancing. By implementing and empirically evaluating an SDN enabled Media Adaptation Network Entity (MANE) we provide a valuable empirical insight into the benefits and limitations of SDN enabled video adaptation for real time video applications. The SDN-MANE is the video adaptation component of our Video Quality Assurance Manager (VQAM) SDN control plane application, which also includes an SDN monitoring component to acquire network metrics and a decision making engine using algorithms to determine the optimum adaptation strategy for any real time video application flow given the current network conditions. Our proposed VQAM application has been implemented and evaluated on an SDN allowing us to provide important benchmarks for video streaming over SDN and for SDN control plane latency.

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

PubMed Central

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

2012-01-01

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

Implementation of WirelessHART in the NS-2 Simulator and Validation of Its Correctness

PubMed Central

Zand, Pouria; Mathews, Emi; Havinga, Paul; Stojanovski, Spase; Sisinni, Emiliano; Ferrari, Paolo

2014-01-01

One of the first standards in the wireless sensor networks domain, WirelessHART (HART (Highway Addressable Remote Transducer)), was introduced to address industrial process automation and control requirements. This standard can be used as a reference point to evaluate other wireless protocols in the domain of industrial monitoring and control. This makes it worthwhile to set up a reliable WirelessHART simulator in order to achieve that reference point in a relatively easy manner. Moreover, it offers an alternative to expensive testbeds for testing and evaluating the performance of WirelessHART. This paper explains our implementation of WirelessHART in the NS-2 network simulator. According to our knowledge, this is the first implementation that supports the WirelessHART network manager, as well as the whole stack (all OSI (Open Systems Interconnection model) layers) of the WirelessHART standard. It also explains our effort to validate the correctness of our implementation, namely through the validation of the implementation of the WirelessHART stack protocol and of the network manager. We use sniffed traffic from a real WirelessHART testbed installed in the Idrolab plant for these validations. This confirms the validity of our simulator. Empirical analysis shows that the simulated results are nearly comparable to the results obtained from real networks. We also demonstrate the versatility and usability of our implementation by providing some further evaluation results in diverse scenarios. For example, we evaluate the performance of the WirelessHART network by applying incremental interference in a multi-hop network. PMID:24841245

Five Years of Research Into Technology-Enhanced Learning at the Faculty of Materials Science and Technology

NASA Astrophysics Data System (ADS)

Svetský, Štefan; Moravčík, Oliver; Rusková, Dagmar; Balog, Karol; Sakál, Peter; Tanuška, Pavol

2011-01-01

The article describes a five-year period of Technology Enhanced Learning (TEL) implementation at the Faculty of Materials Science and Technology (MTF) in Trnava. It is a part of the challenges put forward by the 7th Framework Programme (ICT research in FP7) focused on "how information and communication technologies can be used to support learning and teaching". The empirical research during the years 2006-2008 was focused on technology-driven support of teaching, i. e. the development of VLE (Virtual Learning Environment) and the development of database applications such as instruments developed simultaneously with the information support of the project, and tested and applied directly in the teaching of bachelor students. During this period, the MTF also participated in the administration of the FP7 KEPLER project proposal in the international consortium of 20 participants. In the following period of 2009-2010, the concept of educational activities automation systematically began to develop. Within this concept, the idea originated to develop a universal multi-purpose system BIKE based on the batch processing knowledge paradigm. This allowed to focus more on educational approach, i.e. TEL educational-driven and to finish the programming of the Internet application - network for feedback (communication between teachers and students). Thanks to this specialization, the results of applications in the teaching at MTF could gradually be presented at the international conferences focused on computer-enhanced engineering education. TEL was implemented at a detached workplace and four institutes involving more than 600 students-bachelors and teachers of technical subjects. Four study programmes were supported, including technical English language. Altogether, the results have been presented via 16 articles in five countries, including the EU level (IGIP-SEFI).

Methodological support for the further abstraction of and philosophical examination of empirical findings in the context of caring science

PubMed Central

Lindberg, Elisabeth; Österberg, Sofia A.; Hörberg, Ulrica

2016-01-01

Phenomena in caring science are often complex and laden with meanings. Empirical research with the aim of capturing lived experiences is one way of revealing the complexity. Sometimes, however, results from empirical research need to be further discussed. One way is to further abstract the result and/or philosophically examine it. This has previously been performed and presented in scientific journals and doctoral theses, contributing to a greater understanding of phenomena in caring science. Although the intentions in many of these publications are laudable, the lack of methodological descriptions as well as a theoretical and systematic foundation can contribute to an ambiguity concerning how the results have emerged during the analysis. The aim of this paper is to describe the methodological support for the further abstraction of and/or philosophical examination of empirical findings. When trying to systematize the support procedures, we have used a reflective lifeworld research (RLR) approach. Based on the assumptions in RLR, this article will present methodological support for a theoretical examination that can include two stages. In the first stage, data from several (two or more) empirical results on an essential level are synthesized into a general structure. Sometimes the analysis ends with the general structure, but sometimes there is a need to proceed further. The second stage can then be a philosophical examination, in which the general structure is discussed in relation to a philosophical text, theory, or concept. It is important that the theories are brought in as the final stage after the completion of the analysis. Core dimensions of the described methodological support are, in accordance with RLR, openness, bridling, and reflection. The methodological support cannot be understood as fixed stages, but rather as a guiding light in the search for further meanings. PMID:26925926

Empirical Evidence for Niss' "Implemented Anticipation" in Mathematising Realistic Situations

ERIC Educational Resources Information Center

Stillman, Gloria; Brown, Jill P.

2012-01-01

Mathematisation of realistic situations is an on-going focus of research. Classroom data from a Year 9 class participating in a program of structured modelling of real situations was analysed for evidence of Niss's theoretical construct, implemented anticipation, during mathematisation. Evidence was found for two of three proposed aspects. In…

School Climate, Connectedness and Academic Achievement: Examining Positive Impacts from High School Mentoring Services

ERIC Educational Resources Information Center

Angus, Rebecca; Hughes, Thomas

2017-01-01

Schools regularly implement numerous programs to satisfy widespread expectations. Often, implementation is carried out with little follow-up examining data that could help refine or determine the ultimate worth of the intervention. Through utilization of both descriptive and empirical methods, this study delved into the long-term effectiveness of…

Teachers' Reasons for Using Peer Assessment: Positive Experience Predicts Use

ERIC Educational Resources Information Center

Panadero, Ernesto; Brown, Gavin T. L.

2017-01-01

Peer assessment (PA) is one of the central principles of formative assessment and assessment for learning (AfL) fields. There is ample empirical evidence as to the benefits for students' learning when AfL principles are implemented. However, teachers play a critical role in mediating the implementation of intended policies. Hence, their…

A Study of Transformational Change at Three Schools of Nursing Implementing Healthcare Informatics

ERIC Educational Resources Information Center

Cornell, Revonda Leota

2009-01-01

The "Health Professions Education: A Bridge to Quality" (IOM, 2003) proposed strategies for higher education leaders and faculty to transform their institutions in ways that address the healthcare problems. This study provides higher education leaders and faculty with empirical data about the processes of change involved to implement the…

Electronic Portfolios in Grades One, Two and Three: A Cautionary Tale

ERIC Educational Resources Information Center

Kotsopoulos, Donna; Lee, Joanne; Cordy, Michelle; Bruyns, Susan

2015-01-01

Some electronic portfolios (EPs) developers are proposing that EPs are suitable for implementation in primary education (i.e. kindergarten to grade three). Yet, empirical research evaluating the implementation and efficacy of EPs used in primary school settings at both the teacher and the student level is scarce. In this research, the authors…

Essential Characteristics for a Professional Development Program for Promoting the Implementation of a Multidisciplinary Science Module

ERIC Educational Resources Information Center

Visser, Talitha C.; Coenders, Fer G. M.; Terlouw, Cees; Pieters, Jules M.

2010-01-01

Teachers involved in the implementation of a curriculum innovation can be prepared for this task through a professional development program. In this paper, we describe essential characteristics (identified empirically and theoretically) for such a professional development program that promotes the acquisition of competences by these teachers. The…

Fidelity of Implementation and Instructional Alignment in Response to Intervention Research

ERIC Educational Resources Information Center

Hill, David R.; King, Seth A.; Lemons, Christopher J.; Partanen, Jane N.

2012-01-01

In this review, we explore the extent to which researchers evaluating the efficacy of Tier 2 elementary reading interventions within the framework of Response to Intervention reported on fidelity of implementation and alignment of instruction between tiers. A literature search identified 22 empirical studies from which conclusions were drawn.…

A four stage approach for ontology-based health information system design.

PubMed

Kuziemsky, Craig E; Lau, Francis

2010-11-01

To describe and illustrate a four stage methodological approach to capture user knowledge in a biomedical domain area, use that knowledge to design an ontology, and then implement and evaluate the ontology as a health information system (HIS). A hybrid participatory design-grounded theory (GT-PD) method was used to obtain data and code them for ontology development. Prototyping was used to implement the ontology as a computer-based tool. Usability testing evaluated the computer-based tool. An empirically derived domain ontology and set of three problem-solving approaches were developed as a formalized model of the concepts and categories from the GT coding. The ontology and problem-solving approaches were used to design and implement a HIS that tested favorably in usability testing. The four stage approach illustrated in this paper is useful for designing and implementing an ontology as the basis for a HIS. The approach extends existing ontology development methodologies by providing an empirical basis for theory incorporated into ontology design. Copyright © 2010 Elsevier B.V. All rights reserved.

Roles of Engineering Correlations in Hypersonic Entry Boundary Layer Transition Prediction

NASA Technical Reports Server (NTRS)

Campbell, Charles H.; Anderson, Brian P.; King, Rudolph A.; Kegerise, Michael A.; Berry, Scott A.; Horvath, Thomas J.

2010-01-01

Efforts to design and operate hypersonic entry vehicles are constrained by many considerations that involve all aspects of an entry vehicle system. One of the more significant physical phenomenon that affect entry trajectory and thermal protection system design is the occurrence of boundary layer transition from a laminar to turbulent state. During the Space Shuttle Return To Flight activity following the loss of Columbia and her crew of seven, NASA's entry aerothermodynamics community implemented an engineering correlation based framework for the prediction of boundary layer transition on the Orbiter. The methodology for this implementation relies upon similar correlation techniques that have been is use for several decades. What makes the Orbiter boundary layer transition correlation implementation unique is that a statistically significant data set was acquired in multiple ground test facilities, flight data exists to assist in establishing a better correlation and the framework was founded upon state of the art chemical nonequilibrium Navier Stokes flow field simulations. Recent entry flight testing performed with the Orbiter Discovery now provides a means to validate this engineering correlation approach to higher confidence. These results only serve to reinforce the essential role that engineering correlations currently exercise in the design and operation of entry vehicles. The framework of information related to the Orbiter empirical boundary layer transition prediction capability will be utilized to establish a fresh perspective on this role, and to discuss the characteristics which are desirable in a next generation advancement. The details of the paper will review the experimental facilities and techniques that were utilized to perform the implementation of the Orbiter RTF BLT Vsn 2 prediction capability. Statistically significant results for multiple engineering correlations from a ground testing campaign will be reviewed in order to describe why only certain correlations were selected for complete implementation to support the Shuttle Program. Historical Orbiter flight data on early boundary layer transition due to protruding gap fillers will be described in relation to the selected empirical correlations. In addition, Orbiter entry flight testing results from the BLT Flight Experiment will be discussed in relation to these correlations. Applicability of such correlations to the entry design problem will be reviewed, and finally a perspective on the desirable characteristics for a next generation capability based on high fidelity physical models will be provided.

Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: protocol for a critical interpretive synthesis.

PubMed

Salmon, Victoria E; Hay-Smith, E Jean C; Jarvie, Rachel; Dean, Sarah; Oborn, Eivor; Bayliss, Susan E; Bick, Debra; Davenport, Clare; Ismail, Khaled M; MacArthur, Christine; Pearson, Mark

2017-01-25

Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. PROSPERO: CRD42016042792.

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…

Evaluation criteria for district health management information systems: lessons from the Ministry of Health, Kenya.

PubMed

Odhiambo-Otieno, George W

2005-01-01

There has been no comprehensive evaluation of the district health management information systems (DHMISs) since the establishment of these systems by the Ministry of Health (MoH), in Kenya. This is partly due to lack of defined criteria for evaluating the systems. The objective of this study is to design evaluation criteria for assessing the viability, sustainability and ultimate contribution of DHMIS in the management of the district health system (DHS) in Kenya. This descriptive cross-sectional study was undertaken in three DHSs in Kenya. Empirical evidence was collected through interviews, complemented by a comprehensive review of relevant literature, reports and operational manuals of various health information systems in Kenya. A set of evaluation criteria for DHMISs in Kenya was designed for each of the three phases of implementation: phase one-pre-implementation evaluation criteria (categorized as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; phase two-concurrent (operational) implementation evaluation criteria to be applied during implementation of the new system; phase three-post-implementation evaluation criteria (classified as internal-quality of information; external-resources and managerial support; ultimate-systems impact) to be applied after operating the implemented system for at least 3 years. In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to its implementation; concurrent (operational) implementation evaluation criteria should be used to ascertain the status of the on-going implementation with the view to either fine-tune or abandon it altogether before more resources are used on it; and post-implementation evaluation criteria should be used to assess its overall effectiveness (if it has achieved its hypothesized benefits) towards the management of DHS.

Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

PubMed Central

2012-01-01

Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings. PMID:22769593

Empire's recent history, as seen from the Special Advisory Review Panel on Blue Cross.

PubMed

Barba, J J

1997-01-01

Empire is a smaller and more financially stable company that no longer has an externally imposed social mission. The board and management of Empire have decided to convert to a for-profit company, to compete in the marketplace. In light of this decision, they also decided to turn over the company's charitable value to a new foundation. Because Empire's board has chosen not to maintain a social mission, the Panel strongly supports its proposal to turn over the full value of the charitable asset. This will allow the asset to be used for purposes that are in keeping with Empire's original social mission. Exactly how this asset should be valued, what form it should take, when it should be turned over, who should control the assets, and what activities it should support are just a few of the many important issues that must be resolved during the next few months. Empire will not and should not remain stagnant during the next few months. Given the rapidly evolving health-care market, Empire's board and management must continue to pursue a market strategy that strengthens the company. However, given the factors discussed earlier--hospital deregulation, the increasingly competitive managed-care market, and other pressures in the health-care environment--it is clear that the road ahead for Empire will not be a smooth one and that the company's financial resurgence is no guarantee of continued stability. Much hard work remains. I am confident that Empire's board and its management will continue to do its part, that the Panel will continue to do likewise.

Empire's recent history, as seen from the Special Advisory Review Panel on Blue Cross.

PubMed Central

Barba, J. J.

1997-01-01

Empire is a smaller and more financially stable company that no longer has an externally imposed social mission. The board and management of Empire have decided to convert to a for-profit company, to compete in the marketplace. In light of this decision, they also decided to turn over the company's charitable value to a new foundation. Because Empire's board has chosen not to maintain a social mission, the Panel strongly supports its proposal to turn over the full value of the charitable asset. This will allow the asset to be used for purposes that are in keeping with Empire's original social mission. Exactly how this asset should be valued, what form it should take, when it should be turned over, who should control the assets, and what activities it should support are just a few of the many important issues that must be resolved during the next few months. Empire will not and should not remain stagnant during the next few months. Given the rapidly evolving health-care market, Empire's board and management must continue to pursue a market strategy that strengthens the company. However, given the factors discussed earlier--hospital deregulation, the increasingly competitive managed-care market, and other pressures in the health-care environment--it is clear that the road ahead for Empire will not be a smooth one and that the company's financial resurgence is no guarantee of continued stability. Much hard work remains. I am confident that Empire's board and its management will continue to do its part, that the Panel will continue to do likewise. PMID:9439862

Are Facebook "Friends" Helpful? Development of a Facebook-Based Measure of Social Support and Examination of Relationships Among Depression, Quality of Life, and Social Support.

PubMed

McCloskey, Wilfred; Iwanicki, Sierra; Lauterbach, Dean; Giammittorio, David M; Maxwell, Kendal

2015-09-01

Greater social support is predictive of lower depression and higher quality of life (QOL). However, the way in which social support is provided has changed greatly with the expanding role of social networking sites (e.g., Facebook). While there are numerous anecdotal accounts of the benefits of Facebook-based social support, little empirical evidence exists to support these assertions, and there are no empirically validated measures designed to assess social support provided via this unique social networking medium. This study sought to develop an empirically sound measure of Facebook-based social support (Facebook Measure of Social Support [FMSS]) and to assess how this new measure relates to previously established measures of support and two outcome variables: depression and QOL. Following exploratory factor analysis, the FMSS was determined to assess four factors of social support on Facebook (Perceived, Emotional, Negative, Received/Instrumental). The Negative Support factor on the FMSS was most strongly related to both depression and QOL with magnitudes (and direction of relationships) comparable to a traditional measure of perceived social support. However, two FMSS factors (Received/Instrumental and Perceived) were unrelated to both mental health outcomes. Contrary to expectations, elevations in one FMSS factor (Emotional) was associated with worse symptoms of depression and poorer psychological QOL. When taken together, only the absence of negative social support on Facebook is significantly predictive of mental health functioning. Consequently, those hoping to use Facebook as a medium for reducing depression or improving QOL are unlikely to realize significant therapeutic benefits.

Barriers to Advance Care Planning at the End of Life: An Explanatory Systematic Review of Implementation Studies

PubMed Central

Lund, Susi; Richardson, Alison; May, Carl

2015-01-01

Context Advance Care Plans (ACPs) enable patients to discuss and negotiate their preferences for the future including treatment options at the end of life. Their implementation poses significant challenges. Objective To investigate barriers and facilitators to the implementation of ACPs, focusing on their workability and integration in clinical practice. Design An explanatory systematic review of qualitative implementation studies. Data sources Empirical studies that reported interventions designed to support ACP in healthcare. Web of Knowledge, Ovid MEDLINE, CINAHL, PsycINFO, British Nursing Index and PubMed databases were searched. Methods Direct content analysis, using Normalization Process Theory, to identify and characterise relevant components of implementation processes. Results 13 papers identified from 166 abstracts were included in the review. Key factors facilitating implementation were: specially prepared staff utilizing a structured approach to interactions around ACPs. Barriers to implementation were competing demands of other work, the emotional and interactional nature of patient-professional interactions around ACPs, problems in sharing decisions and preferences within and between healthcare organizations. Conclusions This review demonstrates that doing more of the things that facilitate delivery of ACPs will not reduce the effects of those things that undermine them. Structured tools are only likely to be partially effective and the creation of a specialist cadre of ACP facilitators is unlikely to be a sustainable solution. The findings underscore both the challenge and need to find ways to routinely incorporate ACPs in clinical settings where multiple and competing demands impact on practice. Interventions most likely to meet with success are those that make elements of Advance Care Planning workable within complex and time pressured clinical workflows. PMID:25679395

An Algorithm Using Twelve Properties of Antibiotics to Find the Recommended Antibiotics, as in CPGs.

PubMed

Tsopra, R; Venot, A; Duclos, C

2014-01-01

Clinical Decision Support Systems (CDSS) incorporating justifications, updating and adjustable recommendations can considerably improve the quality of healthcare. We propose a new approach to the design of CDSS for empiric antibiotic prescription, based on implementation of the deeper medical reasoning used by experts in the development of clinical practice guidelines (CPGs), to deduce the recommended antibiotics. We investigated two methods ("exclusion" versus "scoring") for reproducing this reasoning based on antibiotic properties. The "exclusion" method reproduced expert reasoning the more accurately, retrieving the full list of recommended antibiotics for almost all clinical situations. This approach has several advantages: (i) it provides convincing explanations for physicians; (ii) updating could easily be incorporated into the CDSS; (iii) it can provide recommendations for clinical situations missing from CPGs.

Interrogative suggestibility: its relationship with assertiveness, social-evaluative anxiety, state anxiety and method of coping.

PubMed

Gudjonsson, G H

1988-05-01

This paper attempts to investigate empirically in 30 subjects some of the theoretical components related to individual differences that are thought by Gudjonsson & Clark (1986) to mediate interrogative suggestibility as measured by the Gudjonsson Suggestibility Scale (GSS; Gudjonsson, 1984a). The variables studied were: assertiveness, social-evaluative anxiety, state anxiety and the coping methods subjects are able to generate and implement during interrogation. Low assertiveness and high evaluative anxiety were found to correlate moderately with suggestibility, but no significant correlations emerged for 'social avoidance and distress'. State anxiety correlated significantly with suggestibility, particularly after negative feedback had been administered. Coping methods (active-cognitive/behavioural vs. avoidance) significantly predicted suggestibility scores. The findings give strong support to the theoretical model of Gudjonsson & Clark.

Black South African psychiatric recipients: have they been overlooked under the recent democratization?

PubMed

Jones, Lani V

2009-01-01

This article examines the literature on service accessibility, utilization, and treatment needs for Black South African adults with psychiatric disabilities and highlights the paucity of empirical studies in these areas. Current research draws attention to the finding that Black South Africans essentially have been neglected or ignored in the mental health system, suggesting that the government should formulate and implement programs and policies to ensure the effective delivery of psychiatric services. A framework for practice is warranted in which traditional health practices are parallel to mainstream westernized psychiatric care that emphasizes culturally relevant care and naturally occurring community supports rather than large psychiatric institutions. It is suggested here that "psychosocial competence" may provide a resonant and particularly useful framework for practice in this population.

A Spoken Language Intervention for School-Aged Boys with fragile X Syndrome

PubMed Central

McDuffie, Andrea; Machalicek, Wendy; Bullard, Lauren; Nelson, Sarah; Mello, Melissa; Tempero-Feigles, Robyn; Castignetti, Nancy; Abbeduto, Leonard

2015-01-01

Using a single case design, a parent-mediated spoken language intervention was delivered to three mothers and their school-aged sons with fragile X syndrome, the leading inherited cause of intellectual disability. The intervention was embedded in the context of shared story-telling using wordless picture books and targeted three empirically-derived language support strategies. All sessions were implemented via distance video-teleconferencing. Parent education sessions were followed by 12 weekly clinician coaching and feedback sessions. Data was collected weekly during independent homework and clinician observation sessions. Relative to baseline, mothers increased their use of targeted strategies and dyads increased the frequency and duration of story-related talking. Generalized effects of the intervention on lexical diversity and grammatical complexity were observed. Implications for practice are discussed. PMID:27119214

Gender differences in the perception and utilization of social support: theoretical perspectives and an empirical test.

PubMed

Flaherty, J; Richman, J

1989-01-01

The authors contend that women are the more supportive, nurturing and affectively-connected sex. They argue that these gender differences result from socialization experiences which may be modified by social and occupational roles. Theoretical perspectives and research addressing this proposition are reviewed. Empirical data on support-eliciting and support-providing behaviors in a cohort of medical students are then provided to test their thesis. The data suggest that women have developed a greater sensitivity to the needs of themselves and others, leading to a greater capacity to provide support and a greater dependence upon social support for psychological well-being. Personality and developmental factors that may account for these differences are examined. The implications of these findings for gender differences in mental health are discussed.

Consequentialism, complacency, and slippery slope arguments.

PubMed

Oakley, Justin; Cocking, Dean

2005-01-01

The standard problem with many slippery slope arguments is that they fail to provide us with the necessary evidence to warrant our believing that the significantly morally worse circumstances they predict will in fact come about. As such these arguments have widely been criticised as 'scare-mongering'. Consequentialists have traditionally been at the forefront of such criticisms, demanding that we get serious about guiding our prescriptions for right action by a comprehensive appreciation of the empirical facts. This is not surprising, since consequentialism has traditionally been committed to the idea that right action be driven by empirical realities, and this hard-headed approach has been an especially notable feature of Australian consequentialism. But this apparent empirical hard-headedness is very selective. While consequentialists have understood their moral outlook and commitments as guided by a partnership with empirical science - most explicitly in their replies to the arguments of their detractors - some consequentialists have been remarkably complacent about providing empirical support for their own prescriptions. Our key example here is the consequentialist claim that our current practises of partiality in fact maximise the good, impartially conceived. This claim has invariably been made without compelling support for the large empirical claims upon which it rests, and so, like the speculative empirical hand-waving of weak slippery slope arguments, it seems similarly to be undermined. While these arguments have presented us with 'wishful thinking' rather than 'scare-mongering', we argue in this paper that their complacency in meeting the relevant empirical justificatory burden remains much the same.

Hypnosis and the treatment of posttraumatic conditions: an evidence-based approach.

PubMed

Lynn, Steven Jay; Cardeña, Etzel

2007-04-01

This article reviews the evidence for the use of hypnosis in the treatment of posttraumatic conditions including posttraumatic stress disorder and acute stress disorder. The review focuses on empirically supported principles and practices and suggests that hypnosis can be a useful adjunctive procedure in the treatment of posttraumatic conditions. Cognitive-behavioral and exposure-based interventions, which have the greatest empirical support, are highlighted, and an illustrative case study is presented.

The existential function of close relationships: introducing death into the science of love.

PubMed

Mikulincer, Mario; Florian, Victor; Hirschberger, Gilad

2003-01-01

Originally, terror management theory proposed two psychological mechanisms in dealing with the terror of death awareness-cultural worldview validation and self-esteem enhancement. In this article, we would like to promote the idea of close relationships as an additional death-anxiety buffering mechanism and review a growing body of empirical data that support this contention. Based on a comprehensive analysis of the sociocultural and personal functions of close relationships, we formulate two basic hypotheses that have received empirical support in a series of experimental studies. First, death reminders heighten the motivation to form and maintain close relationships. Second, the maintenance of close relationships provides a symbolic shield against the terror of death, whereas the breaking of close relationships results in an upsurge of death awareness. In addition, we present empirical evidence supporting the possibility that close relationships function as a related yet separate mechanism from the self-esteem and cultural worldview defenses.

Support vector machines for nuclear reactor state estimation

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

Zavaljevski, N.; Gross, K. C.

2000-02-14

Validation of nuclear power reactor signals is often performed by comparing signal prototypes with the actual reactor signals. The signal prototypes are often computed based on empirical data. The implementation of an estimation algorithm which can make predictions on limited data is an important issue. A new machine learning algorithm called support vector machines (SVMS) recently developed by Vladimir Vapnik and his coworkers enables a high level of generalization with finite high-dimensional data. The improved generalization in comparison with standard methods like neural networks is due mainly to the following characteristics of the method. The input data space is transformedmore » into a high-dimensional feature space using a kernel function, and the learning problem is formulated as a convex quadratic programming problem with a unique solution. In this paper the authors have applied the SVM method for data-based state estimation in nuclear power reactors. In particular, they implemented and tested kernels developed at Argonne National Laboratory for the Multivariate State Estimation Technique (MSET), a nonlinear, nonparametric estimation technique with a wide range of applications in nuclear reactors. The methodology has been applied to three data sets from experimental and commercial nuclear power reactor applications. The results are promising. The combination of MSET kernels with the SVM method has better noise reduction and generalization properties than the standard MSET algorithm.« less

Piloting a psycho-social intervention for incarcerated women with trauma histories: lessons learned and future recommendations.

PubMed

Liebman, Rachel E; Burnette, Mandi L; Raimondi, Christina; Nichols-Hadeed, Corey; Merle, Patricia; Cerulli, Catherine

2014-08-01

Trauma and related mental health disorders are common among incarcerated women, but empirically sound mental health interventions are lacking in prisons. Implementing such interventions is fraught with legal and logistical barriers. These barriers can be particularly detrimental for trauma-specific interventions given the unique needs of trauma survivors, yet there is little documentation of these issues or how to address them. This study describes a pilot study of an 8-week, strengths-based, trauma-focused intervention for 26 incarcerated women. Women reported considerable mental health problems and trauma. The study highlights the importance of adapting stringent research methodologies for prison-based trauma interventions. For instance, women with trauma were reluctant to participate in an intervention advertised as trauma-based. Moreover, a randomized wait list control design was unfeasible because women wanted the support of their friends when discussing trauma and could not control their schedules 9 weeks in advance. Ultimately, this work may inform future efforts to implement effective trauma-based interventions behind prison walls. © The Author(s) 2013.

[Implementation and evaluation of an ambulatory exercise therapy based rehabilitation program for breast cancer patients].

PubMed

Schulz, K H; Szlovák, C; Schulz, H; Gold, S; Brechtel, L; Braumann, M; Koch, U

1998-01-01

Physical exercise does not only have positive effects on physical fitness but also on mental health. However, there has been little empirical study on effects of rehabilitation programmes based on physical exercise in cancer patients. We conducted a study to examine the interrelation between the participation of breast cancer patients in an exercise rehabilitation training and aspects of quality of life and physical fitness. 28 patients with not metastasized mamma carcinoma participated in a structured exercise rehabilitation program twice a week for ten weeks. Before and after the intervention the patients were asked to fill in questionnaires to assess their quality of life. At the same instants they underwent physical examination and a bicycle ergometry as well as a blood drawing. The training was aimed at changes at the social, emotional, as well as the motor physical level. Pre-post comparisons demonstrated an improvement in quality of life, such as decreased levels of depression and anxiety. Furthermore the women proved to show an obvious increase in physical fitness. Present results support an implementation of an exercise rehabilitation training for breast cancer outpatients.

Intelligent Command and Control Systems for Satellite Ground Operations

NASA Technical Reports Server (NTRS)

Mitchell, Christine M.

1999-01-01

This grant, Intelligent Command and Control Systems for Satellite Ground Operations, funded by NASA Goddard Space Flight Center, has spanned almost a decade. During this time, it has supported a broad range of research addressing the changing needs of NASA operations. It is important to note that many of NASA's evolving needs, for example, use of automation to drastically reduce (e.g., 70%) operations costs, are similar requirements in both government and private sectors. Initially the research addressed the appropriate use of emerging and inexpensive computational technologies, such as X Windows, graphics, and color, together with COTS (commercial-off-the-shelf) hardware and software such as standard Unix workstations to re-engineer satellite operations centers. The first phase of research supported by this grant explored the development of principled design methodologies to make effective use of emerging and inexpensive technologies. The ultimate performance measures for new designs were whether or not they increased system effectiveness while decreasing costs. GT-MOCA (The Georgia Tech Mission Operations Cooperative Associate) and GT-VITA (Georgia Tech Visual and Inspectable Tutor and Assistant), whose latter stages were supported by this research, explored model-based design of collaborative operations teams and the design of intelligent tutoring systems, respectively. Implemented in proof-of-concept form for satellite operations, empirical evaluations of both, using satellite operators for the former and personnel involved in satellite control operations for the latter, demonstrated unequivocally the feasibility and effectiveness of the proposed modeling and design strategy underlying both research efforts. The proof-of-concept implementation of GT-MOCA showed that the methodology could specify software requirements that enabled a human-computer operations team to perform without any significant performance differences from the standard two-person satellite operations team. GT-VITA, using the same underlying methodology, the operator function model (OFM), and its computational implementation, OFMspert, successfully taught satellite control knowledge required by flight operations team members. The tutor structured knowledge in three ways: declarative knowledge (e.g., What is this? What does it do?), procedural knowledge, and operational skill. Operational skill is essential in real-time operations. It combines the two former knowledge types, assisting a student to use them effectively in a dynamic, multi-tasking, real-time operations environment. A high-fidelity simulator of the operator interface to the ground control system, including an almost full replication of both the human-computer interface and human interaction with the dynamic system, was used in the GT-MOCA and GT-VITA evaluations. The GT-VITA empirical evaluation, conducted with a range of'novices' that included GSFC operations management, GSFC operations software developers, and new flight operations team members, demonstrated that GT-VITA effectively taught a wide range of knowledge in a succinct and engaging manner.

The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview

PubMed Central

Black, Ashly D.; Car, Josip; Pagliari, Claudia; Anandan, Chantelle; Cresswell, Kathrin; Bokun, Tomislav; McKinstry, Brian; Procter, Rob; Majeed, Azeem; Sheikh, Aziz

2011-01-01

Background There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. Methods and Findings We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment strategies are lacking. Conclusions There is a large gap between the postulated and empirically demonstrated benefits of eHealth technologies. In addition, there is a lack of robust research on the risks of implementing these technologies and their cost-effectiveness has yet to be demonstrated, despite being frequently promoted by policymakers and “techno-enthusiasts” as if this was a given. In the light of the paucity of evidence in relation to improvements in patient outcomes, as well as the lack of evidence on their cost-effectiveness, it is vital that future eHealth technologies are evaluated against a comprehensive set of measures, ideally throughout all stages of the technology's life cycle. Such evaluation should be characterised by careful attention to socio-technical factors to maximise the likelihood of successful implementation and adoption. Please see later in the article for the Editors' Summary PMID:21267058

Economic theory and evidence on smoking behavior of adults.

PubMed

Sloan, Frank A; Wang, Yang

2008-11-01

To describe: (i) three alternative conceptual frameworks used by economists to study addictive behaviors: rational, imperfectly rational and irrational addiction; (ii) empirical economic evidence on each framework and specific channels to explain adult smoking matched to the frameworks; and (iii) policy implications for each framework. A systematic review and appraisal of important theoretical and empirical economic studies on smoking. There is some empirical support for each framework. For rational and imperfectly rational addiction there is some evidence that anticipated future cigarette prices influence current cigarette consumption, and quitting costs are high for smokers. Smokers are more risk-tolerant in the financial domain than are others and tend to attach a lower value to being in good health. Findings on differences in rates of time preference by smoking status are mixed; however, short-term rates are higher than long-term rates for both smokers and non-smokers, a stylized fact consistent with hyperbolic discounting. The economic literature lends no empirical support to the view that mature adults smoke because they underestimate the probability of harm to health from smoking. In support of the irrationality framework, smokers tend to be more impulsive than others in domains not related directly to smoking, implying that they may be sensitive to cues that trigger smoking. Much promising economic research uses the imperfectly rational addiction framework, but empirical research based on this framework is still in its infancy.

Contract Learning.

ERIC Educational Resources Information Center

Gilbert, Jay

Academic work carried out through learning contracts at Empire State College is described. Learning contracts are defined and examples are given. Faculty roles, educational advantages, and implementation methods are discussed. (MLH)

The Role of Empirical Evidence for Transferring a New Technology to Industry

NASA Astrophysics Data System (ADS)

Baldassarre, Maria Teresa; Bruno, Giovanni; Caivano, Danilo; Visaggio, Giuseppe

Technology transfer and innovation diffusion are key success factors for an enterprise. The shift to a new software technology involves, on one hand, inevitable changes to ingrained and familiar processes and, on the other, requires training, changes in practices and commitment on behalf of technical staff and management. Nevertheless, industry is often reluctant to innovation due to the changes it determines. The process of innovation diffusion is easier if the new technology is supported by empirical evidence. In this sense our conjecture is that Empirical Software Engineering (ESE) serves as means for validating and transferring a new technology within production processes. In this paper, the authors report their experience of a method, Multiview Framework, defined in the SERLAB research laboratory as support for designing and managing a goal oriented measurement program that has been validated through various empirical studies before being transferred to an Italian SME. Our discussion points out the important role of empirical evidence for obtaining management commitment and buy-in on behalf of technical staff, and for making technological transfer possible.

A review of the nurtured heart approach to parenting: evaluation of its theoretical and empirical foundations.

PubMed

Hektner, Joel M; Brennan, Alison L; Brotherson, Sean E

2013-09-01

The Nurtured Heart Approach to parenting (NHA; Glasser & Easley, 2008) is summarized and evaluated in terms of its alignment with current theoretical perspectives and empirical evidence in family studies and developmental science. Originally conceived and promoted as a behavior management approach for parents of difficult children (i.e., with behavior disorders), NHA is increasingly offered as a valuable strategy for parents of any children, despite a lack of published empirical support. Parents using NHA are trained to minimize attention to undesired behaviors, provide positive attention and praise for compliance with rules, help children be successful by scaffolding and shaping desired behavior, and establish a set of clear rules and consequences. Many elements of the approach have strong support in the theoretical and empirical literature; however, some of the assumptions are more questionable, such as that negative child behavior can always be attributed to unintentional positive reinforcement by parents responding with negative attention. On balance, NHA appears to promote effective and validated parenting practices, but its effectiveness now needs to be tested empirically. © FPI, Inc.

Banning Cigarette Smoking on US Navy Submarines: A Case Study

PubMed Central

Lando, Harry A.; Michaud, Mark. E.; Poston, Walker S.C.; Jahnke, Sara A.; Williams, Larry; Haddock, Christopher K.

2014-01-01

Background The military has had a long pro-tobacco tradition. Despite official policy discouraging smoking, tobacco still is widely seen as part of military culture. While active smoking has presented a particular challenge for the military, in recent years there also has been increasing concern with secondhand smoke. This is especially true in closed environments and submarines may be deployed for months at a time. The current case study describes the successful implementation by the Navy of a comprehensive ban on smoking aboard submarines. Methods The authors searched documents on the Internet, popular media, military-based news outlets, and the scientific literature. We also conducted interviews with Navy officers who were instrumental in policy implementation. Findings Data demonstrating substantial exposure of nonsmokers to tobacco smoke aboard submarines had major impact on successful adoption of the policy. A systematic and extended roll out of the ban included establishing a working group, soliciting input and active engagement from submarine personnel, and offering cessation assistance. Support was enlisted from Chief Petty Officers who could have been strongly opposed but who became strong proponents. Fewer problems were encountered than had been expected. In contrast to a previous unsuccessful attempt by a Navy captain to ban smoking on his ship, the ban was adopted without apparent tobacco industry interference. Conclusions Lessons learned included the importance of strong empirical support, effective framing of the issue, setting a realistic timeline, soliciting support from key personnel, and providing appropriate resources. These lessons have implications for those considering further tobacco policy changes in the military and elsewhere. PMID:25163466

Exploring the enablers and barriers to implementing the Medication Appropriateness Tool for Comorbid Health conditions during Dementia (MATCH-D) criteria in Australia: a qualitative study.

PubMed

Page, Amy Theresa; Clifford, Rhonda Marise; Potter, Kathleen; Seubert, Liza; McLachlan, Andrew J; Hill, Xaysja; King, Stephanie; Clark, Vaughan; Ryan, Cristin; Parekh, Nikesh; Etherton-Beer, Christopher D

2017-08-23

The Medication Appropriateness Tool for Comorbid Health conditions in Dementia (MATCH-D) criteria provide expert consensus guidance about medication use for people with dementia. This study aimed to identify enablers and barriers to implementing the criteria in practice. Participants came from both rural and metropolitan communities in two Australian states. Focus groups were held with consumers, general practitioners, nurses and pharmacists. data were analysed thematically. Nine focus groups were conducted. Fifty-five participants validated the content of MATCH-D, appraising them as providing patient-centred principles of care. Participants identified potential applications (including the use of MATCH-D as a discussion aid or educational tool for consumers about medicines) and suggested supporting resources. Participants provided insights into applying MATCH-D in practice and suggested resources to be included in an accompanying toolkit. These data provide external validation of MATCH-D and an empiric basis for their translation to practice. Following resource development, we plan to evaluate the feasibility and efficacy of implementation in practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A large-scale initiative to disseminate an evidence-based drug abuse prevention program in Italy: Lessons learned for practitioners and researchers.

PubMed

Velasco, Veronica; Griffin, Kenneth W; Antichi, Mariella; Celata, Corrado

2015-10-01

Across developed countries, experimentation with alcohol, tobacco, and other drugs often begins in the early adolescent years. Several evidence-based programs have been developed to prevent adolescent substance use. Many of the most rigorously tested and empirically supported prevention programs were initially developed and tested in the United States. Increasingly, these interventions are being adopted for use in Europe and throughout the world. This paper reports on a large-scale comprehensive initiative designed to select, adapt, implement, and sustain an evidence-based drug abuse prevention program in Italy. As part of a large-scale regionally funded collaboration in the Lombardy region of Italy, we report on processes through which a team of stakeholders selected, translated and culturally adapted, planned, implemented and evaluated the Life Skills Training (LST) school-based drug abuse prevention program, an evidence-based intervention developed in the United States. We discuss several challenges and lessons learned and implications for prevention practitioners and researchers attempting to undertake similar international dissemination projects. We review several published conceptual models designed to promote the replication and widespread dissemination of effective programs, and discuss their strengths and limitations in the context of planning and implementing a complex, large-scale real-world dissemination effort. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using Rapid Ethnography to Support the Design and Implementation of Health Information Technologies.

PubMed

Ackerman, Sara; Gleason, Nathaniel; Gonzales, Ralph

2015-01-01

Ethnography is the defining practice - and art - of anthropology. Among health information technology (IT) developers, however, ethnography remains a little used and undervalued mode of inquiry and representation. In this chapter we demonstrate that ethnography can make important contributions to the design and implementation of more user-oriented health IT devices and systems. In particular, we propose 'rapid ethnography' as a pragmatic strategy that draws on classic ethnographic methods, but emphasizes shorter periods of fieldwork and quick turnaround of findings to inform (re)design, programming and implementation efforts. Rapid ethnography is theoretically and empirically situated in science and technology studies' explorations of a) the entanglement of social and technical dimensions of technology use; b) how getting tools to 'work' requires aligning interests across a wide range of human and non-human actors; and c) the ways in which humans and technology transform each other as they interact. We provide two detailed case studies to illustrate the evolution and uses of rapid ethnography at a U.S. academic medical center. By providing deeper insights into the experiences of users, and the contexts and communities in which new tools are introduced, rapid ethnography can serve as a valuable component of Techno-Anthropology and health IT innovation.

Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India

PubMed Central

Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos

2017-01-01

Abstract Objective To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme – the World Health Partners’ Sky Program. Methods We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers’ performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. Findings The programme did not significantly improve health-care providers’ knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Conclusion Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up. PMID:28479635

Criteria for selecting implementation science theories and frameworks: results from an international survey.

PubMed

Birken, Sarah A; Powell, Byron J; Shea, Christopher M; Haines, Emily R; Alexis Kirk, M; Leeman, Jennifer; Rohweder, Catherine; Damschroder, Laura; Presseau, Justin

2017-10-30

Theories provide a synthesizing architecture for implementation science. The underuse, superficial use, and misuse of theories pose a substantial scientific challenge for implementation science and may relate to challenges in selecting from the many theories in the field. Implementation scientists may benefit from guidance for selecting a theory for a specific study or project. Understanding how implementation scientists select theories will help inform efforts to develop such guidance. Our objective was to identify which theories implementation scientists use, how they use theories, and the criteria used to select theories. We identified initial lists of uses and criteria for selecting implementation theories based on seminal articles and an iterative consensus process. We incorporated these lists into a self-administered survey for completion by self-identified implementation scientists. We recruited potential respondents at the 8th Annual Conference on the Science of Dissemination and Implementation in Health and via several international email lists. We used frequencies and percentages to report results. Two hundred twenty-three implementation scientists from 12 countries responded to the survey. They reported using more than 100 different theories spanning several disciplines. Respondents reported using theories primarily to identify implementation determinants, inform data collection, enhance conceptual clarity, and guide implementation planning. Of the 19 criteria presented in the survey, the criteria used by the most respondents to select theory included analytic level (58%), logical consistency/plausibility (56%), empirical support (53%), and description of a change process (54%). The criteria used by the fewest respondents included fecundity (10%), uniqueness (12%), and falsifiability (15%). Implementation scientists use a large number of criteria to select theories, but there is little consensus on which are most important. Our results suggest that the selection of implementation theories is often haphazard or driven by convenience or prior exposure. Variation in approaches to selecting theory warn against prescriptive guidance for theory selection. Instead, implementation scientists may benefit from considering the criteria that we propose in this paper and using them to justify their theory selection. Future research should seek to refine the criteria for theory selection to promote more consistent and appropriate use of theory in implementation science.

Architectural frameworks: defining the structures for implementing learning health systems.

PubMed

Lessard, Lysanne; Michalowski, Wojtek; Fung-Kee-Fung, Michael; Jones, Lori; Grudniewicz, Agnes

2017-06-23

The vision of transforming health systems into learning health systems (LHSs) that rapidly and continuously transform knowledge into improved health outcomes at lower cost is generating increased interest in government agencies, health organizations, and health research communities. While existing initiatives demonstrate that different approaches can succeed in making the LHS vision a reality, they are too varied in their goals, focus, and scale to be reproduced without undue effort. Indeed, the structures necessary to effectively design and implement LHSs on a larger scale are lacking. In this paper, we propose the use of architectural frameworks to develop LHSs that adhere to a recognized vision while being adapted to their specific organizational context. Architectural frameworks are high-level descriptions of an organization as a system; they capture the structure of its main components at varied levels, the interrelationships among these components, and the principles that guide their evolution. Because these frameworks support the analysis of LHSs and allow their outcomes to be simulated, they act as pre-implementation decision-support tools that identify potential barriers and enablers of system development. They thus increase the chances of successful LHS deployment. We present an architectural framework for LHSs that incorporates five dimensions-goals, scientific, social, technical, and ethical-commonly found in the LHS literature. The proposed architectural framework is comprised of six decision layers that model these dimensions. The performance layer models goals, the scientific layer models the scientific dimension, the organizational layer models the social dimension, the data layer and information technology layer model the technical dimension, and the ethics and security layer models the ethical dimension. We describe the types of decisions that must be made within each layer and identify methods to support decision-making. In this paper, we outline a high-level architectural framework grounded in conceptual and empirical LHS literature. Applying this architectural framework can guide the development and implementation of new LHSs and the evolution of existing ones, as it allows for clear and critical understanding of the types of decisions that underlie LHS operations. Further research is required to assess and refine its generalizability and methods.

The impact of SOA for achieving healthcare interoperability. An empirical investigation based on a hypothetical adoption.

PubMed

Daskalakis, S; Mantas, J

2009-01-01

The evaluation of a service-oriented prototype implementation for healthcare interoperability. A prototype framework was developed, aiming to exploit the use of service-oriented architecture (SOA) concepts for achieving healthcare interoperability and to move towards a virtual patient record (VPR) paradigm. The prototype implementation was evaluated for its hypothetical adoption. The evaluation strategy was based on the initial proposition of the DeLone and McLean model of information systems (IS) success [1], as modeled by Iivari [2]. A set of SOA and VPR characteristics were empirically encapsulated within the dimensions of IS success model, combined with measures from previous research works. The data gathered was analyzed using partial least squares (PLS). The results highlighted that system quality is a partial predictor of system use but not of user satisfaction. On the contrary, information quality proved to be a significant predictor of user satisfaction and partially a strong significant predictor of system use. Moreover, system use did not prove to be a significant predictor of individual impact whereas the bi-directional relation between use and user satisfaction did not confirm. Additionally, user satisfaction was found to be a strong significant predictor of individual impact. Finally, individual impact proved to be a strong significant predictor of organizational impact. The empirical study attempted to obtain hypothetical, but still useful beliefs and perceptions regarding the SOA prototype implementation. The deduced observations can form the basis for further investigation regarding the adaptability of SOA implementations with VPR characteristics in the healthcare domain.

Exploring creative activity: a software environment for multimedia systems

NASA Astrophysics Data System (ADS)

Farrett, Peter W.; Jardine, David A.

1992-03-01

This paper examines various issues related to the theory, design, and implementation of a system that supports creative activity for a multimedia environment. The system incorporates artificial intelligence notions to acquire concepts of the problem domain. This paper investigates this environment by considering a model that is a basis for a system, which supports a history of user interaction. A multimedia system that supports creative activity is problematic. It must function as a tool allowing users to experiment dynamically with their own creative reasoning process--a very nebulous task environment. It should also support the acquisition of domain knowledge so that empirical observation can be further evaluated. This paper aims to illustrate that via the reuse of domain-specific knowledge, closely related ideas can be quickly developed. This approach is useful in the following sense: Multimedia navigational systems hardcode referential links with respect to a web or network. Although users can access or control navigation in a nonlinear (static) manner, these referential links are 'frozen' and can not capture their creative actions, which are essential in tutoring or learning applications. This paper describes a multimedia assistant based on the notion of knowledge- links, which allows users to navigate through creative information in a nonlinear (dynamic) fashion. A selection of prototype code based on object-oriented techniques and logic programming partially demonstrates this.

Implementing a Contributory Scoring Approach for the "GRE"® Analytical Writing Section: A Comprehensive Empirical Investigation. Research Report. ETS RR-17-14

ERIC Educational Resources Information Center

Breyer, F. Jay; Rupp, André A.; Bridgeman, Brent

2017-01-01

In this research report, we present an empirical argument for the use of a contributory scoring approach for the 2-essay writing assessment of the analytical writing section of the "GRE"® test in which human and machine scores are combined for score creation at the task and section levels. The approach was designed to replace a currently…

Modularisation in the German VET System: A Study of Policy Implementation

ERIC Educational Resources Information Center

Li, Junmin; Pilz, Matthias

2017-01-01

Modularisation of vocational training courses is a major issue across many European countries. Germany has been slow to implement modularisation in its VET system: the prevailing view of modular concepts in the country is one of great scepticism, but there is very little empirical data to inform the debate. This exploratory study focuses on the…

The Ebb and Flow of Educational Change: Change Agents as Negotiators of Change

ERIC Educational Resources Information Center

McGrath, Cormac; Barman, Linda; Stenfors-Hayes, Terese; Roxå, Torgny; Silén, Charlotte; Laksov, Klara Bolander

2016-01-01

In this paper, we are concerned with how change agents go about and experience change implementation in higher education. We identified change agents and interviewed them about how they implement change. Empirical data was analysed using a theoretical framework of change. The findings suggest that change in the university is enacted through a…

Course-Level Implementation of First Principles, Goal Orientations, and Cognitive Engagement: A Multilevel Mediation Model

ERIC Educational Resources Information Center

Lee, Sunghye; Koszalka, Tiffany A.

2016-01-01

The First Principles of Instruction (FPI) represent ideologies found in most instructional design theories and models. Few attempts, however, have been made to empirically test the relationship of these FPI to instructional outcomes. This study addresses whether the degree to which FPI are implemented in courses makes a difference to student…

The Implementation of Modified Parent-Child Interaction Therapy for Youth with Separation Anxiety Disorder

ERIC Educational Resources Information Center

Pincus, Donna B.; Santucci, Lauren C.; Ehrenreich, Jill T.; Eyberg, Sheila M.

2008-01-01

Separation Anxiety Disorder (SAD) is the most prevalent anxiety disorder experienced by children, and yet empirical treatment studies of SAD in young children are virtually nonexistent. This paper will describe the development and implementation of an innovative treatment for SAD in young children. First, we will highlight the rationale for…

Electronic Medical Records (EMR): An Empirical Testing of Factors Contributing to Healthcare Professionals' Resistance to Use EMR Systems

ERIC Educational Resources Information Center

Bazile, Emmanuel Patrick

2016-01-01

The benefits of using electronic medical records (EMRs) have been well documented; however, despite numerous financial benefits and cost reductions being offered by the federal government, some healthcare professionals have been reluctant to implement EMR systems. In fact, prior research provides evidence of failed EMR implementations due to…

Theoretical and Empirical Base for Implementation Components of Health-Promoting Schools

ERIC Educational Resources Information Center

Samdal, Oddrun; Rowling, Louise

2011-01-01

Purpose: Efforts to create a scientific base for the health-promoting school approach have so far not articulated a clear "Science of Delivery". There is thus a need for systematic identification of clearly operationalised implementation components. To address a next step in the refinement of the health-promoting schools' work, this paper sets out…

Evaluating Motivational Enhancement Therapy Adherence and Competence Among Spanish-speaking Therapists

PubMed Central

Santa Ana, Elizabeth J.; Carroll, Kathleen M.; Añez, Luis; Paris, Manuel; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Suarez-Morales, Lourdes; Szapocznik, José; Martino, Steve

2009-01-01

Despite the fact that the number of Hispanic individuals in need of treatment for substance use problems is increasing internationally, no studies have investigated the extent to which therapists can provide empirically supported treatments to Spanish-speaking clients with adequate fidelity. Twenty-three bilingual Hispanic therapists from five community outpatient treatment programs in the United States were randomly assigned to deliver either three sessions of motivational enhancement therapy (MET) or an equivalent number of drug counseling-as-usual sessions (CAU) in Spanish to 405 Spanish-speaking clients randomly assigned to these conditions. Independent ratings of 325 sessions indicated the adherence/competence rating system had good to excellent interrater reliability and indicated strong support for an a priori defined fundamental MET skill factor. Support for an advanced MET skill factor was relatively weaker. The rating scale indicated significant differences in therapists’ MET adherence and competence across conditions. These findings indicate that the rating system has promise for assessing the performance of therapists who deliver MET in Spanish and suggest that bilingual Spanish-speaking therapists from the community can be trained to implement MET with adequate fidelity and skill using an intensive multisite training and supervision model. PMID:19394164

Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

PubMed Central

Lood, Qarin; Ivanoff, Synneve Dahlin; Dellenborg, Lisen; Mårtensson, Lena

2014-01-01

Objective For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals' experiences of facilitators and barriers for their possibilities to support a healthy ageing in the context of migration. Methods Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with the guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level. Results Five different conditions were found to influence supporting healthy ageing in the context of migration: Sense of belonging through significant others, Emotional bonds to a place called home, Expectations on health and support during the ageing process, Mutual understanding as a means for communication and Heterogeneity as a point of departure. The one comprehensive theme complexity describes how those aspects are interrelated in a complex and unpredictable way. Conclusions The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice. PMID:24605072

From science to action: Principles for undertaking environmental research that enables knowledge exchange and evidence-based decision-making.

PubMed

Cvitanovic, C; McDonald, J; Hobday, A J

2016-12-01

Effective conservation requires knowledge exchange among scientists and decision-makers to enable learning and support evidence-based decision-making. Efforts to improve knowledge exchange have been hindered by a paucity of empirically-grounded guidance to help scientists and practitioners design and implement research programs that actively facilitate knowledge exchange. To address this, we evaluated the Ningaloo Research Program (NRP), which was designed to generate new scientific knowledge to support evidence-based decisions about the management of the Ningaloo Marine Park in north-western Australia. Specifically, we evaluated (1) outcomes of the NRP, including the extent to which new knowledge informed management decisions; (2) the barriers that prevented knowledge exchange among scientists and managers; (3) the key requirements for improving knowledge exchange processes in the future; and (4) the core capacities that are required to support knowledge exchange processes. While the NRP generated expansive and multidisciplinary science outputs directly relevant to the management of the Ningaloo Marine Park, decision-makers are largely unaware of this knowledge and little has been integrated into decision-making processes. A range of barriers prevented efficient and effective knowledge exchange among scientists and decision-makers including cultural differences among the groups, institutional barriers within decision-making agencies, scientific outputs that were not translated for decision-makers and poor alignment between research design and actual knowledge needs. We identify a set of principles to be implemented routinely as part of any applied research program, including; (i) stakeholder mapping prior to the commencement of research programs to identify all stakeholders, (ii) research questions to be co-developed with stakeholders, (iii) implementation of participatory research approaches, (iv) use of a knowledge broker, and (v) tailored knowledge management systems. Finally, we articulate the individual, institutional and financial capacities that must be developed to underpin successful knowledge exchange strategies. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

CPOE in Iran--a viable prospect? Physicians' opinions on using CPOE in an Iranian teaching hospital.

PubMed

Kazemi, Alireza; Ellenius, Johan; Tofighi, Shahram; Salehi, Aref; Eghbalian, Fatemeh; Fors, Uno G

2009-03-01

In recent years, the theory that on-line clinical decision support systems can improve patients' safety among hospitalised individuals has gained greater acceptance. However, the feasibility of implementing such a system in a middle or low-income country has rarely been studied. Understanding the current prescription process and a proper needs assessment of prescribers can act as the key to successful implementation. The aim of this study was to explore physicians' opinions on the current prescription process, and the expected benefits and perceived obstacles to employ Computerised Physician Order Entry in an Iranian teaching hospital. Initially, the interview guideline was developed through focus group discussions with eight experts. Then semi-structured interviews were held with 19 prescribers. After verbatim transcription, inductive thematic analysis was performed on empirical data. Forty hours of on-looker observations were performed in different wards to explore the current prescription process. The current prescription process was identified as a physician-centred, top-down, model, where prescribers were found to mostly rely on their memories as well as being overconfident. Some errors may occur during different paper-based registrations, transcriptions and transfers. Physician opinions on Computerised Physician Order Entry were categorised into expected benefits and perceived obstacles. Confidentiality issues, reduction of medication errors and educational benefits were identified as three themes in the expected benefits category. High cost, social and cultural barriers, data entry time and problems with technical support emerged as four themes in the perceived obstacles category. The current prescription process has a high possibility of medication errors. Although there are different barriers confronting the implementation and continuation of Computerised Physician Order Entry in Iranian hospitals, physicians have a willingness to use them if these systems provide significant benefits. A pilot study in a limited setting and a comprehensive analysis of health outcomes and economic indicators should be performed, to assess the merits of introducing Computerised Physician Order Entry with decision support capabilities in Iran.

Navigational Heads-Up Display: Will a Shipboard Augmented Electronic Navigation System Sink or Swim?

DTIC Science & Technology

2015-03-01

of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. 1. AGENCY USE ONLY (Leave blank) I 2. REPORT DATE I 3. REPORT...empirical results demonstrate the viability of using such a system in an operation environment and support a need for further research and development...empirical results demonstrate the viability of using such a system in an operation environment and support a need for further research and development

Empirically supported treatments for feeding difficulties in young children.

PubMed

Davis, Ann McGrath; Bruce, Amanda; Cocjin, Jose; Mousa, Hayat; Hyman, Paul

2010-06-01

Pediatric feeding problems are common among children and present severe issues for families. Unfortunately, treatment outcome studies with this population are sparse. The current study reviews the literature regarding treatment studies of children with severe feeding issues, provides an overview of empirically supported treatments for children who do eat orally, and finally summarizes interventions that attempt to reintroduce oral feeding to children who have been fed by gastrostomy tube or other non-oral feeding route.

[Diagnosis and treatment of child and adolescent depression].

PubMed

Bunge, Eduardo L; Carrea, Gabriela; Tosas de Molina, Mar; Soto, Natalie

2011-01-01

The present paper reviews the available literature on the current state of knowledge regarding depression in children and adolescents. Empirically supported psychotherapeutic treatment adjustments for children are described, such as the Self-Control Therapy (CBT), Penn Prevention Program; and other treatments that are experimental phase. Similarly empirically supported psychotherapeutic treatment adjustments for adolescents are described, such as Adolescent Coping with Depression, Interpersonal Psychotherapy; and other treatments that are experimental phase as Biblotherapy and Attachment-Based Family Therapy.

Empirical deck for phased construction and widening [summary].

DOT National Transportation Integrated Search

2017-06-01

The most common method used to design and analyze bridge decks, termed the traditional : method, treats a deck slab as if it were made of strips supported by inflexible girders. An : alternative the empirical method treats the deck slab as a ...

Development of traffic data input resources for the mechanistic empirical pavement design process.

DOT National Transportation Integrated Search

2011-12-12

The Mechanistic-Empirical Pavement Design Guide (MEPDG) for New and Rehabilitated Pavement Structures uses : nationally based data traffic inputs and recommends that state DOTs develop their own site-specific and regional : values. To support the MEP...

Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: a systematic integrative review.

PubMed

Li, Shelly-Anne; Jeffs, Lianne; Barwick, Melanie; Stevens, Bonnie

2018-05-05

Organizational contextual features have been recognized as important determinants for implementing evidence-based practices across healthcare settings for over a decade. However, implementation scientists have not reached consensus on which features are most important for implementing evidence-based practices. The aims of this review were to identify the most commonly reported organizational contextual features that influence the implementation of evidence-based practices across healthcare settings, and to describe how these features affect implementation. An integrative review was undertaken following literature searches in CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science, and Cochrane databases from January 2005 to June 2017. English language, peer-reviewed empirical studies exploring organizational context in at least one implementation initiative within a healthcare setting were included. Quality appraisal of the included studies was performed using the Mixed Methods Appraisal Tool. Inductive content analysis informed data extraction and reduction. The search generated 5152 citations. After removing duplicates and applying eligibility criteria, 36 journal articles were included. The majority (n = 20) of the study designs were qualitative, 11 were quantitative, and 5 used a mixed methods approach. Six main organizational contextual features (organizational culture; leadership; networks and communication; resources; evaluation, monitoring and feedback; and champions) were most commonly reported to influence implementation outcomes in the selected studies across a wide range of healthcare settings. We identified six organizational contextual features that appear to be interrelated and work synergistically to influence the implementation of evidence-based practices within an organization. Organizational contextual features did not influence implementation efforts independently from other features. Rather, features were interrelated and often influenced each other in complex, dynamic ways to effect change. These features corresponded to the constructs in the Consolidated Framework for Implementation Research (CFIR), which supports the use of CFIR as a guiding framework for studies that explore the relationship between organizational context and implementation. Organizational culture was most commonly reported to affect implementation. Leadership exerted influence on the five other features, indicating it may be a moderator or mediator that enhances or impedes the implementation of evidence-based practices. Future research should focus on how organizational features interact to influence implementation effectiveness.

Linking molar organizational climate and strategic implementation climate to clinicians' use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study.

PubMed

Williams, Nathaniel J; Ehrhart, Mark G; Aarons, Gregory A; Marcus, Steven C; Beidas, Rinad S

2018-06-25

Behavioral health organizations are characterized by multiple organizational climates, including molar climate, which encompasses clinicians' shared perceptions of how the work environment impacts their personal well-being, and strategic implementation climate, which includes clinicians' shared perceptions of the extent to which evidence-based practice implementation is expected, supported, and rewarded by the organization. Theory suggests these climates have joint, cross-level effects on clinicians' implementation of evidence-based practice and that these effects may be long term (i.e., up to 2 years); however, no empirical studies have tested these relationships. We hypothesize that molar climate moderates implementation climate's concurrent and long-term relationships with clinicians' use of evidence-based practice such that strategic implementation climate will have its most positive effects when it is accompanied by a positive molar climate. Hypotheses were tested using data collected from 235 clinicians in 20 behavioral health organizations. At baseline, clinicians reported on molar climate and implementation climate. At baseline and at a 2-year follow-up, all clinicians who were present in the organizations reported on their use of cognitive-behavioral psychotherapy techniques, an evidence-based practice for youth psychiatric disorders. Two-level mixed-effects regression models tested whether baseline molar climate and implementation climate interacted in predicting clinicians' evidence-based practice use at baseline and at 2-year follow-up. In organizations with more positive molar climates at baseline, higher levels of implementation climate predicted increased evidence-based practice use among clinicians who were present at baseline and among clinicians who were present in the organizations at 2-year follow-up; however, in organizations with less positive molar climates, implementation climate was not related to clinicians' use of evidence-based practice at either time point. Optimizing clinicians' implementation of evidence-based practice in behavioral health requires attention to both molar climate and strategic implementation climate. Strategies that focus exclusively on implementation climate may not be effective levers for behavior change if the organization does not also engender a positive molar climate. These findings have implications for the development of implementation theory and effective implementation strategies.

Impact of Company Size on Manufacturing Improvement Practices: An empirical study

NASA Astrophysics Data System (ADS)

Syan, C. S.; Ramoutar, K.

2014-07-01

There is a constant search for ways to achieve a competitive advantage through new manufacturing techniques. Best performing manufacturing companies tend to use world-class manufacturing (WCM) practices. Although the last few years have witnessed phenomenal growth in the use of WCM techniques, their effectiveness is not well understood specifically in the context of less developed countries. This paper presents an empirical study to investigate the impact of company size on improving manufacturing performance in manufacturing organizations based in Trinidad and Tobago (T&T). Empirical data were collected via a questionnaire survey which was send to 218 manufacturing firms in T&T. Five different company sizes and seven different industry sectors were studied. The analysis of survey data was performed with the aid of Statistical Package for Social Sciences (SPSS) software. The study signified facilitating and impeding factors towards improving manufacturing performance. Their relative impact/importance is dependent on varying company size and industry sectors. Findings indicate that T&T manufacturers are still practicing traditional approaches, when compared with world class manufacturers. In the majority of organizations, these practices were not 100% implemented even though they started the implementation process more than 5 years ago. The findings provided some insights in formulating more optimal operational strategies, and later develop action plans towards more effective implementation of WCM in T&T manufacturers.

Public health and social supervision issues within public administration of ukrainian territories in the late 8th- early 9th centuries.

PubMed

Hrynzovskyi, Anatolii M; Holovanova, Irina A; Omelchuk, Sergei T; Kuzminska, Olena V; Hrynzovska, Anastasia A; Karlova, Olena O; Kondratiuk, Vitalii Ye

Introduction: The public health system modernization history is based upon the progress in state country administration and administration of healthcare within the sectorwide approach. The WHO European Bureau pays much attention to the National Health Service systems development while implementing their basic policies. The Ukrainian state health service management was founded basing on the regulatory field of the Russian Empire, using the European healthcare promotion experience. Aim: of the article is the analysis of the regulatory field of police and amenity authorities of the Russian Empire and Ukraine within the medical and social service in the 18th-19th centuries. Materials and methods: The structure of the article corresponds to the problem city and chronology principles, using the following methods and techniques of scientific learning: the systemic, historic, regulatory comparative, logical and structural-functional analysis of the studied medical-legal phenomena. The study sources are the scientific publications, collections of laws and executive orders of the Russian Empire and Ukraine in the 18th-19th centuries. Review: As a result of the performed work it can be determined were the main directions of the police competence in late 18th- early 19th centuries. Conclusion: Preserving health, treatment of the ill and injured, management of medical and social service of those in need, holding various preventive activities and supporting safe environment and regulating the safety of food were the main directions of the police competence in late 18th- early 19th centuries.

Role of Statistical Random-Effects Linear Models in Personalized Medicine

PubMed Central

Diaz, Francisco J; Yeh, Hung-Wen; de Leon, Jose

2012-01-01

Some empirical studies and recent developments in pharmacokinetic theory suggest that statistical random-effects linear models are valuable tools that allow describing simultaneously patient populations as a whole and patients as individuals. This remarkable characteristic indicates that these models may be useful in the development of personalized medicine, which aims at finding treatment regimes that are appropriate for particular patients, not just appropriate for the average patient. In fact, published developments show that random-effects linear models may provide a solid theoretical framework for drug dosage individualization in chronic diseases. In particular, individualized dosages computed with these models by means of an empirical Bayesian approach may produce better results than dosages computed with some methods routinely used in therapeutic drug monitoring. This is further supported by published empirical and theoretical findings that show that random effects linear models may provide accurate representations of phase III and IV steady-state pharmacokinetic data, and may be useful for dosage computations. These models have applications in the design of clinical algorithms for drug dosage individualization in chronic diseases; in the computation of dose correction factors; computation of the minimum number of blood samples from a patient that are necessary for calculating an optimal individualized drug dosage in therapeutic drug monitoring; measure of the clinical importance of clinical, demographic, environmental or genetic covariates; study of drug-drug interactions in clinical settings; the implementation of computational tools for web-site-based evidence farming; design of pharmacogenomic studies; and in the development of a pharmacological theory of dosage individualization. PMID:23467392

Mass Estimation and Its Applications

DTIC Science & Technology

2012-02-23

parameters); e.g., the rect- angular kernel function has fixed width or fixed per unit size. But the rectangular function used in mass has no parameter...MassTER is implemented in JAVA , and we use DBSCAN in WEKA [13] and a version of DENCLUE implemented in R (www.r-project.org) in our empirical evaluation...Proceedings of SIGKDD, 2010, 989-998. [13] I.H. Witten and E. Frank, Data Mining: Practical Machine Learning Tools and Techniques with Java Implementations

Manifestations of integrated public health policy in Dutch municipalities.

PubMed

Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

2016-06-01

Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Braking the bandwagon: scrutinizing the science and politics of empirically supported therapies.

PubMed

Hagemoser, Steven D

2009-12-01

Proponents of empirically supported therapies (ESTs) argue that because manualized ESTs have demonstrated efficacy in treating a range of psychological disorders, they should be the treatments of choice. In this article, the author uses a hypothetical treatment for obesity to highlight numerous flaws in EST logic and argues for common factors as a more clinically relevant but empirically challenging approach. The author then explores how political variables may be contributing to the expansion of EST and the resulting restriction of practitioner autonomy. Last, the author argues that EST is best viewed as 1 component of a more comprehensive evidence-based practice framework. The author concludes with some cautionary statements about the perils of equating the EST paradigm with the scientist-practitioner ideal.

Food web complexity and stability across habitat connectivity gradients.

PubMed

LeCraw, Robin M; Kratina, Pavel; Srivastava, Diane S

2014-12-01

The effects of habitat connectivity on food webs have been studied both empirically and theoretically, yet the question of whether empirical results support theoretical predictions for any food web metric other than species richness has received little attention. Our synthesis brings together theory and empirical evidence for how habitat connectivity affects both food web stability and complexity. Food web stability is often predicted to be greatest at intermediate levels of connectivity, representing a compromise between the stabilizing effects of dispersal via rescue effects and prey switching, and the destabilizing effects of dispersal via regional synchronization of population dynamics. Empirical studies of food web stability generally support both this pattern and underlying mechanisms. Food chain length has been predicted to have both increasing and unimodal relationships with connectivity as a result of predators being constrained by the patch occupancy of their prey. Although both patterns have been documented empirically, the underlying mechanisms may differ from those predicted by models. In terms of other measures of food web complexity, habitat connectivity has been empirically found to generally increase link density but either reduce or have no effect on connectance, whereas a unimodal relationship is expected. In general, there is growing concordance between empirical patterns and theoretical predictions for some effects of habitat connectivity on food webs, but many predictions remain to be tested over a full connectivity gradient, and empirical metrics of complexity are rarely modeled. Closing these gaps will allow a deeper understanding of how natural and anthropogenic changes in connectivity can affect real food webs.

Boundary work for implementing adaptive management: A water sector application.

PubMed

Adem Esmail, Blal; Geneletti, Davide; Albert, Christian

2017-09-01

Boundary work, defined as effort to mediate between knowledge and action, is a promising approach for facilitating knowledge co-production for sustainable development. Here, we investigate a case study of knowledge co-production, to assess the applicability of boundary work as a conceptual framework to support implementing adaptive management in the water sector. We refer to a boundary work classification recently proposed by Clark et al., (2016), based on three types of knowledge uses, i.e. enlightenment, decision-, and negotiation-support, and three types of sources, i.e. personal expertise, single, and multiple communities of expertise. Our empirical results confirm boundary work has been crucial for the three types of knowledge use. For enlightenment and decision-support, effective interaction among knowledge producers and users was achieved through diverse boundary work practices, including joint agenda setting, and sharing of data and expertise. This initial boundary work eased subsequent knowledge co-production for decision-support and negotiations, in combination with stepping up of cooperation between relevant actors, suitable legislation and pressure for problem solving. Our analysis highlighted the temporal dimension matters - building trust around enlightenment first, and then using this as a basis for managing knowledge co-production for decision-, and negotiation support. We reconfirmed that boundary work is not a single time achievement, rather is a dynamic process, and we emphasized the importance of key actors driving the process, such as water utilities. Our results provide a rich case study of how strategic boundary work can facilitate knowledge co-production for adaptive management in the water sector. The boundary work practices employed here could also be transferred to other cases. Water utilities, as intermediaries between providers and beneficiaries of the important water-related ecosystem service of clean water provision, can indeed serve as key actors for initiating such boundary work practices. Copyright © 2017 Elsevier B.V. All rights reserved.

Recent ecological responses to climate change support predictions of high extinction risk

PubMed Central

Maclean, Ilya M. D.; Wilson, Robert J.

2011-01-01

Predicted effects of climate change include high extinction risk for many species, but confidence in these predictions is undermined by a perceived lack of empirical support. Many studies have now documented ecological responses to recent climate change, providing the opportunity to test whether the magnitude and nature of recent responses match predictions. Here, we perform a global and multitaxon metaanalysis to show that empirical evidence for the realized effects of climate change supports predictions of future extinction risk. We use International Union for Conservation of Nature (IUCN) Red List criteria as a common scale to estimate extinction risks from a wide range of climate impacts, ecological responses, and methods of analysis, and we compare predictions with observations. Mean extinction probability across studies making predictions of the future effects of climate change was 7% by 2100 compared with 15% based on observed responses. After taking account of possible bias in the type of climate change impact analyzed and the parts of the world and taxa studied, there was less discrepancy between the two approaches: predictions suggested a mean extinction probability of 10% across taxa and regions, whereas empirical evidence gave a mean probability of 14%. As well as mean overall extinction probability, observations also supported predictions in terms of variability in extinction risk and the relative risk associated with broad taxonomic groups and geographic regions. These results suggest that predictions are robust to methodological assumptions and provide strong empirical support for the assertion that anthropogenic climate change is now a major threat to global biodiversity. PMID:21746924

Recent ecological responses to climate change support predictions of high extinction risk.

PubMed

Maclean, Ilya M D; Wilson, Robert J

2011-07-26

Predicted effects of climate change include high extinction risk for many species, but confidence in these predictions is undermined by a perceived lack of empirical support. Many studies have now documented ecological responses to recent climate change, providing the opportunity to test whether the magnitude and nature of recent responses match predictions. Here, we perform a global and multitaxon metaanalysis to show that empirical evidence for the realized effects of climate change supports predictions of future extinction risk. We use International Union for Conservation of Nature (IUCN) Red List criteria as a common scale to estimate extinction risks from a wide range of climate impacts, ecological responses, and methods of analysis, and we compare predictions with observations. Mean extinction probability across studies making predictions of the future effects of climate change was 7% by 2100 compared with 15% based on observed responses. After taking account of possible bias in the type of climate change impact analyzed and the parts of the world and taxa studied, there was less discrepancy between the two approaches: predictions suggested a mean extinction probability of 10% across taxa and regions, whereas empirical evidence gave a mean probability of 14%. As well as mean overall extinction probability, observations also supported predictions in terms of variability in extinction risk and the relative risk associated with broad taxonomic groups and geographic regions. These results suggest that predictions are robust to methodological assumptions and provide strong empirical support for the assertion that anthropogenic climate change is now a major threat to global biodiversity.

What should we mean by empirical validation in hypnotherapy: evidence-based practice in clinical hypnosis.

PubMed

Alladin, Assen; Sabatini, Linda; Amundson, Jon K

2007-04-01

This paper briefly surveys the trend of and controversy surrounding empirical validation in psychotherapy. Empirical validation of hypnotherapy has paralleled the practice of validation in psychotherapy and the professionalization of clinical psychology, in general. This evolution in determining what counts as evidence for bona fide clinical practice has gone from theory-driven clinical approaches in the 1960s and 1970s through critical attempts at categorization of empirically supported therapies in the 1990s on to the concept of evidence-based practice in 2006. Implications of this progression in professional psychology are discussed in the light of hypnosis's current quest for validation and empirical accreditation.