SU-E-CAMPUS-J-04: Image Guided Radiation Therapy (IGRT): Review of Technical Standards and Credentialing in Radiotherapy Clinical Trials

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

Giaddui, T; Chen, W; Yu, J

2014-06-15

Purpose: To review IGRT credentialing experience and unexpected technical issues encountered in connection with advanced radiotherapy technologies as implemented in RTOG clinical trials. To update IGRT credentialing procedures with the aim of improving the quality of the process, and to increase the proportion of IGRT credentialing compliance. To develop a living disease site-specific IGRT encyclopedia. Methods: Numerous technical issues were encountered during the IGRT credentialing process. The criteria used for credentialing review were based on: image quality; anatomy included in fused data sets and shift results. Credentialing requirements have been updated according to the AAPM task group reports for IGRTmore » to ensure that all required technical items are included in the quality review process. Implementation instructions have been updated and expanded for recent protocols. Results: Technical issues observed during the credentialing review process include, but are not limited to: poor quality images; inadequate image acquisition region; poor data quality; shifts larger than acceptable; no soft tissue surrogate. The updated IGRT credentialing process will address these issues and will also include the technical items required from AAPM: TG 104; TG 142 and TG 179 reports. An instruction manual has been developed describing a remote credentialing method for reviewers. Submission requirements are updated, including images/documents as well as facility questionnaire. The review report now includes summary of the review process and the parameters that reviewers check. We have reached consensus on the minimum IGRT technical requirement for a number of disease sites. RTOG 1311(NRG-BR002A Phase 1 Study of Stereotactic Body Radiotherapy (SBRT) for the Treatment of Multiple Metastases) is an example, here; the protocol specified the minimum requirement for each anatomical sites (with/without fiducials). Conclusion: Technical issues are identified and reported. IGRT guidelines are updated, with the corresponding credentialing requirements. An IGRT encyclopedia describing site-specific implementation issues is currently in development.« less

77 FR 39425 - Approval and Promulgation of Implementation Plans; Louisiana; Regional Haze State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

... disapproval because of deficiencies in Louisiana's RH SIP submittal that go beyond the issues addressed in the... submittal includes several deficient provisions. The deficiencies identified in the proposal go beyond those...

Educational Policy Issues for the 1990s: Balancing Equity and Excellence in Implementing the Reform Agenda.

ERIC Educational Resources Information Center

Marcoulides, George A.; Heck, Ronald H.

1990-01-01

Discusses problems with reform issues that focus specifically on changing the system of educational policymaking to achieve excellence but lack safeguards against compromising equality of educational opportunity in the public school system. Explores the conflicting political views of reform policy, which include economic issues and democratic…

76 FR 78929 - Establishing Timeframes for Implementation of Product Safety Labeling Changes; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-20

... labeling; (2) supply chain issues; and, (3) other issues. FDA may use the information received to develop...? B. Supply Chain Issues 3. What are the supply chain factors (including storage, shipping, and... the optimal point in the supply chain (e.g., newly manufactured product, newly shipped product) and...

Qualitative and mixed methods research in dissemination and implementation science: introduction to the special issue.

PubMed

Southam-Gerow, Michael A; Dorsey, Shannon

2014-01-01

This special issue provides examples of how qualitative and mixed methods research approaches can be used in dissemination and implementation science. In this introductory article, we provide a brief rationale for why and how qualitative and mixed methods approaches can be useful in moving the field forward. Specifically, we provide a brief primer on common qualitative methods, including a review of guidelines provided by the National Institutes of Health. Next, we introduce the six articles in the issue. The first of the articles by Palinkas represents a more thorough and authoritative discussion related to qualitative methods, using the other five articles in the issue (and other published works) as examples. The remaining five articles are empirical and/or descriptive articles of recently completed or ongoing qualitative or mixed methods studies related to dissemination and implementation of evidence-based practices for children and adolescents.

Developing Information Systems for Competitive Intelligence Support.

ERIC Educational Resources Information Center

Hohhof, Bonnie

1994-01-01

Discusses issues connected with developing information systems for competitive intelligence support; defines the elements of an effective competitive information system; and summarizes issues affecting system design and implementation. Highlights include intelligence information; information needs; information sources; decision making; and…

Ethical issues with colorectal cancer screening-a systematic review.

PubMed

Hofmann, Bjørn

2017-06-01

Colorectal cancer (CRC) screening is widely recommended and implemented. However, sometimes CRC screening is not implemented despite good evidence, and some types of CRC screening are implemented despite lack of evidence. The objective of this article is to expose and elucidate relevant ethical issues in the literature on CRC screening that are important for open and transparent deliberation on CRC screening. An axiological question-based method is used for exposing and elucidating ethical issues relevant in HTA. A literature search in MEDLINE, Embase, PsycINFO, PubMed Bioethics subset, ISI Web of Knowledge, Bioethics Literature Database (BELIT), Ethics in Medicine (ETHMED), SIBIL Base dati di bioetica, LEWI Bibliographic Database on Ethics in the Sciences and Humanities, and EUROETHICS identified 870 references of which 114 were found relevant according to title and abstract. The content of the included papers were subject to ethical analysis to highlight the ethical issues, concerns, and arguments. A wide range of important ethical issues were identified. The main benefits are reduced relative CRC mortality rate, and potentially incidence rate, but there is no evidence of reduced absolute mortality rate. Potential harms are bleeding, perforation, false test results, overdetection, overdiagnosis, overtreatment (including unnecessary removal of polyps), and (rarely) death. Other important issues are related to autonomy and informed choice equity, justice, medicalization, and expanding disease. A series of important ethical issues have been identified and need to be addressed in open and transparent deliberation on CRC screening. © 2016 John Wiley & Sons, Ltd.

Evaluation of physical activity interventions in youth via the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework: A systematic review of randomised and non-randomised trials.

PubMed

McGoey, Tara; Root, Zach; Bruner, Mark W; Law, Barbi

2015-07-01

An identified limitation of existing reviews of physical activity interventions in school-aged youth is the lack of reporting on issues related to the translatability of the research into health promotion practice. This review used the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance framework to determine the extent to which intervention studies promoting physical activity in youth report on factors that inform generalizability across settings and populations. A systematic search for controlled interventions conducted within the last ten years identified 50 studies that met the selection criteria. Based on Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance criteria, most of these studies focused on statistically significant findings and internal validity rather than on issues of external validity. Due to this lack of information, it is difficult to determine whether or not reportedly successful interventions are feasible and sustainable in an uncontrolled, real-world setting. Areas requiring further research include costs associated with recruitment and implementation, adoption rate, and representativeness of participants and settings. This review adds data to support recommendations that interventions promoting physical activity in youth should include assessment of adoption and implementation issues. Copyright © 2015 Elsevier Inc. All rights reserved.

Implementation of a Contingency Management-Based Intervention in a Community Supervision Setting: Clinical Issues and Recommendations

ERIC Educational Resources Information Center

Trotman, Adria J.; Taxman, Faye S.

2011-01-01

A cognitive-behaviorally based substance abuse treatment program was implemented within a community supervision setting. This program included a goals group that used a contingency management component and included the probation agent as a part of the treatment. In this article, the authors describe the contingency management component of the…

Non-compliance with the International Code of Marketing of Breast Milk Substitutes is not confined to the infant formula industry.

PubMed

Forsyth, Stewart

2013-06-01

Infant feeding policy and practice continues to be a contentious area of global health care. The infant formula industry is widely considered to be the bête noire with frequent claims that they adopt marketing and sales practices that are not compliant with the WHO Code. However, failure to resolve these issues over three decades suggests that there may be wider systemic failings. Review of published papers, commentaries and reports relating to the implementation and governance of the WHO Code with specific reference to issues of non-compliance. The analysis set out in this paper indicates that there are systemic failings at all levels of the implementation and monitoring process including the failure of WHO to successfully 'urge' governments to implement the Code in its entirety; a lack of political will by Member States to implement and monitor the Code and a lack of formal and transparent governance structures. Non-compliance with the WHO Code is not confined to the infant formula industry and several actions are identified, including the need to address issues of partnership working and the establishment of governance systems that are robust, independent and transparent.

Technology Solutions for Schools.

ERIC Educational Resources Information Center

Association of School Business Officials International, Reston, VA.

This publication is the third of three publications to assist school business officials with the challenges of improving school facilities. This report explores issues relating to technology implementation in school buildings, including cost and finance issues, space requirements, classroom configuration, equity in technology availability,…

Smart-Glasses: Exposing and Elucidating the Ethical Issues.

PubMed

Hofmann, Bjørn; Haustein, Dušan; Landeweerd, Laurens

2017-06-01

The objective of this study is to provide an overview over the ethical issues relevant to the assessment, implementation, and use of smart-glasses. The purpose of the overview is to facilitate deliberation, decision making, and the formation of knowledge and norms for this emerging technology. An axiological question-based method for human cognitive enhancement including an extensive literature search on smart-glasses is used to identify relevant ethical issues. The search is supplemented with relevant ethical issues identified in the literature on human cognitive enhancement (in general) and in the study of the technical aspects of smart-glasses. Identified papers were subject to traditional content analysis: 739 references were identified of which 247 were regarded as relevant for full text examinations, and 155 were included in the study. A wide variety of ethical issues with smart-glasses have been identified, such as issues related to privacy, safety, justice, change in human agency, accountability, responsibility, social interaction, power and ideology. Smart-glasses are envisioned to change individual human identity and behavior as well as social interaction. Taking these issues into account appears to be relevant when developing, deliberating, deciding on, implementing, and using smart-glasses.

Conducting an Efficient Proactive Risk Assessment Prior to CPOE Implementation in an Intensive Care Unit

PubMed Central

Hundt, Ann Schoofs; Adams, Jean A.; Schmid, J. Andrew; Musser, Linda M.; Walker, James M.; Wetterneck, Tosha B; Douglas, Stephen V.; Paris, Bonnie L.; Carayon, Pascale

2012-01-01

Purpose To develop, conduct, and evaluate a proactive risk assessment (PRA) of the design and implementation of CPOE in an ICU. Methods We developed a PRA method based on issues identified from documented experience with conventional PRA methods and the constraints of an organization about to implement CPOE in an intensive care unit. The PRA method consists of three phases: planning (three months), team (one five-hour meeting), and evaluation (short- and long-term). Results Sixteen unique relevant vulnerabilities were identified as a result of the PRA team’s efforts. Negative consequences resulting from the vulnerabilities included potential patient safety and quality of care issues, non-compliance with regulatory requirements, increases in cognitive burden on CPOE users, and/or worker inconvenience or distress. Actions taken to address the vulnerabilities included redesign of the technology, process (workflow) redesign, user training, and/or ongoing monitoring. Verbal and written evaluation by the team members indicated that the PRA method was useful and that participants were willing to participate in future PRAs. Long-term evaluation was accomplished by monitoring an ongoing “issues list” of CPOE problems identified by or reported to IT staff. Vulnerabilities identified by the team were either resolved prior to CPOE implementation (n = 7) or shortly thereafter (n = 9). No other issues were identified beside those identified by the team. Conclusions Generally positive results from the various evaluations including a long-term evaluation demonstrate the value of developing an efficient PRA method that meets organizational and contextual requirements and constraints. PMID:22608242

Implementation of Community-Wide Teen Pregnancy Prevention Initiatives: Focus on Partnerships.

PubMed

Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Dee, Deborah L; Koumans, Emilia H

2017-03-01

Seeking to reduce teen pregnancy and births in communities with rates above the national average, the Centers for Disease Control and Prevention, in partnership with the U.S. Department of Health and Human Services Office of Adolescent Health Teen Pregnancy Prevention Program, developed a joint funding opportunity through which grantees worked to implement and test an approach involving community-wide teen pregnancy prevention initiatives. Once these projects had been in the field for 2.5 years, Centers for Disease Control and Prevention staff developed plans for a supplemental issue of the Journal of Adolescent Health to present findings from and lessons learned during implementation of the community-wide initiatives. When the articles included in the supplemental issue are considered together, common themes emerge, particularly those related to initiating, building, and maintaining strong partnerships. Themes seen across articles include the importance of (1) sharing local data with partners to advance initiative implementation, (2) defining partner roles from the beginning of the initiatives, (3) developing teams that include community partners to provide direction to the initiatives, and (4) addressing challenges to maintaining strong partnerships including partner staff turnover and delays in implementation. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Gaining Insight into an Organization's Fixed Assets.

ERIC Educational Resources Information Center

Hardy, Elisabet

2003-01-01

Discusses issues related to school district implementation of June 2001 Government Accounting Standards Board (GASB) Statement 34 designed to change how schools report fixed assets. Includes planning for GASB implementation, conducting fixed-asset inventories, and making time for GASB reporting. (PKP)

Next generation air transportation system : issues associated with midterm implementation of capabilities and full system transformation.

DOT National Transportation Integrated Search

2009-03-01

To prepare for forecasted air traffic : growth, the Federal Aviation : Administration (FAA), including its : Joint Planning and Development : Office (JPDO) and Air Traffic : Organization (ATO), is planning for : and implementing the Next : Generation...

5 CFR 2610.308 - Decision.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF THE EQUAL... officer shall issue an initial decision on the application within 30 days after completion of proceedings... amount requested and the amount awarded. The decision shall also include, if at issue, findings on...

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

Amy Honchar

The contribution of funds from DOE supported publication costs of a special issue of Deep Sea Research arising from presentations at the First U.S. Atlantic Meridional Overturning Circulation (AMOC) Meeting held 4-6 May, 2009 to review the US implementation plan and its coordination with other monitoring activities. The special issue includes a total of 16 papers, including publications from three DOE-supported investigators (ie Sevellec, F., and A.V. Fedorov; Hu et. al., and Wan et. al.,). The special issue addresses DOE interests in understanding and simulation/modeling of abrupt climate change.

Implementation of the Project "Including Disabled Senior Citizens in Creative Activities in 2013-2015"

ERIC Educational Resources Information Center

Ploch, Leszek

2015-01-01

This paper made an attempt to indicate the findings of the author's research from the experiences of the implementation of the project "Including disabled senior citizens in creative activities in 2013-2015". The issues of disabled senior citizens have been an object of interest over the recent years though it still has not had a proper…

Next generation air transportation system : status of transformation and issues associated with midterm implementation of capabilities.

DOT National Transportation Integrated Search

2009-03-01

"To prepare for forecasted air traffic growth, the Federal Aviation Administration (FAA), including its Joint Planning and Development Office (JPDO) and Air Traffic Organization (ATO), is planning for and implementing the Next Generation Air Transpor...

Going digital: a checklist in preparing for hospital-wide electronic medical record implementation and digital transformation.

PubMed

Scott, Ian A; Sullivan, Clair; Staib, Andrew

2018-05-24

Objective In an era of rapid digitisation of Australian hospitals, practical guidance is needed in how to successfully implement electronic medical records (EMRs) as both a technical innovation and a major transformative change in clinical care. The aim of the present study was to develop a checklist that clearly and comprehensively defines the steps that best prepare hospitals for EMR implementation and digital transformation. Methods The checklist was developed using a formal methodological framework comprised of: literature reviews of relevant issues; an interactive workshop involving a multidisciplinary group of digital leads from Queensland hospitals; a draft document based on literature and workshop proceedings; and a review and feedback from senior clinical leads. Results The final checklist comprised 19 questions, 13 related to EMR implementation and six to digital transformation. Questions related to the former included organisational considerations (leadership, governance, change leaders, implementation plan), technical considerations (vendor choice, information technology and project management teams, system and hardware alignment with clinician workflows, interoperability with legacy systems) and training (user training, post-go-live contingency plans, roll-out sequence, staff support at point of care). Questions related to digital transformation included cultural considerations (clinically focused vision statement and communication strategy, readiness for change surveys), management of digital disruption syndromes and plans for further improvement in patient care (post-go-live optimisation of digital system, quality and benefit evaluation, ongoing digital innovation). Conclusion This evidence-based, field-tested checklist provides guidance to hospitals planning EMR implementation and separates readiness for EMR from readiness for digital transformation. What is known about the topic? Many hospitals throughout Australia have implemented, or are planning to implement, hospital wide electronic medical records (EMRs) with varying degrees of functionality. Few hospitals have implemented a complete end-to-end digital system with the ability to bring about major transformation in clinical care. Although the many challenges in implementing EMRs have been well documented, they have not been incorporated into an evidence-based, field-tested checklist that can practically assist hospitals in preparing for EMR implementation as both a technical innovation and a vehicle for major digital transformation of care. What does this paper add? This paper outlines a 19-question checklist that was developed using a formal methodological framework comprising literature review of relevant issues, proceedings from an interactive workshop involving a multidisciplinary group of digital leads from hospitals throughout Queensland, including three hospitals undertaking EMR implementation and one hospital with complete end-to-end EMR, and review of a draft checklist by senior clinical leads within a statewide digital healthcare improvement network. The checklist distinguishes between issues pertaining to EMR as a technical innovation and EMR as a vehicle for digital transformation of patient care. What are the implications for practitioners? Successful implementation of a hospital-wide EMR requires senior managers, clinical leads, information technology teams and project management teams to fully address key operational and strategic issues. Using an issues checklist may help prevent any one issue being inadvertently overlooked or underemphasised in the planning and implementation stages, and ensure the EMR is fully adopted and optimally used by clinician users in an ongoing digital transformation of care.

Women with epilepsy: clinically relevant issues

PubMed Central

Bangar, Santosh; Shastri, Abhishek; El-Sayeh, Hany; Cavanna, Andrea E.

2016-01-01

Summary Women with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects. Awareness of these gender-specific issues and implementation/adaptation of effective interventions for WWE results in significantly improved health-related quality of life in this patient population. PMID:27678205

Understanding and avoiding potential problems in implementing automation

NASA Astrophysics Data System (ADS)

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

1985-11-01

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

Understanding and avoiding potential problems in implementing automation

NASA Technical Reports Server (NTRS)

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

1985-01-01

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

The Use and Management of Infant Teachers' Time: Some Policy Issues.

ERIC Educational Resources Information Center

Campbell, R. J.; And Others

The first part of this paper reviews the literature on fundamental issues that relate to the work of teachers as the national curriculum is implemented in the United Kingdom. These issues include: (1) the work day of junior and secondary school teachers; (2) the politics and sociology of teaching; (3) the work of primary school teachers; and (4)…

Dissemination of psychosocial treatments for anxiety: the importance of taking a broad perspective.

PubMed

Taylor, Steven; Abramowitz, Jonathan S

2013-12-01

Dissemination methods are used to increase the likelihood that a given treatment or form of clinical practice is implemented by clinicians in the community. Therapist training in treatment methods is an important component of dissemination. Successful dissemination also requires that roadblocks to treatment implementation are identified and circumvented, such as misconceptions that clinicians might hold about a given treatment. The present article offers a commentary on the papers included in the special issue on treatment dissemination for anxiety disorders. Most papers focus on issues concerning the training and education of clinicians with regard to exposure therapy. Training and education is an important step but should be part of a broad, multifaceted approach. There are several other important methods of treatment dissemination, including methods developed and implemented with success by the pharmaceutical industry, might also be used to disseminate psychosocial therapies. Optimal dissemination likely requires a broad perspective in which multiple dissemination methods are considered for implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Learning from Multiple Collaborating Intelligent Tutors: An Agent-based Approach.

ERIC Educational Resources Information Center

Solomos, Konstantinos; Avouris, Nikolaos

1999-01-01

Describes an open distributed multi-agent tutoring system (MATS) and discusses issues related to learning in such open environments. Topics include modeling a one student-many teachers approach in a computer-based learning context; distributed artificial intelligence; implementation issues; collaboration; and user interaction. (Author/LRW)

Alabama Counseling Association Journal, 1996.

ERIC Educational Resources Information Center

Farrell, R. Joel, II, Ed.

1996-01-01

This document consists of the two issues of the "Alabama Counseling Association Journal" published during 1996. The focus of the journal is on communicating ideas and information that will help counselors to implement the counseling role and develop the profession of counseling. Issue number 1 includes the following articles:…

Implementing programs for chronic illness management: the case of hypertension services.

PubMed

Christianson, J B; Pietz, L; Taylor, R; Woolley, A; Knutson, D J

1997-11-01

This article describes the process by which HealthSystem Minnesota (a vertically integrated health care organization), functioning in a competitive managed care environment, has been implementing a hypertension services program. The program involves a team approach to care, with emphasis on patient participation in treatment; decentralized care delivery by nurse coordinators at primary care practice sites; ongoing training and education for patients and providers; and the continuous monitoring and evaluation of patient outcomes and satisfaction. JOB-LEVEL ISSUES: A variety of issues, such as the role and responsibilities of the nurse coordinator, became evident as the program moved towards operational status at four primary care practice sites, which prolonged the implementation period. PROCESS-LEVEL ISSUES: Issues relating to work process changes were more complicated to resolve and required, in some cases, changes in the proposed model. The most significant process-level issues related to educating physicians about the program to secure their participation and support. ORGANIZATION-LEVEL ISSUES: Such issues, which were the most difficult for program implementors to anticipate and resolve, included an organizational culture that emphasized decision making autonomy at primary practice sites. In part, the difficulty encountered in resolving organization-level issues reflected the implementors' lack of awareness of the strength or complexity of the environmental pressures facing the organization, as well as a lack of sensitivity to nuances relating to organizational culture. Two groups of hypertensive patients--at the implementation and comparison sites--will be compared with respect to satisfaction with care, clinical outcomes, and costs. Expansion of the model to patients with other chronic conditions is under consideration.

Personal Transferable Skills in Higher Education: The Problems of Implementing Good Practice.

ERIC Educational Resources Information Center

Drummond, Ian; Nixon, Iain; Wiltshire, John

1998-01-01

Promotion of effective development of personal transferable skills has had limited success in British higher education. Difficulties inherent in implementing established good practice include institutional inertia, issues of academic freedom, resources, high levels of commitment to a particular discipline, and modularization. (SK)

Practical Issues in Developing a Culturally Tailored Physical Activity Promotion Program for Chinese and Korean American Midlife Women: A Pilot Study

PubMed Central

Chee, Wonshik; Kim, Sangmi; Chu, Tsung-Lan; Ji, Xiaopeng; Zhang, Jingwen; Chee, Eunice; Im, Eun-Ok

2016-01-01

Background With advances in computer technologies, Web-based interventions are widely accepted and welcomed by health care providers and researchers. Although the benefits of Web-based interventions on physical activity promotion have been documented, the programs have rarely targeted Asian Americans, including Asian American midlife women. Subsequently, culturally competent Web-based physical activity programs for Asian Americans may be necessary. Objective The purpose of our study was to explore practical issues in developing and implementing a culturally competent Web-based physical activity promotion program for 2 groups of Asian American women—Chinese American and Korean American midlife women—and to provide implications for future research. Methods While conducting the study, the research team members wrote individual memos on issues and their inferences on plausible reasons for the issues. The team had group discussions each week and kept the minutes of the discussions. Then, the memos and minutes were analyzed using a content analysis method. Results We identified practical issues in 4 major idea categories: (1) bilingual translators’ language orientations, (2) cultural sensitivity requirement, (3) low response rate, interest, and retention, and (4) issues in implementation logistics. Conclusions Based on the issues, we make several suggestions for the use of bilingual translators, motivational strategies, and implementation logistics. PMID:27872035

Observing Teaching. SEDA Paper 79.

ERIC Educational Resources Information Center

Brown, Sally, Ed.; And Others

This publication offers practical support to those in British higher education implementing the Observation of Teaching governmental directives. It provides discussion of key issues as well as a range of materials on how to carry out teaching observation including 23 checklists. The materials are grouped in four main areas: general issues, self…

Forces and Issues Related to Curriculum and Instruction, K-6

ERIC Educational Resources Information Center

DeVault, M. Vere; Weaver, J. Fred

1970-01-01

Traces the development of elementary mathematics curriculum and instruction from colonial times to the present. Each section emphasizes four major issues: Why teach mathematics? What mathematics should be taught? How should the mathematics we teach be organized? How should we organize and implement instruction? Also included are several items…

Issues in Developing the IFSP: A Framework for Establishing Family Outcomes.

ERIC Educational Resources Information Center

Beckman, Paula J.; Bristol, Marie M.

1991-01-01

This paper identifies four key issues in the implementation of Individualized Family Service Plans (IFSPs) to provide services to young handicapped children as required by Public Law 99-457. These include sensitivity to cultural diversity, family assessment, intrusiveness, and establishing family outcomes. A typology of family outcomes which…

School Transportation Issues, Laws and Concerns: Implications for Future Administrators

ERIC Educational Resources Information Center

Durick, Jody M.

2010-01-01

Nearly all building administrators are confronted with a variety of transportation issues. Challenges, concerns and questions can arise from various aspects, including student misbehaviors, transportation laws and its implications at the school level, to importance and implementation of a school bus safety program. As new and upcoming future…

Achieving Standards in a Fiber Optic Mathematics Classroom.

ERIC Educational Resources Information Center

Zbiek, Rose Mary; Foletta, Gina M.

1995-01-01

In response to standards set by the National Council of Teachers of Mathematics, K-12 teachers were interviewed to investigate issues related to implementing standards in K-12 fiber optic mathematics classes. Issues include: achieving student-centered classrooms; incorporating technology into distance education; and structuring assessment so more…

Improving Business-IT Alignment through Business Architecture

ERIC Educational Resources Information Center

Li, Chingmei

2010-01-01

The business and Information Technology (IT) alignment issue has become one of the Top-10 IT management issues since 1980. IT has continually strived to achieve alignment with business goals and objectives. These IT efforts include ERP implementation to benefit from the best practices; data center consolidation and server virtualization to keep…

Virtual Instruction: Issues and Insights from an International Perspective.

ERIC Educational Resources Information Center

Feyten, Carine M., Ed.; Nutta, Joyce W., Ed.

The essays in this book, by contributors from around the world, clarify predominant theoretical issues that pertain to virtual instruction, and offer practical suggestions for implementing these programs in any setting. Chapters include: "Mapping Space and Time: Virtual Instruction as Global Ritual" (Joyce W. Nutta and Carine M. Feyten);…

Classroom Implementation. Issues in Assessment.

ERIC Educational Resources Information Center

Malinowski, Patricia A., Ed.

This booklet, second in a series on issues in assessment, seeks to describe an initiative supported by Finger Lakes Community College (New York) to use classroom assessment techniques (CATs) in different academic areas and to present an overview of some assessment approaches that have been used in the classroom. Papers include: (1) "Enhancing…

Lessons from a Successful Implementation of a Computerized Provider Order Entry System

PubMed Central

Jacobs, Brian R.; Hallstrom, Craig K.; Hart, Kim Ward; Mahoney, Daniela; Lykowski, Gayle

2007-01-01

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success. PMID:23055847

What Today's Educational Technology Needs: Defensible Evaluations and Realistic Implementation.

ERIC Educational Resources Information Center

Roweton, William E.; And Others

It is argued that in order to make computer assisted instruction effective in the schools, educators should pay more attention to implementation issues (including modifying teacher attitudes, changing classroom routines, and offering realistic technical training and support) and to producing understandable product and performance evaluations.…

Evidence-Based Practices in Special Education: Current Assumptions and Future Considerations

ERIC Educational Resources Information Center

Russo-Campisi, Jacqueline

2017-01-01

Background: The research on evidence-based practices (EBP) in special education has shifted over the last decade from identifying efficacious interventions to exploring issues that impede implementation in the classroom. Common barriers to implementation include absence of training and resources, limited collaboration between researchers and…

Identification of Good Practices in the Implementation of Innovative Learning Methodologies

ERIC Educational Resources Information Center

Lincaru, Cristina; Ciuca, Vasilica; Grecu, Liliana; Atanasiu, Draga; Dragoiu, Codruta

2011-01-01

We intend to present the partial issues resulted from the development of the European Project DeInTRA "cooperation for innovative training methodologies deployment in the European Labour Market"--Stage 4: Identification of good practices in the implementation of innovative learning methodologies. This project is included into the…

Environmental concept for engineering software on MIMD computers

NASA Technical Reports Server (NTRS)

Lopez, L. A.; Valimohamed, K.

1989-01-01

The issues related to developing an environment in which engineering systems can be implemented on MIMD machines are discussed. The problem is presented in terms of implementing the finite element method under such an environment. However, neither the concepts nor the prototype implementation environment are limited to this application. The topics discussed include: the ability to schedule and synchronize tasks efficiently; granularity of tasks; load balancing; and the use of a high level language to specify parallel constructs, manage data, and achieve portability. The objective of developing a virtual machine concept which incorporates solutions to the above issues leads to a design that can be mapped onto loosely coupled, tightly coupled, and hybrid systems.

A case study of one school system's adoption and implementation of an elementary science program

NASA Astrophysics Data System (ADS)

Kelly, Michael Patrick

2000-10-01

The researcher's purpose in this study was to examine the process used by the Minot Public Schools to adopt and implement a new elementary science program from Silver Burdett Ginn called Discovery Works. Using case study methods within a naturalistic design, the researcher investigated teachers' concerns as they adopted and implemented Discovery Works in their classrooms. Data were gathered using the Concerns Based Adoption Model (CBAM) instrument, interviews with adoption committee members, classroom teachers, grade level meetings, and document analysis of field notes related to each phase of the study. Content analysis methods were used to analyze the data. Emergent themes were presented and substantiated in the data, in terms of six research questions that guided this research. The data were analyzed both quantitatively and qualitatively to provide a rich, thick description that and enabled the researcher to confirm and triangulate the concerns of teachers in this study. The quantitative data revealed a general nonuser profile by teachers as they implemented Discovery Works. Three major themes of concerns emerged from a qualitative analysis of the data. The first theme was implementation, including issues related to teacher attitudes and inservice needs. The second theme, management issues, had five concerns subsumed within it. These included concerns related to time, materials, storage, reorder, and cooperative groups. The third theme, effects on students, included issues concerning hands-on methods of teaching science, vocabulary, especially at the upper elementary, and assessment issues. Possible solutions to resolve each of the concerns were presented. Major conclusions are that teacher concerns about Discovery Works were normal for any group experiencing a new innovation. Teachers and students enjoyed using the hands-on materials, and that Minot Public Schools has taken a small, but important step forward on the road to science education reform. Although there is still a strong emphasis on the language arts of science, as opposed to scientific inquiry, there has been increased learning of science content and the process skills necessary to do scientific inquiry. Recommendations were made for professional development activities that would assist teachers in the next phase of the implementation process.

Implementation of "New Directions" in Development Assistance: Report to the Committee on International Relations on Implementation of Legislative Reforms in the Foreign Assistance Act of 1973.

ERIC Educational Resources Information Center

Agency for International Development (Dept. of State), Washington, DC.

This report discusses the many policy and procedural issues of the Agency for International Development (AID) in implementing the reforms included in the congressional Foreign Assistance Act of 1973. The act concentrated aid efforts on food and nutrition improvement, population control, health improvement, education, and human resource…

Considering health equity when moving from evidence-based guideline recommendations to implementation: a case study from an upper-middle income country on the GRADE approach

PubMed Central

Mosquera, Paola; Alzate, Juan Pablo; Pottie, Kevin; Welch, Vivian; Akl, Elie A; Jull, Janet; Lang, Eddy; Katikireddi, Srinivasa Vittal; Morton, Rachel; Thabane, Lehana; Shea, Bev; Stein, Airton T; Singh, Jasvinder; Florez, Ivan D; Guyatt, Gordon; Schünemann, Holger; Tugwell, Peter

2017-01-01

Abstract The availability of evidence-based guidelines does not ensure their implementation and use in clinical practice or policy making. Inequities in health have been defined as those inequalities within or between populations that are avoidable, unnecessary and also unjust and unfair. Evidence-based clinical practice and public health guidelines (‘guidelines’) can be used to target health inequities experienced by disadvantaged populations, although guidelines may unintentionally increase health inequities. For this reason, there is a need for evidence-based clinical practice and public health guidelines to intentionally target health inequities experienced by disadvantaged populations. Current guideline development processes do not include steps for planned implementation of equity-focused guidelines. This article describes nine steps that provide guidance for consideration of equity during guideline implementation. A critical appraisal of the literature followed by a process to build expert consensus was undertaken to define how to include consideration of equity issues during the specific GRADE guideline development process. Using a case study from Colombia we describe nine steps that were used to implement equity-focused GRADE recommendations: (1) identification of disadvantaged groups, (2) quantification of current health inequities, (3) development of equity-sensitive recommendations, (4) identification of key actors for implementation of equity-focused recommendations, (5) identification of barriers and facilitators to the implementation of equity-focused recommendations, (6) development of an equity strategy to be included in the implementation plan, (7) assessment of resources and incentives, (8) development of a communication strategy to support an equity focus and (9) development of monitoring and evaluation strategies. This case study can be used as model for implementing clinical practice guidelines, taking into account equity issues during guideline development and implementation. PMID:29029068

Integrating primary care into community behavioral health settings: programs and early implementation experiences.

PubMed

Scharf, Deborah M; Eberhart, Nicole K; Schmidt, Nicole; Vaughan, Christine A; Dutta, Trina; Pincus, Harold Alan; Burnam, M Audrey

2013-07-01

This article describes the characteristics and early implementation experiences of community behavioral health agencies that received Primary and Behavioral Health Care Integration (PBHCI) grants from the Substance Abuse and Mental Health Services Administration to integrate primary care into programs for adults with serious mental illness. Data were collected from 56 programs, across 26 states, that received PBHCI grants in 2009 (N=13) or 2010 (N=43). The authors systematically extracted quantitative and qualitative information about program characteristics from grantee proposals and semistructured telephone interviews with core program staff. Quarterly reports submitted by grantees were coded to identify barriers to implementing integrated care. Grantees shared core features required by the grant but varied widely in terms of characteristics of the organization, such as size and location, and in the way services were integrated, such as through partnerships with a primary care agency. Barriers to program implementation at start-up included difficulty recruiting and retaining qualified staff and issues related to data collection and use of electronic health records, licensing and approvals, and physical space. By the end of the first year, some problems, such as space issues, were largely resolved, but other issues, including problems with staffing and data collection, remained. New challenges, such as patient recruitment, had emerged. Early implementation experiences of PBHCI grantees may inform other programs that seek to integrate primary care into behavioral health settings as part of new, large-scale government initiatives, such as specialty mental health homes.

Problems and issues in implementing innovative curriculum in the developing countries: the Pakistani experience.

PubMed

Ali, Syeda Kauser; Baig, Lubna A

2012-05-16

The Government of Pakistan identified 4 medical Colleges for introduction of COME, one from each province. Curriculum was prepared by the faculty of these colleges and launched in 2001 and despite concerted efforts could not be implemented. The purpose of this research was to identify the reasons for delay in implementation of the COME curriculum and to assess the understanding of the stakeholders about COME. Mixed methods study design was used for data collection. In-depth interviews, mail-in survey questionnaire, and focus group discussions were held with the representatives of federal and provincial governments, Principals of medical colleges, faculty and students of the designated colleges. Rigor was ensured through independent coding and triangulation of data. The reasons for delay in implementation differed amongst the policy makers and faculty and included thematic issues at the institutional, programmatic and curricular level. Majority (92% of the faculty) felt that COME curriculum couldn't be implemented without adequate infrastructure. The administrators were willing to provide financial assistance, political support and better coordination and felt that COME could improve the overall health system of the country whereas the faculty did not agree to it. The paper discusses the reasons of delay based on findings and identifies the strategies for curriculum change in established institutions. The key issues identified in our study included frequent transfer of faculty of the designated colleges and perceived lack of: Continuation at the policy making level. Communication between the stakeholders. Effective leadership.

The clinical, operational, and financial worlds of neonatal palliative care: A focused ethnography.

PubMed

Williams-Reade, Jackie; Lamson, Angela L; Knight, Sharon M; White, Mark B; Ballard, Sharon M; Desai, Priti P

2015-04-01

Due to multiple issues, integrated interdisciplinary palliative care teams in a neonatal intensive care unit (NICU) may be difficult to access, sometimes fail to be implemented, or provide inconsistent or poorly coordinated care. When implementing an effective institution-specific neonatal palliative care program, it is critical to include stakeholders from the clinical, operational, and financial worlds of healthcare. In this study, researchers sought to gain a multidisciplinary perspective into issues that may impact the implementation of a formal neonatal palliative care program at a tertiary regional academic medical center. In this focused ethnography, the primary researcher conducted semistructured interviews that explored the perspectives of healthcare administrators, finance officers, and clinicians about neonatal palliative care. The perspectives of 39 study participants informed the identification of institutional, financial, and clinical issues that impact the implementation of neonatal palliative care services at the medical center and the planning process for a formal palliative care program on behalf of neonates and their families. Healthcare professionals described experiences that influenced their views on neonatal palliative care. Key themes included: (a) uniqueness of neonatal palliative care, (b) communication and conflict among providers, (c) policy and protocol discrepancies, and (d) lack of administrative support. The present study highlighted several areas that are challenging in the provision of neonatal palliative care. Our findings underscored the importance of recognizing and procuring resources needed simultaneously from the clinical, operational, and financial worlds in order to implement and sustain a successful neonatal palliative care program.

Space station operations task force. Panel 4 report: Management integration

NASA Technical Reports Server (NTRS)

1987-01-01

The Management Integration Panel of the Space Station Operations Task Force was chartered to provide a structure and ground rules for integrating the efforts of the other three panels and to address a number of cross cutting issues that affect all areas of space station operations. Issues addressed include operations concept implementation, alternatives development and integration process, strategic policy issues and options, and program management emphasis areas.

Employer Supported Child Care: An Idea Whose Time Has Come. A Conference on Child Care as an Employee Benefit (Costs and Benefits, Successful Programs, Company Options, Current Issues). Conference Proceedings.

ERIC Educational Resources Information Center

Haiman, Peter, Ed.; Sud, Gian, Ed.

Many aspects of employer-sponsored child care programs--including key issues, costs and benefits, programmatic options, and implementation strategies--are discussed in these conference proceedings. Public policy issues, legal aspects of child care as an employee benefit, tax incentives for corporate child care, and funding sources for child care…

Professional Development Leadership and the Diverse Learner. Issues in Science Education.

ERIC Educational Resources Information Center

Rhoton, Jack, Ed.; Bowers, Patricia, Ed.

This book focuses on the professional development of teachers and discusses issues related to science education reform. The content of the book is divided into two parts. Part 1, Professional Development: Implications for Science Leadership, chapters include: (1) "The Role of the Science Leader in Implementing Standards-Based Science Programs"…

Closing the Gap Between Practice Environments and Reality: An Interactive Multimedia Program for Oral Communication Training in Japanese. Part 1 Theory; Part 2 Practice.

ERIC Educational Resources Information Center

Tsutsui, Michio; Kato, Masashi; Mohr, Bradley

1998-01-01

This article is divided into two parts. The first discusses theoretical issues related to the software program introduced, and the second deals with practical issues, including technical and pedagogical considerations in implementing the program. (Author/VWL)

China-U.S. Trade Issues

DTIC Science & Technology

2008-10-07

practices. In response, it filed a number of trade dispute resolution cases against China in the WTO, including China’s failure to protect IPR and...in China. In addition, the Administration reversed a long-standing policy that countervailing cases (dealing with government subsidies) could not be...13 WTO Implementation Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 U.S. WTO Cases Against China

Designing a Citizen Involvement Program: A Guidebook for Involving Citizens in the Resolution of Environmental Issues.

ERIC Educational Resources Information Center

Howell, Robert E.; And Others

A model and supportive materials are presented for design and implementation of a program for involving citizens in decision-making concerning significant environmental issues. Chapter topics include: why citizen involvement? (potential benefits of the process); theoretical basis for citizen involvement (three fundamental perspectives underlying…

An interagency space nuclear propulsion safety policy for SEI - Issues and discussion

NASA Technical Reports Server (NTRS)

Marshall, A. C.; Sawyer, J. C., Jr.

1991-01-01

An interagency Nuclear Safety Policy Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative nuclear propulsion program to facilitate the implementation of mission planning and conceptual design studies. The NSPWG developed a top level policy to provide the guiding principles for the development and implementation of the nuclear propulsion safety program and the development of Safety Functional Requirements. In addition, the NSPWG reviewed safety issues for nuclear propulsion and recommended top level safety requirements and guidelines to address these issues. Safety topics include reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, safeguards, risk/reliability, operational safety, ground testing, and other considerations. In this paper the emphasis is placed on the safety policy and the issues and considerations that are addressed by the NSPWG recommendations.

Local initiatives to access emergency obstetric and neonatal care in Burkina Faso.

PubMed

Yaméogo, Wambi M E; Ouédraogo, Talatou M; Kouanda, Seni

2016-11-01

To describe the various local initiatives to access emergency obstetric and neonatal care in Burkina Faso. An existing framework was used to review the three processes for local initiatives: emergence, formulation, and implementation. Multiple case studies were conducted, followed by literature review and semi-structured interviews with key informants. Sixteen districts had implemented local initiatives, including cost sharing, free care for women and children, and free care for delivery and cesareans. Most districts (n=10) had implemented the cost-sharing intervention. These initiatives were initiated by local actors as well as nongovernmental organizations. The profile of those involved led to different ways of handling the emergence and formulation processes. At implementation, these initiatives faced many issues including late payment of contributions, low involvement of local governments, and equity in participation. There are some issues in the implementation and sustainability of the local initiatives. Although many initiatives exist, these are unable to fully address the financial barriers to care. However, these initiatives highlight context-based financial barriers that must be taken into account to accelerate universal access to health care. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Implementation Issues of Virtual Desktop Infrastructure and Its Case Study for a Physician's Round at Seoul National University Bundang Hospital.

PubMed

Yoo, Sooyoung; Kim, Seok; Kim, Taegi; Kim, Jon Soo; Baek, Rong-Min; Suh, Chang Suk; Chung, Chin Youb; Hwang, Hee

2012-12-01

The cloud computing-based virtual desktop infrastructure (VDI) allows access to computing environments with no limitations in terms of time or place such that it can permit the rapid establishment of a mobile hospital environment. The objective of this study was to investigate the empirical issues to be considered when establishing a virtual mobile environment using VDI technology in a hospital setting and to examine the utility of the technology with an Apple iPad during a physician's rounds as a case study. Empirical implementation issues were derived from a 910-bed tertiary national university hospital that recently launched a VDI system. During the physicians' rounds, we surveyed patient satisfaction levels with the VDI-based mobile consultation service with the iPad and the relationship between these levels of satisfaction and hospital revisits, hospital recommendations, and the hospital brand image. Thirty-five inpatients (including their next-of-kin) and seven physicians participated in the survey. Implementation issues pertaining to the VDI system arose with regard to the highly availability system architecture, wireless network infrastructure, and screen resolution of the system. Other issues were related to privacy and security, mobile device management, and user education. When the system was used in rounds, patients and their next-of-kin expressed high satisfaction levels, and a positive relationship was noted as regards patients' decisions to revisit the hospital and whether the use of the VDI system improved the brand image of the hospital. Mobile hospital environments have the potential to benefit both physicians and patients. The issues related to the implementation of VDI system discussed here should be examined in advance for its successful adoption and implementation.

Implementation Issues of Virtual Desktop Infrastructure and Its Case Study for a Physician's Round at Seoul National University Bundang Hospital

PubMed Central

Yoo, Sooyoung; Kim, Seok; Kim, Taegi; Kim, Jon Soo; Baek, Rong-Min; Suh, Chang Suk; Chung, Chin Youb

2012-01-01

Objectives The cloud computing-based virtual desktop infrastructure (VDI) allows access to computing environments with no limitations in terms of time or place such that it can permit the rapid establishment of a mobile hospital environment. The objective of this study was to investigate the empirical issues to be considered when establishing a virtual mobile environment using VDI technology in a hospital setting and to examine the utility of the technology with an Apple iPad during a physician's rounds as a case study. Methods Empirical implementation issues were derived from a 910-bed tertiary national university hospital that recently launched a VDI system. During the physicians' rounds, we surveyed patient satisfaction levels with the VDI-based mobile consultation service with the iPad and the relationship between these levels of satisfaction and hospital revisits, hospital recommendations, and the hospital brand image. Thirty-five inpatients (including their next-of-kin) and seven physicians participated in the survey. Results Implementation issues pertaining to the VDI system arose with regard to the highly availability system architecture, wireless network infrastructure, and screen resolution of the system. Other issues were related to privacy and security, mobile device management, and user education. When the system was used in rounds, patients and their next-of-kin expressed high satisfaction levels, and a positive relationship was noted as regards patients' decisions to revisit the hospital and whether the use of the VDI system improved the brand image of the hospital. Conclusions Mobile hospital environments have the potential to benefit both physicians and patients. The issues related to the implementation of VDI system discussed here should be examined in advance for its successful adoption and implementation. PMID:23346476

Usability and feasibility of a tablet-based Decision-Support and Integrated Record-keeping (DESIRE) tool in the nurse management of hypertension in rural western Kenya.

PubMed

Vedanthan, Rajesh; Blank, Evan; Tuikong, Nelly; Kamano, Jemima; Misoi, Lawrence; Tulienge, Deborah; Hutchinson, Claire; Ascheim, Deborah D; Kimaiyo, Sylvester; Fuster, Valentin; Were, Martin C

2015-03-01

Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Usability testing consisted of "think aloud" exercises and "mock patient encounters" with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with nurses. Content analysis was performed using both deductive codes and significant inductive codes. Critical incidents were identified and ranked according to severity. A cause-of-error analysis was used to develop corresponding design change suggestions. Fifty-seven critical incidents were identified in usability testing, 21 of which were unique. The cause-of-error analysis yielded 23 design change suggestions. Feasibility themes included barriers to implementation along both human and technical axes, facilitators to implementation, provider issues, patient issues and feature requests. This participatory, iterative human-centered design process revealed previously unaddressed usability and feasibility issues affecting the implementation of the DESIRE tool in western Kenya. In addition to well-known technical issues, we highlight the importance of human factors that can impact implementation of mHealth interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Usability and Feasibility of a Tablet-Based Decision-Support and Integrated Record-Keeping (DESIRE) Tool in the Nurse Management of Hypertension in Rural Western Kenya

PubMed Central

Vedanthan, Rajesh; Blank, Evan; Tuikong, Nelly; Kamano, Jemima; Misoi, Lawrence; Tulienge, Deborah; Hutchinson, Claire; Ascheim, Deborah D.; Kimaiyo, Sylvester; Fuster, Valentin; Were, Martin C.

2015-01-01

Background Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. Objective To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Methods Usability testing consisted of “think aloud” exercises and “mock patient encounters” with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with nurses. Content analysis was performed using both deductive codes and significant inductive codes. Critical incidents were identified and ranked according to severity. A cause-of-error analysis was used to develop corresponding design change suggestions. Results Fifty-seven critical incidents were identified in usability testing, 21 of which were unique. The cause-of-error analysis yielded 23 design change suggestions. Feasibility themes included barriers to implementation along both human and technical axes, facilitators to implementation, provider issues, patient issues and feature requests. Conclusions This participatory, iterative human-centered design process revealed previously unaddressed usability and feasibility issues affecting the implementation of the DESIRE tool in western Kenya. In addition to well-known technical issues, we highlight the importance of human factors that can impact implementation of mHealth interventions. PMID:25612791

Assessment Case Studies: Common Issues in Implementation with Various Campus Approaches to Resolution.

ERIC Educational Resources Information Center

Nichols, James O.

This is a collection of case studies on the implementation of institutional assessment and evaluation of student outcomes in higher education. The cases are drawn from eleven institutions. Research universities and four-year colleges included were: Clemson University (South Carolina), State University of New York (Albany), University of Kentucky…

[Recommendations for implementing the quality policy and organisation of a quality management system].

PubMed

Daunizeau, A

2013-06-01

Preliminary issues to implement a quality management system are described. They include the definition of the structure, a hierarchical and functional organization chart and the engagement of the whole personnel to apply the requirements of the standard EN ISO 15189. The policy has to be translated into objectives.

Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center.

PubMed

Rizer, Milisa K; Kaufman, Beth; Sieck, Cynthia J; Hefner, Jennifer L; McAlearney, Ann Scheck

2015-01-01

Electronic medical record (EMR) implementation efforts face many challenges, including individual and organizational barriers and concerns about loss of productivity during the process. These issues may be particularly complex in large and diverse settings with multiple specialties providing inpatient and outpatient care. This case report provides an example of a successful EMR implementation that emphasizes the importance of flexibility and adaptability on the part of the implementation team. It also presents the top 10 lessons learned from this EMR implementation in a large midwestern academic medical center. Included are five overarching lessons related to leadership, initial approach, training, support, and optimization as well as five lessons related to the EMR system itself that are particularly important elements of a successful implementation.

Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center

PubMed Central

Rizer, Milisa K.; Kaufman, Beth; Sieck, Cynthia J.; Hefner, Jennifer L.; McAlearney, Ann Scheck

2015-01-01

Electronic medical record (EMR) implementation efforts face many challenges, including individual and organizational barriers and concerns about loss of productivity during the process. These issues may be particularly complex in large and diverse settings with multiple specialties providing inpatient and outpatient care. This case report provides an example of a successful EMR implementation that emphasizes the importance of flexibility and adaptability on the part of the implementation team. It also presents the top 10 lessons learned from this EMR implementation in a large midwestern academic medical center. Included are five overarching lessons related to leadership, initial approach, training, support, and optimization as well as five lessons related to the EMR system itself that are particularly important elements of a successful implementation. PMID:26396558

Never the twain shall meet? - a comparison of implementation science and policy implementation research

PubMed Central

2013-01-01

Background Many of society’s health problems require research-based knowledge acted on by healthcare practitioners together with implementation of political measures from governmental agencies. However, there has been limited knowledge exchange between implementation science and policy implementation research, which has been conducted since the early 1970s. Based on a narrative review of selective literature on implementation science and policy implementation research, the aim of this paper is to describe the characteristics of policy implementation research, analyze key similarities and differences between this field and implementation science, and discuss how knowledge assembled in policy implementation research could inform implementation science. Discussion Following a brief overview of policy implementation research, several aspects of the two fields were described and compared: the purpose and origins of the research; the characteristics of the research; the development and use of theory; determinants of change (independent variables); and the impact of implementation (dependent variables). The comparative analysis showed that there are many similarities between the two fields, yet there are also profound differences. Still, important learning may be derived from several aspects of policy implementation research, including issues related to the influence of the context of implementation and the values and norms of the implementers (the healthcare practitioners) on implementation processes. Relevant research on various associated policy topics, including The Advocacy Coalition Framework, Governance Theory, and Institutional Theory, may also contribute to improved understanding of the difficulties of implementing evidence in healthcare. Implementation science is at a relatively early stage of development, and advancement of the field would benefit from accounting for knowledge beyond the parameters of the immediate implementation science literature. Summary There are many common issues in policy implementation research and implementation science. Research in both fields deals with the challenges of translating intentions into desired changes. Important learning may be derived from several aspects of policy implementation research. PMID:23758952

Never the twain shall meet?--a comparison of implementation science and policy implementation research.

PubMed

Nilsen, Per; Ståhl, Christian; Roback, Kerstin; Cairney, Paul

2013-06-10

Many of society's health problems require research-based knowledge acted on by healthcare practitioners together with implementation of political measures from governmental agencies. However, there has been limited knowledge exchange between implementation science and policy implementation research, which has been conducted since the early 1970s. Based on a narrative review of selective literature on implementation science and policy implementation research, the aim of this paper is to describe the characteristics of policy implementation research, analyze key similarities and differences between this field and implementation science, and discuss how knowledge assembled in policy implementation research could inform implementation science. Following a brief overview of policy implementation research, several aspects of the two fields were described and compared: the purpose and origins of the research; the characteristics of the research; the development and use of theory; determinants of change (independent variables); and the impact of implementation (dependent variables). The comparative analysis showed that there are many similarities between the two fields, yet there are also profound differences. Still, important learning may be derived from several aspects of policy implementation research, including issues related to the influence of the context of implementation and the values and norms of the implementers (the healthcare practitioners) on implementation processes. Relevant research on various associated policy topics, including The Advocacy Coalition Framework, Governance Theory, and Institutional Theory, may also contribute to improved understanding of the difficulties of implementing evidence in healthcare. Implementation science is at a relatively early stage of development, and advancement of the field would benefit from accounting for knowledge beyond the parameters of the immediate implementation science literature. There are many common issues in policy implementation research and implementation science. Research in both fields deals with the challenges of translating intentions into desired changes. Important learning may be derived from several aspects of policy implementation research.

Instructional Technology. IDRA Focus.

ERIC Educational Resources Information Center

IDRA Newsletter, 1997

1997-01-01

This theme issue includes five articles that focus on implementing instructional technology in ways that benefit all students, including limited-English-proficient, minority, economically disadvantaged, and at-risk students. "Cruising the Web with English Language Learners" (Laura Chris Green) presents three scenarios using the World…

Disability Policy Implementation From a Cross-Cultural Perspective.

PubMed

Verdugo, Miguel A; Jenaro, Cristina; Calvo, Isabel; Navas, Patricia

2017-07-01

Implementation of disability policy is influenced by social, political, and cultural factors. Based on published work, this article discusses four guidelines considered critical for successful policy implementation from a cross-cultural perspective. These guidelines are to: (a) base policy implementation on a contextual analysis, (b) employ a value-based approach, (c) align the service delivery system both vertically and horizontally, and (d) engage in a partnership in policy implementation. Public policy should be understood from a systems perspective that includes cross-cultural issues, such as how different stakeholders are acting and the way they plan and implement policy.

Supporting Teaching and Learning Using Authentic Scientific Texts: A Rejoinder to Danielle J. Ford

ERIC Educational Resources Information Center

Yarden, Anat; Falk, Hedda; Federico-Agraso, Marta; Jimenez-Aleixandre, Maria Pilar; Norris, Stephen P.; Phillips, Linda M.

2009-01-01

In her commentary Danielle J. Ford mainly focused on three issues that highlight the promises and challenges for the use of Adapted Primary Literature (APL) in science curricula: the possible contribution of APL to authentic experiences in secondary schools, implementation issues of APL including the support required for the teachers, and the…

Classroom Assessment in Mathematics: Views from a National Science Foundation Working Conference (Greensboro, North Carolina, May 16-18, 1997).

ERIC Educational Resources Information Center

Bright, George W., Ed.; Joyner, Jeane M., Ed.

This document presents papers from a National Science Foundation (NSF) working conference to identify research issues and implementation strategies that support quality classroom assessment. Papers include: (1) "Understanding and Improving Classroom Assessment: Summary of Issues Raised" (George W. Bright and Jeane M. Joyner); (2) "Recommendations…

Group visits for chronic illness management: implementation challenges and recommendations.

PubMed

Jones, Katherine R; Kaewluang, Napatsawan; Lekhak, Nirmala

2014-01-01

The group visit approach to improve chronic illness self-management appears promising in terms of selected outcomes, but little information is available about best ways to organize and implement group visits. This literature review of 84 articles identified group visit implementation challenges, including lack of a group visit billing code, inadequate administrative support and resources, difficult participant recruitment and retention, and logistical issues such as space and scheduling. Recommendations for future implementation initiatives were also abstracted from the literature. Patients and providers can benefit from well-planned and well-conducted group visits. These benefits include greater patient and provider satisfaction, reduced overall utilization, improved clinical outcomes, and greater provider efficiency and productivity.

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2014-04-01

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

The Relationship between Organizational Culture and the Implementation of Response to Intervention in One Elementary School

ERIC Educational Resources Information Center

Methner, Lynn M.

2013-01-01

This study investigated the relationship between organizational culture and the implementation of Response to Intervention in one elementary school. It examined issues corresponding to change within a system, with particular attention to those relating to school culture. An ethnographic approach was used to gather data, including the collection of…

Genitourinary issues during spaceflight: a review.

PubMed

Jones, J A; Jennings, R; Pietryzk, R; Ciftcioglu, N; Stepaniak, P

2005-12-01

The genitourinary (GU) system is not uncommonly affected during previous spaceflights. GU issues that have been observed during spaceflight include urinary calculi, infections, retention, waste management, and reproductive. In-flight countermeasures for each of these issues are being developed to reduce the likelihood of adverse sequelae, due to GU issues during exploration-class spaceflight, to begin in 2018 with flights back to the Moon and on to Mars, according to the February 2004 Presendent's Vision for US Space Exploration. With implementation of a robust countermeasures program, GU issues should not have a significant threat for mission impact during future spaceflights.

Implementation of Audio Computer-Assisted Interviewing Software in HIV/AIDS Research

PubMed Central

Pluhar, Erika; Yeager, Katherine A.; Corkran, Carol; McCarty, Frances; Holstad, Marcia McDonnell; Denzmore-Nwagbara, Pamela; Fielder, Bridget; DiIorio, Colleen

2007-01-01

Computer assisted interviewing (CAI) has begun to play a more prominent role in HIV/AIDS prevention research. Despite the increased popularity of CAI, particularly audio computer assisted self-interviewing (ACASI), some research teams are still reluctant to implement ACASI technology due to lack of familiarity with the practical issues related to using these software packages. The purpose of this paper is to describe the implementation of one particular ACASI software package, the Questionnaire Development System™ (QDS™), in several nursing and HIV/AIDS prevention research settings. We present acceptability and satisfaction data from two large-scale public health studies in which we have used QDS with diverse populations. We also address issues related to developing and programming a questionnaire, discuss practical strategies related to planning for and implementing ACASI in the field, including selecting equipment, training staff, and collecting and transferring data, and summarize advantages and disadvantages of computer assisted research methods. PMID:17662924

African leaders' views on critical human resource issues for the implementation of family medicine in Africa.

PubMed

Moosa, Shabir; Downing, Raymond; Essuman, Akye; Pentz, Stephen; Reid, Stephen; Mash, Robert

2014-01-17

The World Health Organisation has advocated for comprehensive primary care teams, which include family physicians. However, despite (or because of) severe doctor shortages in Africa, there is insufficient clarity on the role of the family physician in the primary health care team. Instead there is a trend towards task shifting without thought for teamwork, which runs the risk of dangerous oversimplification. It is not clear how African leaders understand the challenges of implementing family medicine, especially in human resource terms. This study, therefore, sought to explore the views of academic and government leaders on critical human resource issues for implementation of family medicine in Africa. In this qualitative study, key academic and government leaders were purposively selected from sixteen African countries. In-depth interviews were conducted using an interview guide. All interviews were audio-recorded, transcribed and thematically analysed. There were 27 interviews conducted with 16 government and 11 academic leaders in nine Sub-Saharan African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Malawi, Nigeria, Rwanda, South Africa and Uganda. Respondents spoke about: educating doctors in family medicine suited to Africa, including procedural skills and holistic care, to address the difficulty of recruiting and retaining doctors in rural and underserved areas; planning for primary health care teams, including family physicians; new supervisory models in primary health care; and general human resource management issues. Important milestones in African health care fail to specifically address the human resource issues of integrated primary health care teamwork that includes family physicians. Leaders interviewed in this study, however, proposed organising the district health system with a strong embrace of family medicine in Africa, especially with regard to providing clinical leadership in team-based primary health care. Whilst these leaders focussed positively on entry and workforce issues, in terms of the 2006 World Health Report on human resources for health, they did not substantially address retention of family physicians. Family physicians need to respond to the challenge by respondents to articulate human resource policies appropriate to Africa, including the organisational development of the primary health care team with more sophisticated skills and teamwork.

Implementation of Mamdani Fuzzy Method in Employee Promotion System

NASA Astrophysics Data System (ADS)

Zulfikar, W. B.; Jumadi; Prasetyo, P. K.; Ramdhani, M. A.

2018-01-01

Nowadays, employees are big assets to an institution. Every employee has a different educational background, degree, work skill, attitude and ethic that affect the performance. An institution including government institution implements a promotion system in order to improve the performance of the employees. Pangandaran Tourism, Industry, Trade, and SME Department is one of government agency that implements a promotion system to discover employees who deserve to get promotion. However, there are some practical deficiencies in the promotion system, one of which is the subjectivity issue. This work proposed a classification model that could minimize the subjectivity issue in employee promotion system. This paper reported a classification employee based on their eligibility for promotion. The degree of membership was decided using Mamdani Fuzzy based on determinant factors of the performance of employees. In the evaluation phase, this model had an accuracy of 91.4%. It goes to show that this model may minimize the subjectivity issue in the promotion system, especially at Pangandaran Tourism, Industry, Trade, and SME Department.

Multi-registration of software library resources

DOEpatents

Archer, Charles J [Rochester, MN; Blocksome, Michael A [Rochester, MN; Ratterman, Joseph D [Rochester, MN; Smith, Brian E [Rochester, MN

2011-04-05

Data communications, including issuing, by an application program to a high level data communications library, a request for initialization of a data communications service; issuing to a low level data communications library a request for registration of data communications functions; registering the data communications functions, including instantiating a factory object for each of the one or more data communications functions; issuing by the application program an instruction to execute a designated data communications function; issuing, to the low level data communications library, an instruction to execute the designated data communications function, including passing to the low level data communications library a call parameter that identifies a factory object; creating with the identified factory object the data communications object that implements the data communications function according to the protocol; and executing by the low level data communications library the designated data communications function.

Unmanned Aircraft System / Remotely Piloted Aircraft (UAS/RPA) Human Factors and Human Systems Integration Research Workshop Held in Dayton, Ohio on November 8-9, 2011

DTIC Science & Technology

2012-05-25

station design . These issues include: poor ergonomics ; varying data input methods; multiple inputs required to implement a single command; lack of...facing the UAS/RPA discipline. Major discussion topics included: UAS operator selection, training, control station design , manpower and scheduling...Break 1400 – 1430: Naval UAS Training  LCDR Brent Olde 1430 – 1500: Control Station Design Issues  Melissa Walwanis 1500 – 1600: Tour of NAMRU-D

Extending systematic reviews to include evidence on implementation: methodological work on a review of community-based initiatives to prevent injuries.

PubMed

Roen, Katrina; Arai, Lisa; Roberts, Helen; Popay, Jennie

2006-08-01

Unintentional injury is a leading cause of mortality and disability among young and old. While evidence about the effectiveness of interventions in reducing injuries is accumulating, reviews of this evidence frequently fail to include details of implementation processes. Our research, of which the work reported here formed a part, had two main objectives: (1) to identify evidence about the implementation of interventions aimed at reducing unintentional injuries amongst children and young people; and (2) to explore methods for systematically reviewing evidence on implementation. Existing systematic reviews of the effectiveness of interventions aiming to reduce unintentional injuries in children and young people formed the starting point for the work reported here. In summary, many of the published papers we identified contained little information on implementation processes and, even when these were discussed, the extent to which authors' claims were based on research evidence was unclear. On the basis of the studies we reviewed implementation data were insufficiently strong to provide a sound evidence base for practitioners and policymakers. Notwithstanding this, we identified valuable data about the context in which such initiatives are implemented and the type of factors that might impinge on implementation. This work has implications in three areas: (1) researchers with an interest in evidence-based public health could be encouraged to consider implementation issues in the design of intervention studies; (2) funding bodies could be encouraged to prioritise intervention studies using mixed methods that will enable researchers to consider effectiveness and implementation; (3) journal editors could work towards increasing the quality of reporting on implementation issues through the development of guidelines.

Psychosocial issues and mental health treatment recommendations for patients with hepatitis C.

PubMed

Silberbogen, Amy K; Ulloa, Erin W; Janke, E Amy; Mori, DeAnna L

2009-01-01

Mental health needs of patients with HCV are increasingly being addressed in medical contexts. The authors review the psychosocial issues relevant to patients with hepatitis C and provide mental health treatment recommendations. Patients with HCV are faced with a number of challenges, including adjustment to a chronic medical illness, management of symptoms and treatment side effects, and making and maintaining lifestyle changes. Given these issues, mental health clinicians have the opportunity to make a significant contribution to patient care. After reviewing the relevant research on these psychosocial issues, the authors have identified areas in which clinicians can intervene; these include adjustment to having a chronic medical illness, coping with stigma and relationship changes, management of side effects, and implementing healthy lifestyle changes.

Implementation Considerations for Multisite Clinical Trials with Cognitive Neuroscience Tasks

PubMed Central

Keefe, Richard S. E.; Harvey, Philip D.

2008-01-01

Multisite clinical trials aimed at cognitive enhancement across various neuropsychiatric conditions have employed standard neuropsychological tests as outcome measures. While these tests have enjoyed wide clinical use and have proven reliable and predictive of functional disability, a number of implementation challenges have arisen when these tests are used in clinical trials. These issues are likely to be magnified in future studies when cognitive neuroscience (CN) procedures are explored in these trials, because in their current forms CN procedures are less standardized and more difficult to teach and monitor. For multisite trials, we anticipate that the most challenging issues will include assuring tester competence, monitoring tester performance, specific challenges with complex assessment methods, and having resources available for adequate monitoring of data quality. Suggestions for overcoming these implementation challenges are offered. PMID:18495645

Economic turmoil, new administration to affect revenue cycle in 2009.

PubMed

2009-01-01

Healthcare revenue cycle leaders willface some pressing issues in 2009, including continuing economic turmoil, increasing numbers of underinsured patients, avoiding unreimbursable medical errors, and implementation of ICD-10.

Practical Issues in Developing a Culturally Tailored Physical Activity Promotion Program for Chinese and Korean American Midlife Women: A Pilot Study.

PubMed

Chee, Wonshik; Kim, Sangmi; Chu, Tsung-Lan; Tsai, Hsiu-Min; Ji, Xiaopeng; Zhang, Jingwen; Chee, Eunice; Im, Eun-Ok

2016-11-21

With advances in computer technologies, Web-based interventions are widely accepted and welcomed by health care providers and researchers. Although the benefits of Web-based interventions on physical activity promotion have been documented, the programs have rarely targeted Asian Americans, including Asian American midlife women. Subsequently, culturally competent Web-based physical activity programs for Asian Americans may be necessary. The purpose of our study was to explore practical issues in developing and implementing a culturally competent Web-based physical activity promotion program for 2 groups of Asian American women-Chinese American and Korean American midlife women-and to provide implications for future research. While conducting the study, the research team members wrote individual memos on issues and their inferences on plausible reasons for the issues. The team had group discussions each week and kept the minutes of the discussions. Then, the memos and minutes were analyzed using a content analysis method. We identified practical issues in 4 major idea categories: (1) bilingual translators' language orientations, (2) cultural sensitivity requirement, (3) low response rate, interest, and retention, and (4) issues in implementation logistics. Based on the issues, we make several suggestions for the use of bilingual translators, motivational strategies, and implementation logistics. ©Wonshik Chee, Sangmi Kim, Tsung-Lan Chu, Hsiu-Min Tsai, Xiaopeng Ji, Jingwen Zhang, Eunice Chee, Eun-Ok Im. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.11.2016.

Supports and Concerns for Teacher Professional Growth During the Implementation of a Science Curriculum Innovation

NASA Astrophysics Data System (ADS)

Peers, Cheryl (Shelley) E.; Diezmann, Carmel M.; Watters, James J.

2003-02-01

Internationally, considerable reform in science education is occurring which promotes constructivist philosophies and advocates constructivist-inspired pedagogical strategies that are new to many teachers. This paper reports on the supporting factors necessary for teacher professional growth and the issues of concern that were evident during one primary teacher''s successful implementation of a unit of work based on a draft of a new state-wide science syllabus which proposes such approaches. One researcher (CEP) provided guidance during the writing and implementation of the unit through professional development workshops complemented by ongoing collegial support. The analysis of the teacher''s practice reveals that professional growth required a willingness of the teacher to engage with change and modify his professional practice. The support factors for teacher growth consisted of an appropriate program of professional development, teacher understanding of the elements of the curriculum innovation, and successful experiences in implementing new approaches. In contrast, the issues of concern were: the adequacy of support for planning including the time required to understand the innovation and make changes to teaching practice; science equipment; teacher knowledge; classroom management strategies; and ways to cope with change. Understanding of these support factors and issues of concern is vital for the successful implementation of science curriculum innovations.

White lions: Reintroduction to their natural and spiritual homelands

Treesearch

Linda Tucker

2007-01-01

The Global White Lion Protection Trust is committed to establishing the White Lions both as South Africa’s national treasure and as a global heritage. All conservation issues today are global issues. With many species, including many of the big cats, on the brink of extinction, urgent conservation measures need to be implemented to ensure their survival. The White...

Promoting Mental Health and Preventing Substance Abuse and Violence in Elementary Students: A Randomized Control Study of the Michigan Model for Health

ERIC Educational Resources Information Center

O'Neill, James M.; Clark, Jeffrey K.; Jones, James A.

2011-01-01

Background: In elementary grades, comprehensive health education curricula mostly have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on multiple health issues, including social and emotional skills, prosocial behavior, and drug use and…

Implementation issues of the nearfield equivalent source imaging microphone array

NASA Astrophysics Data System (ADS)

Bai, Mingsian R.; Lin, Jia-Hong; Tseng, Chih-Wen

2011-01-01

This paper revisits a nearfield microphone array technique termed nearfield equivalent source imaging (NESI) proposed previously. In particular, various issues concerning the implementation of the NESI algorithm are examined. The NESI can be implemented in both the time domain and the frequency domain. Acoustical variables including sound pressure, particle velocity, active intensity and sound power are calculated by using multichannel inverse filters. Issues concerning sensor deployment are also investigated for the nearfield array. The uniform array outperformed a random array previously optimized for far-field imaging, which contradicts the conventional wisdom in far-field arrays. For applications in which only a patch array with scarce sensors is available, a virtual microphone approach is employed to ameliorate edge effects using extrapolation and to improve imaging resolution using interpolation. To enhance the processing efficiency of the time-domain NESI, an eigensystem realization algorithm (ERA) is developed. Several filtering methods are compared in terms of computational complexity. Significant saving on computations can be achieved using ERA and the frequency-domain NESI, as compared to the traditional method. The NESI technique was also experimentally validated using practical sources including a 125 cc scooter and a wooden box model with a loudspeaker fitted inside. The NESI technique proved effective in identifying broadband and non-stationary sources produced by the sources.

The Design and Implementation of Teacher Training Programmes. Report on the Dunford House Seminar (England, United Kingdom, July 11-21, 1983).

ERIC Educational Resources Information Center

Holes, Clive, Ed.; And Others

Proceedings of a seminar on the design and implementation of training education programs for English-as-a-Second-Language (ESL) teachers are presented in the form of papers, presentations, and summary narrative. They include: the keynote address (Keith Morrow); "Participants' Views of Issues and Constraints in Teacher Training";…

The Commercial Challenges Of Pacs

NASA Astrophysics Data System (ADS)

Vanden Brink, John A.

1984-08-01

The increasing use of digital imaging techniques create a need for improved methods of digital processing, communication and archiving. However, the commercial opportunity is dependent on the resolution of a number of issues. These issues include proof that digital processes are more cost effective than present techniques, implementation of information system support in the imaging activity, implementation of industry standards, conversion of analog images to digital formats, definition of clinical needs, the implications of the purchase decision and technology requirements. In spite of these obstacles, a market is emerging, served by new and existing companies, that may become a $500 million market (U.S.) by 1990 for equipment and supplies.

Floating point only SIMD instruction set architecture including compare, select, Boolean, and alignment operations

DOEpatents

Gschwind, Michael K [Chappaqua, NY

2011-03-01

Mechanisms for implementing a floating point only single instruction multiple data instruction set architecture are provided. A processor is provided that comprises an issue unit, an execution unit coupled to the issue unit, and a vector register file coupled to the execution unit. The execution unit has logic that implements a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA). The floating point vector registers of the vector register file store both scalar and floating point values as vectors having a plurality of vector elements. The processor may be part of a data processing system.

System Identification and Uncertainty Quantification Using Orthogonal Excitations and the Semi-span Super Sonic Transport (S4T) Model

NASA Technical Reports Server (NTRS)

Heeg, Jennifer; Wieseman, Carol D.

2012-01-01

Orthogonal harmonic multisine excitations were utilized in a wind tunnel test and in simulation of the SemiSpan Supersonic Transport model to assess aeroservoelastic characteristics. Fundamental issues associated with analyzing sinusoidal signals were examined, including spectral leakage, excitation truncation, and uncertainties on frequency response functions and mean-square coherence. Simulation allowed for evaluation of these issues relative to a truth model, while wind tunnel data introduced real-world implementation issues.

Implementation challenges of free maternity services policy in Kenya: the health workers' perspective.

PubMed

Wamalwa, Emmanuel Wekesa

2015-01-01

Kenya implemented the policy of free maternity services to reduce maternal mortality and morbidity. For successful implementation of this policy, there is need to monitor the implementation progress, identify the challenges and mitigate them and determine better strategies for implementation based on emerging implementation issues. This study was carried out to determine the challenges facing policy implementation and strategies for better implementation. This was a cross-sectional descriptive study carried at the Rift Valley Provincial General Hospital (RVPGH) and Bondeni maternity. All the staff who work at Bondeni Maternity (including nursing officer in-charge) were included in the study. All the staff who work at the Maternity Unit of the RVPGH were included in the study, as well as the Medical Superintendent of the facility. A total of 110 respondents were sampled. A questionnaire and interview guide were used to collect data. Data was analyzed using SPSS software. A response rate of 91% (n=100) was achieved. Major implementation challenges include inadequate supplies (86%), inadequate funding (38%), staff shortage (92%), lack of motivation among health workers (62%), overwhelming workload (89%) and abuse of services by clients (32%). Strategies for better implementation include employment of more staff, motivation of health workers, improvement in policy financing, training of health workers and provision of adequate supplies. Implementation of free maternity services policy in Kenya is facing challenges but there exists strategies, which, if implemented, will help address these challenges.

American Academy of Pediatrics Guidelines for Infant Bioethics Committees.

ERIC Educational Resources Information Center

College and University, 1985

1985-01-01

Examples are given of points hospitals must consider when adopting and implementing infant bioethics committees, including committee functions (educational, policy development, and consultative), structure, membership, jurisdiction, recordkeeping, and legal issues. (MSE)

Science Teachers Taking their First Steps toward Teaching Socioscientific Issues through Collaborative Action Research

NASA Astrophysics Data System (ADS)

Lee, Hyunju; Yang, Jung-eun

2017-06-01

This study presents two science teachers, Catherine and Jennifer, who took their first steps toward teaching socioscientific issues through collaborative action research. The teachers participated in the collaborative action research project because they wanted to address socioscientific issues but had limited experience in teaching them. The research questions included what kinds of challenges the teachers encountered when implementing socioscientific issues and to what extent they resolved the challenging issues as participating in collaborative action research. The primary data source consisted of audiotapes of regular group meetings containing information on the process of constructing and implementing lesson plans and reflecting on their teaching of socioscientific issues. We also collected classroom videotapes of the teachers' instruction and audiotapes of students' small group discussions and their worksheets. The findings indicated that when addressing socioscientific issues in the classes, the teachers encountered several challenging issues. We categorized them into four: (1) restructuring classroom dynamics and culture, (2) scaffolding students' engagement in socioscientific issues, (3) dealing with values, and (4) finding their niche in schools. However, this study showed that collaborative action research could be a framework for helping the teachers to overcome such challenges and have successful experiences of teaching socioscientific issues. These experiences became good motivation, to gradually develop their understanding of teaching socioscientific issues and instructional strategies for integrating the knowledge and skills that they had accumulated over the years.

End-of Life Issues in the Context of Alzheimer’s Disease

PubMed Central

Allen, Rebecca S.; Kwak, Jung; Lokken, Kristine L.; Haley, William E.

2009-01-01

This article presents an overview of end-of-life care for individuals with Alzheimer’s disease (AD) and their family caregivers. We define end-stage AD, and review neuropsychological and behavioral characteristics along with concomitant issues in therapeutic assessment. We then review the literature regarding programs and treatments for end-stage AD, the need for advance care planning and family participation in medical decision-making, familial caregiving stress, and issues associated with palliative care and bereavement outcomes. Methodological issues in the extant research literature are addressed, including issues of treatment implementation, validity, and clinical significance. Translational research and demonstration projects are encouraged. PMID:19997523

Implementation of a documentation model comprising nursing terminologies--theoretical and methodological issues.

PubMed

von Krogh, Gunn; Nåden, Dagfinn

2008-04-01

To describe and discuss theoretical and methodological issues of implementation of a nursing services documentation model comprising NANDA nursing diagnoses, Nursing Intervention Classification and Nursing Outcome Classification terminologies. The model is developed for electronic patient record and was implemented in a psychiatric hospital on an organizational level and on five test wards in 2001-2005. The theory of Rogers guided the process of innovation, whereas the implementation procedure of McCloskey and Bulecheck combined with adult learning principals guided the test site implementation. The test wards managed in different degrees to adopt the model. Two wards succeeded fully, including a ward with high percentage of staff with interdisciplinary background. Better planning regarding the impact of the organization's innovative aptitude, the innovation strategies and the use of differentiated methods regarding the clinician's individual premises for learning nursing terminologies might have enhanced the adoption to the model. To better understand the nature of barriers and the importance of careful planning regarding the implementation of electronic patient record elements in nursing care services, focusing on nursing terminologies. Further to indicate how a theory and specific procedure can be used to guide the process of implementation throughout the different levels of management.

Workers' Experiences of RPL in South Africa: Some Implications for Redress, Equity and Transformation.

ERIC Educational Resources Information Center

Lugg, Rosie; Mabitla, Aubrey; Louw, Gordon; Angelis, Desi

1998-01-01

The Congress of South African Trade Unions sought to include prior learning assessment in education and training as a mechanism for redressing inequities. Issues that arose included worker representation in implementation, linkage to accreditation and training opportunities, accessibility, and support and guidance for workers. (SK)

Critical Issues in Large-Scale Assessment: A Resource Guide.

ERIC Educational Resources Information Center

Redfield, Doris

The purpose of this document is to provide practical guidance and support for the design, development, and implementation of large-scale assessment systems that are grounded in research and best practice. Information is included about existing large-scale testing efforts, including national testing programs, state testing programs, and…

Wynoochee Hydropower/Fish Hatchery: Feasibility Report and Environmental Impact Statement.

DTIC Science & Technology

1982-09-30

Unresolved Issues. There are no unresolved issues associated with the Wynoochee hydropower/fish hatchery plan. 4. Relationship to Environmental...Requirements.l/ The relationship of the Wynoochee hydropower/fish hatchery plan to environmental requirements is summarized in the following table...Implementation of the plan would I/The relationship of the satellite fish station to the environmental requirements is not included in this discussion. Compliance

Student-Issued One-to-One Laptop Computers on Secondary Campuses in Four Texas School Districts: A Phenomenological Case Study

ERIC Educational Resources Information Center

Hoyer, Randall J.

2011-01-01

The purpose of this phenomenological case study was to investigate the impact of one-to-one student issued laptop computers on secondary campuses in four rural Texas school districts. Data were collected using focus groups which included 27 leaders in four rural Texas school districts that had implemented the one-to-one laptop initiative. The…

A Survey to Evaluate Facilitators and Barriers to Quality Measurement and Improvement: Adapting Tools for Implementation Research in Palliative Care Programs.

PubMed

Dy, Sydney M; Al Hamayel, Nebras Abu; Hannum, Susan M; Sharma, Ritu; Isenberg, Sarina R; Kuchinad, Kamini; Zhu, Junya; Smith, Katherine; Lorenz, Karl A; Kamal, Arif H; Walling, Anne M; Weaver, Sallie J

2017-12-01

Although critical for improving patient outcomes, palliative care quality indicators are not yet widely used. Better understanding of facilitators and barriers to palliative care quality measurement and improvement might improve their use and program quality. Development of a survey tool to assess palliative care team perspectives on facilitators and barriers to quality measurement and improvement in palliative care programs. We used the adapted Consolidated Framework for Implementation Research to define domains and constructs to select instruments. We assembled a draft survey and assessed content validity through pilot testing and cognitive interviews with experts and frontline practitioners for key items. We analyzed responses using a constant comparative process to assess survey item issues and potential solutions. We developed a final survey using these results. The survey includes five published instruments and two additional item sets. Domains include organizational characteristics, individual and team characteristics, intervention characteristics, and process of implementation. Survey modules include Quality Improvement in Palliative Care, Implementing Quality Improvement in the Palliative Care Program, Teamwork and Communication, Measuring the Quality of Palliative Care, and Palliative Care Quality in Your Program. Key refinements from cognitive interviews included item wording on palliative care team members, programs, and quality issues. This novel, adaptable instrument assesses palliative care team perspectives on barriers and facilitators for quality measurement and improvement in palliative care programs. Next steps include evaluation of the survey's construct validity and how survey results correlate with findings from program quality initiatives. Copyright © 2017 American Academy of Hospice and Palliative Medicine. All rights reserved.

Development of an existential support training program for healthcare professionals.

PubMed

Henoch, Ingela; Strang, Susann; Browall, Maria; Danielson, Ella; Melin-Johansson, Christina

2015-12-01

Our aim was to describe the developmental process of a training program for nurses to communicate existential issues with severely ill patients. The Medical Research Council (MRC) framework for the development and evaluation of complex interventions was used to develop a training program for nurses to communicate about existential issues with their patients. The steps in the framework were employed to describe the development of the training intervention, and the development, feasibility and piloting, evaluation, and implementation phases. The development and feasibility phases are described in the Methods section. The evaluation and implementation phases are described in the Results section. In the evaluation phase, the effectiveness of the intervention was shown as nurses' confidence in communication increased after training. The understanding of the change process was considered to be that the nurses could describe their way of communicating in terms of prerequisites, process, and content. Some efforts have been made to implement the training intervention, but these require further elaboration. Existential and spiritual issues are very important to severely ill patients, and healthcare professionals need to be attentive to such questions. It is important that professionals be properly prepared when patients need this communication. An evidence-based training intervention could provide such preparation. Healthcare staff were able to identify situations where existential issues were apparent, and they reported that their confidence in communication about existential issues increased after attending a short-term training program that included reflection. In order to design a program that should be permanently implemented, more knowledge is needed of patients' perceptions of the quality of the healthcare staff's existential support.

Implementation impacts : volume 3, summer 2014.

DOT National Transportation Integrated Search

2014-01-01

Summary of research projects at the Louisiana Transportation Research Center. Projects in this issue include: Edge Lines Reduce the : Number of Crashes on : Rural Two-lane Highways; New Approach Slab Design Decreases Bridge Bumps : in the Road;...

Analysis of State Laws and Policies Following the Implementation of the Fostering Connections to Success and Increasing Adoptions Act

ERIC Educational Resources Information Center

Perfect, Michelle M.; Stoll, Katherine A.; Thompson, Kristin C.; Scott, Roxanne E.

2013-01-01

The Fostering Connections to Success and Increasing Adoptions Act was implemented in 2008 (P.L. 110-351) in an effort to meet the needs of youth in foster care, including issues related to educational stability, educational services to support stability, and transition into higher education or the workforce. This article examines the written laws,…

A web-based tool for the Comprehensive Unit-based Safety Program (CUSP).

PubMed

Pronovost, Peter J; King, Jay; Holzmueller, Christine G; Sawyer, Melinda; Bivens, Shauna; Michael, Michelle; Haig, Kathy; Paine, Lori; Moore, Dana; Miller, Marlene

2006-03-01

An organization's ability to change is driven by its culture, which in turn has a significant impact on safety. The six-step Comprehensive Unit-Based Safety Program (CUSP) is intended to improve local culture and safety. A Web-based project management tool for CUSP was developed and then pilot tested at two hospitals. HOW ECUSP WORKS: Once a patient safety concern is identified (step 3), a unit-level interdisciplinary safety committee determines issue criticality and starts up the projects (step 4), which are managed using project management tools within eCUSP (step 5). On a project's completion, the results are disseminated through a shared story (step 6). OSF St. Joseph's Medical Center-The Medical Birthing Center (Bloomington, Illinois), identified 11 safety issues, implemented 11 projects, and created 9 shared stories--including one for its Armband Project. The Johns Hopkins Hospital (Baltimore) Medical Progressive Care (MPC4) Unit identified 5 safety issues and implemented 4 ongoing projects, including the intravenous (IV) Tubing Compliance Project. The eCUSP tool's success depends on an organizational commitment to creating a culture of safety.

Toward implementation of a national ground water monitoring network

USGS Publications Warehouse

Schreiber, Robert P.; Cunningham, William L.; Copeland, Rick; Frederick, Kevin D.

2008-01-01

The Federal Advisory Committee on Water Information's (ACWI) Subcommittee on Ground Water (SOGW) has been working steadily to develop and encourage implementation of a nationwide, long-term ground-water quantity and quality monitoring framework. Significant progress includes the planned submission this fall of a draft framework document to the full committee. The document will include recommendations for implementation of the network and continued acknowledgment at the federal and state level of ACWI's potential role in national monitoring toward an improved assessment of the nation's water reserves. The SOGW mission includes addressing several issues regarding network design, as well as developing plans for concept testing, evaluation of costs and benefits, and encouraging the movement from pilot-test results to full-scale implementation within a reasonable time period. With the recent attention to water resource sustainability driven by severe droughts, concerns over global warming effects, and persistent water supply problems, the SOGW mission is now even more critical.

Principles for a Successful Computerized Physician Order Entry Implementation

PubMed Central

Ash, Joan S.; Fournier, Lara; Stavri, P. Zoë; Dykstra, Richard

2003-01-01

To identify success factors for implementing computerized physician order entry (CPOE), our research team took both a top-down and bottom-up approach and reconciled the results to develop twelve overarching principles to guide implementation. A consensus panel of experts produced ten Considerations with nearly 150 sub-considerations, and a three year project using qualitative methods at multiple successful sites for a grounded theory approach yielded ten general themes with 24 sub-themes. After reconciliation using a meta-matrix approach, twelve Principles, which cluster into groups forming the mnemonic CPOE emerged. Computer technology principles include: temporal concerns; technology and meeting information needs; multidimensional integration; and costs. Personal principles are: value to users and tradeoffs; essential people; and training and support. Organizational principles include: foundational underpinnings; collaborative project management; terms, concepts and connotations; and improvement through evaluation and learning. Finally, Environmental issues include the motivation and context for implementing such systems. PMID:14728129

Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems.

PubMed

Ji, Hyerim; Yoo, Sooyoung; Heo, Eun-Young; Hwang, Hee; Kim, Jeong-Whun

2017-10-01

This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals. In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work. Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field. The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

Critical issues using brain-computer interfaces for augmentative and alternative communication.

PubMed

Hill, Katya; Kovacs, Thomas; Shin, Sangeun

2015-03-01

Brain-computer interfaces (BCIs) may potentially be of significant practical value to patients in advanced stages of amyotrophic lateral sclerosis and locked-in syndrome for whom conventional augmentative and alternative communication (AAC) systems, which require some measure of consistent voluntary muscle control, are not satisfactory options. However, BCIs have primarily been used for communication in laboratory research settings. This article discusses 4 critical issues that should be addressed as BCIs are translated out of laboratory settings to become fully functional BCI/AAC systems that may be implemented clinically. These issues include (1) identification of primary, secondary, and tertiary system features; (2) integrating BCI/AAC systems in the World Health Organization's International Classification of Functioning, Disability and Health framework; (3) implementing language-based assessment and intervention; and (4) performance measurement. A clinical demonstration project is presented as an example of research beginning to address these critical issues. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Scientific Reporting: Raising the Standards.

PubMed

McLeroy, Kenneth R; Garney, Whitney; Mayo-Wilson, Evan; Grant, Sean

2016-10-01

This article is based on a presentation that was made at the 2014 annual meeting of the editorial board of Health Education & Behavior. The article addresses critical issues related to standards of scientific reporting in journals, including concerns about external and internal validity and reporting bias. It reviews current reporting guidelines, effects of adopting guidelines, and offers suggestions for improving reporting. The evidence about the effects of guideline adoption and implementation is briefly reviewed. Recommendations for adoption and implementation of appropriate guidelines, including considerations for journals, are provided. © 2016 Society for Public Health Education.

The semantic architecture of the World-Wide Molecular Matrix (WWMM)

PubMed Central

2011-01-01

The World-Wide Molecular Matrix (WWMM) is a ten year project to create a peer-to-peer (P2P) system for the publication and collection of chemical objects, including over 250, 000 molecules. It has now been instantiated in a number of repositories which include data encoded in Chemical Markup Language (CML) and linked by URIs and RDF. The technical specification and implementation is now complete. We discuss the types of architecture required to implement nodes in the WWMM and consider the social issues involved in adoption. PMID:21999475

The semantic architecture of the World-Wide Molecular Matrix (WWMM).

PubMed

Murray-Rust, Peter; Adams, Sam E; Downing, Jim; Townsend, Joe A; Zhang, Yong

2011-10-14

The World-Wide Molecular Matrix (WWMM) is a ten year project to create a peer-to-peer (P2P) system for the publication and collection of chemical objects, including over 250, 000 molecules. It has now been instantiated in a number of repositories which include data encoded in Chemical Markup Language (CML) and linked by URIs and RDF. The technical specification and implementation is now complete. We discuss the types of architecture required to implement nodes in the WWMM and consider the social issues involved in adoption.

Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

PubMed

Rockwell, Kimberly Lovett; Gilroy, Alexis

2018-03-12

Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

Implementation of audio computer-assisted interviewing software in HIV/AIDS research.

PubMed

Pluhar, Erika; McDonnell Holstad, Marcia; Yeager, Katherine A; Denzmore-Nwagbara, Pamela; Corkran, Carol; Fielder, Bridget; McCarty, Frances; Diiorio, Colleen

2007-01-01

Computer-assisted interviewing (CAI) has begun to play a more prominent role in HIV/AIDS prevention research. Despite the increased popularity of CAI, particularly audio computer-assisted self-interviewing (ACASI), some research teams are still reluctant to implement ACASI technology because of lack of familiarity with the practical issues related to using these software packages. The purpose of this report is to describe the implementation of one particular ACASI software package, the Questionnaire Development System (QDS; Nova Research Company, Bethesda, MD), in several nursing and HIV/AIDS prevention research settings. The authors present acceptability and satisfaction data from two large-scale public health studies in which they have used QDS with diverse populations. They also address issues related to developing and programming a questionnaire; discuss practical strategies related to planning for and implementing ACASI in the field, including selecting equipment, training staff, and collecting and transferring data; and summarize advantages and disadvantages of computer-assisted research methods.

Research Project Evaluation-Learnings from the PATHWAYS Project Experience.

PubMed

Galas, Aleksander; Pilat, Aleksandra; Leonardi, Matilde; Tobiasz-Adamczyk, Beata

2018-05-25

Every research project faces challenges regarding how to achieve its goals in a timely and effective manner. The purpose of this paper is to present a project evaluation methodology gathered during the implementation of the Participation to Healthy Workplaces and Inclusive Strategies in the Work Sector (the EU PATHWAYS Project). The PATHWAYS project involved multiple countries and multi-cultural aspects of re/integrating chronically ill patients into labor markets in different countries. This paper describes key project's evaluation issues including: (1) purposes, (2) advisability, (3) tools, (4) implementation, and (5) possible benefits and presents the advantages of a continuous monitoring. Project evaluation tool to assess structure and resources, process, management and communication, achievements, and outcomes. The project used a mixed evaluation approach and included Strengths (S), Weaknesses (W), Opportunities (O), and Threats (SWOT) analysis. A methodology for longitudinal EU projects' evaluation is described. The evaluation process allowed to highlight strengths and weaknesses and highlighted good coordination and communication between project partners as well as some key issues such as: the need for a shared glossary covering areas investigated by the project, problematic issues related to the involvement of stakeholders from outside the project, and issues with timing. Numerical SWOT analysis showed improvement in project performance over time. The proportion of participating project partners in the evaluation varied from 100% to 83.3%. There is a need for the implementation of a structured evaluation process in multidisciplinary projects involving different stakeholders in diverse socio-environmental and political conditions. Based on the PATHWAYS experience, a clear monitoring methodology is suggested as essential in every multidisciplinary research projects.

Challenges During Implementation of a Patient-Facing Mobile App for Surgical Rehabilitation: Feasibility Study

PubMed Central

Piper, Kalman; Bokor, Desmond; Martin, Paige; Lau, Victor SL; Coiera, Enrico

2017-01-01

Background Translating research into practice, especially the implementation of digital health technologies in routine care, is increasingly important. Yet, there are few studies examining the challenges of implementing patient-facing digital technologies in health care settings. Objective The aim of this study was to report challenges experienced when implementing mobile apps for patients to support their postsurgical rehabilitation in an orthopedic setting. Methods A mobile app was tailored to the needs of patients undergoing rotator cuff repair. A 30-min usability session and a 12-week feasibility study were conducted with patients to evaluate the app in routine care. Implementation records (observation reports, issues log, and email correspondence) explored factors that hindered or facilitated patient acceptance. Interviews with clinicians explored factors that influenced app integration in routine care. Results Participant completion was low (47%, 9/19). Factors that affected patient acceptance included digital literacy, health status, information technology (IT) infrastructure at home, privacy concerns, time limitations, the role of a caregiver, inconsistencies in instruction received from clinicians and the app, and app advice not reflective of patient progress over time. Factors that negatively influenced app integration in routine care included competing demands among clinicians, IT infrastructure in health care settings, identifying the right time to introduce the app to patients, user interface complexity for older patients, lack of coordination among multidisciplinary clinicians, and technical issues with app installation. Conclusions Three insights were identified for mobile app implementation in routine care: (1) apps for patients need to reflect their journey over time and in particular, postoperative apps ought to be introduced as part of preoperative care with opportunities for patients to learn and adopt the app during their postoperative journey; (2) strategies to address digital literacy issues among patients and clinicians are essential; and (3) impact of the app on patient outcomes and clinician workflow needs to be communicated, monitored, and reviewed. Lastly, digital health interventions should supplement but not replace patient interaction with clinicians. PMID:29217504

Implementation impacts : volume 2, summer 2013.

DOT National Transportation Integrated Search

2013-01-01

Summary of research projects at the Louisiana Transportation Research Center. Projects in this issue include: : LTRC Project No. 06-4B, Optimization of Tack Coat for HMA Placement; : LTRC Project No. 10-2GT, : Geotechnical Information Database, Phase...

Adventure.

ERIC Educational Resources Information Center

Ongena, Jim

1981-01-01

Addresses the issue of whether there is reasonable justification to warrant public school sponsorship of adventure programs; considers accident rates, advantages and values, legal implications, and program implementation effects including staffing, facilities, equipment, and scheduling. Concludes that adventure education is a healthy, valuable,…

It's more complicated than that Comment on "Translating evidence into healthcare policy and practice: single versus multi-faceted implementation strategies - is there a simple answer to a complex question?".

PubMed

Rycroft-Malone, Jo

2015-03-17

In this commentary the findings from a systematic review that concluded there is no compelling evidence to suggest that implementing complicated, multi-faceted interventions is more effective than simple, single component interventions to changing healthcare professional's behaviour are considered through the lens of Harvey and Kitson's editorial. Whilst an appealing conclusion, it is one that hides a myriad of complexities. These include issues concerning how best to tailor interventions and how best to evaluate such efforts. These are complex issues that do not have simple solutions. © 2015 by Kerman University of Medical Sciences.

Addressing overuse of health services in health systems: a critical interpretive synthesis.

PubMed

Ellen, Moriah E; Wilson, Michael G; Vélez, Marcela; Shach, Ruth; Lavis, John N; Grimshaw, Jeremy M; Moat, Kaelan A

2018-06-15

Health systems are increasingly focusing on the issue of 'overuse' of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approach to reduce overuse and (3) implementation considerations for addressing overuse. We conducted a critical interpretive synthesis informed by a stakeholder-engagement process. The synthesis identified relevant empirical and non-empirical articles about system-level overuse. Two reviewers independently screened records, assessed for inclusion and conceptually mapped included articles. From these, we selected a purposive sample, created structured summaries of key findings and thematically synthesised the results. Our search identified 3545 references, from which we included 251. Most articles (76%; n = 192) were published within 5 years of conducting the review and addressed processes for addressing overuse (63%; n = 158) or political and health system context (60%; n = 151). Besides negative outcomes at the patient, system and global level, there were various contextual factors to addressing service overuse that seem to be key issue drivers. Processes for addressing overuse can be grouped into three elements comprising a comprehensive approach, including (1) approaches to identify overused health services, (2) stakeholder- or patient-led approaches and (3) government-led initiatives. Key implementation considerations include the need to develop 'buy in' from stakeholders and citizens. Health systems want to ensure the use of high-value services to keep citizens healthy and avoid harm. Our synthesis can be used by policy-makers, stakeholders and researchers to understand how the issue has been prioritised, what approaches have been used to address it and implementation considerations. PROSPERO CRD42014013204 .

Containment Sodium Chemistry Models in MELCOR.

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

Louie, David; Humphries, Larry L.; Denman, Matthew R

To meet regulatory needs for sodium fast reactors’ future development, including licensing requirements, Sandia National Laboratories is modernizing MELCOR, a severe accident analysis computer code developed for the U.S. Nuclear Regulatory Commission (NRC). Specifically, Sandia is modernizing MELCOR to include the capability to model sodium reactors. However, Sandia’s modernization effort primarily focuses on the containment response aspects of the sodium reactor accidents. Sandia began modernizing MELCOR in 2013 to allow a sodium coolant, rather than water, for conventional light water reactors. In the past three years, Sandia has been implementing the sodium chemistry containment models in CONTAIN-LMR, a legacy NRCmore » code, into MELCOR. These chemistry models include spray fire, pool fire and atmosphere chemistry models. Only the first two chemistry models have been implemented though it is intended to implement all these models into MELCOR. A new package called “NAC” has been created to manage the sodium chemistry model more efficiently. In 2017 Sandia began validating the implemented models in MELCOR by simulating available experiments. The CONTAIN-LMR sodium models include sodium atmosphere chemistry and sodium-concrete interaction models. This paper presents sodium property models, the implemented models, implementation issues, and a path towards validation against existing experimental data.« less

Crossing the implementation chasm: a proposal for bold action.

PubMed

Lorenzi, Nancy M; Novak, Laurie L; Weiss, Jacob B; Gadd, Cynthia S; Unertl, Kim M

2008-01-01

As health care organizations dramatically increase investment in information technology (IT) and the scope of their IT projects, implementation failures become critical events. Implementation failures cause stress on clinical units, increase risk to patients, and result in massive costs that are often not recoverable. At an estimated 28% success rate, the current level of investment defies management logic. This paper asserts that there are "chasms" in IT implementations that represent risky stages in the process. Contributors to the chasms are classified into four categories: design, management, organization, and assessment. The American College of Medical Informatics symposium participants recommend bold action to better understand problems and challenges in implementation and to improve the ability of organizations to bridge these implementation chasms. The bold action includes the creation of a Team Science for Implementation strategy that allows for participation from multiple institutions to address the long standing and costly implementation issues. The outcomes of this endeavor will include a new focus on interdisciplinary research and an inter-organizational knowledge base of strategies and methods to optimize implementations and subsequent achievement of organizational objectives.

Anticipating issues related to increasing preimplantation genetic diagnosis use: a research agenda.

PubMed

Klitzman, Robert; Appelbaum, Paul S; Chung, Wendy; Sauer, Mark

2008-01-01

Increasing use of preimplantation genetic diagnosis (PGD) poses numerous clinical, social, psychological, ethical, legal and policy dilemmas, many of which have received little attention. Patients and providers are now considering and using PGD for a widening array of genetic disorders, and patients may increasingly seek 'designer babies.' In the USA, although governmental oversight policies have been discussed, few specific guidelines exist. Hence, increasingly, patients and providers will face challenging ethical and policy questions of when and for whom to use PGD, and how it should be financed. These issues should be better clarified and addressed through collection of data concerning the current use of PGD in the USA, including factors involved in decision making about PGD use, as well as the education of the various communities that are, and should be, involved in its implementation. Improved understanding of these issues will ultimately enhance the development and implementation of future clinical guidelines and policies.

Ethics in Evaluating a Sociotechnical Intervention With Socially Isolated Older Adults.

PubMed

Waycott, Jenny; Morgans, Amee; Pedell, Sonja; Ozanne, Elizabeth; Vetere, Frank; Kulik, Lars; Davis, Hilary

2015-11-01

The purpose of this article is to consider how ethical principles can inform the effective design and implementation of technology-based interventions that aim to promote the well-being of socially isolated older adults. We evaluated a new iPad application with small groups of older adults. In this article, we reflect on the ethical issues encountered at each stage of the research process. Drawing on the ethical principles of beneficence, research merit and integrity, justice, and respect, we identify key issues to consider in the future design and implementation of social isolation interventions that use new technologies. Key issues include (a) providing sufficient support to facilitate ongoing social interactions, (b) managing older adults' expectations, (c) providing encouragement without coercion, and (d) responding to individual needs. We conclude that it is important to report on ethical challenges incurred when evaluating social isolation interventions to inform future research in this important area. © The Author(s) 2015.

Genetic Information Nondiscrimination Act. Final rule.

PubMed

2016-05-17

The Equal Employment Opportunity Commission (EEOC or Commission) is issuing a final rule to amend the regulations implementing Title II of the Genetic Information Nondiscrimination Act of 2008 as they relate to employer-sponsored wellness programs. This rule addresses the extent to which an employer may offer an inducement to an employee for the employee's spouse to provide information about the spouse's manifestation of disease or disorder as part of a health risk assessment (HRA) administered in connection with an employer-sponsored wellness program. Several technical changes to the existing regulations are included. Published elsewhere in this issue of the Federal Register, the EEOC also issued a final rule to amend the regulations and interpretive guidance implementing Title I of the Americans with Disabilities Act (ADA) that addresses the extent to which employers may use incentives to encourage employees to participate in wellness programs that ask them to respond to disability-related inquiries and/or undergo medical examinations.

Telepathology Impacts and Implementation Challenges: A Scoping Review.

PubMed

Meyer, Julien; Paré, Guy

2015-12-01

Telepathology is a particular form of telemedicine that fundamentally alters the way pathology services are delivered. Prior reviews in this area have mostly focused on 2 themes, namely technical feasibility issues and diagnosis accuracy. To synthesize the literature on telepathology implementation challenges and broader organizational and societal impacts and to propose a research agenda to guide future efforts in this domain. Two complementary databases were systematically searched: MEDLINE (PubMed) and ABI/INFORM (ProQuest). Peer-reviewed articles and conference proceedings were considered. The final sample consisted of 159 papers published between 1992 and 2013. This review highlights the diversity of telepathology networks and the importance of considering these distinctions when interpreting research findings. Various network structures are associated with different benefits. Although the dominant rationale in single-site projects is financial, larger centralized and decentralized telepathology networks are targeting a more diverse set of benefits, including extending access to pathology to a whole region, achieving substantial economies of scale in workforce and equipment, and improving quality by standardizing care. Importantly, our synthesis reveals that the nature and scale of encountered implementation challenges also varies depending on the network structure. In smaller telepathology networks, organizational concerns are less prominent, and implementers are more focused on usability issues. As the network scope widens, organizational and legal issues gain prominence.

Two-dimensional gap analysis: a tool for efficient conservation planning and biodiversity policy implementation.

PubMed

Angelstam, Per; Mikusiński, Grzegorz; Rönnbäck, Britt-Inger; Ostman, Anders; Lazdinis, Marius; Roberge, Jean-Michel; Arnberg, Wolter; Olsson, Jan

2003-12-01

The maintenance of biodiversity by securing representative and well-connected habitat networks in managed landscapes requires a wise combination of protection, management, and restoration of habitats at several scales. We suggest that the integration of natural and social sciences in the form of "Two-dimensional gap analysis" is an efficient tool for the implementation of biodiversity policies. The tool links biologically relevant "horizontal" ecological issues with "vertical" issues related to institutions and other societal issues. Using forest biodiversity as an example, we illustrate how one can combine ecological and institutional aspects of biodiversity conservation, thus facilitating environmentally sustainable regional development. In particular, we use regional gap analysis for identification of focal forest types, habitat modelling for ascertaining the functional connectivity of "green infrastructures", as tools for the horizontal gap analysis. For the vertical dimension we suggest how the social sciences can be used for assessing the success in the implementation of biodiversity policies in real landscapes by identifying institutional obstacles while implementing policies. We argue that this interdisciplinary approach could be applied in a whole range of other environments including other terrestrial biota and aquatic ecosystems where functional habitat connectivity, nonlinear response to habitat loss and a multitude of economic and social interests co-occur in the same landscape.

In and across bureaucracy: structural and administrative issues for the tobacco endgame.

PubMed

Isett, Kimberley R

2013-05-01

This article assesses the structural choices for the proposed tobacco endgame strategies. I focus on the issues associated with particular structural choices for the location of the implementation. Specifically, I discuss issues related to implementation of the endgame within a specific single agency, and issues related to a more widespread, broad implementation involving several agencies. Where appropriate, I provide examples of how the dynamics discussed would apply to particular endgame strategies. Issues related to design, administration, authority and finances are raised.

In and across bureaucracy: structural and administrative issues for the tobacco endgame

PubMed Central

Isett, Kimberley R

2013-01-01

This article assesses the structural choices for the proposed tobacco endgame strategies. I focus on the issues associated with particular structural choices for the location of the implementation. Specifically, I discuss issues related to implementation of the endgame within a specific single agency, and issues related to a more widespread, broad implementation involving several agencies. Where appropriate, I provide examples of how the dynamics discussed would apply to particular endgame strategies. Issues related to design, administration, authority and finances are raised. PMID:23591514

The implementation of a lossless data compression module in an advanced orbiting system: Analysis and development

NASA Technical Reports Server (NTRS)

Yeh, Pen-Shu; Miller, Warner H.; Venbrux, Jack; Liu, Norley; Rice, Robert F.

1993-01-01

Data compression has been proposed for several flight missions as a means of either reducing on board mass data storage, increasing science data return through a bandwidth constrained channel, reducing TDRSS access time, or easing ground archival mass storage requirement. Several issues arise with the implementation of this technology. These include the requirement of a clean channel, onboard smoothing buffer, onboard processing hardware and on the algorithm itself, the adaptability to scene changes and maybe even versatility to the various mission types. This paper gives an overview of an ongoing effort being performed at Goddard Space Flight Center for implementing a lossless data compression scheme for space flight. We will provide analysis results on several data systems issues, the performance of the selected lossless compression scheme, the status of the hardware processor and current development plan.

29 CFR 2204.308 - Decision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION IMPLEMENTATION OF THE EQUAL ACCESS TO JUSTICE ACT IN PROCEEDINGS BEFORE THE OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION... also include, if at issue, findings on whether the Secretary's position was substantially justified...

Building the Digital Library Infrastructure: A Primer.

ERIC Educational Resources Information Center

Tebbetts, Diane R.

1999-01-01

Provides a framework for examining the complex infrastructure needed to successfully implement a digital library. Highlights include database development, online public-access catalogs, interactive technical services, full-text documents, hardware and wiring, licensing, access, and security issues. (Author/LRW)

44 CFR 79.3 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION GRANTS § 79.3...-related hazard mitigation programs and grants, including: (1) Issue program implementation procedures, as... governments regarding the mitigation and grants management process; (5) Review and approve State, Indian...

Fiberoptic characteristics for extreme operating environments

NASA Technical Reports Server (NTRS)

Delcher, R. C.

1992-01-01

Fiberoptics could offer several major benefits for cryogenic liquid-fueled rocket engines, including lightning immunity, weight reduction, and the possibility of implementing a number of new measurements for engine condition monitoring. The technical feasibility of using fiberoptics in the severe environments posed by cryogenic liquid-fueled rocket engines was determined. The issues of importance and subsequent requirements for this use of fiberoptics were compiled. These included temperature ranges, moisture embrittlement succeptability, and the ability to withstand extreme shock and vibration levels. Different types of optical fibers were evaluated and several types of optical fibers' ability to withstand use in cryogenic liquid-fueled rocket engines was demonstrated through environmental testing of samples. This testing included: cold-bend testing, moisture embrittlement testing, temperature cycling, temperature extremes testing, vibration testing, and shock testing. Three of five fiber samples withstood the tests to a level proving feasibility, and two of these remained intact in all six of the tests. A fiberoptic bundle was also tested, and completed testing without breakage. Preliminary cabling and harnessing for fiber protection was also demonstrated. According to cable manufacturers, the successful -300 F cold bend, vibration, and shock tests are the first instance of any major fiberoptic cable testing below roughly -55 F. This program has demonstrated the basic technical feasibility of implementing optical fibers on cryogenic liquid-fueled rocket engines, and a development plan is included highlighting requirements and issues for such an implementation.

A Nationwide Study of Pharmacists' Perception of the Impact of Medicare Part D on the Pharmacist-Patient Relationship.

PubMed

Spooner, Joshua J; Spotts, Harlan; Khan, Shamima

2017-10-01

Medicare Part D was implemented in 2006, introducing change to the community pharmacy marketplace, with profound disruption to independent pharmacy operations across the United States. To understand pharmacist perceptions about Part D and their perceived obligation to address Part D issues on behalf of their beneficiaries. A nationwide, cross-sectional survey of pharmacists was conducted between April and July 2013. The 43-item online survey collected information about demographics, implications of Part D on community pharmacy and patients, and beliefs about ideal pharmacy practice. Pharmacists reported more responsibility to address prior authorization issues (55.3% strongly agree or agree) than dispensing preferred medications (43.5%) or addressing patient copayment issues (38.1%). Predictors of the perceived responsibility to assist patients varied and included practice site, pharmacist age, pharmacy prescription volume, and pharmacy financial performance. Financial concerns continue to be the most significant issue following Part D implementation. The degree to which pharmacists feel responsible for addressing patient Part D concerns is variable and dependent on a variety of factors. Pharmacists who felt a personal responsibility to address patient copayment issues reported a better pharmacy financial performance, a larger increase in prescription volume, and a better pharmacist-patient relationship since Part D implementation. Nationwide, Part D financial concerns remain significant. Pharmacists can assist patients with managing cost issues, which can help alleviate pharmacy financial concerns. Many pharmacists practicing at independent locations do not feel responsible for addressing patient cost concerns, which may inadvertently impart a negative financial effect upon their pharmacy.

The use of coupled atmospheric and hydrological models for water-resources management in headwater basins

USGS Publications Warehouse

Leavesley, G.; Hay, L.

1998-01-01

Coupled atmospheric and hydrological models provide an opportunity for the improved management of water resources in headwater basins. Issues currently limiting full implementation of coupled-model methodologies include (a) the degree of uncertainty in the accuracy of precipitation and other meteorological variables simulated by atmospheric models, and (b) the problem of discordant scales between atmospheric and bydrological models. Alternative methodologies being developed to address these issues are reviewed.

Mapping the existing body of health policy implementation research in lower income settings: what is covered and what are the gaps?

PubMed

Erasmus, E; Orgill, M; Schneider, H; Gilson, L

2014-12-01

This article uses 85 peer-reviewed articles published between 1994 and 2009 to characterize and synthesize aspects of the health policy analysis literature focusing on policy implementation in low- and middle-income countries (LMICs). It seeks to contribute, first, to strengthening the field of LMIC health policy analysis by highlighting gaps in the literature and generating ideas for a future research agenda and, second, to thinking about the value and applicability of qualitative synthesis approaches to the health policy analysis field. Overall, the article considers the disciplinary perspectives from which LMIC health policy implementation is studied and the extent to which the focus is on systems or programme issues. It then works with the more specific themes of the key thrusts of the reviewed articles, the implementation outcomes studied, implementation improvement recommendations made and the theories used in the reviewed articles. With respect to these more specific themes, the article includes explorations of patterns within the themes themselves, the contributions of specific disciplinary perspectives and differences between systems and programme articles. It concludes, among other things, that the literature remains small, fragmented, of limited depth and quite diverse, reflecting a wide spectrum of health system dimensions studied and many different suggestions for improving policy implementation. However, a range of issues beyond traditional 'hardware' health system concerns, such as funding and organizational structure, are understood to influence policy implementation, including many 'software' issues such as the understandings of policy actors and the need for better communication and actor relationships. Looking to the future, there is a need, given the fragmentation in the literature, to consolidate the existing body of work where possible and, given the often broad nature of the work and its limited depth, to draw more explicitly on theoretical frames and concepts to deepen work by sharpening and focusing concerns and questions. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Strategies to use tablet computers for collection of electronic patient-reported outcomes.

PubMed

Schick-Makaroff, Kara; Molzahn, Anita

2015-01-22

Mobile devices are increasingly being used for data collection in research. However, many researchers do not have experience in collecting data electronically. Hence, the purpose of this short report was to identify issues that emerged in a study that incorporated electronic capture of patient-reported outcomes in clinical settings, and strategies used to address the issues. The issues pertaining to electronic patient-reported outcome data collection were captured qualitatively during a study on use of electronic patient-reported outcomes in two home dialysis units. Fifty-six patients completed three surveys on tablet computers, including the Kidney Disease Quality of Life-36, the Edmonton Symptom Assessment Scale, and a satisfaction measure. Issues that arose throughout the research process were recorded during ethics reviews, implementation process, and data collection. Four core issues emerged including logistics of technology, security, institutional and financial support, and electronic design. Although use of mobile devices for data collection has many benefits, it also poses new challenges for researchers. Advance consideration of possible issues that emerge in the process, and strategies that can help address these issues, may prevent disruption and enhance validity of findings.

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

PubMed

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

2015-07-01

Reflective practice is used increasingly to enhance team functioning and service effectiveness; however, there is little evidence of its use in interdisciplinary teams. This paper presents the qualitative evaluation of the Interdisciplinary Management Tool (IMT), an evidence-based change tool designed to enhance interdisciplinary teamwork through structured team reflection. The IMT incorporates three components: an evidence-based resource guide; a reflective implementation framework based on Structured, Facilitated Action Research for Implementation methodology; and formative and summative evaluation components. The IMT was implemented with intermediate care teams supported by independent facilitators in England. Each intervention lasted 6 months and was evaluated over a 12-month period. Data sources include interviews, a focus group with facilitators, questionnaires completed by team members and documentary feedback from structured team reports. Data were analysed qualitatively using the Framework approach. The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resource use; need for role clarity and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues identified. Participants valued dedicated time to focus on the processes of team functioning; however, some were uncomfortable with a focus on teamwork at the expense of delivering direct patient care. The IMT is a relatively low-cost, structured, reflective way to enhance team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective teamwork, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take for reflection, and executive support to be able to broker changes that are beyond the scope of the team. © 2014 John Wiley & Sons Ltd.

PrEP implementation: moving from trials to policy and practice.

PubMed

Cáceres, Carlos F; O'Reilly, Kevin R; Mayer, Kenneth H; Baggaley, Rachel

2015-01-01

It is increasingly clear that the HIV response will not be sustainable if the number of infections is not significantly reduced. For two decades, research has been ongoing to identify new behavioural and biomedical strategies to prevent HIV infection. In the past few years, the efficacy of several new strategies has been demonstrated, including oral pre-exposure prophylaxis (PrEP; i.e. daily use of tenofovir/emtricitabine). Because several social, political and logistic barriers remain, however, optimal PrEP implementation will require a better dissemination of new evidence in a number of areas and additional implementation research from various disciplinary perspectives (i.e. social science, policy and ethics; health systems; and economics, including cost-effectiveness studies). Discussion of new evidence on those topics, as well as case studies of potential PrEP implementation in diverse environments, can improve the understanding of the role that PrEP may play in addressing the global HIV/AIDS epidemic.In light of these needs, the Network for Multidisciplinary Studies in ARV-based HIV Prevention (NEMUS) and the World Health Organization (WHO) were honoured to co-organize a special issue of JIAS aimed at contributing to a scholarly discussion of current conditions surrounding PrEP implementation, potential impact and efficiency, social science concerns and the study of PrEP implementation in specific country cases. The papers included in this monograph identify and cover many of the main aspects of the complex yet promising discussions around PrEP implementation today. This is a collection of timely contributions from global leaders in HIV research and policy that addresses geographic diversity, uses a trans-disciplinary approach and covers a variety of the complex issues raised by PrEP. As this publication will become accessible to all, we hope that it will remain a valuable resource for policy makers, programme managers, researchers and activists around the world at a moment of a paradigm shift of the global response to HIV.

PrEP implementation: moving from trials to policy and practice

PubMed Central

Cáceres, Carlos F; O'Reilly, Kevin R; Mayer, Kenneth H; Baggaley, Rachel

2015-01-01

Introduction It is increasingly clear that the HIV response will not be sustainable if the number of infections is not significantly reduced. Discussion For two decades, research has been ongoing to identify new behavioural and biomedical strategies to prevent HIV infection. In the past few years, the efficacy of several new strategies has been demonstrated, including oral pre-exposure prophylaxis (PrEP; i.e. daily use of tenofovir/emtricitabine). Because several social, political and logistic barriers remain, however, optimal PrEP implementation will require a better dissemination of new evidence in a number of areas and additional implementation research from various disciplinary perspectives (i.e. social science, policy and ethics; health systems; and economics, including cost-effectiveness studies). Discussion of new evidence on those topics, as well as case studies of potential PrEP implementation in diverse environments, can improve the understanding of the role that PrEP may play in addressing the global HIV/AIDS epidemic. In light of these needs, the Network for Multidisciplinary Studies in ARV-based HIV Prevention (NEMUS) and the World Health Organization (WHO) were honoured to co-organize a special issue of JIAS aimed at contributing to a scholarly discussion of current conditions surrounding PrEP implementation, potential impact and efficiency, social science concerns and the study of PrEP implementation in specific country cases. The papers included in this monograph identify and cover many of the main aspects of the complex yet promising discussions around PrEP implementation today. Conclusions This is a collection of timely contributions from global leaders in HIV research and policy that addresses geographic diversity, uses a trans-disciplinary approach and covers a variety of the complex issues raised by PrEP. As this publication will become accessible to all, we hope that it will remain a valuable resource for policy makers, programme managers, researchers and activists around the world at a moment of a paradigm shift of the global response to HIV. PMID:26198349

Tempest in a Therapeutic Community: Implementation and Evaluation Issues for Faith-Based Programming

ERIC Educational Resources Information Center

Scott, Diane L.; Crow, Matthew S.; Thompson, Carla J.

2010-01-01

The therapeutic community (TC) is an increasingly utilized intervention model in corrections settings. Rarely do these TCs include faith-based curriculum other than that included in Alcoholics Anonymous or Narcotics Anonymous programs as does the faith-based TC that serves as the basis for this article. Borrowing from the successful TC model, the…

Identifying the challenges and facilitators of implementing a COPD care bundle.

PubMed

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges.

Problem-based learning in undergraduate medical education: can we really implement it in the West African subregion?

PubMed

Gukas, I D

2007-01-01

A major global pedagogical shift has occurred in the way medicine is taught over the last half a century. Problem-based learning (PBL) has emerged as one of the most popular, of these learner-centred new methods. To examine the evolution and educational principles of PBL and the feasibility of implementing it in the West African subregion. Key literature detailing the history, educational value and principle behind PBL were reviewed. Issues regarding the implication of implementing PBL to West Africa were deduced and suggestions made for the way forward. Since its introduction in McMaster University in Canada in the 60s, PBL has spread all over world. It is rooted in sound educational theories like the Kolb's experiential learning, adult education, collaborative learning, contextual learning and constructivism. Compared to traditionally trained students, PBL students find learning more enjoyable and develop better relational and professional skills. They show more causal reasoning in diagnosis and become better lifelong learners. Issues that may affect its implementation in West Africa include high start up costs, lack of supporting educational technology and relative lack of medical school managers with appropriate medical education background to assess and evaluate such innovations. The evidence for the need for a change from the traditional method of training is overwhelming. Implementation of PBL as an educational method in medical training in the West African subregion is both desirable and practicable if we address some of the issues outlined above.

APhA 2011 REMS white paper: Summary of the REMS stakeholder meeting on improving program design and implementation.

PubMed

American Pharmacists Association; Bough, Marcie

2011-01-01

To develop an improved risk evaluation and mitigation strategies (REMS) system for maximizing effective and safe patient medication use while minimizing burden on the health care delivery system. 34 stakeholders gathered October 6-7, 2010, in Arlington, VA, for the REMS Stakeholder Meeting, convened by the American Pharmacists Association (APhA). Participants included national health care provider associations, including representatives for physicians, physician assistants, nurses, nurse practitioners, and pharmacists, as well as representatives for patient advocates, drug distributors, community pharmacists (chain and independent), drug manufacturer associations (brand, generic, and biologic organizations), and health information technology, standards, and safety organizations. Staff from the Food and Drug Administration (FDA) Center for Drug Evaluation and Research participated as observers. The meeting built on themes from the APhA's 2009 REMS white paper. The current REMS environment presents many challenges for health care providers due to the growing number of REMS programs and the lack of standardization or similarities among various REMS programs. A standardized REMS process that focuses on maximizing patient safety and minimizing impacts on patient access and provider implementation could offset these challenges. A new process that includes effective provider interventions and standardized tools and systems for implementing REMS programs may improve patient care and overcome some of the communication issues providers and patients currently face. Metrics could be put in place to evaluate the effectiveness of REMS elements. By incorporating REMS program components into existing technologies and data infrastructures, achieving REMS implementation that is workflow neutral and minimizes administrative burden may be possible. An appropriate compensation model could ensure providers have adequate resources for patient care and REMS implementation. Overall, stakeholders should continue to work collaboratively with FDA and manufacturers to improve REMS program design and implementation issues. A workable REMS system will require effective patient interventions, standardized elements that limit barriers to implementation for both patients and providers, standardized yet flexible implementation strategies, use of existing technologies in practice settings, increased opportunities for provider input early in REMS design processes, improved communication strategies and awareness of program requirements, and viable provider compensation models needed to offset costs to implement and comply with REMS program requirements.

Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom

PubMed Central

Devlin, Alison M; McGee-Lennon, Marilyn; O’Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O’Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan

2016-01-01

Objective To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Materials and Methods Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Results Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. Conclusions The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care. PMID:26254480

Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom.

PubMed

Devlin, Alison M; McGee-Lennon, Marilyn; O'Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O'Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan; Mair, Frances S

2016-01-01

To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program-a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit-led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Run-time implementation issues for real-time embedded Ada

NASA Technical Reports Server (NTRS)

Maule, Ruth A.

1986-01-01

A motivating factor in the development of Ada as the department of defense standard language was the high cost of embedded system software development. It was with embedded system requirements in mind that many of the features of the language were incorporated. Yet it is the designers of embedded systems that seem to comprise the majority of the Ada community dissatisfied with the language. There are a variety of reasons for this dissatisfaction, but many seem to be related in some way to the Ada run-time support system. Some of the areas in which the inconsistencies were found to have the greatest impact on performance from the standpoint of real-time systems are presented. In particular, a large part of the duties of the tasking supervisor are subject to the design decisions of the implementer. These include scheduling, rendezvous, delay processing, and task activation and termination. Some of the more general issues presented include time and space efficiencies, generic expansions, memory management, pragmas, and tracing features. As validated compilers become available for bare computer targets, it is important for a designer to be aware that, at least for many real-time issues, all validated Ada compilers are not created equal.

Methods for implementing a medicine outlet survey: lessons from the anti-malarial market.

PubMed

O'Connell, Kathryn A; Poyer, Stephen; Solomon, Tsione; Munroe, Erik; Patouillard, Edith; Njogu, Julius; Evance, Illah; Hanson, Kara; Shewchuk, Tanya; Goodman, Catherine

2013-02-05

In recent years an increasing number of public investments and policy changes have been made to improve the availability, affordability and quality of medicines available to consumers in developing countries, including anti-malarials. It is important to monitor the extent to which these interventions are successful in achieving their aims using quantitative data on the supply side of the market. There are a number of challenges related to studying supply, including outlet sampling, gaining provider cooperation and collecting accurate data on medicines. This paper provides guidance on key steps to address these issues when conducting a medicine outlet survey in a developing country context. While the basic principles of good survey design and implementation are important for all surveys, there are a set of specific issues that should be considered when conducting a medicine outlet survey. This paper draws on the authors' experience of designing and implementing outlet surveys, including the lessons learnt from ACTwatch outlet surveys on anti-malarial retail supply, and other key studies in the field. Key lessons and points of debate are distilled around the following areas: selecting a sample of outlets; techniques for collecting and analysing data on medicine availability, price and sales volumes; and methods for ensuring high quality data in general. The authors first consider the inclusion criteria for outlets, contrasting comprehensive versus more focused approaches. Methods for developing a reliable sampling frame of outlets are then presented, including use of existing lists, key informants and an outlet census. Specific issues in the collection of data on medicine prices and sales volumes are discussed; and approaches for generating comparable price and sales volume data across products using the adult equivalent treatment dose (AETD) are explored. The paper concludes with advice on practical considerations, including questionnaire design, field worker training, and data collection. Survey materials developed by ACTwatch for investigating anti-malarial markets in sub-Saharan Africa and Asia provide a helpful resource for future studies in this area.

Qualitative analysis of vendor discussions on the procurement of Computerised Physician Order Entry and Clinical Decision Support systems in hospitals

PubMed Central

Cresswell, Kathrin M; Lee, Lisa; Slee, Ann; Coleman, Jamie; Bates, David W; Sheikh, Aziz

2015-01-01

Objectives We studied vendor perspectives about potentially transferable lessons for implementing organisations and national strategies surrounding the procurement of Computerised Physician Order Entry (CPOE)/Clinical Decision Support (CDS) systems in English hospitals. Setting Data were collected from digitally audio-recorded discussions from a series of CPOE/CDS vendor round-table discussions held in September 2014 in the UK. Participants Nine participants, representing 6 key vendors operating in the UK, attended. The discussions were transcribed verbatim and thematically analysed. Results Vendors reported a range of challenges surrounding the procurement and contracting processes of CPOE/CDS systems, including hospitals’ inability to adequately assess their own needs and then select a suitable product, rushed procurement and implementation processes that resulted in difficulties in meaningfully engaging with vendors, as well as challenges relating to contracting leading to ambiguities in implementation roles. Consequently, relationships between system vendors and hospitals were often strained, the vendors attributing this to a lack of hospital management's appreciation of the complexities associated with implementation efforts. Future anticipated challenges included issues surrounding the standardisation of data to enable their aggregation across systems for effective secondary uses, and implementation of data exchange with providers outside the hospital. Conclusions Our results indicate that there are significant issues surrounding capacity to procure and optimise CPOE/CDS systems among UK hospitals. There is an urgent need to encourage more synergistic and collaborative working between providers and vendors and for a more centralised support for National Health Service hospitals, which draws on a wider body of experience, including a formalised procurement framework with value-based product specifications. PMID:26503385

[Implementation of a Clinical Practice Guidelines for the Management of Adults With Schizophrenia in Colombia].

PubMed

Sánchez Díaz, Natalia; Duarte Osorio, Andrés; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia

2016-01-01

To present overall strategies and activities for the implementation process of the recommendations contained in the clinical practice guideline for the management of adults with schizophrenia (GPC_E) published by the Colombian Ministry of Health and Welfare (MSPS). Prioritize the proposed recommendations, identify barriers and solving strategies to implement the GPC_E, and develop a monitoring and evaluation system for the key recommendations. The Guideline Developer Group (GDG) included professionals with primary dedication to implementation issues that accompanied the entire process. During the GDG meetings implementation topics were identified and discussed, and later complemented by literature reviews concerning the experience of mental health guidelines implementation at national and international level. Additionally, feedback from the discussions raised during the socialization meetings, and joint meetings with the MSPS and the Institute of Technology Assessment in Health (IETS) were included. The prioritization of recommendations was made in conjunction with the GDG, following the proposed steps in the methodological guide for the development of Clinical Practice Guidelines with Economic Evaluation in the General System of Social Security in Colombian Health (GMEGPC) using the tools 13 and 14. the conclusions and final adjustments were discussed with the GPC_E leaders. The implementation chapter includes a description of the potential barriers, solution strategies, facilitators and monitoring indicators. The identified barriers were categorized in the following 3 groups: Cultural context, health system and proposed interventions. The issues related to solving strategies and facilitating education programs include community mental health, mental health training for health workers in primary care, decentralization and integration of mental health services at the primary care level, use of technologies information and communication and telemedicine. To monitor and evaluate o the implementation process, five (5) indicators were designed one (1) structure, two (2) process and two (2)outcome indicators. The GPC_E implementation within the Colombian General health System of Social Security (SGSSSC) poses multiple challenges. Potential barriers, enabling strategies and indicators for monitoring and evaluation described in this article, can provide efficient support to ensure the success of this process in the institutions that will adopt the guideline. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Need for Enhanced Environmental Representation in the Implementation of One Health.

PubMed

Barrett, Meredith A; Bouley, Timothy A

2015-06-01

Issues of global environmental change, global health, emerging disease, and sustainability present some of the most complex challenges of the twenty-first century. Individual disciplines cannot address these issues in isolation. Proactive, innovative, and trans-disciplinary solutions are required. Recognizing the inherent connectedness of humans, animals, plants, and their shared environment, One Health encourages the collaboration of many disciplines-including human and veterinary medicine, public health, social science, public policy, environmental science, and others-to address global and local health challenges. Despite great progress in this shift toward transdisciplinarity, the environmental component of the One Health paradigm remains underrepresented in One Health discourse. Human and animal health issues are commonly discussed under the umbrella of the One Health paradigm, while upstream environmental drivers and solutions are less prominent. We assessed the current integration of environmental issues in One Health publications and leadership. There is room for enhanced integration of environmental knowledge in the implementation of One Health approaches. We discuss the potential benefits from the collaboration between One Health and ecohealth, and explore strategies for increased environmental involvement.

NRC comprehensive records disposition schedule. Revision 3

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

NONE

1998-02-01

Title 44 US Code, ``Public Printing and Documents,`` regulations issued by the General Service Administration (GSA) in 41 CFR Chapter 101, Subchapter B, ``Management and Use of Information and Records,`` and regulations issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter 12, Subchapter B, ``Records Management,`` require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA`s General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate durationmore » of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 3, contains ``NRC`s Comprehensive Records Disposition Schedule,`` and the original authorized approved citation numbers issued by NARA. Rev. 3 incorporates NARA approved changes and additions to the NRC schedules that have been implemented since the last revision dated March, 1992, reflects recent organizational changes implemented at the NRC, and includes the latest version of NARA`s General Records Schedule (dated August 1995).« less

Towards gender-sensitivity: the Philippine POPCOM experience. How sensitive to gender issues are our family planning personnel?

PubMed

Danguilan, M

1995-04-01

The Philippine Commission on Population (POPCOM) sets and coordinates the country's population policy. POPCOM launched Gender I in early 1994 in the attempt to find out how aware and sensitive its board of commissioners, staff, and the provincial and city population officers were on gender and population issues. The assessment covered the respondents' gender relations at the workplace; gender, work, and family responsibilities; job satisfaction; their perceptions about gender-related issues in reproductive health; personal sex attitudes; and general perceptions on gender issues. The project also explored respondents' knowledge and perceptions on population growth and structure; population information generation and use; quality of life; reproductive health; law, ethics, and policy; and men's and women's roles. Having completed the institutional assessment, POPCOM has now implemented the Gender II project designed to strengthen the formulation, coordination, and implementation of gender-aware population and reproductive health policies and programs. Project activities include policy review and framework development, capability building through gender and reproductive health training and information management, and special research projects.

Periodontal Research: Basics and beyond – Part II (Ethical issues, sampling, outcome measures and bias)

PubMed Central

Avula, Haritha

2013-01-01

A good research beginning refers to formulating a well-defined research question, developing a hypothesis and choosing an appropriate study design. The first part of the review series has discussed these issues in depth and this paper intends to throw light on other issues pertaining to the implementation of research. These include the various ethical norms and standards in human experimentation, the eligibility criteria for the participants, sampling methods and sample size calculation, various outcome measures that need to be defined and the biases that can be introduced in research. PMID:24174747

The Dark Side of Nuclear Arms Education.

ERIC Educational Resources Information Center

Jungerman, Nancy K.; Jungerman, John A.

1985-01-01

Outlines a course (offered jointly by physics and applied science departments) which focuses on basic physics and nuclear war effects. Due to the emotional impact of issues discussed in the course, faculty implemented a plan which included the use of counseling professionals. (DH)

Expert Systems in Reference Services.

ERIC Educational Resources Information Center

Roysdon, Christine, Ed.; White, Howard D., Ed.

1989-01-01

Eleven articles introduce expert systems applications in library and information science, and present design and implementation issues of system development for reference services. Topics covered include knowledge based systems, prototype development, the use of artificial intelligence to remedy current system inadequacies, and an expert system to…

Information Technology and Indigenous People

ERIC Educational Resources Information Center

Dyson, Laurel, Ed.; Hendriks, Max, Ed.; Grant, Stephen, Ed.

2007-01-01

Information Technology and Indigenous People provides theoretical and empirical information related to the planning and execution of IT projects aimed at serving indigenous people. It explores many cultural concerns with IT implementation, including language issues and questions of cultural appropriateness, and brings together cutting-edge…

ISSUES OF BEST MANAGEMENT PRACTICE DESIGN TO IMPROVE WATER QUALITY

EPA Science Inventory

Today, many municipalities are implementing low-cost best management practices (BMPs). Structural control BMPs involve building a structure of some kind to store stormwater until it can be discharged into a nearby receiving water. Commonly used structural treatment BMPs include...

Secondary Market Disclosure.

ERIC Educational Resources Information Center

Jones, Robert J.; Zehner, Mark R.

1996-01-01

In late 1994, the United States Securities and Exchange Commission (SEC) issued new rules applicable to issuers of municipal securities (including school districts) concerning disclosure to the investment community. Describes how SEC's existing Rule 15c2-12 has been implemented. Discusses its purpose, jurisdiction, obligated persons, written…

Solar power satellites: The Engineering Challenges

NASA Technical Reports Server (NTRS)

Woodcock, G. R.

1978-01-01

Certain elements of solar power satellite design and system engineering studies are reviewed analyzing solar power satellites as a potential baseload electric power source. The complete system concept concept includes not only the satellites and their ground stations, but also the space transportation for delivery of the satellites, piece by piece, into space, and the factories for their construction in space. Issues related to carrying the solar power satellite concept from the present design study phase through implementation of actual hardware are considered. The first issue category is environmental aspects of the SPS systems. The second category of issues is the technology risks associated with achieving the necessary component and subsystem performances. The third category includes the engineering issues associated with carrying out such a large scale project. The fourth issue category is financial: the funding required to bring such a project into being and the costs of the satellites and resulting cost of the power produced as compared to potential alternative energy sources.

Development of pediatric vaccine recommendations and policies.

PubMed

Pickering, Larry K; Orenstein, Walter A

2002-07-01

A significant decrease in each vaccine-preventable disease has occurred since the introduction of the respective immunizations now included in the recommended childhood immunization schedule. The process through which a vaccine must travel from development to approval and implementation is complex. Hurdles include receiving approval from several advisory committees, government agencies, and professional organizations. At each step in the process, data regarding safety, immunogenicity, and efficacy are evaluated continuously and rigorously. Once a vaccine is approved by the Food and Drug Administration (FDA) and incorporated into the recommended childhood immunization schedule, continuing issues include those that deal with supply, safety, effectiveness, and financing. The logistics of development and implementation of pediatric vaccine recommendations and policies are reviewed.

Evidence or eminence in abdominal surgery: Recent improvements in perioperative care

PubMed Central

Segelman, Josefin; Nygren, Jonas

2014-01-01

Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery (ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioperative management, the implementation of this complex protocol has been slow. Barriers to implementation involve both patient- and staff-related factors as well as practice-related issues and resources. To support efficient and successful implementation, further educational and structural measures have to be made on a national or regional level to improve the standard of general health care. Besides postoperative morbidity, biological and physiological variables have been quite commonly reported in previous ERAS studies. Little information, however, has been obtained on cost-effectiveness, long-term outcomes, quality of life and patient-related outcomes, and these issues remain important areas of research for future studies. PMID:25469030

Issues in Designing Tutors for Games of Incomplete Information: a Bridge Case Study

NASA Astrophysics Data System (ADS)

Kemp, Ray; McKenzie, Ben; Kemp, Elizabeth

There are a number of commercial packages for playing the game of bridge, and even more papers on possible techniques for improving the quality of such systems. We examine some of the AI techniques that have proved successful for implementing bridge playing systems and discuss how they might be adapted for teaching the game. We pay particular attention to the issue of incomplete information and include some of our own research into the subject.

The future of microarray technology: networking the genome search.

PubMed

D'Ambrosio, C; Gatta, L; Bonini, S

2005-10-01

In recent years microarray technology has been increasingly used in both basic and clinical research, providing substantial information for a better understanding of genome-environment interactions responsible for diseases, as well as for their diagnosis and treatment. However, in genomic research using microarray technology there are several unresolved issues, including scientific, ethical and legal issues. Networks of excellence like GA(2)LEN may represent the best approach for teaching, cost reduction, data repositories, and functional studies implementation.

Steam generator issues in the United States

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

Strosnider, J.R.

1997-02-01

Alloy 600 steam generator tubes in the US have exhibited degradation mechanisms similar to those observed in other countries. Effective programs have been implemented to address several degradation mechanisms including: wastage; mechanical wear; pitting; and fatigue. These degradation mechanisms are fairly well understood as indicated by the ability to effectively mitigate/manage them. Stress corrosion cracking (SCC) is the dominant degradation mechanism in the US. SCC poses significant inspection and management challenges to the industry and the regulators. The paper also addresses issues of research into SCC, inspection programs, plugging, repair strategies, water chemistry, and regulatory control. Emerging issues in themore » US include: parent tube cracking at sleeve joints; detection and repair of circumferential cracks; free span cracking; inspection and cracking of dented regions; and severe accident analysis.« less

Development of a novel regulatory pharmacovigilance prioritisation system: an evaluation of its performance at the UK Medicines and Healthcare products Regulatory Agency.

PubMed

Seabroke, Suzie; Wise, Lesley; Waller, Patrick

2013-10-01

The prioritisation of drug safety issues for further evaluation or regulatory action is critical to ensure that acceptable timelines and appropriate resource allocation are defined to meet public health and regulatory obligations. Our objective was to develop, pilot and implement a novel tool for prioritising pharmacovigilance issues within the Medicines and Healthcare products Regulatory Agency (MHRA). An initial system was developed empirically and then piloted over a 10-month period in the pharmacovigilance signal management meeting at the MHRA that discusses potential pharmacovigilance issues, and determines, through consensus, their priority and a timescale for action. The priority assigned by the tool was compared with the priority decided by collective judgement at the meeting. Once an acceptable level of concordance between the tool and the meeting had been achieved, the finalised tool was implemented into routine use at the MHRA, with an evaluation of its performance conducted after the first year. The Regulatory Pharmacovigilance Prioritisation System (RPPS) tool prioritises pharmacovigilance issues according to the following four broad categories, each with four inputs: strength of evidence, public health implications, agency regulatory obligations and public perceptions. A weighted scoring system links the inputs to a pre-defined number of points where if a threshold is reached then the points are awarded. The overall priority is determined by the sum of all points obtained from each of the inputs. The pilot study included a total of 73 pharmacovigilance issues during the 10-month study period, with an overall exact agreement between the RPPS priority and the collective judgement of the meeting of 60.3 %. Where exact agreement was not obtained, the RPPS generally prioritised the issues slightly higher than the meeting. Over the first year following implementation, the RPPS achieved an overall exact agreement of 82.2 %. Following the pilot study and implementation at the UK MHRA, the RPPS has provided a systematic approach to drug safety issue prioritisation that should help to reduce the subjectivity of reliance on individual judgement.

Accessibility Considerations for Hybrid Courses

ERIC Educational Resources Information Center

Behling, Kirsten

2017-01-01

This chapter explores the central questions and issues that faculty and administrators need to consider when designing and implementing hybrid courses to ensure that all students, including those with disabilities, have equal access. The author offers resources on faculty development programs, accessibility checklists, and online resources on…

Faculty Salary Equity: Issues and Options.

ERIC Educational Resources Information Center

Snyder, Julie K.; And Others

1994-01-01

An approach to identifying and correcting college faculty salary inequities based on gender is presented. Steps include determining whether a problem exists using an objective, legally sound procedure; developing feasible adjustment strategies; and implementing correction and a monitoring process consistent with institutional culture and values.…

Can Value Added Add Value to Teacher Evaluation?

ERIC Educational Resources Information Center

Darling-Hammond, Linda

2015-01-01

The five thoughtful papers included in this issue of "Educational Researcher" ("ER") raise new questions about the use of value-added methods (VAMs) to estimate teachers' contributions to students' learning as part of personnel evaluation. The papers address both technical and implementation concerns, considering potential…

I'm OK, Are You Y2K OK?

ERIC Educational Resources Information Center

Wilson, Thomas F.

1999-01-01

Y2K problems include software programming issues involving chronology and microchips embedded in every conceivable piece of electronic equipment. Procrastination is not in schools' best interest. Administrators should initiate five conversion stages: awareness, assessment, renovation, validation, and implementation. A sample equipment checklist…

CALL FOR PAPERS: Optical implementation of quantum computers

NASA Astrophysics Data System (ADS)

Rarity, John; Weinfurter, Harald

2004-09-01

A topical issue of Journal of Optics B: Quantum and Semiclassical Optics will be devoted to recent advances in optical implementation of quantum computers. The topics to be covered will include, but are not limited to: bullet Linear optics quantum gates bullet Progress towards nonlinear optics quantum gates bullet Interface between optical qubits and atomic/solid state qubits bullet Novel architectures bullet Single-photon sources and detectors bullet Photonic quantum networks bullet Few-qubit applications The DEADLINE for submission of contributions is 15 January 2005 to allow the topical issue to be published in about October 2005. All contributions will be peer-reviewed in accordance with the normal refereeing procedures and standards of Journal of Optics B: Quantum and Semiclassical Optics. Submissions should preferably be in either standard LaTeX form or Microsoft Word. Advice on publishing your work in the journal may be found at www.iop.org/journals/authors/jopb. There are no page charges for publication. The corresponding author of each paper published will receive a complimentary copy of the topical issue. Contributions to the topical issue should preferably be submitted electronically at www.iop.org/journals/authors/jopb or by e-mail to jopb@iop.org. Authors unable to submit online or by e-mail may send hard copy contributions (enclosing the electronic code) to: Dr Claire Bedrock (Publisher), Journal of Optics B: Quantum and Semiclassical Optics, Institute of Physics Publishing, Dirac House, Temple Back, Bristol BS1 6BE, UK. All contributions should be accompanied by a readme file or covering letter, quoting `JOPB Topical Issue - Optical implementation of quantum computers', giving the postal and e-mail addresses for correspondence. Any subsequent change of address should be notified to the publishing office. We look forward to receiving your contribution to this topical issue.

Solving the worldwide emergency department crowding problem - what can we learn from an Israeli ED?

PubMed

Pines, Jesse M; Bernstein, Steven L

2015-01-01

ED crowding is a prevalent and important issue facing hospitals in Israel and around the world, including North and South America, Europe, Australia, Asia and Africa. ED crowding is associated with poorer quality of care and poorer health outcomes, along with extended waits for care. Crowding is caused by a periodic mismatch between the supply of ED and hospital resources and the demand for patient care. In a recent article in the Israel Journal of Health Policy Research, Bashkin et al. present an Ishikawa diagram describing several factors related to longer length of stay (LOS), and higher levels of ED crowding, including management, process, environmental, human factors, and resource issues. Several solutions exist to reduce ED crowding, which involve addressing several of the issues identified by Bashkin et al. This includes reducing the demand for and variation in care, and better matching the supply of resources to demands in care in real time. However, what is needed to reduce crowding is an institutional imperative from senior leadership, implemented by engaged ED and hospital leadership with multi-disciplinary cross-unit collaboration, sufficient resources to implement effective interventions, access to data, and a sustained commitment over time. This may move the culture of a hospital to facilitate improved flow within and across units and ultimately improve quality and safety over the long-term.

Developing lay health worker policy in South Africa: a qualitative study

PubMed Central

2012-01-01

Background Over the past half decade South Africa has been developing, implementing and redeveloping its Lay Health Worker (LHW) policies. Research during this period has highlighted challenges with LHW programme implementation. These challenges have included an increased burden of care for female LHWs. The aim of this study was to explore contemporary LHW policy development processes and the extent to which issues of gender are taken up within this process. Methods The study adopted a qualitative approach to exploring policy development from the perspective of policy actors. Eleven policy actors (policy makers and policy commentators) were interviewed individually. Data from the interviews were analysed thematically. Results Considerations of LHW working conditions drove policy redevelopment. From the interviews it seems that gender as an issue never reached the policy making agenda. Although there was strong recognition that the working conditions of LHWs needed to be improved, poor working conditions were not necessarily seen as a gender concern. Our data suggests that in the process of defining the problem which the redeveloped policy had to address, gender was not included. There was no group or body who brought the issue of gender to the attention of policy developers. As such the issue of gender never entered the policy debates. These debates focused on whether it was appropriate to have LHWs, what LHW programme model should be adopted and whether or not LHWs should be incorporated into the formal health system. Conclusion LHW policy redevelopment focused on resolving issues of LHW working conditions through an active process involving many actors and strong debates. Within this process the issue of gender had no champion and never reached the LHW policy agenda. Future research may consider how to incorporate the voices of ordinary women into the policy making process. PMID:22410185

Towards pervasive computing in health care - a literature review.

PubMed

Orwat, Carsten; Graefe, Andreas; Faulwasser, Timm

2008-06-19

The evolving concepts of pervasive computing, ubiquitous computing and ambient intelligence are increasingly influencing health care and medicine. Summarizing published research, this literature review provides an overview of recent developments and implementations of pervasive computing systems in health care. It also highlights some of the experiences reported in deployment processes. There is no clear definition of pervasive computing in the current literature. Thus specific inclusion criteria for selecting articles about relevant systems were developed. Searches were conducted in four scientific databases alongside manual journal searches for the period of 2002 to 2006. Articles included present prototypes, case studies and pilot studies, clinical trials and systems that are already in routine use. The searches identified 69 articles describing 67 different systems. In a quantitative analysis, these systems were categorized into project status, health care settings, user groups, improvement aims, and systems features (i.e., component types, data gathering, data transmission, systems functions). The focus is on the types of systems implemented, their frequency of occurrence and their characteristics. Qualitative analyses were performed of deployment issues, such as organizational and personnel issues, privacy and security issues, and financial issues. This paper provides a comprehensive access to the literature of the emerging field by addressing specific topics of application settings, systems features, and deployment experiences. Both an overview and an analysis of the literature on a broad and heterogeneous range of systems are provided. Most systems are described in their prototype stages. Deployment issues, such as implications on organization or personnel, privacy concerns, or financial issues are mentioned rarely, though their solution is regarded as decisive in transferring promising systems to a stage of regular operation. There is a need for further research on the deployment of pervasive computing systems, including clinical studies, economic and social analyses, user studies, etc.

Implementation of an i.v.-compounding robot in a hospital-based cancer center pharmacy.

PubMed

Yaniv, Angela W; Knoer, Scott J

2013-11-15

The implementation of a robotic device for compounding patient-specific chemotherapy doses is described, including a review of data on the robot's performance over a 13-month period. The automated system prepares individualized i.v. chemotherapy doses in a variety of infusion bags and syringes; more than 50 drugs are validated for use in the machine. The robot is programmed to recognize the physical parameters of syringes and vials and uses photographic identification, barcode identification, and gravimetric measurements to ensure that the correct ingredients are compounded and the final dose is accurate. The implementation timeline, including site preparation, logistics planning, installation, calibration, staff training, development of a pharmacy information system (PIS) interface, and validation by the state board of pharmacy, was about 10 months. In its first 13 months of operation, the robot was used to prepare 7384 medication doses; 85 doses (1.2%) found to be outside the desired accuracy range (±4%) were manually modified by pharmacy staff. Ongoing system monitoring has identified mechanical and materials-related problems including vial-recognition failures (in many instances, these issues were resolved by the system operator and robotic compounding proceeded successfully), interface issues affecting robot-PIS communication, and human errors such as the loading of an incorrect vial or bag into the machine. Through staff training, information technology improvements, and workflow adjustments, the robot's throughput has been steadily improved. An i.v.-compounding robot was successfully implemented in a cancer center pharmacy. The robot performs compounding tasks safely and accurately and has been integrated into the pharmacy's workflow.

A new, but old business model for family physicians: cash.

PubMed

Weber, J Michael

2013-01-01

The following study is an exploratory investigation into the opportunity identification, opportunity analysis, and strategic implications of implementing a cash-only family physician practice. The current market dynamics (i.e., increasing insurance premiums, decreasing benefits, more regulations and paperwork, and cuts in federal and state programs) suggest that there is sufficient motivation for these practitioners to change their current business model. In-depth interviews were conducted with office managers and physicians of family physician practices. The results highlighted a variety of issues, including barriers to change, strategy issues, and opportunities/benefits. The implications include theory applications, strategic marketing applications, and managerial decision-making.

Voltammetry Method Evaluation

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

Hoyt, N.; Pereira, C.; Willit, J.

2016-07-29

The purpose of the ANL MPACT Voltammetry project is to evaluate the suitability of previously developed cyclic voltammetry techniques to provide electroanalytical measurements of actinide concentrations in realistic used fuel processing scenarios. The molten salts in these scenarios are very challenging as they include high concentrations of multiple electrochemically active species, thereby creating a variety of complications. Some of the problems that arise therein include issues related to uncompensated resistance, cylindrical diffusion, and alloying of the electrodeposited metals. Improvements to the existing voltammetry technique to account for these issues have been implemented, resulting in good measurements of actinide concentrations acrossmore » a wide range of adverse conditions.« less

Hydrolysis of ammonia borane as a hydrogen source: fundamental issues and potential solutions towards implementation.

PubMed

Sanyal, Udishnu; Demirci, Umit B; Jagirdar, Balaji R; Miele, Philippe

2011-12-16

In today's era of energy crisis and global warming, hydrogen has been projected as a sustainable alternative to depleting CO(2)-emitting fossil fuels. However, its deployment as an energy source is impeded by many issues, one of the most important being storage. Chemical hydrogen storage materials, in particular B-N compounds such as ammonia borane, with a potential storage capacity of 19.6 wt % H(2) and 0.145 kg(H2)L(-1), have been intensively studied from the standpoint of addressing the storage issues. Ammonia borane undergoes dehydrogenation through hydrolysis at room temperature in the presence of a catalyst, but its practical implementation is hindered by several problems affecting all of the chemical compounds in the reaction scheme, including ammonia borane, water, borate byproducts, and hydrogen. In this Minireview, we exhaustively survey the state of the art, discuss the fundamental problems, and, where applicable, propose solutions with the prospect of technological applications. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Participatory monitoring and evaluation approaches that influence decision-making: lessons from a maternal and newborn study in Eastern Uganda.

PubMed

Kananura, Rornald Muhumuza; Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Bumba, Ahmed; Mulekwa, Godfrey; Nakiganda-Busiku, Dinah; Oo, Htet Nay Lin; Kiwanuka, Suzanne Namusoke; George, Asha; Peters, David H

2017-12-28

The use of participatory monitoring and evaluation (M&E) approaches is important for guiding local decision-making, promoting the implementation of effective interventions and addressing emerging issues in the course of implementation. In this article, we explore how participatory M&E approaches helped to identify key design and implementation issues and how they influenced stakeholders' decision-making in eastern Uganda. The data for this paper is drawn from a retrospective reflection of various M&E approaches used in a maternal and newborn health project that was implemented in three districts in eastern Uganda. The methods included qualitative and quantitative M&E techniques such as  key informant interviews, formal surveys and supportive supervision, as well as participatory approaches, notably participatory impact pathway analysis. At the design stage, the M&E approaches were useful for identifying key local problems and feasible local solutions and informing the activities that were subsequently implemented. During the implementation phase, the M&E approaches provided evidence that informed decision-making and helped identify emerging issues, such as weak implementation by some village health teams, health facility constraints such as poor use of standard guidelines, lack of placenta disposal pits, inadequate fuel for the ambulance at some facilities, and poor care for low birth weight infants. Sharing this information with key stakeholders prompted them to take appropriate actions. For example, the sub-county leadership constructed placenta disposal pits, the district health officer provided fuel for ambulances, and health workers received refresher training and mentorship on how to care for newborns. Diverse sources of information and perspectives can help researchers and decision-makers understand and adapt evidence to contexts for more effective interventions. Supporting districts to have crosscutting, routine information generating and sharing platforms that bring together stakeholders from different sectors is therefore crucial for the successful implementation of complex development interventions.

Implementation of the first wellness-fitness evaluation for the Dallas Fire-Rescue Department

PubMed Central

Seals, Norman; Martin, JoAnn; Russell, Bryan

2010-01-01

More than 100 firefighters lose their lives in the line of duty each year; many of these deaths are caused by cardiovascular events and underlying coronary heart disease. In addition, firefighters are at higher-than-normal risk of developing certain types of cancer. To improve health and fitness among its firefighters, the Dallas Fire-Rescue Department developed and implemented an annual wellness-fitness program in 2008. The program detected and addressed medical issues including coronary disease, hypertension, high triglyceride levels, high cholesterol, high blood glucose levels, and hematuria. Prostate, thyroid, breast, kidney, and bladder cancers were also detected. By identifying these issues, engaging the firefighters' personal physicians, and recommending individualized treatment plans, this program may have extended lives and improved the quality of life for the firefighters. PMID:20671818

Gutter oil: an overview of Chinese food safety issues and policies.

PubMed

Li, Jia; Cui, Naixue; Liu, Jianghong

2017-09-01

Food safety has become a focus of attention worldwide. In China, one of the top concerns in food safety is gutter oil, known as 'swill-cooked oil'. This Commentary summarizes the key incidents disclosed to the public by the media, and the policies regarding gutter oil at national, regional, and provincial or city levels. Several challenges the country still faces in tackling this issue are identified, including a lack of evaluation of the implementation and effect of the policies, a lack of effective technology to detect and recycle gutter oil, and the overlooking of the hazardous effect of gutter oil on health. This commentary suggests that strengthening policy implementation and evaluation, improving measurement and recycling technologies, and launching public health campaigns would help eliminate gutter oil from dining tables.

Final report of the National Health and Hospitals Reform Commission: will we get the health care governance reform we need?

PubMed

Stoelwinder, Johannes U

2009-10-05

The National Health and Hospitals Reform Commission (NHHRC) has recommended that Australia develop a "single health system", governed by the federal government. Steps to achieving this include: a "Healthy Australia Accord" to agree on the reform framework; the progressive takeover of funding of public hospitals by the federal government; and the possible implementation of a consumer-choice health funding model, called "Medicare Select". These proposals face significant implementation issues, and the final solution needs to deal with both financial and political sustainability. If the federal and state governments cannot agree on a reform plan, the Prime Minister may need to go to the electorate for a mandate, which may be shaped by other economic issues such as tax reform and intergenerational challenges.

Implementation of the first wellness-fitness evaluation for the Dallas Fire-Rescue Department.

PubMed

Winter, F David; Seals, Norman; Martin, Joann; Russell, Bryan

2010-07-01

More than 100 firefighters lose their lives in the line of duty each year; many of these deaths are caused by cardiovascular events and underlying coronary heart disease. In addition, firefighters are at higher-than-normal risk of developing certain types of cancer. To improve health and fitness among its firefighters, the Dallas Fire-Rescue Department developed and implemented an annual wellness-fitness program in 2008. The program detected and addressed medical issues including coronary disease, hypertension, high triglyceride levels, high cholesterol, high blood glucose levels, and hematuria. Prostate, thyroid, breast, kidney, and bladder cancers were also detected. By identifying these issues, engaging the firefighters' personal physicians, and recommending individualized treatment plans, this program may have extended lives and improved the quality of life for the firefighters.

PrEP implementation research in Africa: what is new?

PubMed

Cowan, Frances M; Delany-Moretlwe, Sinead; Sanders, Eduard J; Mugo, Nelly R; Guedou, Fernand A; Alary, Michel; Behanzin, Luc; Mugurungi, Owen; Bekker, Linda-Gail

2016-01-01

Of the two million new HIV infections in adults in 2014, 70% occurred in sub-Saharan Africa. Several African countries have already approved guidelines for pre-exposure prophylaxis (PrEP) for individuals at substantial risk of HIV as part of combination HIV prevention but key questions remain about how to identify and deliver PrEP to those at greatest need. Throughout the continent, individuals in sero-discordant relationships, and members of key populations (sex workers, men who have sex with men (MSM), transgender women and injection drug users) are likely to benefit from the availability of PrEP. In addition, adolescent girls and young women (AGYW) are at substantial risk in some parts of the continent. It has been estimated that at least three million individuals in Africa are likely to be eligible for PrEP according to WHO's criteria. Tens of demonstration projects are planned or underway across the continent among a range of countries, populations and delivery settings. In each of the target populations, there are overarching issues related to (i) creating demand for PrEP, (ii) addressing supply-side issues and (iii) providing appropriate and tailored adherence support. Critical for creating demand for PrEP is the normalization of HIV prevention. Community-level interventions which engage opinion leaders as well as empowerment interventions for those at highest risk will be key. Critical to supply of PrEP is that services are accessible for all, including for stigmatized populations. Establishing accessible integrated services provides the opportunity to address other public health priorities including the unmet need for HIV testing, contraception and sexually transmitted infections treatment. National policies need to include minimum standards for training and quality assurance for PrEP implementation and to address supply chain issues. Adherence support needs to recognize that social and structural factors are likely to have an important influence. Combining interventions that build self-efficacy, empowerment and social cohesion, with evidence-based individualized adherence support for PrEP, are most likely to be effective. Efficacy of tenfovir-based PrEP is proven but many issues related to implementation remain unclear. Here, we have summarized some of the important implementation questions that need to be assessed as PrEP is rolled out across Africa.

PrEP implementation research in Africa: what is new?

PubMed Central

Cowan, Frances M; Delany-Moretlwe, Sinead; Sanders, Eduard J; Mugo, Nelly R; Guedou, Fernand A; Alary, Michel; Behanzin, Luc; Mugurungi, Owen; Bekker, Linda-Gail

2016-01-01

Introduction Of the two million new HIV infections in adults in 2014, 70% occurred in sub-Saharan Africa. Several African countries have already approved guidelines for pre-exposure prophylaxis (PrEP) for individuals at substantial risk of HIV as part of combination HIV prevention but key questions remain about how to identify and deliver PrEP to those at greatest need. Throughout the continent, individuals in sero-discordant relationships, and members of key populations (sex workers, men who have sex with men (MSM), transgender women and injection drug users) are likely to benefit from the availability of PrEP. In addition, adolescent girls and young women (AGYW) are at substantial risk in some parts of the continent. It has been estimated that at least three million individuals in Africa are likely to be eligible for PrEP according to WHO's criteria. Tens of demonstration projects are planned or underway across the continent among a range of countries, populations and delivery settings. Discussion In each of the target populations, there are overarching issues related to (i) creating demand for PrEP, (ii) addressing supply-side issues and (iii) providing appropriate and tailored adherence support. Critical for creating demand for PrEP is the normalization of HIV prevention. Community-level interventions which engage opinion leaders as well as empowerment interventions for those at highest risk will be key. Critical to supply of PrEP is that services are accessible for all, including for stigmatized populations. Establishing accessible integrated services provides the opportunity to address other public health priorities including the unmet need for HIV testing, contraception and sexually transmitted infections treatment. National policies need to include minimum standards for training and quality assurance for PrEP implementation and to address supply chain issues. Adherence support needs to recognize that social and structural factors are likely to have an important influence. Combining interventions that build self-efficacy, empowerment and social cohesion, with evidence-based individualized adherence support for PrEP, are most likely to be effective. Conclusions Efficacy of tenfovir-based PrEP is proven but many issues related to implementation remain unclear. Here, we have summarized some of the important implementation questions that need to be assessed as PrEP is rolled out across Africa. PMID:27760680

Modelling robot construction systems

NASA Technical Reports Server (NTRS)

Grasso, Chris

1990-01-01

TROTER's are small, inexpensive robots that can work together to accomplish sophisticated construction tasks. To understand the issues involved in designing and operating a team of TROTER's, the robots and their components are being modeled. A TROTER system that features standardized component behavior is introduced. An object-oriented model implemented in the Smalltalk programming language is described and the advantages of the object-oriented approach for simulating robot and component interactions are discussed. The presentation includes preliminary results and a discussion of outstanding issues.

Reliability issues in PACS

NASA Astrophysics Data System (ADS)

Taira, Ricky K.; Chan, Kelby K.; Stewart, Brent K.; Weinberg, Wolfram S.

1991-07-01

Reliability is an increasing concern when moving PACS from the experimental laboratory to the clinical environment. Any system downtime may seriously affect patient care. The authors report on the several classes of errors encountered during the pre-clinical release of the PACS during the past several months and present the solutions implemented to handle them. The reliability issues discussed include: (1) environmental precautions, (2) database backups, (3) monitor routines of critical resources and processes, (4) hardware redundancy (networks, archives), and (5) development of a PACS quality control program.

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

David Lawrence

Calibrations and conditions databases can be accessed from within the JANA Event Processing framework through the API defined in its JCalibration base class. The API is designed to support everything from databases, to web services to flat files for the backend. A Web Service backend using the gSOAP toolkit has been implemented which is particularly interesting since it addresses many modern cybersecurity issues including support for SSL. The API allows constants to be retrieved through a single line of C++ code with most of the context, including the transport mechanism, being implied by the run currently being analyzed and themore » environment relieving developers from implementing such details.« less

The JANA calibrations and conditions database API

NASA Astrophysics Data System (ADS)

Lawrence, David

2010-04-01

Calibrations and conditions databases can be accessed from within the JANA Event Processing framework through the API defined in its JCalibration base class. The API is designed to support everything from databases, to web services to flat files for the backend. A Web Service backend using the gSOAP toolkit has been implemented which is particularly interesting since it addresses many modern cybersecurity issues including support for SSL. The API allows constants to be retrieved through a single line of C++ code with most of the context, including the transport mechanism, being implied by the run currently being analyzed and the environment relieving developers from implementing such details.

Protecting Ideas: Ethical and Legal Considerations When a Grant's Principal Investigator Changes.

PubMed

Koniaris, Leonidas G; Coombs, Mary I; Meslin, Eric M; Zimmers, Teresa A

2016-08-01

Ethical issues related the responsible conduct of research involve questions concerning the rights and obligations of investigators to propose, design, implement, and publish research. When a principal investigator (PI) transfers institutions during a grant cycle, financial and recognition issues need to be addressed to preserve all parties' obligations and best interests in a mutually beneficial way. Although grants often transfer with the PI, sometimes they do not. Maintaining a grant at an institution after the PI leaves does not negate the grantee institution's obligation to recognize the PI's original ideas, contributions, and potential rights to some forms of expression and compensation. Issues include maintaining a role for the PI in determining how to take credit for, share and publish results that involve his or her original ideas. Ascribing proper credit can become a thorny issue. This paper provides a framework for addressing situations and disagreements that may occur when a new PI continues the work after the original PI transfers. Included are suggestions for proactively developing institutional mechanisms that address such issues. Considerations include how to develop solutions that comply with the responsible conduct of research, equitably resolve claims regarding reporting of results, and avoid the possibility of plagiarism.

Awareness of Societal Issues Among High School Biology Teachers Teaching Genetics

NASA Astrophysics Data System (ADS)

Lazarowitz, Reuven; Bloch, Ilit

2005-12-01

The purpose of this study was to investigate how aware high school biology teachers are of societal issues (values, moral, ethic, and legal issues) while teaching genetics, genetics engineering, molecular genetics, human heredity, and evolution. The study includes a short historical review of World War II atrocities during the Holocaust when scientists from all the above-mentioned disciplines had been involved in trying to support and develop the eugenics theories. It investigates pre- and postwar theories of the eugenics movement in the United States which were implemented successfully in Germany and a literature survey of the studies of societal issues related to these subjects. The sample consisted of 30 male and female biology teachers. Enclosed are teachers' answers in favor or against including debates about societal issues in their classrooms while teaching the disciplines mentioned above. Teachers' answers were analyzed in relation to three variables: years of teaching experience, gender, and religion faith. Data were collected from questionnaires and personal interviews and analyzed according to qualitative and quantitative methods. The results show that amongst the teachers there is a medium to low level of awareness of societal issues, while mainly emphasizing scientific subjects in preparation of matriculation examinations. The majority of the teachers do not include societal issues in their teaching, but if students raise these issues, teachers claimed to address them. No differences in teachers' opinions to societal issues were found in relation to gender or religious faith. Teachers with more years of teaching experience tend to teach with a more Science, Technology, and Society (STS) approach than novice teachers. The results are discussed in relation to teachers' professional development and teaching strategies are suggested to be used in their classrooms based on a STS approach, which includes the societal issues as a main goal.

75 FR 67947 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

... DEPARTMENT OF COMMERCE Submission for OMB Review; Comment Request The Department of Commerce will... Secretary of Commerce to issue regulations to implement the EAA including those provisions authorizing the... Obligation: Required to obtain benefits. OMB Desk Officer: Jasmeet Seehra, (202) 395-3123. Copies of the...

77 FR 34129 - Heavy-Duty Highway Program: Revisions for Emergency Vehicles

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

... diesel vehicles, including emergency vehicles. Some control system designs and implementation strategies... broad engine families and vehicle test groups that are defined by similar emissions and performance... public safety issue related to design of engines and emission control systems on emergency vehicles that...

Research Visibility: Preparation of Professional Personnel for Vocational Education.

ERIC Educational Resources Information Center

Brandon, George L., Ed.

1969-01-01

Sixteen reviews in this issue pertain to the preparation of professional personnel for vocational education. Topics under "Seminars and Workshops" include implementing the project method in distributive education, an off-farm agriculture workshop, innovative technical teacher education programs, a national vocational teacher education seminar, and…

Improving TCP Performance over Mobile Satellite Channels: The ACKPrime Approach

NASA Technical Reports Server (NTRS)

Scott, Keith; Czetty, Stephen

1998-01-01

Various issues associated with "Improving TCP Performance over Mobile Satellite Channels: The ACKPrime Approach" are presented in viewgraph form. Specific topics include: 1) TCP over mobile satellite links; 2) ways of breaking the control loop at the groundstation; 3) ACK implementation; and 4) ACK performance.

Report: Multiple Actions Taken to Address Electronic Waste, But EPA Needs to Provide Clear National Direction

EPA Pesticide Factsheets

Report #2004-P-00028, September 1, 2004. EPA’s Office of Solid Waste (OSW) has implemented or participated in many recent projects that have enhanced the general awareness of E-waste issues and included a wide range of stakeholders.

Aspiration, Performance, Reward: The Advanced Placement Program at 40.

ERIC Educational Resources Information Center

Rothschild, Eric

1995-01-01

The history of the College Entrance Examination Board's Advanced Placement Program is chronicled from its conception in 1951 through early developmental stages and 40 years of implementation. Issues discussed include test development, funding, administration at the institutional level, expansion of curriculum areas and testing options, teacher…

Preparing for the Twenty-First Century: Geography Education in Australia.

ERIC Educational Resources Information Center

Lidstone, John; Wiber, Marilyn

1996-01-01

Profiles the current geography curriculum in Australian schools and discusses the policy decisions that resulted in its implementation. Australian geography education features a prominent social education component that emphasizes development, the environment, and other social issues. Includes several tables listing national curriculum goals and…

Curriculum Leadership: Development and Implementation

ERIC Educational Resources Information Center

Glatthorn, Allan A.; Boschee, Floyd; Whitehead, Bruce M.

2005-01-01

This book is a resource written for educational leaders who want to successfully restructure and enhance curriculum in schools today. It provides innovative and successful curriculum ideas, including reflective case studies, "Keys to Leadership" sections, curriculum tips, and "Challenge" sections with key issues and questions in every chapter.…

Translating Research to Practice: Overcoming Barriers to Implementing Effective Off-Campus Party Intervention. Issues in Prevention

ERIC Educational Resources Information Center

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

2012-01-01

This issue of "Issues in Prevention" focuses on overcoming barriers in implementing effective off-campus party intervention. This issue contains the following articles: (1) Confronting the Problems Associated With Off-Campus Parties With Evidence-Based Strategies (John D. Clapp); (2) Overview of Research on Effective Off-Campus Party…

12 CFR 1204.1 - Why did FHFA issue this part?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Why did FHFA issue this part? 1204.1 Section 1204.1 Banks and Banking FEDERAL HOUSING FINANCE AGENCY ORGANIZATION AND OPERATIONS PRIVACY ACT IMPLEMENTATION § 1204.1 Why did FHFA issue this part? FHFA issued this part to: (a) Implement the Privacy Act of...

Toward a procedure for integrating moral issues in health technology assessment.

PubMed

Hofmann, Bjørn

2005-01-01

Although ethics has been on the agenda in health technology assessment (HTA) since its inception, the integration of moral issues is still not standard and is performed in a vast variety of ways. Therefore, there is a need for a procedure for integrating moral issues in HTA. Literature review of existing approaches together with application of various theories in moral philosophy and axiology. The article develops a set of questions that addresses a wide range of moral issues related to the assessment and implementation of health technology. The issues include general moral issues and moral issues related to stakeholders, methodology, characteristics of technology, and to the HTA process itself. The questions form a kind of checklist for use in HTAs. The presented approach for integrating moral issues in HTA has a broad theoretical foundation and has shown to be useful in practice. Integrating ethical issues in HTAs can be of great importance with respect to the dissemination of HTA results and in efficient health policy making.

General specifications for the development of a PC-based simulator of the NASA RECON system

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Triantafyllopoulos, Spiros

1984-01-01

The general specifications for the design and implementation of an IBM PC/XT-based simulator of the NASA RECON system, including record designs, file structure designs, command language analysis, program design issues, error recovery considerations, and usage monitoring facilities are discussed. Once implemented, such a simulator will be utilized to evaluate the effectiveness of simulated information system access in addition to actual system usage as part of the total educational programs being developed within the NASA contract.

Application guide for universal source encoding for space

NASA Technical Reports Server (NTRS)

Yeh, Pen-Shu; Miller, Warner H.

1993-01-01

Lossless data compression was studied for many NASA missions. The Rice algorithm was demonstrated to provide better performance than other available techniques on most scientific data. A top-level description of the Rice algorithm is first given, along with some new capabilities implemented in both software and hardware forms. Systems issues important for onboard implementation, including sensor calibration, error propagation, and data packetization, are addressed. The latter part of the guide provides twelve case study examples drawn from a broad spectrum of science instruments.

Institutional Issues in the Planning and Implementation of a Program to Dispose of High-Level Radioactive Wastes

DTIC Science & Technology

1981-02-01

environment including political and psychosociological variables, (2) implementation (2) H. Igor Ansoff , Roger P. Declerck and Robert L. Hayes, "From...Strategic Planning to Strategic Management" in From Strategic Planning to Strategic Management, edited by H. Igor Ansoff et al., John Wiley & Sons, 1976...Hanagement," in From Strategic Planning to Strategic Nanagement, edited by H. Igor Ansoff et al., Jon.𔃻 Wiley & Sons, 1976, p. 33. -44- is not willing to

Newborn Survival Case Study in Rwanda - Bottleneck Analysis and Projections in Key Maternal and Child Mortality Rates Using Lives Saved Tool (LiST).

PubMed

Khurmi, Manpreet Singh; Sayinzoga, Felix; Berhe, Atakilt; Bucyana, Tatien; Mwali, Assumpta Kayinamura; Manzi, Emmanuel; Muthu, Maharajan

2017-01-01

The Newborn Survival Case study in Rwanda provides an analysis of the newborn health and survival situation in the country. It reviews evidence-based interventions and coverage levels already implemented in the country; identifies key issues and bottlenecks in service delivery and uptake of services by community/beneficiaries, and provides key recommendations aimed at faster reduction in newborn mortality rate. This study utilized mixed method research including qualitative and quantitative analyses of various maternal and newborn health programs implemented in the country. This included interviewing key stakeholders at each level, field visits and also interviewing beneficiaries for assessment of uptake of services. Monitoring systems such as Health Management Information Systems (HMIS), maternal and newborn death audits were reviewed and data analyzed to aid these analyses. Policies, protocols, various guidelines and tools for monitoring are already in place however, implementation of these remains a challenge e.g. infection control practices to reduce deaths due to sepsis. Although existing staff are quite knowledgeable and are highly motivated, however, shortage of health personnel especially doctors in an issue. New facilities are being operationalized e.g. at Gisenyi, however, the existing facilities needs expansion. It is essential to implement high impact evidence based interventions but coverage levels need to be significantly high in order to achieve higher reduction in newborn mortality rate. Equity approach should be considered in planning so that the services are better implemented and the poor and needy can get the benefits of public health programs.

Ada (trademark) projects at NASA. Runtime environment issues and recommendations

NASA Technical Reports Server (NTRS)

Roy, Daniel M.; Wilke, Randall W.

1988-01-01

Ada practitioners should use this document to discuss and establish common short term requirements for Ada runtime environments. The major current Ada runtime environment issues are identified through the analysis of some of the Ada efforts at NASA and other research centers. The runtime environment characteristics of major compilers are compared while alternate runtime implementations are reviewed. Modifications and extensions to the Ada Language Reference Manual to address some of these runtime issues are proposed. Three classes of projects focusing on the most critical runtime features of Ada are recommended, including a range of immediately feasible full scale Ada development projects. Also, a list of runtime features and procurement issues is proposed for consideration by the vendors, contractors and the government.

The tug-of-war: fidelity versus adaptation throughout the health promotion program life cycle.

PubMed

Bopp, Melissa; Saunders, Ruth P; Lattimore, Diana

2013-06-01

Researchers across multiple fields have described the iterative and nonlinear phases of the translational research process from program development to dissemination. This process can be conceptualized within a "program life cycle" framework that includes overlapping and nonlinear phases: development, adoption, implementation, maintenance, sustainability or termination, and dissemination or diffusion, characterized by tensions between fidelity to the original plan and adaptation for the setting and population. In this article, we describe the life cycle (phases) for research-based health promotion programs, the key influences at each phase, and the issues related to the tug-of-war between fidelity and adaptation throughout the process using a fictionalized case study based on our previous research. This article suggests the importance of reconceptualizing intervention design, involving stakeholders, and monitoring fidelity and adaptation throughout all phases to maintain implementation fidelity and completeness. Intervention fidelity should be based on causal mechanisms to ensure effectiveness, while allowing for appropriate adaption to ensure maximum implementation and sustainability. Recommendations for future interventions include considering the determinants of implementation including contextual factors at each phase, the roles of stakeholders, and the importance of developing a rigorous, adaptive, and flexible definition of implementation fidelity and completeness.

Web 2.0 and Emerging Technologies in Online Learning

ERIC Educational Resources Information Center

Diaz, Veronica

2010-01-01

As online learning continues to grow, so do the free or nearly free Web 2.0 and emerging online learning technologies available to faculty and students. This chapter explores the implementation process and corresponding considerations of adapting such tools for teaching and learning. Issues addressed include copyright, intellectual property,…

Associate Degree Education--Current Issues. Publication Number 23-1371.

ERIC Educational Resources Information Center

National League for Nursing, New York, NY. Dept. of Associate Degree Programs.

Papers included in the documents are: (1) "Nursing Education for the Community" by Shirley Chater, (2) "Key Problems in Implementing Associate Degree Nursing Programs" by Elsa L. Brown, (3) "The Allied Health Professions Projects at the University of California" by Mary E. Jensen, (4) "The Profession's…

Is There a Chance for a Standardised User Interface?

ERIC Educational Resources Information Center

Fletcher, Liz

1993-01-01

Issues concerning the implementation of standard user interfaces for CD-ROMs are discussed, including differing perceptions of the ideal interface, graphical user interfaces, user needs, and the standard protocols. It is suggested users should be able to select from a variety of user interfaces on each CD-ROM. (EA)

The Internationalisation of Curricula: The Complexity and Diversity of Meaning in and beyond Japanese Universities

ERIC Educational Resources Information Center

Takagi, Hiroyuki

2015-01-01

The interpretation and implementation of ideas about the internationalisation of curricula (IoC) are complicated and multi-faceted. The complex and diverse perspectives on IoC reflect two concepts: "internationalisation" and "curriculum". These concepts embody contrasting perspectives on issues, including the competition-type…

Scale Up in Education: Volume 2: Issues in Practice

ERIC Educational Resources Information Center

Schneider, Barbara, Ed.; McDonald, Sarah-Kathryn, Ed.

2006-01-01

This book explores the challenges of implementing and assessing educational interventions in varied classroom contexts. Included are reflections on the challenges of designing studies for improving the instructional core of schools, guidelines for establishing evidence of interventions' impacts across a wide range of settings, and an assessment of…

Impact Evaluations of Corporate E-Learning.

ERIC Educational Resources Information Center

Ring, Geoff; Reeves, Thomas C.

This paper describes key issues in conducting impact evaluations of corporate eLearning and reports the results of a study that evaluated the impact (including return on investment) of an eLearning implementation by a large telecommunications company. The program was designed to "multi-skill" over 1,000 Customer Service Officers (CSOs)…

40 CFR 69.41 - New exemptions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Significant Deterioration of Air Quality (PSD) permit issued to HOVIC; and shall include as a minimum, the... purpose of implementing the ICS at nearby locations approved by EPA and specified in the PSD permit. The... the NAAQS. (e) HOVIC must comply with all fuel switching requirements, contained in HOVIC's PSD permit...

40 CFR 69.41 - New exemptions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Significant Deterioration of Air Quality (PSD) permit issued to HOVIC; and shall include as a minimum, the... purpose of implementing the ICS at nearby locations approved by EPA and specified in the PSD permit. The... the NAAQS. (e) HOVIC must comply with all fuel switching requirements, contained in HOVIC's PSD permit...

40 CFR 69.41 - New exemptions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Significant Deterioration of Air Quality (PSD) permit issued to HOVIC; and shall include as a minimum, the... purpose of implementing the ICS at nearby locations approved by EPA and specified in the PSD permit. The... the NAAQS. (e) HOVIC must comply with all fuel switching requirements, contained in HOVIC's PSD permit...

The Control of Hazardous Wastes and the Role of Environmental Educators.

ERIC Educational Resources Information Center

Pfortner, Ray

1984-01-01

Discusses legislation aimed at hazardous waste issues which are implemented by the Environmental Protection Agency and state governments. Particular attention is given to Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). A case study of an abandoned acres superfund site is included with two related student…

The Promise of Baldrige for K-12 Education. ACT Policy Report.

ERIC Educational Resources Information Center

Walpole, MaryBeth.; Noeth, Richard J.

This report examines the evidence available on improving school quality through implementation of the Malcolm Baldrige Education Criteria for Performance Excellence. The Baldrige criteria address many issues other failed educational efforts have not, including leadership, systems thinking, changes in school culture, and data-driven decision…

Structuring a Clinical Learning Environment for a Hybrid-PBL Dental Curriculum.

ERIC Educational Resources Information Center

MacNeil, M. A. J.; Walton, Joanne N.; Clark, D. Christopher; Tobias, David L.; Harrison, Rosamund L.

1998-01-01

Describes the evolution and implementation of a joint medical-dental problem-based learning (PBL) curriculum at the University of British Columbia's medical and dental schools, featuring development of an integrated care clinic. Issues in structuring the new curriculum are discussed, including management of the clinic's group practices, affective…

Understanding the Civil Justice System.

ERIC Educational Resources Information Center

Hirshon, Robert E.; Bolduan, Linda M.

1997-01-01

Provides a concise and informative overview of the civil justice system. Examines various components and issues including the federal and state court systems, differences between civil and criminal law, background in common law, types of civil law, civil procedure, and the effect and implementation of civil law in everyday life. (MJP)

Public Health Control Measures in Response to Global Pandemics and Drug Resistance.

PubMed

Price, Polly J

2015-01-01

These teaching materials provide problem-based exercises exploring the specific powers of governments to implement control measures in response to communicable disease. Topics include global pandemic disease and, in the United States, legal issues in tuberculosis control. © 2015 American Society of Law, Medicine & Ethics, Inc.

40 CFR 72.70 - Relationship to title V operating permit program.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Phase II Implementation § 72.70 Relationship to... operating permit programs and acceptance of State Acid Rain programs, the procedure for including State Acid... of an accepted State program, to issue Phase II Acid Rain permits. (b) Relationship to operating...

40 CFR 72.70 - Relationship to title V operating permit program.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Phase II Implementation § 72.70 Relationship to... operating permit programs and acceptance of State Acid Rain programs, the procedure for including State Acid... of an accepted State program, to issue Phase II Acid Rain permits. (b) Relationship to operating...

40 CFR 72.70 - Relationship to title V operating permit program.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Phase II Implementation § 72.70 Relationship to... operating permit programs and acceptance of State Acid Rain programs, the procedure for including State Acid... of an accepted State program, to issue Phase II Acid Rain permits. (b) Relationship to operating...

40 CFR 72.70 - Relationship to title V operating permit program.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Phase II Implementation § 72.70 Relationship to... operating permit programs and acceptance of State Acid Rain programs, the procedure for including State Acid... of an accepted State program, to issue Phase II Acid Rain permits. (b) Relationship to operating...

40 CFR 72.70 - Relationship to title V operating permit program.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Phase II Implementation § 72.70 Relationship to... operating permit programs and acceptance of State Acid Rain programs, the procedure for including State Acid... of an accepted State program, to issue Phase II Acid Rain permits. (b) Relationship to operating...

Edward W. Jennings | NREL

Science.gov Websites

practices promoting a safe and supportive working environment. His research interests include environmental, safety, and health (ESH) and facility issues, he is responsible for implementing safe work plan; working directly with awardees by performing on-site validations to collect and analyze enzyme

School Dropout Indicators, Trends, and Interventions for School Counselors

ERIC Educational Resources Information Center

Dockery, Donna J.

2012-01-01

School counselors are expected to develop programs that promote academic success for all students, including those at risk for dropping out of school. Knowledge of key indicators of potential dropouts and current trends in dropout prevention research may assist school counselors in better understanding this complex issue. Implementing recommended…

Examining the Impediments to Indigenous Strategy and Approaches in Mainstream Secondary Schools

ERIC Educational Resources Information Center

Hynds, Anne; Averill, Robin; Penetito, Wally; Meyer, Luanna; Hindle, Rawiri; Faircloth, Susan

2016-01-01

Noted Maori scholar Russell Bishop identified three impediments to developing Indigenous principles and practices in schools within colonized countries. These include confusion about the culture of Indigenous children, uneven programme implementation and issues with measuring student achievement. In this article, we present results from a mixed…

Issues Management Process Course # 38401

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

Binion, Ula Marie

The purpose of this training it to advise Issues Management Coordinators (IMCs) on the revised Contractor Assurance System (CAS) Issues Management (IM) process. Terminal Objectives: Understand the Laboratory’s IM process; Understand your role in the Laboratory’s IM process. Learning Objectives: Describe the IM process within the context of the CAS; Describe the importance of implementing an institutional IM process at LANL; Describe the process flow for the Laboratory’s IM process; Apply the definition of an issue; Use available resources to determine initial screening risk levels for issues; Describe the required major process steps for each risk level; Describe the personnelmore » responsibilities for IM process implementation; Access available resources to support IM process implementation.« less

Integrating natural and social sciences to inspire public confidence in radioactive waste policy case study - Committee on radioactive waste management

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

Usher, Sam

2007-07-01

Integrating Natural and Social Sciences to Inspire Public Confidence in Radioactive Waste Policy Case Study: Committee on Radioactive Waste Management Implementing effective long-term radioactive waste management policy is challenging, and both UK and international experience is littered with policy and programme failures. Policy must not only be underpinned by sound science and technical rationale, it must also inspire the confidence of the public and other stakeholders. However, in today's modern society, communities will not simply accept the word of scientists for setting policy based purely on technical grounds. This is particularly so in areas where there are significant social andmore » ethical issues, such as radioactive waste disposal. To develop and implement effective policy, governments, waste owners and implementing bodies must develop processes which effectively integrate both complex technical and scientific issues, with equally challenging social and ethical concerns. These integrating processes must marry often intricate technical issues with broad public and stakeholder engagement programmes, in programmes which can expect the highest levels of public scrutiny, and must invariably be delivered within challenging time and budget constraints. This paper considers a model for how such integrating processes can be delivered. The paper reviews, as a case study, how such challenges were overcome by the Committee on Radioactive Waste Management (CoRWM), which, in July 2006, made recommendations to the UK government for the establishment of a long-term radioactive waste policy. Its recommendations were underpinned by sound science, but also engendered public confidence through undertaking the largest and most significant deliberative public and stakeholder engagement programme on a complex policy issue in the UK. Effective decision-making was enabled through the integration of both proven and bespoke methodologies, including Multi-criteria Decision Analysis and Holistic assessments, coupled with an overarching deliberative approach. How this was managed and delivered to programme demonstrates how important effective integration of different issues, interests and world views can be achieved, and the paper looks forward to how the continued integration of both natural and social sciences is essential if public confidence is to be maintained through implementation stages. This paper will be particularly relevant to governments, waste owners and implementing bodies who are responsible for developing and implementing policy. (author)« less

Facilitators and barriers to implementation of the AIDES initiative, a social innovation for participative assessment of children in need and for coordination of services.

PubMed

Dufour, Sarah; Lessard, Danielle; Chamberland, Claire

2014-12-01

As part of an implementation evaluation, this study aims to identify the conditions of practice that facilitated or hindered implementation of the AIDES initiative, a social innovation to support collaboration between partners involved with vulnerable children. Evaluators conducted qualitative telephone interviews with 36 respondents (19 practitioners and 17 managers) who participated in the AIDES initiative trial. Respondents were chosen to include all participating organisations (child protection services, prevention social services). Participants' comments were submitted to descriptive content analysis. Conditions facilitating or hindering implementation of the initiative included the following dimensions: (1) implementation quality; (2) organisational elements (organisational functioning, cooperation between organisations); (3) socio-political issues; and (4) personal and professional characteristics. The study highlights critical elements to consider in implementing and maintaining significant changes in practice in organisations providing assistance to vulnerable children and their families. Social innovations that do not consider such elements are likely to compromise their implementation and sustainability. We must prevent promising social changes from being considered unrealistic or inappropriate due to contextual barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Commentary: Learning from Variations in Fidelity of Implementation.

PubMed

Balu, Rekha; Doolittle, Fred

2016-12-01

The articles in this special issue discuss efforts to improve academic reading outcomes for students and ways to achieve high implementation fidelity of promising strategies. At times the authors discuss if-and how-strong fidelity is associated with strong outcomes and potentially even impacts (the difference between program and control group outcomes). We want to explore this theme in two ways: (a) learning from the variation in fidelity to think about potential points of entry and levers for improvement in implementation, and (b) broadening the evaluation focus to include "service contrast" as a factor driving impacts on student outcomes. We conclude with suggestions for future research. © 2016 Wiley Periodicals, Inc.

The CLASS Act: is it dead or just sleeping?

PubMed

Wiener, Joshua M

2012-01-01

The Affordable Care Act (ACA) established a voluntary public insurance program for long-term care: the Community Living Assistance Services and Supports (CLASS) Act. In October 2011, the Obama Administration announced that the program would not be implemented because of the high risk of fiscal insolvency. Under the legislative design, adverse selection was a major risk and premiums would have been very high. This article discusses several CLASS Act design and implementation issues, including the design features that led to the decision not to implement the program: the voluntary enrollment, the weak work requirement, the lifetime and cash benefits, and the premium subsidy for low-income workers and students.

A cloud-based X73 ubiquitous mobile healthcare system: design and implementation.

PubMed

Ji, Zhanlin; Ganchev, Ivan; O'Droma, Máirtín; Zhang, Xin; Zhang, Xueji

2014-01-01

Based on the user-centric paradigm for next generation networks, this paper describes a ubiquitous mobile healthcare (uHealth) system based on the ISO/IEEE 11073 personal health data (PHD) standards (X73) and cloud computing techniques. A number of design issues associated with the system implementation are outlined. The system includes a middleware on the user side, providing a plug-and-play environment for heterogeneous wireless sensors and mobile terminals utilizing different communication protocols and a distributed "big data" processing subsystem in the cloud. The design and implementation of this system are envisaged as an efficient solution for the next generation of uHealth systems.

The Vatican at the United Nations. Cairo + 5.

PubMed

Kissling, F

1999-01-01

During the International Conference on Population and Development in Cairo, a remarkable consensus on population and development was forged and a Programme of Action was issued. With its permanent observer status among governments at the UN, the Vatican had attempted to block such a worldwide consensus on a new structure for population and development programs, based on women's empowerment, universal and voluntary access to contraception, and improved reproductive health for all. After 5 years of implementing the Cairo Programme of Action, the UN conducted a review and appraisal of its implementation, ending with a final preparatory meeting and a Special Session of the UN General Assembly. During the review process and the meeting, the Vatican remained active but fell short, on the whole, of thwarting progress. The Vatican delegation was made up of five individuals--two women and three men, including two priests. Almost all their interventions were focused on the goal of obstructing progressive understanding of what would be necessary if the Programme of Action were to be fully and fairly implemented. This included the provision of emergency contraception to refugees; the definition of human rights; addressing unsafe abortion as a major public health issue; the provision of condoms for protection against HIV/AIDS; adolescent rights to privacy and confidentiality; and the inclusion of sex education in school curricula.

Design of a Blended Learning Environment: Considerations and Implementation Issues

ERIC Educational Resources Information Center

Gedik, Nuray; Kiraz, Ercan; Ozden, M. Yasar

2013-01-01

This study identified critical issues in the design of a blended learning environment by examining basic design considerations and implementation issues. Following a design-based research approach with the phenomenological tradition of qualitative research, the study investigated instructor experiences relating to the design, development, and…

Master's Program Module "Environmental Issues--Decision Making Experience" as Precondition for Implementation of Education for Sustainable Development for Professional Training of Teachers

ERIC Educational Resources Information Center

Vinokurova, Natalia Fedorovna; Martilova, Natalia Viktorovna; Krivdina, Irina Yurievna; Badin, Mikhail Mikhailovich; Efimova, Olga Evgenyevna

2016-01-01

The article discusses current issues related to the implementation of the UNESCO roadmap implementing Global action programme on education for sustainable development. In the context of increasing the professional level of pedagogical workers is a priority area in the implementation of education for sustainable development. Therefore, we believe…

Implementing risk-stratified screening for common cancers: a review of potential ethical, legal and social issues

PubMed Central

Hall, A.E.; Chowdhury, S.; Hallowell, N.; Pashayan, N.; Dent, T.; Pharoah, P.; Burton, H.

2014-01-01

Background The identification of common genetic variants associated with common cancers including breast, prostate and ovarian cancers would allow population stratification by genotype to effectively target screening and treatment. As scientific, clinical and economic evidence mounts there will be increasing pressure for risk-stratified screening programmes to be implemented. Methods This paper reviews some of the main ethical, legal and social issues (ELSI) raised by the introduction of genotyping into risk-stratified screening programmes, in terms of Beauchamp and Childress's four principles of biomedical ethics—respect for autonomy, non-maleficence, beneficence and justice. Two alternative approaches to data collection, storage, communication and consent are used to exemplify the ELSI issues that are likely to be raised. Results Ultimately, the provision of risk-stratified screening using genotyping raises fundamental questions about respective roles of individuals, healthcare providers and the state in organizing or mandating such programmes, and the principles, which underpin their provision, particularly the requirement for distributive justice. Conclusions The scope and breadth of these issues suggest that ELSI relating to risk-stratified screening will become increasingly important for policy-makers, healthcare professionals and a wide diversity of stakeholders. PMID:23986542

Guideline implementation strategies for specialist mental healthcare.

PubMed

Girlanda, Francesca; Fiedler, Ines; Ay, Esra; Barbui, Corrado; Koesters, Markus

2013-07-01

Clinical practice guidelines in mental healthcare are viewed as an essential asset if appropriately developed and implemented. The purpose of this article was to review the existing literature on how guidelines should be implemented to optimize their impact on provider performance and patient outcomes in specialist mental healthcare settings. Findings from recent studies suggest a trend toward an improvement in process and patient outcomes following guideline implementation. However, studies are heterogeneous in terms of design, implementation strategies and outcome measures, making it very difficult to draw firm conclusions about which implementation strategy is effective in different healthcare contexts. Current knowledge about how guidelines should be implemented is still sparse and inconclusive in mental healthcare. Future studies should attempt to employ more rigorous designs, including random allocation of patients or clusters of patients, to shed further light on this compelling issue. Research on guideline implementation strategies should additionally take into account potential barriers to knowledge translation, which can heavily influence the implementability of treatment recommendations.

Benefit-finding intervention for Alzheimer caregivers: conceptual framework, implementation issues, and preliminary efficacy.

PubMed

Cheng, Sheung-Tak; Lau, Rosanna W L; Mak, Emily P M; Ng, Natalie S S; Lam, Linda C W

2014-12-01

To describe an intervention promoting benefit-finding in Alzheimer caregivers, to discuss key issues in implementation and ways to resolve them, and to examine whether the intervention reduced burden and depression in a small randomized trial. Twenty-five caregivers were randomized into benefit-finding and psychoeducation groups. Both groups had eight weekly sessions. Outcome measures including role overload, Zarit Burden Interview, and Hamilton depression scale were collected at baseline and after treatment. Results were analyzed using analysis of covariance. Additionally, the challenges of implementing such interventions, some of which related to cultural issues, were analyzed qualitatively. Controlling for pretest, the benefit-finding group had lower depression than the psychoeducation group at post-test, despite the fact that some caregivers found benefit-finding challenging. The two groups did not differ on overload and burden. However, within-group analysis suggested that both groups showed significant reductions in overload from pretest to post-test. In addition, we discussed participants' difficulties in grasping the technique of thought modification for benefit-finding, recording such exercises at home, and sharing their thoughts and experiences in groups. We described measures undertaken in the main trial to overcome these issues. Cognitive approaches focusing on benefit-finding are feasible among Chinese caregivers, with preliminary evidence suggesting an effect on alleviating depression. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

General practice and the New Zealand health reforms – lessons for Australia?

PubMed Central

McAvoy, Brian R; Coster, Gregor D

2005-01-01

New Zealand's health sector has undergone three significant restructures within 10 years. The most recent has involved a Primary Health Care Strategy, launched in 2001. Primary Health Organisations (PHOs), administered by 21 District Health Boards, are the local structures for implementing the Primary Health Care Strategy. Ninety-three percent of the New Zealand population is now enrolled within 79 PHOs, which pose a challenge to the well-established Independent Practitioner Associations (IPAs). Although there was initial widespread support for the philosophy underlying the Primary Health Care Strategy, there are concerns amongst general practitioners (GPs) and their professional organisations relating to its implementation. These centre around 6 main issues: 1. Loss of autonomy 2. Inadequate management funding and support 3. Inconsistency and variations in contracting processes 4. Lack of publicity and advice around enrolment issues 5. Workforce and workload issues 6. Financial risks On the other hand, many GPs are feeling positive regarding the opportunities for PHOs, particularly for being involved in the provision of a wider range of community health services. Australia has much to learn from New Zealand's latest health sector and primary health care reforms. The key lessons concern: • the need for a national primary health care strategy • active engagement of general practitioners and their professional organisations • recognition of implementation costs • the need for infrastructural support, including information technology and quality systems • robust management and governance arrangements • issues related to critical mass and population/distance trade offs in service delivery models PMID:16262908

Community Mobilization and Readiness: Planning Flaws which Challenge Effective Implementation of 'Communities that Care' (CTC) Prevention System.

PubMed

Basic, Josipa

2015-01-01

This article reviews the experience of implementing a community approach to drug use and youth delinquency prevention based on the 'Communities that Care' (CTC) system implemented in one Croatian county consisting of 12 communities, 2002 to 2013 (Hawkins, 1999; Hawkins & Catalano, 2004). This overview explores selected critical issues which are often not considered in substance use(r) community intervention planning, implementation as well as in associated process and outcome assessments. These issues include, among others, the mobilization process of adequate representation of people; the involvement of relevant key individual and organizational stakeholders and being aware of the stakeholders' willingness to participate in the prevention process. In addition, it is important to be aware of the stakeholders' knowledge and perceptions about the 'problems' of drug use and youth delinquency in their communities as well as the characteristics of the targeted population(s). Sometimes there are community members and stakeholders who block needed change and therefore prevention process enablers and 'bridges' should be involved in moving prevention programming forward. Another barrier that is often overlooked in prevention planning is community readiness to change and a realistic assessment of available and accessible resources for initiating the planned change(s) and sustaining them. All of these issues have been found to be potentially related to intervention success. At the end of this article, I summarize perspectives from prevention scientists and practitioners and lessons learned from communities' readiness research and practice in Croatian that has international relevance.

Coaching: a different approach to the nursing dilemma.

PubMed

Stedman, Martha E; Nolan, Thomas L

2007-01-01

While the current nursing shortage continues, many new approaches from sign-on bonuses to "fast track training" are being suggested and implemented to ameliorate the situation. Yet, even with these expanded opportunities turnover is still too high. Recent studies suggest embedded factors called fit, links, and sacrifice exist between the employer and employees including nurses that account for current employees staying on their job. Creating a better understanding of embedded issues and creating an open but confidential environment to deal with conflict issues and job problems is suggested as a way to reduce turnover. A specific issue such as an unfavorable job assignment or more complex issues such as unmet expectations can cause conflict and job dissatisfaction. It is suggested that a coaching model can be used to understand the issues that create conflict and provide a method for resolution of job dissatisfaction.

Implementation of Epic Beaker Anatomic Pathology at an Academic Medical Center.

PubMed

Blau, John Larry; Wilford, Joseph D; Dane, Susan K; Karandikar, Nitin J; Fuller, Emily S; Jacobsmeier, Debbie J; Jans, Melissa A; Horning, Elisabeth A; Krasowski, Matthew D; Ford, Bradley A; Becker, Kent R; Beranek, Jeanine M; Robinson, Robert A

2017-01-01

Beaker is a relatively new laboratory information system (LIS) offered by Epic Systems Corporation as part of its suite of health-care software and bundled with its electronic medical record, EpicCare. It is divided into two modules, Beaker anatomic pathology (Beaker AP) and Beaker Clinical Pathology. In this report, we describe our experience implementing Beaker AP version 2014 at an academic medical center with a go-live date of October 2015. This report covers preimplementation preparations and challenges beginning in September 2014, issues discovered soon after go-live in October 2015, and some post go-live optimizations using data from meetings, debriefings, and the project closure document. We share specific issues that we encountered during implementation, including difficulties with the proposed frozen section workflow, developing a shared specimen source dictionary, and implementation of the standard Beaker workflow in large institution with trainees. We share specific strategies that we used to overcome these issues for a successful Beaker AP implementation. Several areas of the laboratory-required adaptation of the default Beaker build parameters to meet the needs of the workflow in a busy academic medical center. In a few areas, our laboratory was unable to use the Beaker functionality to support our workflow, and we have continued to use paper or have altered our workflow. In spite of several difficulties that required creative solutions before go-live, the implementation has been successful based on satisfaction surveys completed by pathologists and others who use the software. However, optimization of Beaker workflows has continued to be an ongoing process after go-live to the present time. The Beaker AP LIS can be successfully implemented at an academic medical center but requires significant forethought, creative adaptation, and continued shared management of the ongoing product by institutional and departmental information technology staff as well as laboratory managers to meet the needs of the laboratory.

Identifying the challenges and facilitators of implementing a COPD care bundle

PubMed Central

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Background Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. Methods An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Results Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Conclusions Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges. PMID:25478183

H-P adaptive methods for finite element analysis of aerothermal loads in high-speed flows

NASA Technical Reports Server (NTRS)

Chang, H. J.; Bass, J. M.; Tworzydlo, W.; Oden, J. T.

1993-01-01

The commitment to develop the National Aerospace Plane and Maneuvering Reentry Vehicles has generated resurgent interest in the technology required to design structures for hypersonic flight. The principal objective of this research and development effort has been to formulate and implement a new class of computational methodologies for accurately predicting fine scale phenomena associated with this class of problems. The initial focus of this effort was to develop optimal h-refinement and p-enrichment adaptive finite element methods which utilize a-posteriori estimates of the local errors to drive the adaptive methodology. Over the past year this work has specifically focused on two issues which are related to overall performance of a flow solver. These issues include the formulation and implementation (in two dimensions) of an implicit/explicit flow solver compatible with the hp-adaptive methodology, and the design and implementation of computational algorithm for automatically selecting optimal directions in which to enrich the mesh. These concepts and algorithms have been implemented in a two-dimensional finite element code and used to solve three hypersonic flow benchmark problems (Holden Mach 14.1, Edney shock on shock interaction Mach 8.03, and the viscous backstep Mach 4.08).

Preferred drug lists: potential impact on healthcare economics.

PubMed

Ovsag, Kimberly; Hydery, Sabrina; Mousa, Shaker A

2008-01-01

To analyze the implementation of Medicaid preferred drug lists (PDLs) in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare. We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included "drug lists," "prior authorization," "prior approval," and "Medicaid." We added terms such as "influence use of other healthcare services," "quality of care," and "overall economic impact." We mainly used primary sources. Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a) the potential for PDLs to influence the utilization of other healthcare services, (b) criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c) the effect of PDL implementation on compliance to new regimens, (d) the potential effects of restricting medication availability on quality of care, (e) administrative costs associated with PDLs, and (f) satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact. The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care.

Making Strategic Planning Work: Experiences from a Private University. AIR 1986 Annual Forum Paper.

ERIC Educational Resources Information Center

Chan, Susy S.

Issues in implementating strategic planning in higher education management are considered, along with successful strategies and problem areas in implementing an integrated planning and budgeting process at DePaul University, a comprehensive Catholic university. Key implementation issues are as follows: (1) maintaining an organizational balance…

Fluor Daniel Hanford implementation plan for DOE Order 5480.28, Natural phenomena hazards mitigation

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

Conrads, T.J.

1997-09-12

Natural phenomena hazards (NPH) are unexpected acts of nature that pose a threat or danger to workers, the public, or the environment. Earthquakes, extreme winds (hurricane and tornado), snow, flooding, volcanic ashfall, and lightning strikes are examples of NPH that could occur at the Hanford Site. U.S. Department of Energy (DOE) policy requires facilities to be designed, constructed, and operated in a manner that protects workers, the public, and the environment from hazards caused by natural phenomena. DOE Order 5480.28, Natural Phenomena Hazards Mitigation, includes rigorous new natural phenomena criteria for the design of new DOE facilities, as well asmore » for the evaluation and, if necessary, upgrade of existing DOE facilities. The Order was transmitted to Westinghouse Hanford Company in 1993 for compliance and is also identified in the Project Hanford Management Contract, Section J, Appendix C. Criteria and requirements of DOE Order 5480.28 are included in five standards, the last of which, DOE-STD-1023, was released in fiscal year 1996. Because the Order was released before all of its required standards were released, enforcement of the Order was waived pending release of the last standard and determination of an in-force date by DOE Richland Operations Office (DOE-RL). Agreement also was reached between the Management and Operations Contractor and DOE-RL that the Order would become enforceable for new structures, systems, and components (SSCS) 60 days following issue of a new order-based design criteria in HNF-PRO-97, Engineering Design and Evaluation. The order also requires that commitments addressing existing SSCs be included in an implementation plan that is to be issued 1 year following the release of the last standard. Subsequently, WHC-SP-1175, Westinghouse Hanford Company Implementation Plan for DOE Order 5480.28, Natural Phenomena Hazards Mitigation, Rev. 0, was issued in November 1996, and this document, HNF-SP-1175, Fluor Daniel Hanford Implementation Plan for DOE Order 5480.28, Natural Phenomena Hazards Mitigation, is Rev. 1 of that plan.« less

Defining Safety in the Nursing Home Setting: Implications for Future Research.

PubMed

Simmons, Sandra F; Schnelle, John F; Sathe, Nila A; Slagle, Jason M; Stevenson, David G; Carlo, Maria E; McPheeters, Melissa L

2016-06-01

Currently, the Agency for Healthcare Research and Quality (AHRQ) Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to safety in the NH setting to inform a research agenda. Thirty-six recent systematic reviews evaluated NH safety-related interventions to address these 4 adverse events and reported mostly mixed evidence about effective approaches to ameliorate them. Furthermore, these 4 events are likely inadequate to capture safety issues that are unique to the NH setting and encompass other domains related to residents' quality of care and quality of life. Future research needs include expanding our definition of safety in the NH setting, which differs considerably from that of hospitals, to include contributing factors to adverse events as well as more resident-centered care measures. Second, future research should reflect more rigorous implementation science to include objective measures of care processes related to adverse events, intervention fidelity, and staffing resources for intervention implementation to inform broader uptake of efficacious interventions. Weaknesses in implementation contribute to the current inconclusive and mixed evidence base as well as remaining questions about what outcomes are even achievable in the NH setting, given the complexity of most resident populations. Also related to implementation, future research should determine the effects of specific staffing models on care processes related to safety outcomes. Last, future efforts should explore the potential for safety issues in other care settings for older adults, most notably dementia care within assisted living. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

Implementing new care models: learning from the Greater Manchester demonstrator pilot experience.

PubMed

Elvey, Rebecca; Bailey, Simon; Checkland, Kath; McBride, Anne; Parkin, Stephen; Rothwell, Katy; Hodgson, Damian

2018-06-19

Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additional availability' appointments during evenings and at weekends. In Greater Manchester, six 'demonstrator sites' were funded: four sites delivered additional availability appointments, other services included case management and rapid response. The aim of this paper is to explore the factors influencing the implementation of services within a programme designed to improve access to primary care. The paper consists of a qualitative process evaluation undertaken within provider organisations, including general practices, hospitals and care homes. Semi-structured interviews, with the data subjected to thematic analysis. Ninety-one people participated in interviews. Six key factors were identified as important for the establishment and running of the demonstrators: information technology; information governance; workforce and organisational development; communications and engagement; supporting infrastructure; federations and alliances. These factors brought to light challenges in the attempt to provide new or modify existing services. Underpinning all factors was the issue of trust; there was consensus amongst our participants that trusting relationships, particularly between general practices, were vital for collaboration. It was also crucial that general practices trusted in the integrity of anyone external who was to work with the practice, particularly if they were to access data on the practice computer system. A dialogical approach was required, which enabled staff to see themselves as active rather than passive participants. The research highlights various challenges presented by the context within which extended access is implemented. Trust was the fundamental underlying issue; there was consensus amongst participants that trusting relationships were vital for effective collaboration in primary care.

Effects of the Clean Power Plan

EIA Publications

2016-01-01

This report, the first of six Issue in Focus articles from the Annual Energy Outlook 2016, analyzes possible impacts of the U.S. Environmental Protection Agency’s Clean Power Plan (CPP). Cases analyzed include alternative approaches to implementation of the CPP and the impact of extension of the program beyond 2030. Results include effects on CO2 emissions, electricity capacity expansion and retirements, generation fuel mix, electricity prices, and regional impacts.

The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: adoption rate, challenges and strategies for effective implementation into surgical residency programs.

PubMed

Korndorffer, James R; Arora, Sonal; Sevdalis, Nick; Paige, John; McClusky, David A; Stefanidis, Dimitris

2013-07-01

The American College of Surgeons/Association of Program Directors in Surgery (ACS/APDS) National Skills Curriculum is a 3-phase program targeting technical and nontechnical skills development. Few data exist regarding the adoption of this curriculum by surgical residencies. This study attempted to determine the rate of uptake and identify implementation enablers/barriers. A web-based survey was developed by an international expert panel of surgical educators (5 surgeons and 1 psychologist). After piloting, the survey was sent to all general surgery program directors via email link. Descriptive statistics were used to determine the residency program characteristics and perceptions of the curriculum. Implementation rates for each phase and module were calculated. Adoption barriers were identified quantitatively and qualitatively using free text responses. Standardized qualitative methodology of emergent theme analysis was used to identify strategies for success and details of support required for implementation. Of the 238 program directors approached, 117 (49%) responded to the survey. Twenty-one percent (25/117) were unaware of the ACS/APDS curriculum. Implementation rates for were 36% for phase I, 19% for phase II, and 16% for phase III. The most common modules adopted were the suturing, knot-tying, and chest tube modules of phase I. Over 50% of respondents identified lack of faculty protected time, limited personnel, significant costs, and resident work-hour restrictions as major obstacles to implementation. Strategies for effective uptake included faculty incentives, adequate funding, administrative support, and dedicated time and resources. Despite the availability of a comprehensive curriculum, its diffusion into general surgery residency programs remains low. Obstacles related to successful implementation include personnel, learner, and administrative issues. Addressing these issues may improve the adoption rate of the curriculum. Copyright © 2013 Mosby, Inc. All rights reserved.

Implementing the NHS information technology programme: qualitative study of progress in acute trusts.

PubMed

Hendy, Jane; Fulop, Naomi; Reeves, Barnaby C; Hutchings, Andrew; Collin, Simon

2007-06-30

To describe progress and perceived challenges in implementing the NHS information and technology (IT) programme in England. Case studies and in-depth interviews, with themes identified using a framework developed from grounded theory. We interviewed personnel who had been interviewed 18 months earlier, or new personnel in the same posts. Four NHS acute hospital trusts in England. Senior trust managers and clinicians, including chief executives, directors of IT, medical directors, and directors of nursing. Interviewees unreservedly supported the goals of the programme but had several serious concerns. As before, implementation is hampered by local financial deficits, delays in implementing patient administration systems that are compliant with the programme, and poor communication between Connecting for Health (the agency responsible for the programme) and local managers. New issues were raised. Local managers cannot prioritise implementing the programme because of competing financial priorities and uncertainties about the programme. They perceive a growing risk to patients' safety associated with delays and a loss of integration of components of the programme, and are discontented with Choose and Book (electronic booking for referrals from primary care). We recommend that the programme sets realistic timetables for individual trusts and advises managers about interim IT systems they have to purchase because of delays outside their control. Advice needs to be mindful of the need for trusts to ensure longer term compatibility with the programme and value for money. Trusts need assistance in prioritising modernisation of IT by, for example, including implementation of the programme in the performance management framework. Even with Connecting for Health adopting a different approach of setting central standards with local implementation, these issues will still need to be addressed. Lessons learnt in the NHS have wider relevance as healthcare systems, such as in France and Australia, look to realise the potential of large scale IT modernisation.

USMC Ground Surveillance Robot (GSR): Lessons Learned

NASA Astrophysics Data System (ADS)

Harmon, S. Y.

1987-02-01

This paper describes the design of an autonomous vehicle and the lessons learned during the implementation of that complex robot. The major problems encountered to which solutions were found include sensor processing bandwidth limitations, coordination of the interactions between major subsystems, sensor data fusion and system knowledge representation. Those problems remaining unresolved include system complexity management, the lack of powerful system monitoring and debugging tools, exploratory implementation of a complex system and safety and testing issues. Many of these problems arose from working with underdeveloped and continuously evolving technology and will probably be resolved as the technological resources mature and stabilize. Unfortunately, other problems will continue to plague developers throughout the evolution of autonomous system technology.

Stakeholder views on pharmacogenomic testing.

PubMed

Patel, Haridarshan N; Ursan, Iulia D; Zueger, Patrick M; Cavallari, Larisa H; Pickard, A Simon

2014-02-01

Pharmacogenomics has an important role in the evolution of personalized medicine, and its widespread uptake may ultimately depend on the interests and perspectives of key players in health care. Our aim was to summarize studies on stakeholder perspectives and attitudes toward pharmacogenomic testing. Thus, we conducted a review of original research studies that reported stakeholder views on pharmacogenomic testing using a structured approach in PubMed, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and EMBASE. A standardized data abstraction form was developed that included stakeholder group of interest-patients, general public, providers, and payers. Stakeholder views regarding barriers to pharmacogenetic implementation were organized into the following themes: ancillary information-related, clinical, economic, educational, ethical or legal, medical mistrust, and practicality. Of 34 studies that met our inclusion criteria, 37 perspectives were reported (15 on providers, 9 on the general public, 9 on patients, and 4 on payers). The most common topics that arose in studies of providers related to clinical usefulness of genetic data (n=11) and educational needs (n=11). Among the general public, the most common concerns were medical mistrust (n=5), insufficient education (n=5), and practicality (n=5). The most prevalent issues from the patient perspective were ethical or legal (n=6) and economic (n=5) issues. Among payers, leading issues were practicality (n=4) and clinical usefulness (n=3). There was overlap in the topics and concerns across stakeholder perspectives, including lack of knowledge about pharmacogenomic testing. Views on issues related to privacy, cost, and test result dissemination varied by stakeholder perspective. Limited research had been conducted in underrepresented groups. Efforts to address the issues raised by stakeholders may facilitate the implementation of pharmacogenomic testing into clinical practice. © 2013 American College of Clinical Pharmacy.

The Unanticipated Challenges Associated With Implementing an Observational Study Protocol in a Large-Scale Physical Activity and Global Positioning System Data Collection

PubMed Central

Walker, David; Ellaway, Anne

2018-01-01

Background Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. Objectives In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. Methods The SPACES (Studying Physical Activity in Children’s Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. Results Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through letterboxes, as well as the employment of fieldworkers to increase recruitment and the return of consent forms. Finally, we encountered data issues when processing physical activity and GPS data that had been initiated across daylight saving time. Conclusions We present learning points and recommendations that may benefit future studies of similar methodology in their early stages of development. PMID:29712624

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

PubMed

Duran, Antonio; Kutzin, Joseph; Menabde, Nata

2014-02-01

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

High-κ/Metal Gate Science and Technology

NASA Astrophysics Data System (ADS)

Guha, Supratik; Narayanan, Vijay

2009-08-01

High-κ/metal gate technology is on the verge of replacing conventional oxynitride dielectrics in state-of-the-art transistors for both high-performance and low-power applications. In this review we discuss some of the key materials issues that complicated the introduction of high-κ dielectrics, including reduced electron mobility, oxygen-based thermal instabilities, and the absence of thermally stable dual-metal electrodes. We show that through a combination of materials innovations and engineering ingenuity these issues were successfully overcome, thereby paving the way for high-κ/metal gate implementation.

TUTORIAL: Validating biorobotic models

NASA Astrophysics Data System (ADS)

Webb, Barbara

2006-09-01

Some issues in neuroscience can be addressed by building robot models of biological sensorimotor systems. What we can conclude from building models or simulations, however, is determined by a number of factors in addition to the central hypothesis we intend to test. These include the way in which the hypothesis is represented and implemented in simulation, how the simulation output is interpreted, how it is compared to the behaviour of the biological system, and the conditions under which it is tested. These issues will be illustrated by discussing a series of robot models of cricket phonotaxis behaviour. .

Pervasive Sensing: Addressing the Heterogeneity Problem

NASA Astrophysics Data System (ADS)

O'Grady, Michael J.; Murdoch, Olga; Kroon, Barnard; Lillis, David; Carr, Dominic; Collier, Rem W.; O'Hare, Gregory M. P.

2013-06-01

Pervasive sensing is characterized by heterogeneity across a number of dimensions. This raises significant problems for those designing, implementing and deploying sensor networks, irrespective of application domain. Such problems include for example, issues of data provenance and integrity, security, and privacy amongst others. Thus engineering a network that is fit-for-purpose represents a significant challenge. In this paper, the issue of heterogeneity is explored from the perspective of those who seek to harness a pervasive sensing element in their applications. A initial solution is proposed based on the middleware construct.

Responses to Issues Raised by Industry on Clean Air Act Implementation Reform

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Nurturing a growing field: Computers & Geosciences

NASA Astrophysics Data System (ADS)

Mariethoz, Gregoire; Pebesma, Edzer

2017-10-01

Computational issues are becoming increasingly critical for virtually all fields of geoscience. This includes the development of improved algorithms and models, strategies for implementing high-performance computing, or the management and visualization of the large datasets provided by an ever-growing number of environmental sensors. Such issues are central to scientific fields as diverse as geological modeling, Earth observation, geophysics or climatology, to name just a few. Related computational advances, across a range of geoscience disciplines, are the core focus of Computers & Geosciences, which is thus a truly multidisciplinary journal.

Key Policy Issues in the Implementation of User Choice. Working Paper No. 8.

ERIC Educational Resources Information Center

Smith, Joy Selby; Smith, Chris Selby; Ferrier, Fran

This working paper examines key policy issues in the implementation of Australia's User Choice policy regarding allocating public funds for vocational education and training (VET). Part 1 explains the process used to obtain stakeholders regarding the User Choice policy, the administrative arrangements required to support it, and issues that must…

Challenges Faced by Teachers Implementing Socio-Scientific Issues as Core Elements in Their Classroom Practices

ERIC Educational Resources Information Center

Bossér, Ulrika; Lundin, Mattias; Lindahl, Mats; Linder, Cedric

2015-01-01

Teachers may face considerable challenges when implementing socio-scientific issues (SSI) in their classroom practices, such as incorporating student-centred teaching practices and exploring knowledge and values in the context of socioscientific issues. This year-long study explores teachers' reflections on the process of developing their…

Human Resource Development Issues in the Implementation of the Western China Development Strategy

ERIC Educational Resources Information Center

Xiao, Mingzheng

2007-01-01

This paper systematically illustrates the value and role of human resource development in the implementation of the Western China development strategy. It analyzes in details some current human resource issues constraining the implementation of the Western China development strategy and those on the sustainable development process of economic…

A Framework for Identifying Implementation Issues Affecting Extension Human Sciences Programming

ERIC Educational Resources Information Center

Abell, Ellen; Cummings, Rebekah; Duke, Adrienne M.; Marshall, Jennifer Wells

2015-01-01

Extension programs based on identified needs, relevant theory, and solid research too often fail to realize their objectives. Program implementation is acknowledged to contribute to program effectiveness, yet systematic attention has not been paid to the array of implementation issues that can complicate achieving program goals. We developed the…

A Required Online Course with a Public Health Focus for Third Professional Year Pharmacy Students.

PubMed

King, Amber E; Egras, Amy M

2015-06-25

To design, deliver, and evaluate the impact of a required course on student knowledge acquisition and ability to evaluate contemporary public health issues. A 2-credit course was implemented using asynchronous, online delivery. Learning activities included literature retrieval and assessment, analytic writing, quizzes, and creation of a group wiki evaluating a current public health issue. Course topics included health care reform, social determinants of health, health disparities, evidence-based medicine, end-of-life care, patient safety, and research ethics. Strong student performance on assessments indicated an ability to use higher-order cognitive domains. Online delivery provided students with the flexibility to complete assignments at their convenience, allowed participation by all students, and encouraged self-directed learning. Completion of a required, online, asynchronous course with a public health focus allowed pharmacy students to increase their knowledge of and ability to evaluate contemporary ethical, social, cultural, and governmental issues affecting pharmacy practice.

75 FR 439 - Glen Canyon Dam Adaptive Management Work Group (AMWG)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... Canyon Dam Adaptive Management Program (AMP) was implemented as a result of the Record of Decision on the... of the Grand Canyon Protection Act (Pub. L. 102-575) of 1992. The AMP includes a Federal advisory... addition, other administrative and resource issues pertaining to the AMP may be discussed as necessary. To...

Iterative Purification and Effect Size Use with Logistic Regression for Differential Item Functioning Detection

ERIC Educational Resources Information Center

French, Brian F.; Maller, Susan J.

2007-01-01

Two unresolved implementation issues with logistic regression (LR) for differential item functioning (DIF) detection include ability purification and effect size use. Purification is suggested to control inaccuracies in DIF detection as a result of DIF items in the ability estimate. Additionally, effect size use may be beneficial in controlling…

Project-Based Pedagogy for the Facilitation of Webpage Design

ERIC Educational Resources Information Center

Jakovljevic, Maria; Ankiewicz, Piet

2016-01-01

Real issues of web design and development include many problem-solving tasks. There are, however, some inadequacies associated with the implementation of appropriate pedagogy for organised and structured instruction that supports the rational problem-solving paradigm. The purpose of this article is to report on a study for the design and…

Planning for Computer-Based Distance Education: A Review of Administrative Issues.

ERIC Educational Resources Information Center

Lever-Duffy, Judy C.

The Homestead Campus of Miami-Dade Community College, in Florida, serves a sparsely populated area with a culturally diverse population including migrant farm workers, prison inmates, and U.S. Air Force personnel. To increase access to college services, the campus focused on implementing a computer-based distance education program as its primary…

20 CFR 632.22 - Modification of a Comprehensive Annual Plan (CAP) and/or Master Plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (CAP) and/or Master Plan. 632.22 Section 632.22 Employees' Benefits EMPLOYMENT AND TRAINING... Master Plan. (a) The requirements for modifying a Master Plan and/or CAP will be included in administrative instructions issued by the Grant Officer upon final implementation of the Master Plan/CAP system...

20 CFR 632.22 - Modification of a Comprehensive Annual Plan (CAP) and/or Master Plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (CAP) and/or Master Plan. 632.22 Section 632.22 Employees' Benefits EMPLOYMENT AND TRAINING... Master Plan. (a) The requirements for modifying a Master Plan and/or CAP will be included in administrative instructions issued by the Grant Officer upon final implementation of the Master Plan/CAP system...

The Changing Context for Sign Bilingual Education Programs: Issues in Language and the Development of Literacy

ERIC Educational Resources Information Center

Mayer, Connie; Leigh, Greg

2010-01-01

The widespread implementation of newborn hearing screening and advances in amplification technologies (including cochlear implants) have fundamentally changed the educational landscape for deaf learners. These changes are discussed in terms of their impact on sign bilingual education programs with a focus on the relationships between language and…

77 FR 44198 - Approval and Promulgation of Implementation Plans; State of Florida: New Source Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-27

....e., lung disease, decreased lung function asthma attacks and certain cardiovascular issues... with heart and lung diseases. For more details regarding health effects and PM 2.5 see EPA's Web site...'' and ``minor source baseline date'' (including trigger dates) to establish the PM 2.5 NAAQS specific...

Sand Trap: The Military and the Media during the Persian Gulf War. Symposium Issue.

ERIC Educational Resources Information Center

Katz, Steven L.; And Others

1992-01-01

Five articles discuss the military-media relationship during the Persian Gulf War. Highlights include the development and implementation of the Pentagon's press policy; concerns of the media and military public affairs officers; first person accounts by journalists and a public affairs officer; and First Amendment principles. (29 references) (LRW)

The Kamusi Project Edit Engine: A Tool for Collaborative Lexicography.

ERIC Educational Resources Information Center

Benjamin, Martin; Biersteker, Ann

2001-01-01

Discusses the design and implementation of the Kamusi Project Edit Engine, a Web-based software system uniquely suited to the needs of Swahili collaborative lexicography. Describes the edit engine, including organization of the lexicon and the mechanics by which participants use the system, discusses philosophical issues confronted in the design,…

Plan well, plan often

Treesearch

Bill Block

2013-01-01

This issue includes an invited paper by Courtney Schultz and her colleagues commenting on the application of the newly adopted U.S. Forest Service Planning Rule (hereafter, the rule) for wildlife. The rule is basically implementing language to interpret the spirit and intent of the National Forest Management Act (NFMA) of 1976. Laws such as NFMA require additional...

Flexible Learning, Human Resource and Organisational Development: Putting Theory To Work.

ERIC Educational Resources Information Center

Jakupec, Viktor, Ed.; Garrick, John, Ed.

This book addresses contemporary contexts of flexible learning and its practices and provides insights about directions that education and training providers may be required to follow to implement flexible learning in a variety of settings. Key issues and debates include the following: social and economic dimensions of flexible learning and…

Two-Phase Item Selection Procedure for Flexible Content Balancing in CAT

ERIC Educational Resources Information Center

Cheng, Ying; Chang, Hua-Hua; Yi, Qing

2007-01-01

Content balancing is an important issue in the design and implementation of computerized adaptive testing (CAT). Content-balancing techniques that have been applied in fixed content balancing, where the number of items from each content area is fixed, include constrained CAT (CCAT), the modified multinomial model (MMM), modified constrained CAT…

Special Education History, Current Status and Future: India

ERIC Educational Resources Information Center

Antony, Pavan John

2013-01-01

Education of all children in public schools, including those with disabilities, continues to be an unresolved issue in many countries around the globe. While education of all children is mandated by law and considered a basic human right in many countries, the current status of implementation varies. India, for example, is an ancient country that…

Assessing the Impact of Planned Social Change. Occasional Paper Series, #8.

ERIC Educational Resources Information Center

Campbell, Donald T.

Program impact methodology--usually referred to as evaluation research--is described as it is developing in the United States. Several problems face the field of evaluation research. First, those issues grouped as "meta-scientific" include: (1) the distinction between qualitative and quantitative studies; (2) the separation of implementation and…

Help Central: Creating a Help Desk and Knowledge Portal in SharePoint

ERIC Educational Resources Information Center

Ennis, Lisa A.; Tims, Randy S.

2012-01-01

This article discusses the authors' implementation of Help Central, a site within the Lister Hill Library Collection on the University of Alabama-Birmingham's SharePoint server. Initially, Help Central was designed to address the inadequacies in the library's old, static HTML web-based support system, including haphazard issue reporting by staff…

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 8: Academic Computing and Libraries.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Eight papers are presented from the 1995 CAUSE conference track on academic computing and library issues faced by managers of information technology at colleges and universities. The papers include: (1) "Where's the Beef?: Implementation of Discipline-Specific Training on Internet Resources" (Priscilla Hancock and others); (2)…

The Importance of Technology in the Education and Training of Persons with Mental Retardation.

ERIC Educational Resources Information Center

Parette, Howard P., Jr.

1991-01-01

This paper examines issues related to implementation of Public Law 100-407, the Technology-Related Assistance for Individuals with Disabilities Act of 1988, including the meaning of technology, the need for information systems, funding mechanisms, transportation needs, technology evaluation, hands-on experiences before purchasing, and training…

Improving Finance for Qatari Education Reform. Research Brief

ERIC Educational Resources Information Center

Guarino, Cassandra M.; Galama, Titus; Constant, Louay; Gonzalez, Gabriella; Tanner, Jeffery C.; Goldman, Charles A.

2009-01-01

Qatar's education reform, which included implementation of a new finance system, appears to be providing schools with adequate funding but is still struggling with issues of transparency and swift policy shifts that have been difficult to accommodate. [For full report, "Developing a School Finance System for K-12 Reform in Qatar", see…

Research gaps: adaptive management to cross-cutting issues

Treesearch

Jonathan W. Long; Carl Skinner; Malcolm North; Lenya Quinn-Davidson

2014-01-01

A number of studies undertaken by the Forest Service within the synthesis area have been designed and implemented to better understand both more immediate and long-term effects of treatments, including the Blacks Mountain Ecological Research Project (Oliver 2000); Goosenest Adaptive Management Area Project (Ritchie 2005); Long-Term Soil Productivity Study (Powers 2006...

A Case Study of the Implementation of Chinese Kindergarten Mathematics Curriculum

ERIC Educational Resources Information Center

Hu, Bi Ying; Fuentes, Sarah Quebec; Wang, Chun Yan; Ye, Feiwei

2014-01-01

In 2001, the Chinese Ministry of Education issued Guidelines for Preschool Education (GPE) (trial version) to call on early childhood practitioners to use a child-centered and play-based approach to teaching and learning. The guidelines also include mathematics within the science domain and described its standards in a way that significantly…

PBTE (Performance-Based Teacher Education); Vol 2, No, 2, May 1973.

ERIC Educational Resources Information Center

Andrews, Theodore E., Ed.

This issue of the Multi-State Consortium for Performance-Based Teacher Education (PBTE) newsletter discusses (1) the evolutionary approach adopted by the state of Minnesota toward the implementation of PBTE, which includes discussion of what is known about PBTE, whether Minnesota ought (or wishes) to adopt the program, and state participation in…

Authentic and Self-Directed Learning in Vocational Education: Challenges to Vocational Educators

ERIC Educational Resources Information Center

de Bruijn, Elly; Leeman, Yvonne

2011-01-01

This article analyses the dilemmas and practical tensions in implementing competence-based vocational education. Eleven case studies were conducted, including observation of lessons and interviews with teachers and students. The results show that schools meet various fundamental issues in realising this approach. A crucial question is how to…

Changes and Challenges: Key Issues for Scottish Rural Schools and Communities

ERIC Educational Resources Information Center

Dowling, Jennie

2009-01-01

Education in rural Scottish schools has changed rapidly over the past 15 years. These changes include the implementation of national curriculum and assessment guidelines, increased parental influence and a shift from local authority based management to more locally based schemes. During the 1990s, research in the field focused largely on learning…

Psychiatry and psychotherapy as political processes.

PubMed

Breggin, P R

1975-07-01

Therapy is applied politics. From hospitalizing a patient to offering psychoanalytic insight, a therapist's every action reflects his own attitudes toward political issues, including individual freedom vs. state control, or capitalism versus socialism. Ultimately every therapy implements some utopian political vision against which the client will measure his own success and failure in the therapy.

Financial Awareness Education with Apprentices in the Australian Construction Industry: Program Evaluation

ERIC Educational Resources Information Center

Du Plessis, Karin; Green, Emma

2013-01-01

A financial awareness education program was implemented with construction industry apprentices in Victoria, Australia. The program included face-to-face delivery of education around a range of financial management issues that apprentices face as they begin their apprenticeship. The paper reports on an evaluation of the program, which included…

Moving towards Effective English Language Teaching in Japan: Issues and Challenges

ERIC Educational Resources Information Center

Sakamoto, Mitsuyo

2012-01-01

Compared with other countries in Asia, Japan is far behind in terms of introducing and delivering bilingual education, let alone effective immersion programmes. In order to make its citizens more bilingual, Japan has been introducing innovative measures including the implementation of the teaching of English in elementary education and a new…

The UARS (Upper Atmosphere Research Satellite): A program to study global ozone change

NASA Technical Reports Server (NTRS)

1989-01-01

NASA's Upper Atmosphere Research Satellite (UARS) program, its goals and objectives are described. Also included are its significance to upper atmosphere science, the experimental and theoretical investigations that comprise it, and the compelling issues of global change, driven by human activities, that led NASA to plan and implement it.

Proposal for Implementing Multi-User Database (MUD) Technology in an Academic Library.

ERIC Educational Resources Information Center

Filby, A. M. Iliana

1996-01-01

Explores the use of MOO (multi-user object oriented) virtual environments in academic libraries to enhance reference services. Highlights include the development of multi-user database (MUD) technology from gaming to non-recreational settings; programming issues; collaborative MOOs; MOOs as distinguished from other types of virtual reality; audio…

76 FR 39132 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... NRC action to submit an information collection request to the Office of Management and Budget (OMB... authorizes agencies to issue regulations to implement FAR policies and procedures internally and to include... quality, utility, and clarity of the information to be collected? 4. How can the burden of the information...

Mileage-based user fees : defining a path toward implementation phase 2, an assessment of technology issues : final report

DOT National Transportation Integrated Search

2009-10-01

This report reviews technology options for a mileage-based user fee system in the state of Texas. The report was : compiled based on input from a diverse range of sources, including a literature review of existing mileage-based : user fee technical w...

Designing and Implementing the First Environmental and Science Journalism Course for an Uzbekistan Journalism School

ERIC Educational Resources Information Center

Freedman, Eric

2004-01-01

Uzbekistan faces severe ecological problems including the rapidly shrinking Aral Sea, desertification, residues of biochemical weapons, and environmentally related respiratory disease. Even so, the country's print and broadcast media do little in-depth or analytical reporting on environmental issues, nor are journalists trained to cover such…

Issues in Assessment: Implementation.

ERIC Educational Resources Information Center

Malinowski, Patricia A., Ed.

This collection of articles is the third in a series on assessment produced by Finger Lakes Community College (New York). It deals with classroom assessment as an ongoing process that can be of significant value to teachers as well as to students. Assessment at the college and assessment in the classroom in general are explored. Articles include:…

Active Supervision, Precorrection, and Explicit Timing: A High School Case Study on Classroom Behavior

ERIC Educational Resources Information Center

Haydon, Todd; Kroeger, Stephen D.

2016-01-01

One proactive approach to increasing student engagement in schools is implementing Positive Behavior Intervention and Support (PBIS) strategies. PBIS focuses on prevention and concentrates on quality-of-life issues that include improved academic achievement, enhanced social competence, and safe learning and teaching environments. This study is a…

Efficiency, Accountability, and Equity Issues in Title I Schoolwide Program Implementation. Research in Educational Productivity.

ERIC Educational Resources Information Center

Wong, Kenneth K., Ed.; Wang, Margaret C., Ed.

This collection of conference papers includes: (1) "Using Market Forces to Make Title I More Effective" (Marci Kanstoroom and Tyce Palmaffy); (2) "Making Economically Grounded Decisions about Comprehensive School Reform Models: Considerations of Costs, Effects, and Contexts" (Jennifer King Rice); (3) "Does Title I Money…

Developing a novel Poverty in Healthcare curriculum for medical students at the University of Michigan Medical School.

PubMed

Doran, Kelly M; Kirley, Katherine; Barnosky, Andrew R; Williams, Joy C; Cheng, Jason E

2008-01-01

Nearly 90 million Americans live below 200% of the federal poverty threshold. The links between lower socioeconomic status and poor health are clear, and all physicians face the resulting challenges in patient care. Current medical school curricula do not adequately prepare students to address this issue despite recommendations from the Association of American Medical Colleges and the Institute of Medicine. In response, students and faculty at the University of Michigan Medical Center established the Poverty in Healthcare curriculum, which encompasses required learning experiences spanning all four years of undergraduate medical education. This article describes the design and implementation of this curriculum. The authors provide thorough descriptions of the individual learning experiences, including community site visits, longitudinal cases, mini-electives, and family centered experiences. The authors also discuss the history, costs, challenges, and evaluation process related to the Poverty in Healthcare curriculum, including issues specifically related to medical students' involvement in developing and implementing the curriculum. This information may be used as a guide for other medical schools in the development of curricula to address this current gap in medical student education.

Supportive and palliative care for patients with chronic mental illness including dementia.

PubMed

Lloyd-Williams, Mari; Abba, Katharine; Crowther, Jacqueline

2014-09-01

People with preexisting mental illness are known to have difficulty accessing healthcare services including palliative care and people with dementia have similar issues accessing palliative care. The review addressed the time period from January 2013 to March 2014. There were few articles addressing issues for palliative and supportive care for patients with preexisting mental health issues. The main factor that would improve care is interdisciplinary working between mental healthcare teams and palliative care teams. In contrast, there were many published articles on the palliative and supportive care needs for people with dementia. These articles included consensus statements, models of care; studies of why models of care, for example Advanced Care Planning were not being implemented; and carer reports of care in the last year of life. Urgent research is required as to how support for people with preexisting mental illness who require palliative care can be improved--excellent liaison between mental health and palliative care teams is essential. There is much research on palliative care needs for people with dementia but an apparent lack of innovative approaches to care including care of people within their family home.

The Virtual Orchestra: Technical and Creative Issues

NASA Astrophysics Data System (ADS)

BIANCHI, F. W.; CAMPBELL, R. H.

2000-04-01

The interactive multi-channel computer music system known as the Virtual Orchestra has been used several times in professional opera and theater as an alternative to a live pit orchestra. The technical issues associated with this emerging technology, and the logistical problems of implementing it are discussed. In addition, this paper describes the equally important issues regarding the creative impact this will have on the industry. In particular, this paper explores the role of the musician/technologist and suggests that many of the fundamental premises of opera production will change as the industry begins to retool. This would include the way opera is rehearsed and performed, how it is created and disseminated, and how it will adjust to changing demographics.

Micro sensor node for air pollutant monitoring: hardware and software issues.

PubMed

Choi, Sukwon; Kim, Nakyoung; Cha, Hojung; Ha, Rhan

2009-01-01

Wireless sensor networks equipped with various gas sensors have been actively used for air quality monitoring. Previous studies have typically explored system issues that include middleware or networking performance, but most research has barely considered the details of the hardware and software of the sensor node itself. In this paper, we focus on the design and implementation of a sensor board for air pollutant monitoring applications. Several hardware and software issues are discussed to explore the possibilities of a practical WSN-based air pollution monitoring system. Through extensive experiments and evaluation, we have determined the various characteristics of the gas sensors and their practical implications for air pollutant monitoring systems.

Integration of micro-/nano-/quantum-scale photonic devices: scientific and technological considerations

NASA Astrophysics Data System (ADS)

Lee, El-Hang; Lee, Seung-Gol; O, Beom Hoan; Park, Se Geun

2004-08-01

Scientific and technological issues and considerations regarding the integration of miniaturized microphotonic devices, circuits and systems in micron, submicron, and quantum scale, are presented. First, we examine the issues regarding the miniaturization of photonic devices including the size effect, proximity effect, energy confinement effect, microcavity effect, optical and quantum interference effect, high field effect, nonlinear effect, noise effect, quantum optical effect, and chaotic effect. Secondly, we examine the issues regarding the interconnection including the optical alignment, minimizing the interconnection losses, and maintaining optical modes. Thirdly, we address the issues regarding the two-dimensional or three-dimensional integration either in a hybrid format or in a monolithic format between active devices and passive devices of varying functions. We find that the concept of optical printed circuit board (O-PCB) that we propose is highly attractive as a platform for micro/nano/quantum-scale photonic integration. We examine the technological issues to be addressed in the process of fabrication, characterization, and packaging for actual implementation of the miniaturization, interconnection and integration. Devices that we have used for our study include: mode conversion schemes, micro-ring and micro-racetrack resonator devices, multimode interference devices, lasers, vertical cavity surface emitting microlasers, and their arrays. Future prospects are also discussed.

Implementation of heaters on thermally actuated spacecraft mechanisms

NASA Technical Reports Server (NTRS)

Busch, John D.; Bokaie, Michael D.

1994-01-01

This paper presents general insight into the design and implementation of heaters as used in actuating mechanisms for spacecraft. Problems and considerations that were encountered during development of the Deep Space Probe and Science Experiment (DSPSE) solar array release mechanism are discussed. Obstacles included large expected fluctuations in ambient temperature, variations in voltage supply levels outgassing concerns, heater circuit design, materials selection, and power control options. Successful resolution of these issues helped to establish a methodology which can be applied to many of the heater design challenges found in thermally actuated mechanisms.

Information Security Management (ISM)

NASA Astrophysics Data System (ADS)

Šalgovičová, Jarmila; Prajová, Vanessa

2012-12-01

Currently, all organizations have to tackle the issue of information security. The paper deals with various aspects of Information Security Management (ISM), including procedures, processes, organizational structures, policies and control processes. Introduction of Information Security Management should be a strategic decision. The concept and implementation of Information Security Management in an organization are determined by the corporate needs and objectives, security requirements, the processes deployed as well as the size and structure of the organization. The implementation of ISM should be carried out to the extent consistent with the needs of the organization.

Ring-array processor distribution topology for optical interconnects

NASA Technical Reports Server (NTRS)

Li, Yao; Ha, Berlin; Wang, Ting; Wang, Sunyu; Katz, A.; Lu, X. J.; Kanterakis, E.

1992-01-01

The existing linear and rectangular processor distribution topologies for optical interconnects, although promising in many respects, cannot solve problems such as clock skews, the lack of supporting elements for efficient optical implementation, etc. The use of a ring-array processor distribution topology, however, can overcome these problems. Here, a study of the ring-array topology is conducted with an aim of implementing various fast clock rate, high-performance, compact optical networks for digital electronic multiprocessor computers. Practical design issues are addressed. Some proof-of-principle experimental results are included.

Integrating research, policy, and practice in juvenile justice education.

PubMed

Blomberg, Thomas G; Waldo, Gordon P

2002-06-01

This article provides an overview of the history and context leading to Florida's efforts to implement an evaluation-driven research and associated quality assurance system for its juvenile justice education policies and practices. The Juvenile Justice Educational Enhancement Program began implementing Florida's evaluation research and quality assurance system to juvenile justice education in 1998. The article includes a brief summary of articles comprising this special issue of Evaluation Review that address the Juvenile Justice Educational Enhancement Program's various functions, methodological components, data, preliminary findings, continuing evaluation research efforts, and impediments.

Investigating Climate Change Issues With Web-Based Geospatial Inquiry Activities

NASA Astrophysics Data System (ADS)

Dempsey, C.; Bodzin, A. M.; Sahagian, D. L.; Anastasio, D. J.; Peffer, T.; Cirucci, L.

2011-12-01

In the Environmental Literacy and Inquiry middle school Climate Change curriculum we focus on essential climate literacy principles with an emphasis on weather and climate, Earth system energy balance, greenhouse gases, paleoclimatology, and how human activities influence climate change (http://www.ei.lehigh.edu/eli/cc/). It incorporates a related set of a framework and design principles to provide guidance for the development of the geospatial technology-integrated Earth and environmental science curriculum materials. Students use virtual globes, Web-based tools including an interactive carbon calculator and geologic timeline, and inquiry-based lab activities to investigate climate change topics. The curriculum includes educative curriculum materials that are designed to promote and support teachers' learning of important climate change content and issues, geospatial pedagogical content knowledge, and geographic spatial thinking. The curriculum includes baseline instructional guidance for teachers and provides implementation and adaptation guidance for teaching with diverse learners including low-level readers, English language learners and students with disabilities. In the curriculum, students use geospatial technology tools including Google Earth with embedded spatial data to investigate global temperature changes, areas affected by climate change, evidence of climate change, and the effects of sea level rise on the existing landscape. We conducted a designed-based research implementation study with urban middle school students. Findings showed that the use of the Climate Change curriculum showed significant improvement in urban middle school students' understanding of climate change concepts.

Surviving the Implementation of a New Science Curriculum

NASA Astrophysics Data System (ADS)

Lowe, Beverly; Appleton, Ken

2015-12-01

Queensland schools are currently teaching with the first National Curriculum for Australia. This new curriculum was one of a number of political responses to address the recurring low scores in literacy, mathematics, and science that continue to hold Australia in poor international rankings. Teachers have spent 2 years getting to know the new science curriculum through meetings, training, and exploring the new Australian curriculum documents. This article examines the support and preparation for implementation provided in two regional schools, with a closer look at six specific teachers and their science teaching practices as they attempted to implement the new science curriculum. The use of a survey, field observations, and interviews revealed the schools' preparation practices and the teachers' practices, including the support provided to implement the new science curriculum. A description and analysis of school support and preparation as well as teachers' views of their experiences implementing the new science curriculum reveal both achievements and shortcomings. Problematic issues for the two schools and teachers include time to read and comprehend the curriculum documents and content expectations as well as time to train and change the current processes effectively. The case teachers' experiences reveal implications for the successful and effective implementation of new curriculum and curriculum reform.

Regulations Under the Americans With Disabilities Act; Genetic Information Nondiscrimination Act. Final rule.

PubMed

2016-05-17

The Equal Employment Opportunity Commission (EEOC or Commission) is issuing its final rule to amend the regulations and interpretive guidance implementing Title I of the Americans with Disabilities Act (ADA) to provide guidance on the extent to which employers may use incentives to encourage employees to participate in wellness programs that ask them to respond to disability-related inquiries and/or undergo medical examinations. This rule applies to all wellness programs that include disability-related inquiries and/or medical examinations whether they are offered only to employees enrolled in an employer-sponsored group health plan, offered to all employees regardless of whether they are enrolled in such a plan, or offered as a benefit of employment by employers that do not sponsor a group health plan or group health insurance. Published elsewhere in this issue of the Federal Register, the EEOC also issued a final rule to amend the regulations implementing Title II of the Genetic Information Nondiscrimination Act (GINA) that addresses the extent to which employers may offer incentives for an employee's spouse to participate in a wellness program.

Behavioral medicine and clinical health psychology: introduction to the special issue.

PubMed

Christensen, Alan J; Nezu, Arthur M

2013-04-01

This issue represents the 4th Journal of Consulting and Clinical Psychology special issue on behavioral medicine and clinical health psychology over the past 4 decades. Recent developments in health care policy, as well as in the maturation of the science, make a special issue in this area particularly timely. This collection includes state of the clinical science reviews, reports of clinical trials, and articles addressing theory and methods in behavioral medicine and clinical health psychology. A multilevel, ecological perspective that considers multiple levels of influences (e.g., cultural influences on behavior-health linkages, individual differences) is salient throughout many of the articles. Our hope is that this sampling of this broad field, and coverage of some key issues and areas, will play a role in stimulating the next 10 years of research, practice, and policy implementation in behavioral medicine and clinical health psychology.

CMS issues updated rules for the Medicare claims appeal process.

PubMed

Davidson, Nancy J

2003-01-01

BIPA requires extensive changes to Medicare's appeal process. However, due to the lack of funding and adequate resources, CMS has been unable to immediately implement many of BIPA's far-reaching changes. CMS is committed to making a transition to the new process as quickly as possible and intends to implement as many key issues as feasible within budget and resource limits. Once Congress allocates funds for the new changes, CMS will be in a better position to implement all aspects of BIPA. [table: see text] The most significant change that BIPA presents is that Congress will require 12 new contractors to handle Part A and Part B appeals. These entities will be known as qualified independent contractors (QICs). CMS has completed development of the requests for proposals needed to solicit bids for the QIC contracts, including full statements of the scope of work (SOW) for these contracts. CMS released the draft SOW on Oct. 7, 2002. It is anticipated that the addition of the QICs will provide a more uniform and consistent handling of Medicare appeals on a national level.

The spectrum of ethical issues in a Learning Health Care System: a systematic qualitative review.

PubMed

McLennan, Stuart; Kahrass, Hannes; Wieschowski, Susanne; Strech, Daniel; Langhof, Holger

2018-04-01

To determine systematically the spectrum of ethical issues that is raised for stakeholders in a 'Learning Health Care System' (LHCS). The systematic review was conducted in PubMed and Google Books between the years 2007 and 2015. The literature search retrieved 1258 publications. Each publication was independently screened by two reviewers for eligibility for inclusion. Ethical issues were defined as arising when a relevant normative principle is not adequately considered or two principles come into conflict. A total of 65 publications were included in the final analysis and were analysed using an adapted version of qualitative content analysis. A coding frame was developed inductively from the data, only the highest-level categories were generated deductively for a life-cycle perspective. A total of 67 distinct ethical issues could be categorized under different phases of the LHCS life-cycle. An overarching theme that was repeatedly raised was the conflict between the current regulatory system and learning health care. The implementation of a LHCS can help realize the ethical imperative to continuously improve the quality of health care. However, the implementation of a LHCS can also raise a number of important ethical issues itself. This review highlights the importance for health care leaders and policy makers to balance the need to protect and respect individual participants involved in learning health care activities with the social value of improving health care.

The Caltech Concurrent Computation Program - Project description

NASA Technical Reports Server (NTRS)

Fox, G.; Otto, S.; Lyzenga, G.; Rogstad, D.

1985-01-01

The Caltech Concurrent Computation Program wwhich studies basic issues in computational science is described. The research builds on initial work where novel concurrent hardware, the necessary systems software to use it and twenty significant scientific implementations running on the initial 32, 64, and 128 node hypercube machines have been constructed. A major goal of the program will be to extend this work into new disciplines and more complex algorithms including general packages that decompose arbitrary problems in major application areas. New high-performance concurrent processors with up to 1024-nodes, over a gigabyte of memory and multigigaflop performance are being constructed. The implementations cover a wide range of problems in areas such as high energy and astrophysics, condensed matter, chemical reactions, plasma physics, applied mathematics, geophysics, simulation, CAD for VLSI, graphics and image processing. The products of the research program include the concurrent algorithms, hardware, systems software, and complete program implementations.

Universal Free School Breakfast: A Qualitative Process Evaluation According to the Perspectives of Senior Stakeholders.

PubMed

Harvey-Golding, Louise; Donkin, Lynn Margaret; Defeyter, Margaret Anne

2016-01-01

In the last decade, the provision of school breakfast has increased significantly in the UK. However, there is an absence of knowledge regarding senior stakeholder views on the processes and potential outcomes on different groups, within the communities served by school breakfast programs. The purpose of this study was to examine the views and experiences of senior level stakeholders and thereby provide an original qualitative contribution to the research. A sample of senior level stakeholders was recruited, including senior officers, directors, and elected members, from within a Local Authority (LA) involved in the leadership, implementation and delivery of a council-wide universal free school breakfast (UFSB) program, and from the senior staff body of mainstream primary and special schools, participating in the program. A grounded theory analysis of the data collected identified issues encountered in the implementation and delivery, and views on the funding and future of a USFB program, in addition to perceived outcomes for children, parents, families, schools, and the wider community. The results refer to both positive and negative issues and implications associated with the program, according to the perspectives of senior level stakeholders. Perceived positive outcomes included benefits to children, families, schools, and the community. For instance, alleviating hunger, improving health outcomes, and conferring financial benefits, with the potential to cumulate in overall improvements in educational, social, and behavioral outcomes. Reported negative implications included the absence of an effective communication strategy in implementing the USFB program; in addition to concerns about the impacts of "double-breakfasting" on obesity levels among children, particularly in less deprived communities. Findings were validated using theoretical sampling and saturation, triangulation methods, member checks, and inter-rater reliability measures. In presenting these findings, this paper provides a unique qualitative insight into the processes, issues and outcomes of a council-wide UFSB program within a socioeconomically deprived community, according to the perceptions of senior level stakeholders.

Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial

PubMed Central

Hill, Keith D.; Brand, Caroline A.; Livingston, Patricia M.; Botti, Mari

2017-01-01

There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; ‘falls alert’ signs; supervision of patients in the bathroom; ensuring patients’ walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including: Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on program acceptability (suitability, practicality and benefits) was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%). Views were mixed regarding positioning patients’ walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised highlighting issues to be addressed by the implementation plan. PMID:28199376

A Multi-TeV Linear Collider Based on CLIC Technology : CLIC Conceptual Design Report

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

Aicheler, M; Burrows, P.; Draper, M.

This report describes the accelerator studies for a future multi-TeV e +e - collider based on the Compact Linear Collider (CLIC) technology. The CLIC concept as described in the report is based on high gradient normal-conducting accelerating structures where the RF power for the acceleration of the colliding beams is extracted from a high-current Drive Beam that runs parallel with the main linac. The focus of CLIC R&D over the last years has been on addressing a set of key feasibility issues that are essential for proving the fundamental validity of the CLIC concept. The status of these feasibility studiesmore » are described and summarized. The report also includes a technical description of the accelerator components and R&D to develop the most important parts and methods, as well as a description of the civil engineering and technical services associated with the installation. Several larger system tests have been performed to validate the two-beam scheme, and of particular importance are the results from the CLIC test facility at CERN (CTF3). Both the machine and detector/physics studies for CLIC have primarily focused on the 3 TeV implementation of CLIC as a benchmark for the CLIC feasibility. This report also includes specific studies for an initial 500 GeV machine, and some discussion of possible intermediate energy stages. The performance and operation issues related to operation at reduced energy compared to the nominal, and considerations of a staged construction program are included in the final part of the report. The CLIC accelerator study is organized as an international collaboration with 43 partners in 22 countries. An associated report describes the physics potential and experiments at CLIC and a shorter report in preparation will focus on the CLIC implementation strategy, together with a plan for the CLIC R&D studies 2012–2016. Critical and important implementation issues such as cost, power and schedule will be addressed there.« less

Utility Green-Pricing Programs: What Defines Success? (Topical Issues Brief)

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

Swezey, B.; Bird, L.

2001-09-13

''Green pricing'' is an optional service through which customers can support a greater level of investment by their electric utility in renewable energy technologies. Electric utilities in 29 states are now implementing green-pricing programs. This report examines important elements of green-pricing programs, including the different types of programs offered, the premiums charged, customer response, and additional factors that experience indicates are key to the development of successful programs. The best-performing programs tend to share a number of common attributes related to product design, value creation, product pricing, and program implementation. The report ends with a list of ''best practices'' formore » utilities to follow when developing and implementing programs.« less

A Cloud-Based X73 Ubiquitous Mobile Healthcare System: Design and Implementation

PubMed Central

Ji, Zhanlin; O'Droma, Máirtín; Zhang, Xin; Zhang, Xueji

2014-01-01

Based on the user-centric paradigm for next generation networks, this paper describes a ubiquitous mobile healthcare (uHealth) system based on the ISO/IEEE 11073 personal health data (PHD) standards (X73) and cloud computing techniques. A number of design issues associated with the system implementation are outlined. The system includes a middleware on the user side, providing a plug-and-play environment for heterogeneous wireless sensors and mobile terminals utilizing different communication protocols and a distributed “big data” processing subsystem in the cloud. The design and implementation of this system are envisaged as an efficient solution for the next generation of uHealth systems. PMID:24737958

A four-country comparison of healthcare systems, implementation of diagnostic criteria, and treatment availability for functional gastrointestinal disorders: a report of the Rome Foundation Working Team on cross-cultural, multinational research.

PubMed

Schmulson, M; Corazziari, E; Ghoshal, U C; Myung, S-J; Gerson, C D; Quigley, E M M; Gwee, K-A; Sperber, A D

2014-10-01

Variations in healthcare provision around the world may impact how patients with functional gastrointestinal disorder (FGIDs) are investigated, diagnosed, and treated. However, these differences have not been reviewed. The Multinational Working Team of the Rome Foundation, established to make recommendations on the conduct of multinational, cross-cultural research in FGIDs, identified seven key issues that are analyzed herein: (i) coverage afforded by different healthcare systems/providers; (ii) level of the healthcare system where patients with FGIDs are treated; (iii) extent/types of diagnostic procedures typically undertaken to diagnose FGIDs; (iv) physicians' familiarity with and implementation of the Rome diagnostic criteria in clinical practice; (v) range of medications approved for FGIDs and approval process for new agents; (vi) costs involved in treating FGIDs; and (vii) prevalence and role of complementary/alternative medicine (CAM) for FGIDs. Because it was not feasible to survey all countries around the world, we compared a selected number of countries based on their geographical and ethno-cultural diversity. Thus, we included Italy and South Korea as representative of nations with broad-based coverage of healthcare in the population and India and Mexico as newly industrialized countries where there may be limited provision of healthcare for substantial segments of the population. In light of the paucity of formal publications on these issues, we included additional sources from the medical literature as well as perspectives provided by local experts and the media. Finally, we provide future directions on healthcare issues that should be taken into account and implemented when conducting cross-cultural and multinational research in FGIDs. © 2014 John Wiley & Sons Ltd.

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

PubMed

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

2014-11-01

This paper provides a review of EHR (electronic health record) implementations around the world and reports on findings including benefits and issues associated with EHR implementation. A systematic literature review was conducted from peer-reviewed scholarly journal publications from the last 10 years (2001-2011). The search was conducted using various publication collections including: Scopus, Embase, Informit, Medline, Proquest Health and Medical Complete. This paper reports on our analysis of previous empirical studies of EHR implementations. We analysed data based on an extension of DeLone and McLean's information system (IS) evaluation framework. The extended framework integrates DeLone and McLean's dimensions, including information quality, system quality, service quality, intention of use and usage, user satisfaction and net benefits, together with contingent dimensions, including systems development, implementation attributes and organisational aspects, as identified by Van der Meijden and colleagues. A mix of evidence-based positive and negative impacts of EHR was found across different evaluation dimensions. In addition, a number of contingent factors were found to contribute to successful implementation of EHR. This review does not include white papers or industry surveys, non-English papers, or those published outside the review time period. This review confirms the potential of this technology to aid patient care and clinical documentation; for example, in improved documentation quality, increased administration efficiency, as well as better quality, safety and coordination of care. Common negative impacts include changes to workflow and work disruption. Mixed observations were found on EHR quality, adoption and satisfaction. The review warns future implementers of EHR to carefully undertake the technology implementation exercise. The review also informs healthcare providers of contingent factors that potentially affect EHR development and implementation in an organisational setting. Our findings suggest a lack of socio-technical connectives between the clinician, the patient and the technology in developing and implementing EHR and future developments in patient-accessible EHR. In addition, a synthesis of DeLone and McLean's framework and Van der Meijden and colleagues' contingent factors has been found useful in comprehensively understanding and evaluating EHR implementations. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

User involvement in the implementation of clinical guidelines for common mental health disorders: a review and compilation of strategies and resources.

PubMed

Moreno, Eliana M; Moriana, Juan Antonio

2016-08-09

There is now broad consensus regarding the importance of involving users in the process of implementing guidelines. Few studies, however, have addressed this issue, let alone the implementation of guidelines for common mental health disorders. The aim of this study is to compile and describe implementation strategies and resources related to common clinical mental health disorders targeted at service users. The literature was reviewed and resources for the implementation of clinical guidelines were compiled using the PRISMA model. A mixed qualitative and quantitative analysis was performed based on a series of categories developed ad hoc. A total of 263 items were included in the preliminary analysis and 64 implementation resources aimed at users were analysed in depth. A wide variety of types, sources and formats were identified, including guides (40%), websites (29%), videos and leaflets, as well as instruments for the implementation of strategies regarding information and education (64%), self-care, or users' assessment of service quality. The results reveal the need to establish clear criteria for assessing the quality of implementation materials in general and standardising systems to classify user-targeted strategies. The compilation and description of key elements of strategies and resources for users can be of interest in designing materials and specific actions for this target audience, as well as improving the implementation of clinical guidelines.

Measuring Fidelity of Implementation--Methodological and Conceptual Issues and Challenges. CRESST Report 811

ERIC Educational Resources Information Center

Osmundson, Ellen; Herman, Joan; Ringstaff, Cathy; Dai, Yunyun; Timms, Mike

2012-01-01

A central challenge in efficacy studies centers on the issue of "fidelity of implementation," that is, the extent to which participants use the curriculum specified by curriculum developers. In this study, we describe and discuss a "fidelity of implementation" model using multiple methods and instruments to compare two versions of a science…

77 FR 44441 - Swap Transaction Compliance and Implementation Schedule: Clearing Requirement Under Section 2(h...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... implementing Title VII, the Commission should focus first on systemic risk issues and then issues relating to... implementation of the Clearing Requirement will serve to reduce systemic risk by mitigating counterparty credit... non-financial end-users because they do not pose systemic risk, and, therefore, should be given the...

Moving from Good Ideas in Educational Systems Change to Sustainable Program Implementation: Coming to Terms with Some of the Realities

ERIC Educational Resources Information Center

Noell, George H.; Gansle, Kristin A.

2009-01-01

Proponents of systemic changes in education commonly encounter ethical, theoretical, and pragmatic challenges in moving from possibility to implementation of their vision of change. Although ethical and theoretical issues are critically important to a successful change initiative, pragmatic issues relevant to assuring program implementation have…

Implementation of therapeutic hypothermia guidelines for post-cardiac arrest syndrome at a glacial pace: seeking guidance from the knowledge translation literature.

PubMed

Brooks, Steven C; Morrison, Laurie J

2008-06-01

The 2005 International Liaison Committee on Resuscitation (ILCOR) Consensus on Science and Treatment Recommendations document represents the most extensive and rigorous systematic review of the resuscitation literature to date and included evidence-based recommendations for post-resuscitation care. A new recommendation for the induction of mild therapeutic hypothermia for comatose cardiac arrest survivors was included in this document. Accordingly, constituent national member associations of ILCOR, including the American Heart Association, incorporated the recommendation for therapeutic hypothermia into their respective guidelines. Despite these endorsements there is a concern that therapeutic hypothermia is not being used in practice. Data from a number of surveys in Europe and the United States suggest that rates of use among physicians may be as low as 30-40%. Despite the cost and effort associated with the production of these guidelines and the potential impact on patient care, current efforts in implementing the guideline have not achieved widespread success. This commentary explores the issue of underutilization of the American Heart Association guidelines for therapeutic hypothermia and looks to the knowledge translation literature to inform a new approach to implementation. We will review the underlying phenomenon of research implementation into practice, specific barriers to guideline implementation and interventions that may improve therapeutic hypothermia uptake.

Support vector machines and generalisation in HEP

NASA Astrophysics Data System (ADS)

Bevan, Adrian; Gamboa Goñi, Rodrigo; Hays, Jon; Stevenson, Tom

2017-10-01

We review the concept of Support Vector Machines (SVMs) and discuss examples of their use in a number of scenarios. Several SVM implementations have been used in HEP and we exemplify this algorithm using the Toolkit for Multivariate Analysis (TMVA) implementation. We discuss examples relevant to HEP including background suppression for H → τ + τ - at the LHC with several different kernel functions. Performance benchmarking leads to the issue of generalisation of hyper-parameter selection. The avoidance of fine tuning (over training or over fitting) in MVA hyper-parameter optimisation, i.e. the ability to ensure generalised performance of an MVA that is independent of the training, validation and test samples, is of utmost importance. We discuss this issue and compare and contrast performance of hold-out and k-fold cross-validation. We have extended the SVM functionality and introduced tools to facilitate cross validation in TMVA and present results based on these improvements.

Quantitative Effectiveness Analysis of Solar Photovoltaic Policies, Introduction of Socio-Feed-in Tariff Mechanism (SocioFIT) and its Implementation in Turkey

NASA Astrophysics Data System (ADS)

Mustafaoglu, Mustafa Sinan

Some of the main energy issues in developing countries are high dependence on non-renewable energy sources, low energy efficiency levels and as a result of this high amount of CO2 emissions. Besides, a common problem of many countries including developing countries is economic inequality problem. In the study, solar photovoltaic policies of Germany, Japan and the USA is analyzed through a quantitative analysis and a new renewable energy support mechanism called Socio Feed-in Tariff Mechanism (SocioFIT) is formed based on the analysis results to address the mentioned issues of developing countries as well as economic inequality problem by using energy savings as a funding source for renewable energy systems. The applicability of the mechanism is solidified by the calculations in case of an implementation of the mechanism in Turkey.

Rio + 5 -- INSTRAW's activities regarding the implementation of Agenda 21.

PubMed

1997-01-01

The International Research and Training Institute for the Advancement of Women (INSTRAW) was involved in research analysis and training activities that address women's issues on water supply, sanitation and waste management, development of new and renewable sources of energy, and natural resources since 1982. The four main thrusts of the INSTRAW program include: 1) the economic and political empowerment of the women; 2) women, media and communications; 3) women, environment and sustainable development; and 4) statistics and indicators on gender issues. These areas are approached in an integrated and holistic manner, which is crosscutting and cross disciplinary with relevant chapters Agenda 21. In addition, poverty, population growth, health, structural adjustment policies, education and training, water, energy, agriculture and forestry are addressed within the women's roles and activities context. This article presents an overview of the succeeding chapters, which focus on the programs developed and implemented to promote the well being of the women worldwide.

Lessons learned from the implementation of a Web-based nursing intervention.

PubMed

Bond, Gail E

2006-01-01

The emergence of the World Wide Web in the last decade has introduced the belief that the Internet has the potential to revolutionize healthcare delivery and empower consumers. Given the power of technology to change the way we live, the healthcare community has begun to explore the feasibility of delivering interventions via the Web, including personalized care with chronic disease management. The purpose of this article is to describe this researcher's experience with the development and implementation of a Web-based intervention to enhance diabetes self-management for older adults. Challenges faced by the project involved inadequate funding to cover technology issues (programming, graphics design, etc),decisions regarding the appropriate environment/framework, and questions on how to merge the practice and theory of a given discipline with the limitations of Internet technology. This article will examine and discuss these issues and make recommendations on possible methods of improving the process.

Towards pervasive computing in health care – A literature review

PubMed Central

Orwat, Carsten; Graefe, Andreas; Faulwasser, Timm

2008-01-01

Background The evolving concepts of pervasive computing, ubiquitous computing and ambient intelligence are increasingly influencing health care and medicine. Summarizing published research, this literature review provides an overview of recent developments and implementations of pervasive computing systems in health care. It also highlights some of the experiences reported in deployment processes. Methods There is no clear definition of pervasive computing in the current literature. Thus specific inclusion criteria for selecting articles about relevant systems were developed. Searches were conducted in four scientific databases alongside manual journal searches for the period of 2002 to 2006. Articles included present prototypes, case studies and pilot studies, clinical trials and systems that are already in routine use. Results The searches identified 69 articles describing 67 different systems. In a quantitative analysis, these systems were categorized into project status, health care settings, user groups, improvement aims, and systems features (i.e., component types, data gathering, data transmission, systems functions). The focus is on the types of systems implemented, their frequency of occurrence and their characteristics. Qualitative analyses were performed of deployment issues, such as organizational and personnel issues, privacy and security issues, and financial issues. This paper provides a comprehensive access to the literature of the emerging field by addressing specific topics of application settings, systems features, and deployment experiences. Conclusion Both an overview and an analysis of the literature on a broad and heterogeneous range of systems are provided. Most systems are described in their prototype stages. Deployment issues, such as implications on organization or personnel, privacy concerns, or financial issues are mentioned rarely, though their solution is regarded as decisive in transferring promising systems to a stage of regular operation. There is a need for further research on the deployment of pervasive computing systems, including clinical studies, economic and social analyses, user studies, etc. PMID:18565221

Using Interdisciplinary Workgroups to Educate Surgery Residents in Systems-Based Practice.

PubMed

Gillen, Jacob R; Ramirez, Adriana G; Farineau, Diane W; Hoke, Tracey R; Schirmer, Bruce D; Williams, Michael D; Lau, Christine L

Meaningful education of residents in systems-based practice is notoriously challenging, despite its recognition as 1 of the 6 Accreditation Council for Graduate Medical Education core competencies. To address this challenge, surgery residents and other members of the health care team were organized into interdisciplinary workgroups that were tasked with developing solutions to "systems issues" confronted on a daily basis. The project's goals included providing more meaningful, hands-on educational experience for residents in system-based practice, while also generating practical solutions to workflow issues through interprofessional collaboration. Project participants included all surgery residents at the University of Virginia in Charlottesville, VA, as well as surgical health care professionals across all disciplines. Participants were organized into workgroups. Over the course of 3 sessions, each of 1-hour, each workgroup identified commonly encountered systems issues, chose 1 issue to address, and determined an implementable solution for this issue. In total, 140 participants were divided among 13 workgroups. Workgroup topics ranged from improving paging etiquette to standardizing interdisciplinary communication. In total, 9 of the 13 proposals have been piloted or fully implemented as standard practice at our institution, either within a single unit or over the entire health system. This project demonstrates an innovative approach toward resident education in system-based practice, providing residents with a hands-on experience in problem solving from a systems perspective. These interdisciplinary workgroups generated effective solutions to issues that were meaningful to frontline health care providers. Interdisciplinary collaboration within the workgroups served as a valuable team-building exercise to improve relations between the disciplines. This project can serve as a model for other institutions desiring meaningful education in the Accreditation Council for Graduate Medical Education competency of systems-based practice. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Implementing the community health worker model within diabetes management: challenges and lessons learned from programs across the United States.

PubMed

Cherrington, Andrea; Ayala, Guadalupe X; Amick, Halle; Allison, Jeroan; Corbie-Smith, Giselle; Scarinci, Isabel

2008-01-01

The purpose of this qualitative study was to examine methods of implementation of the community health worker (CHW) model within diabetes programs, as well as related challenges and lessons learned. Semi-structured interviews were conducted with program managers. Four databases (PubMed, CINAHL, ISI Web of Knowledge, PsycInfo), the CDC's 1998 directory of CHW programs, and Google Search Engine were used to identify CHW programs. Criteria for inclusion were: DM program; used CHW strategy; occurred in United States. Two independent reviewers performed content analyses to identify major themes and findings. Sixteen programs were assessed, all but 3 focused on minority populations. Most CHWs were recruited informally; 6 programs required CHWs to have diabetes. CHW roles and responsibilities varied across programs; educator was the most commonly identified role. Training also varied in terms of both content and intensity. All programs gave CHWs remuneration for their work. Common challenges included difficulties with CHW retention, intervention fidelity and issues related to sustainability. Cultural and gender issues also emerged. Examples of lessons learned included the need for community buy-in and the need to anticipate nondiabetes related issues. Lessons learned from these programs may be useful to others as they apply the CHW model to diabetes management within their own communities. Further research is needed to elucidate the specific features of this model necessary to positively impact health outcomes.

Implementing person-environment approaches to prevent falls: a qualitative inquiry in applying the Westmead approach to occupational therapy home visits.

PubMed

Clemson, Lindy; Donaldson, Alex; Hill, Keith; Day, Lesley

2014-10-01

Despite evidence of the effectiveness of home safety interventions for preventing falls, there is limited uptake of such interventions within community services. Therefore, as part of a broader translational project, we explored issues underlying the implementation of an evidence-based home safety fall prevention intervention. We conducted in-depth interviews with eight occupational therapists and two programme coordinators engaged to deliver a home safety fall prevention intervention. Six community health centres within two metropolitan regions of Melbourne, Australia participated. The RE-AIM framework and Diffusion of Innovations theory underpinned the interviews which examine the enablers and barriers to implementing a home safety fall prevention intervention and integrating it into routine community preventive practice. Analysis involved thematic and content analysis. Investment in the home safety for fall prevention intervention was supported and valued by coordinators and therapists alike, and a number of themes emerged which influenced implementation of this intervention. These included issues of: compatibility with organisational processes, individual practitioner practices and skills, a prevention approach, and client expectations; relative advantage in terms of flexibility of the process, client engagement and regional capacity building; complexity of implementing the intervention; and observability related to the invisible nature of fall prevention outcomes. Implementation of this home safety fall prevention intervention was influenced by a range of interrelated organisational, practitioner and client related factors. The findings from this project provide insights into, and opportunities to increase the sustainable implementation of the home safety fall prevention intervention into practice. © 2014 Occupational Therapy Australia.

Utilizing Radiofrequency Identification Technology to Improve Safety and Management of Blood Bank Supply Chains.

PubMed

Coustasse, Alberto; Meadows, Pamela; Hall, Robert S; Hibner, Travis; Deslich, Stacie

2015-11-01

The importance of efficiency in the supply chain of perishable products, such as the blood products used in transfusion services, cannot be overstated. Many problems can occur, such as the outdating of products, inventory management issues, patient misidentification, and mistransfusion. The purpose of this article was to identify the benefits and barriers associated with radiofrequency identification (RFID) usage in improving the blood bank supply chain. The methodology for this study was a qualitative literature review following a systematic approach. The review was limited to sources published from 2000 to 2014 in the English language. Sixty-five sources were found, and 56 were used in this research study. According to the finding of the present study, there are numerous benefits and barriers to RFID utilization in blood bank supply chains. RFID technology offers several benefits with regard to blood bank product management, including decreased transfusion errors, reduction of product loss, and more efficient inventory management. Barriers to RFID implementation include the cost associated with system implementation and patient privacy issues. Implementation of an RFID system can be a significant investment. However, when observing the positive impact that such systems may have on transfusion safety and inventory management, the cost associated with RFID systems can easily be justified. RFID in blood bank inventory management is vital to ensuring efficient product inventory management and positive patient outcomes.

Development of a MELCOR Sodium Chemistry (NAC) Package - FY17 Progress.

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

Louie, David; Humphries, Larry L.

This report describes the status of the development of MELCOR Sodium Chemistry (NAC) package. This development is based on the CONTAIN-LMR sodium physics and chemistry models to be implemented in MELCOR. In the past three years, the sodium equation of state as a working fluid from the nuclear fusion safety research and from the SIMMER code has been implemented into MELCOR. The chemistry models from the CONTAIN-LMR code, such as the spray and pool fire mode ls, have also been implemented into MELCOR. This report describes the implemented models and the issues encountered. Model descriptions and input descriptions are provided.more » Development testing of the spray and pool fire models is described, including the code-to-code comparison with CONTAIN-LMR. The report ends with an expected timeline for the remaining models to be implemented, such as the atmosphere chemistry, sodium-concrete interactions, and experimental validation tests .« less

High-performance parallel analysis of coupled problems for aircraft propulsion

NASA Technical Reports Server (NTRS)

Felippa, C. A.; Farhat, C.; Lanteri, S.; Gumaste, U.; Ronaghi, M.

1994-01-01

Applications are described of high-performance parallel, computation for the analysis of complete jet engines, considering its multi-discipline coupled problem. The coupled problem involves interaction of structures with gas dynamics, heat conduction and heat transfer in aircraft engines. The methodology issues addressed include: consistent discrete formulation of coupled problems with emphasis on coupling phenomena; effect of partitioning strategies, augmentation and temporal solution procedures; sensitivity of response to problem parameters; and methods for interfacing multiscale discretizations in different single fields. The computer implementation issues addressed include: parallel treatment of coupled systems; domain decomposition and mesh partitioning strategies; data representation in object-oriented form and mapping to hardware driven representation, and tradeoff studies between partitioning schemes and fully coupled treatment.

A survey of unmanned ground vehicles with applications to agricultural and environmental sensing

NASA Astrophysics Data System (ADS)

Bonadies, Stephanie; Lefcourt, Alan; Gadsden, S. Andrew

2016-05-01

Unmanned ground vehicles have been utilized in the last few decades in an effort to increase the efficiency of agriculture, in particular, by reducing labor needs. Unmanned vehicles have been used for a variety of purposes including: soil sampling, irrigation management, precision spraying, mechanical weeding, and crop harvesting. In this paper, unmanned ground vehicles, implemented by researchers or commercial operations, are characterized through a comparison to other vehicles used in agriculture, namely airplanes and UAVs. An overview of different trade-offs of configurations, control schemes, and data collection technologies is provided. Emphasis is given to the use of unmanned ground vehicles in food crops, and includes a discussion of environmental impacts and economics. Factors considered regarding the future trends and potential issues of unmanned ground vehicles include development, management and performance. Also included is a strategy to demonstrate to farmers the safety and profitability of implementing the technology.

Implementing risk-stratified screening for common cancers: a review of potential ethical, legal and social issues.

PubMed

Hall, A E; Chowdhury, S; Hallowell, N; Pashayan, N; Dent, T; Pharoah, P; Burton, H

2014-06-01

The identification of common genetic variants associated with common cancers including breast, prostate and ovarian cancers would allow population stratification by genotype to effectively target screening and treatment. As scientific, clinical and economic evidence mounts there will be increasing pressure for risk-stratified screening programmes to be implemented. This paper reviews some of the main ethical, legal and social issues (ELSI) raised by the introduction of genotyping into risk-stratified screening programmes, in terms of Beauchamp and Childress's four principles of biomedical ethics--respect for autonomy, non-maleficence, beneficence and justice. Two alternative approaches to data collection, storage, communication and consent are used to exemplify the ELSI issues that are likely to be raised. Ultimately, the provision of risk-stratified screening using genotyping raises fundamental questions about respective roles of individuals, healthcare providers and the state in organizing or mandating such programmes, and the principles, which underpin their provision, particularly the requirement for distributive justice. The scope and breadth of these issues suggest that ELSI relating to risk-stratified screening will become increasingly important for policy-makers, healthcare professionals and a wide diversity of stakeholders. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

The quest for engaging AmI: Patient engagement and experience design tools to promote effective assisted living.

PubMed

Triberti, Stefano; Barello, Serena

2016-10-01

Recent research highlights that patient engagement, conceived as a patient's behavioral, cognitive and emotional commitment to his own care management, is a key issue while implementing new technologies in the healthcare process. Indeed, eHealth interventions may systematically fail when the patient's subjective experience has not been taken into consideration since the first steps of the technology design. In the present contribution, we argue that such an issue is more and more crucial as regarded to the field of Ambient Intelligence (AmI). Specifically, the exact concept of technologies embedded in the patients' surrounding environment implies a strong impact on their everyday life, which can be perceived as a limitation to autonomy and privacy, and therefore refused or even openly opposed by the final users. The present contribution tackles this issue directly, highlighting: (1) a theoretical framework to include patient engagement in the design of AmI technologies; (2) assessment measures for patient engagement while developing and testing the effectiveness of AmI prototypes for healthcare. Finally (3) this contribution provides an overview of the main issues emerging while implementing AmI technologies and suggests specific design solutions to address them. Copyright © 2016 Elsevier Inc. All rights reserved.

Preferred drug lists: Potential impact on healthcare economics

PubMed Central

Ovsag, Kimberly; Hydery, Sabrina; Mousa, Shaker A

2008-01-01

Objectives To analyze the implementation of Medicaid preferred drug lists (PDLs) in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare. Methods We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included “drug lists,” “prior authorization,” “prior approval,” and “Medicaid.” We added terms such as “influence use of other healthcare services,” “quality of care,” and “overall economic impact.” We mainly used primary sources. Results Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a) the potential for PDLs to influence the utilization of other healthcare services, (b) criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c)the effect of PDL implementation on compliance to new regimens, (d) the potential effects of restricting medication availability on quality of care, (e) administrative costs associated with PDLs, and (f) satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact. Conclusions The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care. PMID:18561515

New patient-centered care standards from the commission on cancer: opportunities and challenges.

PubMed

Fashoyin-Aje, Lola A; Martinez, Kathryn A; Dy, Sydney M

2012-01-01

The Commission on Cancer of the American College of Surgeons publishes accreditation standards that hospitals and cancer treatment centers implement to ensure quality care to cancer patients. These standards address the full spectrum of cancer care, from cancer prevention to survivorship and end-of-life care. The most recent revisions of these standards included new standards in "patient-centered areas," including the provision of palliative care services, treatment and survivorship plans, psychological distress screening, and patient navigation programs. Unified by their emphasis on the early identification of patients at risk of receiving suboptimal care and the importance of ensuring that issues arising during and after completion of cancer treatment are addressed, they are a welcome expansion of the standards guiding cancer care. As with all standards, however, the next steps will be to further define how they will be implemented and to determine how success will be assessed. This will require ongoing critical evaluation of the standards and their implementation, including the need for member institutions to define successful implementation methods and measurable outcomes and identification of areas most in need of further research. Copyright © 2012 Elsevier Inc. All rights reserved.

The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

PubMed Central

Fusheini, Adam

2016-01-01

Background: National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Methods: Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Results: Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. Conclusion: The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS requires political stewardship. Political leadership has the responsibility to build trust and confidence in the system by providing the necessary resources and backing with minimal interference in the operations. For sustainability of the scheme, authorities need to review the exemption policy, rate of contributions, especially, from informal sector employees and recruitment criteria of scheme workers, explore additional sources of funding and re-examine training needs of employees to strengthen their competences among others. PMID:27694681

The Politico-Economic Challenges of Ghana's National Health Insurance Scheme Implementation.

PubMed

Fusheini, Adam

2016-04-27

National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS requires political stewardship. Political leadership has the responsibility to build trust and confidence in the system by providing the necessary resources and backing with minimal interference in the operations. For sustainability of the scheme, authorities need to review the exemption policy, rate of contributions, especially, from informal sector employees and recruitment criteria of scheme workers, explore additional sources of funding and re-examine training needs of employees to strengthen their competences among others. © 2016 by Kerman University of Medical Sciences

Architectural Optimization of Digital Libraries

NASA Technical Reports Server (NTRS)

Biser, Aileen O.

1998-01-01

This work investigates performance and scaling issues relevant to large scale distributed digital libraries. Presently, performance and scaling studies focus on specific implementations of production or prototype digital libraries. Although useful information is gained to aid these designers and other researchers with insights to performance and scaling issues, the broader issues relevant to very large scale distributed libraries are not addressed. Specifically, no current studies look at the extreme or worst case possibilities in digital library implementations. A survey of digital library research issues is presented. Scaling and performance issues are mentioned frequently in the digital library literature but are generally not the focus of much of the current research. In this thesis a model for a Generic Distributed Digital Library (GDDL) and nine cases of typical user activities are defined. This model is used to facilitate some basic analysis of scaling issues. Specifically, the calculation of Internet traffic generated for different configurations of the study parameters and an estimate of the future bandwidth needed for a large scale distributed digital library implementation. This analysis demonstrates the potential impact a future distributed digital library implementation would have on the Internet traffic load and raises questions concerning the architecture decisions being made for future distributed digital library designs.

Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

PubMed

Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin

2018-02-01

To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting ethical principles. © 2017 John Wiley & Sons Ltd.

Quality of herbal medicines: challenges and solutions.

PubMed

Zhang, Junhua; Wider, Barbara; Shang, Hongcai; Li, Xuemei; Ernst, Edzard

2012-01-01

The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of herbal medicines can be classified into two categories: external and internal. In this review, external issues including contamination (e.g. toxic metals, pesticides residues and microbes), adulteration and misidentification are detailed. Complexity and non-uniformity of the ingredients in herbal medicines are the internal issues affecting the quality of herbal medicines. Solutions to the raised problems are discussed. The rigorous implementation of Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP) would undoubtedly reduce the risk of external issues. Through the use of modern analytical methods and pharmaceutical techniques, previously unsolved internal issues have become solvable. Standard herbal products can be manufactured from the standard herbal extracts. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Pitfalls of Mobile Devices in Learning: A Different View and Implications for Pedagogical Design

ERIC Educational Resources Information Center

Ting, Yu-Liang

2012-01-01

Studies have been devoted to the design, implementation, and evaluation of mobile learning in practice. A common issue among students' responses toward this type of learning concerns the pitfalls of mobile devices, including small screen, limited input options, and low computational power. As a result, mobile devices are not always perceived by…

76 FR 24516 - Glen Canyon Dam Adaptive Management Work Group

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

... Adaptive Management Program (AMP) was implemented as a result of the Record of Decision on the Operation of... Grand Canyon Protection Act (Pub. L. 102-575) of 1992. The AMP includes a Federal advisory committee... administrative and resource issues pertaining to the AMP. To view a copy of the agenda and documents related to...

75 FR 44809 - Glen Canyon Dam Adaptive Management Work Group (AMWG)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-29

... Canyon Dam Adaptive Management Program (AMP) was implemented as a result of the Record of Decision on the... of the Grand Canyon Protection Act (Pub. L. 102-575) of 1992. The AMP includes a Federal advisory... other administrative and resource issues pertaining to the AMP. To view a copy of the agenda and...

76 FR 47237 - Notice of Public Meeting for the Glen Canyon Dam Adaptive Management Work Group Federal Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... . SUPPLEMENTARY INFORMATION: The Glen Canyon Dam Adaptive Management Program (AMP) was implemented as a result of... AMP includes a Federal advisory committee, the AMWG, a technical work group (TWG), a Grand Canyon... other administrative and resource issues pertaining to the AMP. To view a copy of the agenda and...

77 FR 9265 - Glen Canyon Dam Adaptive Management Work Group

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-16

... (AMP) was implemented as a result of the Record of Decision on the Operation of Glen Canyon Dam Final.... L. 102-575) of 1992. The AMP includes a Federal advisory committee, the AMWG, a technical work group... administrative and resource issues pertaining to the AMP. To view a copy of the agenda and documents related to...

Turkey: Women in Development. A World Bank Country Study.

ERIC Educational Resources Information Center

Hadler, Sandra

This report is intended to serve as the basis of the World Bank's support to the government of Turkey in the implementation of its policies to enhance the participation of women in the economic development process. The report provides background information on the situation of women in Turkey, including legal and health issues, and examines…

"Change is Hard": What Science Teachers Are Telling Us about Reform and Teacher Learning of Innovative Practices.

ERIC Educational Resources Information Center

Davis, Kathleen S.

2003-01-01

Provides a critical analysis of the implementation of an innovative science curriculum at a middle school site. Explores the issues that surround teacher learning of new practices including the structures, policies, and practices that were in place within the reform context that supported or impeded teacher learning. Identifies parallels between…

School-University Partnerships: A Means for the Inclusion of Policy Studies in Music Teacher Education

ERIC Educational Resources Information Center

Hunter, Lisa R.

2011-01-01

The need for music educators to become more actively involved in policy issues, including analysis, design, implementation, and research, is critical to the future of music education. Bridging the gap between policy and practice requires a collaborative effort among music professionals. This article explores the inclusive use of policy studies in…

Necessary versus Sufficient Conditions for Using New Languages in South African Higher Education: A Linguistic Appraisal

ERIC Educational Resources Information Center

Mesthrie, Rajend

2008-01-01

This paper critically examines one particular issue against the background of changes in South Africa's higher education system consequent upon the advent of a non-racial democracy--the possibility of implementing multilingual instructional polices that include indigenous African languages in its universities. Currently, a great deal of applied…

Spotlight on the Future. NECC '99: National Educational Computing Conference Proceedings (20th, Atlantic City, NJ, June 22-24, 1999).

ERIC Educational Resources Information Center

International Society for Technology in Education, Eugene, OR.

This proceedings contains summaries of sessions on topics related to the use of computing across a wide range of disciplines and levels of education, including curriculum and instructional strategies, current and emerging technologies, social and ethical issues, library/media, technology implementation, exhibitors, teacher education and training,…

76 FR 31518 - Public Roundtable on the Protection of Cleared Swaps Customer Collateral

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

...: Notice of roundtable discussion; request for comment. SUMMARY: On June 3, 2011, commencing at 9:30 a.m. and ending at 5 p.m., staff of the CFTC will hold a public roundtable discussion at which invited.... The roundtable will include discussions of the issues surrounding the implementation of the complete...

Realizing the Potential of Information Resources: Information, Technology, and Services. Track 3: Serving Clients with Client/Server.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Eight papers are presented from the 1995 CAUSE conference track on client/server issues faced by managers of information technology at colleges and universities. The papers include: (1) "The Realities of Client/Server Development and Implementation" (Mary Ann Carr and Alan Hartwig), which examines Carnegie Mellon University's transition…

TORCAPP: time-dependent cyclotron orbit calculation and plotting package

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

Malarkey, C.H.; McNeilly, G.S.; Merriman, L.D.

1982-11-01

This addendum describes the modifications and additions to TORCAPP which have been implemented since the original report was issued in November 1979 by L.B. Maddox and G.S. McNeilly. Major changes include input of electric field data for central region studies, provision for extractor elements to allow extraction studies, and three-dimensional tracking of central rays.

Primary English Language Education Policy in Vietnam: Insights from Implementation

ERIC Educational Resources Information Center

Nguyen, Hoa Thi Mai

2011-01-01

The introduction of English in primary education curricula is a phenomenon occurring in many non-English-speaking countries in Asia, including Vietnam. Recently, the Ministry of Education and Training (MOET) in Vietnam issued guidelines for the piloting of an English as a foreign language (EFL) primary curriculum in which English is taught as a…

Implementation of a School Districtwide Grassroots Antibullying Initiative: A School Staff and Parent-Focused Evaluation of Because Nice Matters

ERIC Educational Resources Information Center

De Pedro, Kris Tunac; Pineda, Diana; Capp, Gordon; Moore, Hadass; Benbenishty, Rami; Astor, Ron Avi

2017-01-01

Military-connected youths experience stressful life events, including deployments and multiple school transitions, that make them vulnerable to bullying. Social workers have highlighted the power of grassroots school community initiatives that address risk issues among youths while empowering the community (see http://www.thecommunityguide.org).…

The Development and Implementation of a Teaching and Learning Strategy at a Modern Military Academy

ERIC Educational Resources Information Center

Thain, Richard Holman; McDonough, Ambrose; Priestley, Alan Duncan

2008-01-01

A strategy for teaching and learning was developed at Britannia Royal Naval College during 2006 in order to address several key issues. These included improving professional knowledge and skills retention, enhancing pedagogical practices to increase levels of student motivation, and adapting the training and educational package to an extremely…

Defense Acquisitions: Assessments of Selected Weapon Programs

DTIC Science & Technology

2015-03-01

offices on technology, design , and manufacturing knowledge; the use of knowledge- based acquisition practices; and the implementation of acquisition...and production maturity using two data-collection instruments, including a questionnaire on issues such as systems engineering reviews, design ...Demonstrating technology maturity is a prerequisite for moving forward into system development, during which the focus should be on design and

Organizational Learning as an Organization Development Intervention in Six High-Technology Firms in Taiwan: An Exploratory Case Study

ERIC Educational Resources Information Center

Lien, Bella Ya-Hui; Hung, Richard Y.; McLean, Gary N.

2007-01-01

Organizational learning (OL) is about how individuals collect, absorb, and transform information into organizational memory and knowledge. This case study explored how six high-technology firms in Taiwan chose OL as an organization development intervention strategy. Issues included how best to implement OL; how individuals, teams, and…

How to Defuse Censorship: Implementing 404.2 of the Standards for Accreditation of Montana Schools, 4th Ed.

ERIC Educational Resources Information Center

Bechtold, Brian; And Others

To help defuse censorship efforts, this booklet identifies issues and strategies for handling censorship efforts and provides the instructional materials selection policies of two Montana school districts. The booklet also includes sample forms for a citizen requesting reconsideration of materials and for a school media committee's reconsideration…

Developing and Implementing Quality Inclusive Education in Hong Kong: Implications for Teacher Education

ERIC Educational Resources Information Center

Forlin, Chris

2010-01-01

The government in Hong Kong has mandated that all schools should start to accept children with special educational needs by employing a whole school approach. This is not a simple move for teachers as inclusive education is complex, involving a range of issues including developing appropriate government and school policy; providing relevant…

High power neutron production targets

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

Wender, S.

1996-06-01

The author describes issues of concern in the design of targets and associated systems for high power neutron production facilities. The facilities include uses for neutron scattering, accelerator driven transmutation, accelerator production of tritium, short pulse spallation sources, and long pulse spallation sources. Each of these applications requires a source with different design needs and consequently different implementation in practise.

Characterization and remediation of 91B radioactive waste sites under performance based contracts at Lackland Air Force Base, San Antonio, Texas

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

Trujillo, P.A.; Anderson, K.D.

2007-07-01

This paper describes the challenges behind the implementation of the characterization, remediation, and the Site Closure for three 91b Radioactive Wastes under a Performance Based Contract at Lackland Air Force Base, San Antonio, Texas. The Defense Environmental Restoration Program (DERP) was established by Section 211 of the Superfund Amendments and Reauthorization Act of 1986 (SARA). A part of the DERP provides for the cleanup of hazardous substances associated with past Department of Defense (DoD) activities and is consistent with the provisions of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA). It is the Air Force Installation Restoration Program (IRP)more » that has responsibility for the cleanup activities associated with CERCLA. Under contract to the Air Force Center for Environmental Excellence (AFCEE), the ECC Project Team, that included ECC, Cabrera Services, and Malcolm Pirnie, was responsible for the implementation of the actions at three sites. The three IRP (91b) sites included RW015, a 0.02 square kilometer (5.5 acre) site, RW017 a 0.003 square kilometer (0.9 acre) site, and RW033 an 0.356 square kilometer (88 acre) site. Adding to the complexities of the project were issues of archaeological areas of interest, jurisdictional wetlands, land open to hunting, issues of security as well as compliance to the myriad of air force base rules, regulations, and Air Force Instructions (AFI). The award of the project task order was July of 2005, the project plan phase started in July of 2005 followed by the remedy implementation that included characterization and remediation as required reached completion in June of 2006. The project closure including the development and approval final status survey reports, proposed plans, and decision documents that parallel the CERCLA process was initiated in June of 2006 and is expected to reach completion in August of 2007. This paper will focus on the issues of working to achieve radiological and chemical closure under a performance based contract vehicle and the challenges encountered while reaching this goal. (authors)« less

Health Professionals' Views of Informatics Education

PubMed Central

Staggers, Nancy; Gassert, Carole A.; Skiba, Diane J.

2000-01-01

Health care leaders emphasize the need to include information technology and informatics concepts in formal education programs, yet integration of informatics into health educational programs has progressed slowly. The AMIA 1999 Spring Congress was held to address informatics educational issues across health professions, including the educational needs in the various health professions, goals for health informatics education, and implementation strategies to achieve these goals. This paper presents the results from AMIA work groups focused on informatics education for non-informatics health professionals. In the categories of informatics needs, goals, and strategies, conference attendees suggested elements in these areas: educational responsibilities for faculty and students, organizational responsibilities, core computer skills and informatics knowledge, how to learn informatics skills, and resources required to implement educational strategies. PMID:11062228

Implementation Challenges for Ceramic Matrix Composites in High Temperature Applications

NASA Technical Reports Server (NTRS)

Singh, Mrityunjay

2004-01-01

Ceramic matrix composites are leading candidate materials for a number of applications in aeronautics, space, energy, electronics, nuclear, and transportation industries. In the aeronautics and space exploration systems, these materials are being considered for applications in hot sections of jet engines such as the combustor liner, nozzle components, nose cones, leading edges of reentry vehicles and space propulsion components. Applications in the energy and environmental industries include radiant heater tubes, heat exchangers, heat recuperators, gas and diesel particulate filters (DPFs), and components for land based turbines for power generation. These materials are also being considered for use in the first wall and blanket components of fusion reactors. There are a number of critical issues and challenges related to successful implementation of composite materials. Fabrication of net and complex shape components with high density and tailorable matrix properties is quite expensive, and even then various desirable properties are not achievable. In this presentation, microstructure and thermomechanical properties of composites fabricated by two techniques (chemical vapor infiltration and melt infiltration), will be presented. In addition, critical need for robust joining and assembly technologies in successful implementation of these systems will be discussed. Other implementation issues will be discussed along with advantages and benefits of using these materials for various components in high temperature applications.

A common evaluation framework for the African Health Initiative.

PubMed

Bryce, Jennifer; Requejo, Jennifer Harris; Moulton, Lawrence H; Ram, Malathi; Black, Robert E

2013-01-01

The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results.

Honoring the Past and Looking to the Future: Updates on Seminal Behavior Therapy Publications on Current Therapies and Future Directions.

PubMed

Newman, Michelle G

2016-11-01

This is the introduction to the second of two special issues in honor of the 50 th anniversary of the Association for Behavioral and Cognitive Therapies. The goal of this issue is to pay tribute to prior seminal Behavior Therapy publications on current therapies and future directions, to provide an updated review of important topics covered by these papers, and to make recommendations for the future. Each invited paper in this issue highlights a particular Behavior Therapy publication's contribution to our understanding and also provides an updated review or meta-analysis on the topic of the original paper. The topics covered here include review papers on current therapies such as cognitive and behavioral therapies, youth and family psychotherapy, unified protocols, and third-wave therapies. In addition, we include a review paper on implementation science, and meta-analyses on individualized psychotherapy, and culturally adapted interventions. With the two 50 th anniversary issues of Behavior Therapy, we hope to inspire additional research and discussion. Copyright © 2016. Published by Elsevier Ltd.

Ethical issues in microbicide clinical trials for HIV prevention.

PubMed

Gangestad, Angelina K; Salata, Robert A

2012-01-01

Women account for half of new infections with HIV annually. Heterosexual transmission is the most common route of infection in resource limited settings (RLS). An effective microbicide would help decrease transmission of HIV and potentially enable women to have more control in sexual relationships. Research into microbicides is done predominantly in RLS. In addition, there will be different issues and challenges to consider with respect to rectal microbicide use in men. There exist several ethical issues around microbicide development and clinical research which we explore in this review. Respect for persons, including autonomy and protection of vulnerable populations, beneficence, and justice are explored as they relate to microbicide research. Improving standards of care in RLS, trial design, and informed consent are discussed in more detail. Special populations including pregnant women, adolescents, and men who have sex with men are considered in more detail. A multipronged approach to HIV prevention will be necessary to have an impact on HIV prevention. A continued discussion around ethical issues in regard to study design, interpretation of results and implementation of compounds brought to market will remain critically important.

Food Supply and Food Safety Issues in China

PubMed Central

Lam, Hon-Ming; Remais, Justin; Fung, Ming-Chiu; Xu, Liqing; Sun, Samuel Sai-Ming

2013-01-01

Food supply and food safety are major global public health issues, and are particularly important in heavily populated countries such as China. Rapid industrialisation and modernisation in China are having profound effects on food supply and food safety. In this Review, we identified important factors limiting agricultural production in China, including conversion of agricultural land to other uses, freshwater deficits, and soil quality issues. Additionally, increased demand for some agricultural products is examined, particularly those needed to satisfy the increased consumption of animal products in the Chinese diet, which threatens to drive production towards crops used as animal feed. Major sources of food poisoning in China include pathogenic microorganisms, toxic animals and plants entering the food supply, and chemical contamination. Meanwhile, two growing food safety issues are illegal additives and contamination of the food supply by toxic industrial waste. China’s connections to global agricultural markets are also having important effects on food supply and food safety within the country. Although the Chinese Government has shown determination to reform laws, establish monitoring systems, and strengthen food safety regulation, weak links in implementation remain. PMID:23746904

Australian blue-collar men's health and well-being: contextual issues for workplace health promotion interventions.

PubMed

Du Plessis, Karin; Cronin, David; Corney, Tim; Green, Emma

2013-09-01

In Australia, blue-collar workers are predominantly male and form a unique and large (approximately 30%) subset of the Australian workforce. They exhibit particular health-related issues and, in comparison to other groups, often a lack of health promoting behavior. This article briefly discusses the Australian context and some of the key health issues blue-collar men face, in particular as it relates to construction workers. It reviews the impact of gender and socioeconomic factors in designing workplace health promotion interventions. This article considers practice strategies for health promoters in a specific workplace setting: it looks at meta-factors and industry-based contextual factors, including barriers to implementation and participation, while addressing common misconceptions about Australian blue-collar workers.

Information technology and hospice palliative care: social, cultural, ethical and technical implications in a rural setting.

PubMed

Kuziemsky, Craig; Jewers, Heather; Appleby, Brenda; Foshay, Neil; Maccaull, Wendy; Miller, Keith; Macdonald, Madonna

2012-01-01

There is a need to better understand the specific settings in which health information technology (HIT) is used and implemented. Factors that will determine the successful implementation of HIT are context-specific and often reside not at the technical level but rather at the process and people level. This paper provides the results of a needs assessment for HIT to support hospice palliative care (HPC) delivery in rural settings. Roundtable discussions using the nominal group technique were done to identify priority issues regarding HIT usage to support rural HPC delivery. Qualitative content analysis was then used to identify sociotechnical themes from the roundtable data. Twenty priority issues were identified at the roundtable session. Content analysis grouped the priority issues into one central theme and five supporting themes to form a sociotechnical framework for patient-centered care in rural settings. There are several sociotechnical themes and associated issues that need to be considered prior to implementing HIT in rural HPC settings. Proactive evaluation of these issues can enhance HIT implementation and also help to make ethical aspects of HIT design more explicit.

Companion piece: Convention on the Rights of the Child special protection measures: overview of implications and value for children in the United States.

PubMed

Svevo-Cianci, Kimberly; Velazquez, Sonia C

2010-01-01

The United Nations Convention on the Rights of the Child (CRC) is an international treaty that commits ratifying states parties to uphold the rights of all children under the age of 18. This article discusses the issues of highest relevance to the United States and reviews the pros and cons of ratifying, from the perspective of the convention's intent and potential, sovereignty of states, and national public policies, and regarding the special protection recommended for particularly vulnerable children. Specific implementation issues discussed include training, accountability, and monitoring.

Trust in Vaccines: Why It Takes More than Good Faith.

PubMed

Begg, Norman

2013-08-12

This Vaccines issue on "Confidence in Vaccines" provides sound evidence through multiple perspectives of life-saving impacts when vaccination programs are effectively implemented in a population. Yet there remain challenges to achieving this impact, including scientific, medical, manufacturing, policy-related and logistical issues. Additionally, socio-cultural, religious and political agendas can come into play, taking public health hostage and sometimes allowing the circulation of myths regarding vaccination. All of these challenges play a role in public confidence in vaccines and vaccination. What we trust, we embrace. What we do not trust, we do not embrace.

Practicing participatory research in American Indian communities1–3

PubMed Central

Davis, Sally M; Reid, Raymond

2016-01-01

The purpose of this article is to explore the historical issues that affect research in American Indian communities and examine the implications of these issues as they relate to culturally sensitive, respectful, and appropriate research with this population. Methods include review and analysis of the literature and examination of our collective experience and that of our colleagues. Recommendations are given for conducting culturally sensitive, participatory research. We conclude that research efforts must build on the establishment of partnerships between investigators and American Indian communities to ensure accurate findings and analyses and to implement culturally relevant benefits. PMID:10195598

Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

PubMed Central

Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

2004-01-01

This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

Preparing for national implementation of an evidence-based, effective HIV prevention program among bahamian sixth-grade students.

PubMed

Knowles, Valerie; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Jones, Giavana; Harris, Carole; Kaljee, Linda; Li, Xiaoming; Koci, Veronica; Chen, Xinguang; Marshall, Sharon; Stanton, Bonita

2012-01-01

Using data from the preparatory phase prior to national implementation of an effective HIV prevention program (Focus on Youth in the Caribbean; FOYC) in all Bahamian government sixth-grade classes, we describe (1) actual FOYC implementation, (2) factors that influenced implementation, and (3) the relationship of implementation with intervention outcome. Six elementary schools (with 17 grade six classrooms) were selected to participate in the preparatory phase. The 17 teachers were invited to attend a training workshop, coordinate administration of questionnaires to the students, teach the 10 sessions of FOYC and complete self-assessment checklists. A total of 395 students submitted baseline and 311 students submitted year-end questionnaires. Thirteen teachers initiated FOYC; five completed all 10 sessions. Implementation of FOYC was not related to teacher FOYC workshop experience but did cluster by school. There were significant positive correlations between improved student knowledge of HIV/AIDS, protective health skills, perceived parental monitoring and reduced risk behaviours with the number of FOYC sessions delivered. Implementation was impeded by logistics issues, structural issues with the measures, and comfort-level issues, most of which can be addressed for national implementation. Degree of FOYC implementation is correlated with positive student outcomes.

Providers' perceptions of the implementation of a performance measurement system for substance abuse treatment: A process evaluation of the Service Quality Measures initiative.

PubMed

Myers, Bronwyn; Williams, Petal Petersen; Johnson, Kim; Govender, Rajen; Manderscheid, Ron; Koch, J Randy

2016-02-22

In South Africa, concerns exist about the quality of substance abuse treatment. We developed a performance measurement system, known as the Service Quality Measures (SQM) initiative, to monitor the quality of treatment and assess efforts to improve quality of care. In 2014, the SQM system was implemented at six treatment sites to evaluate how implementation protocols could be improved in preparation for wider roll-out. To describe providers' perceptions of the feasibility and acceptability of implementing the SQM system, including barriers to and facilitators of implementation. We conducted 15 in-depth interviews (IDIs) with treatment providers from six treatment sites (two sites in KwaZulu-Natal and four in the Western Cape). Providers were asked about their experiences in implementing the system, the perceived feasibility of the system, and barriers to implementation. All IDIs were audio-recorded and transcribed verbatim. A framework approach was used to analyse the data. Providers reported that the SQM system was feasible to implement and acceptable to patients and providers. Issues identified through the IDIs included a perceived lack of clarity about sequencing of key elements in the implementation of the SQM system, questions on integration of the system into clinical care pathways, difficulties in tracking patients through the system, and concerns about maximising patient participation in the process. Findings suggest that the SQM system is feasible to implement and acceptable to providers, but that some refinements to the implementation protocols are needed to maximise patient participation and the likelihood of sustained implementation.

Improving implementation of mental health services for trauma in multicultural elementary schools: stakeholder perspectives on parent and educator engagement.

PubMed

Langley, Audra; Santiago, Catherine DeCarlo; Rodríguez, Adriana; Zelaya, Jennifer

2013-07-01

Although more schools are offering mental health programs, few studies have involved the school community in research to improve their successful implementation. In this community-partnered study, focus groups were conducted with school staff and parents to explore issues related to community engagement and feasibility of a mental health intervention for elementary school students exposed to trauma. Four educator focus groups, including 23 participants, and 2 parent focus groups, consisting of 9 Spanish-speaking and 7 English-speaking parents were conducted. Participants discussed facilitators and barriers to successful implementation of the program. Participants identified the importance of pre-implementation parent education, raising awareness of the impact of student mental health among educators, maintaining ongoing communication during the intervention, and addressing logistical concerns. Participants described clear considerations for parent and educator engagement, both at the pre-implementation phase and during implementation of the program. Implications for next steps of this community-partnered approach are described.

Improving Implementation of Mental Health Services for Trauma in Multicultural Elementary Schools: Stakeholder Perspectives on Parent and Educator Engagement

PubMed Central

Santiago, Catherine DeCarlo; Rodríguez, Adriana; Zelaya, Jennifer

2013-01-01

Although more schools are offering mental health programs, few studies have involved the school community in research to improve their successful implementation. In this community partnered study, focus groups were conducted with school staff and parents to explore issues related to community engagement and feasibility of a mental health intervention for elementary school students exposed to trauma. Four educator focus groups, including 23 participants, and 2 parent focus groups, consisting of 9 Spanish-speaking and 7 English-speaking parents were conducted. Participants discussed facilitators and barriers to successful implementation of the program. Participants identified the importance of pre-implementation parent education, raising awareness of the impact of student mental health among educators, maintaining ongoing communication during the intervention, and addressing logistical concerns. Participants described clear considerations for parent and educator engagement both at the pre implementation phase and during implementation of the program. Implications for next steps of this community partnered approach are described. PMID:23576136

Oncologists' strategies and barriers to effective communication about the end of life.

PubMed

Granek, Leeat; Krzyzanowska, Monika K; Tozer, Richard; Mazzotta, Paolo

2013-07-01

Communicating about the end of life with patients has been reported as one of the most difficult and stressful part of the work of oncologists. Despite this fact, oncologists receive little training in this area, and many do not communicate effectively with patients. The purpose of this analysis, part of a larger study examining oncologists' experiences of patient loss, was to explore oncologists' communication strategies and communication barriers when discussing end-of-life issues with patients. Twenty oncologists were interviewed at three hospitals about their communication strategies on end-of-life issues with patients. The data were analyzed using the grounded theory method. The findings revealed the strategies to effective communication about the end of life included: being open and honest; having ongoing, early conversations; communicating about modifying treatment goals; and balancing hope and reality. Barriers to implementing these strategies fell broadly into three domains, including physician factors, patient factors, and institutional factors. Physician factors included difficulty with treatment and palliation, personal discomfort with death and dying, diffusion of responsibility among colleagues, using the "death-defying mode," lack of experience, and lack of mentorship. Patient factors included, patients and/or families being reluctant to talk about the end of life, language barriers, and younger age. Institutional factors included stigma around palliative care, lack of protocol about end-of-life issues; and lack of training for oncologists on how to talk with patients about end-of-life issues. We conclude by drawing implications from our study and suggest that further research and intervention are necessary to aid oncologists in achieving effective communication about end-of-life issues.

Affordable housing and health: a health impact assessment on physical inspection frequency.

PubMed

Klein, Elizabeth G; Keller, Brittney; Hood, Nancy; Holtzen, Holly

2015-01-01

To characterize the prevalence of health-related housing quality exposure for the vulnerable populations that live in affordable housing. Retrospective cross-sectional study. Affordable housing properties in Ohio inspected between 2007 and 2011. Stratified random sample of physical inspection reports (n = 370), including a case study of properties receiving multiple inspections (n = 35). Health-related housing factors, including mold, fire hazard, and others. The majority of affordable housing property inspections (85.1%) included at least 1 health-related housing quality issue. The prevalence of specific health-related violations was varied, with appliance and plumbing issues being the most common, followed by fire, mold, and pest violations. Across funding agencies, the actual implementation of inspection protocols differed. The majority of physical inspections identified housing quality issues that have the potential to impact human health. If the frequency of physical inspections is reduced as a result of inspection alignment, the most health protective inspection protocol should be selected for funding agency inspections; a standardized physical inspection tool is recommended to improve the consistency of inspection findings between mandatory physical inspections in order to promote optimum tenant health.

A data-driven approach to quality risk management.

PubMed

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-10-01

An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. ONLY A SUBSET OF THE RISK FACTORS HAD A SIGNIFICANT ASSOCIATION WITH QUALITY ISSUES, AND INCLUDED: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety.

Tailored program evaluation: Past, present, future.

PubMed

Suggs, L Suzanne; Cowdery, Joan E; Carroll, Jennifer B

2006-11-01

This paper discusses measurement issues related to the evaluation of computer-tailored health behavior change programs. As the first generation of commercially available tailored products is utilized in health promotion programming, programmers and researchers are becoming aware of the unique challenges that the evaluation of these programs presents. A project is presented that used an online tailored health behavior assessment (HBA) in a worksite setting. Process and outcome evaluation methods are described and include the challenges faced, and strategies proposed and implemented, for meeting them. Implications for future research in tailored program development, implementation, and evaluation are also discussed.

Training survey -- educational profile for Hanford HANDI 2000 project

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

Wilson, D.

Fluor Daniel Hanford, Inc. (FDH) is currently adopting streamlined business processes through integrated software solutions. Replacing the legacy software (current/replacement systems, attached) also avoids significant maintenance required to resolve Year 2000 issues. This initiative is being referred to as `HANDI 2000`. The software being implemented in the first phase of this project includes Indus International`s PASSPORT Software, Peoplesoft and Primavera P3 Software. The project, which encompasses all the system replacements that will occur, has been named `HANDI 2000.` The PASSPORT applications being implemented are Inventory Management, Purchasing, Contract Management, Accounts Payable, and MSDS (Material Safety Data Sheets).

CASE tools and UML: state of the ART.

PubMed

Agarwal, S

2001-05-01

With increasing need for automated tools to assist complex systems development, software design methods are becoming popular. This article analyzes the state of art in computer-aided software engineering (CASE) tools and unified modeling language (UML), focusing on their evolution, merits, and industry usage. It identifies managerial issues for the tools' adoption and recommends an action plan to select and implement them. While CASE and UML offer inherent advantages like cheaper, shorter, and efficient development cycles, they suffer from poor user satisfaction. The critical success factors for their implementation include, among others, management and staff commitment, proper corporate infrastructure, and user training.

The Making of SPINdle

NASA Astrophysics Data System (ADS)

Lam, Ho-Pun; Governatori, Guido

We present the design and implementation of SPINdle - an open source Java based defeasible logic reasoner capable to perform efficient and scalable reasoning on defeasible logic theories (including theories with over 1 million rules). The implementation covers both the standard and modal extensions to defeasible logics. It can be used as a standalone theory prover and can be embedded into any applications as a defeasible logic rule engine. It allows users or agents to issues queries, on a given knowledge base or a theory generated on the fly by other applications, and automatically produces the conclusions of its consequences. The theory can also be represented using XML.

Empowering women: participatory approaches in women's health and development projects.

PubMed

Manderson, L; Mark, T

1997-01-01

The authors describe the experience of NGOs (nongovernmental organizations) and community-based organizations in implementing projects aimed at improving women's health. The study included 16 projects, reflecting Australian NGO experiences in Africa, China, Southeast Asia, the Pacific, and South America. They illustrate the value of participatory approaches in determining needs and priorities, and the value of the continued involvement of women in implementation, monitoring, and evaluation. Approaches that succeeded in increasing women's access to and use of health services addressed gender issues, set realistic and achievable objectives, and recognized and enhanced the roles and status of women.

Compressive Sensing Image Sensors-Hardware Implementation

PubMed Central

Dadkhah, Mohammadreza; Deen, M. Jamal; Shirani, Shahram

2013-01-01

The compressive sensing (CS) paradigm uses simultaneous sensing and compression to provide an efficient image acquisition technique. The main advantages of the CS method include high resolution imaging using low resolution sensor arrays and faster image acquisition. Since the imaging philosophy in CS imagers is different from conventional imaging systems, new physical structures have been developed for cameras that use the CS technique. In this paper, a review of different hardware implementations of CS encoding in optical and electrical domains is presented. Considering the recent advances in CMOS (complementary metal–oxide–semiconductor) technologies and the feasibility of performing on-chip signal processing, important practical issues in the implementation of CS in CMOS sensors are emphasized. In addition, the CS coding for video capture is discussed. PMID:23584123

Issues in Planning and Implementing National Literacy Programmes.

ERIC Educational Resources Information Center

Carron, G., Ed.; Bordia, A., Ed.

The following papers were produced by participants and resource persons on specific issues of planning, management and implementation of literacy and post-literacy strategies: "People's Participation and Mobilization: Characteristics of the Literacy Campaigns in China" (Yanwei); "Strategies for Mobilization and Participation of…

Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

PubMed

Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek

2017-12-01

Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation produced perceptions of patient safety improvement. TDF use enabled behaviour change analysis due to implementation, for example, staff adoption of behaviours to ensure general practitioners receive good quality discharge information.

Implementing a National Scottish Digital Health & Wellbeing Service at Scale: A Qualitative Study of Stakeholders' Views.

PubMed

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

2015-01-01

Digital technologies are being used as part of international efforts to revolutionize healthcare in order to meet increasing demands such as the rising burden of chronic disease and ageing populations. In Scotland there is a government push towards a national service (Living It Up) as a single point of reference where citizens can access information, products and services to support their health and wellbeing. The aim of the study is to examine implementation issues including the challenges or facilitators which can help to sustain this intervention. We gathered data in three ways: a) participant observation to gain an understanding of LiU (N=16); b) in-depth interviews (N=21) with stakeholders involved in the process; and c) analysis of documentary evidence about the progress of the implementation (N=45). Barriers included the need to "work at risk" due to delays in financing, inadequate infrastructure and skill-set deficiencies, whilst facilitators included trusted relationships, champions and a push towards normalisation. The findings suggest that a Scottish ehealth service is achievable but identifies key considerations for future large scale initiatives.

Implementation and Evaluation of the Debate-Style Tutorial Study in a Third-Year Dental Curriculum in Japan

ERIC Educational Resources Information Center

Shingaki, Ryuji; Kamioka, Hiroshi; Irie, Masao; Nishimura, Fusanori

2006-01-01

We introduced a debate-style tutorial exercise into the third-year tutorial classes with the purpose of developing the students' logic, broadening their vision and encouraging them to express their opinions in public, before an audience. The issues for debate included medical (dental) and non-medical topics. Two separate debate exercises were…

Three Approaches to Teaching Art Methods Courses: Child Art, Visual Culture, and Issues-Based Art Education

ERIC Educational Resources Information Center

Chang, EunJung; Lim, Maria; Kim, Minam

2012-01-01

In this article, three art educators reflect on their ideas and experiences in developing and implementing innovative projects for their courses focusing on art for elementary education majors. They explore three different approaches. The three areas that are discussed in depth include: (1) understanding child art; (2) visual culture; and (3)…

Identifying gaps in conservation networks: of indicators and uncertainty in geographic-based analyses

Treesearch

Curtis H. Flather; Kenneth R. Wilson; Denis J. Dean; William C. McComb

1997-01-01

Mapping of biodiversity elements to expose gaps in. conservation networks has become a common strategy in nature-reserve design. We review a set of critical assumptions and issues that influence the interpretation and implementation of gap analysis, including: (1) the assumption that a subset of taxa can be used to indicate overall diversity patterns, and (2) the...

Professional Development, Capacity Building, and Research Needs: Critical Issues for Response to Intervention Implementation

ERIC Educational Resources Information Center

Danielson, Louis; Doolittle, Jennifer; Bradley, Renee

2007-01-01

The No Child Left Behind Act of 2001 in conjunction with the Individuals With Disabilities Education Act amendments of 2004 (IDEA) have created incentives to improve how K-12 instruction is provided and to improve the achievement of all students, including those with disabilities. To reach these goals, however, a thorough research base is needed,…

Strategies for integrating computer-based activities into your educational environment: a practical guide.

PubMed Central

Miller, J G; Wolf, F M

1996-01-01

Strategies for implementing instructional technology are based on recent experiences at the University of Michigan Medical Center. The issues covered include 1) addressing facilities, hardware, and staffing needs, 2) determining learners' skill requirements and appropriate training activities, and 3) selecting and customizing educational software. Many examples are provided, and nine key points for success are emphasized. PMID:8653447

Making Sustainability "Real": Using Group-Enquiry to Promote Education for Sustainable Development

ERIC Educational Resources Information Center

Ellis, Geraint; Weekes, Tony

2008-01-01

Sustainable development is now widely held as a transcendental ideal of town and country planning, yet the way in which it is taught in planning schools remains problematic. This arises from a range of factors, including the all-persuasive nature of sustainability and the lack of solid examples of success through implementation. The issue of how…

Fuels planning: science synthesis and integration; social issues fact sheet 13: Strategies for managing fuels and visual quality

Treesearch

Christine Esposito

2006-01-01

The public's acceptance of forest management practices, including fuels reduction, is heavily based on how forests look. Fuels managers can improve their chances of success by considering aesthetics when making management decisions. This fact sheet reviews a three-part general strategy for managing fuels and visual quality: planning, implementation, and monitoring...

76 FR 36011 - Airworthiness Directives; Fokker Services B.V. Model F.27 Mark 050, 200, 300, 400, 500, 600, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-21

...: Comments Invited We invite you to send any written relevant data, views, or arguments about this proposed...-operate in developing and implementing common safety regulatory standards and procedures.) Under this...-28-042, including Drawing June 23, 2010. W41192, Sheet 012, Issue AG, dated June 23, 2010, Drawing...

Developing a Continuous Improvement System

DTIC Science & Technology

2016-09-16

disagree that continuous improvement is critical to an organization’s suc-cess, since conducting business using a status quo philosophy will not work...for implementing one of these processes include: better operational efficiency, increased customer satisfaction, improved employee morale ...when a problem in reliability or maintenance may become the greatest opportunity. As described in the January-February 2011 issue of Defense AT&L

Listening to food workers: Factors that impact proper health and hygiene practice in food service.

PubMed

Clayton, Megan L; Clegg Smith, Katherine; Neff, Roni A; Pollack, Keshia M; Ensminger, Margaret

2015-01-01

Foodborne disease is a significant problem worldwide. Research exploring sources of outbreaks indicates a pronounced role for food workers' improper health and hygiene practice. To investigate food workers' perceptions of factors that impact proper food safety practice. Interviews with food service workers in Baltimore, MD, USA discussing food safety practices and factors that impact implementation in the workplace. A social ecological model organizes multiple levels of influence on health and hygiene behavior. Issues raised by interviewees include factors across the five levels of the social ecological model, and confirm findings from previous work. Interviews also reveal many factors not highlighted in prior work, including issues with food service policies and procedures, working conditions (e.g., pay and benefits), community resources, and state and federal policies. Food safety interventions should adopt an ecological orientation that accounts for factors at multiple levels, including workers' social and structural context, that impact food safety practice.

Transportation Institutional Plan

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

Not Available

This Institutional Plan is divided into three chapters. Chapter 1 provides background information, discusses the purposes of the Plan and the policy guidance for establishing the transportation system, and describes the projected system and the plans for its integrated development. Chapter 2 discusses the major participants who must interact to build the system. Chapter 3 suggests mechanisms for interaction that will foster wide participation in program planning and implementation and provides a framework for managing and resolving the issues related to development and operation of the transportation system. A list of acronyms and a glossary are included for the reader'smore » convenience. Also included in this Plan are four appendices. Of particular importance is Appendix A, which includes detailed discussion of specific transportation issues. Appendices B, C, and D provide supporting material to assist the reader in understanding the roles of the involved institutions.« less

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model.

PubMed

Zeigler, Bernard P; Redding, Sarah; Leath, Brenda A; Carter, Ernest L; Russell, Cynthia

2016-01-01

The Pathways Community HUB Model provides a unique strategy to effectively supplement health care services with social services needed to overcome barriers for those most at risk of poor health outcomes. Pathways are standardized measurement tools used to define and track health and social issues from identification through to a measurable completion point. The HUB use Pathways to coordinate agencies and service providers in the community to eliminate the inefficiencies and duplication that exist among them. Experience with the Model has brought out the need for better information technology solutions to support implementation of the Pathways themselves through decision-support tools for care coordinators and other users to track activities and outcomes, and to facilitate reporting. Here we provide a basis for discussing recommendations for such a data infrastructure by developing a conceptual model that formalizes the Pathway concept underlying current implementations. The main contribution is a set of core recommendations as a framework for developing and implementing a data architecture to support implementation of the Pathways Community HUB Model. The objective is to present a tool for communities interested in adopting the Model to learn from and to adapt in their own development and implementation efforts. Experience with the Community Health Access Project (CHAP) data base system (the core implementation of the Model) has identified several issues and remedies that have been developed to address these issues. Based on analysis of issues and remedies, we present several key features for a data architecture meeting the just mentioned recommendations. Presentation of features is followed by a practical guide to their implementation allowing an organization to consider either tailoring off-the-shelf generic systems to meet the requirements or offerings that are specialized for community-based care coordination. Looking to future extensions, we discuss the utility and prospects for an ontology to include care coordination in the Unified Medical Language System (UMLS) of the National Library of Medicine and other existing medical and nursing taxonomies. Pathways structures are an important principle, not only for organizing the care coordination activities, but also for structuring the data stored in electronic form in the conduct of such care. We showed how the proposed architecture encourages design of effective decision support systems for coordinated care and suggested how interested organizations can set about acquiring such systems. Although the presentation focuses on the Pathways Community HUB Model, the principles for data architecture are stated in generic form and are applicable to any health information system for improving care coordination services and population health.

Lithium Ion Batteries in Electric Drive Vehicles

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

Pesaran, Ahmad A.

2016-05-16

This research focuses on the technical issues that are critical to the adoption of high-energy-producing lithium Ion batteries. In addition to high energy density / high power density, this publication considers performance requirements that are necessary to assure lithium ion technology as the battery format of choice for electrified vehicles. Presentation of prime topics includes: long calendar life (greater than 10 years); sufficient cycle life; reliable operation under hot and cold temperatures; safe performance under extreme conditions; end-of-life recycling. To achieve aggressive fuel economy standards, carmakers are developing technologies to reduce fuel consumption, including hybridization and electrification. Cost and affordabilitymore » factors will be determined by these relevant technical issues which will provide for the successful implementation of lithium ion batteries for application in future generations of electrified vehicles.« less

The Unanticipated Challenges Associated With Implementing an Observational Study Protocol in a Large-Scale Physical Activity and Global Positioning System Data Collection.

PubMed

McCrorie, Paul; Walker, David; Ellaway, Anne

2018-04-30

Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. The SPACES (Studying Physical Activity in Children's Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through letterboxes, as well as the employment of fieldworkers to increase recruitment and the return of consent forms. Finally, we encountered data issues when processing physical activity and GPS data that had been initiated across daylight saving time. We present learning points and recommendations that may benefit future studies of similar methodology in their early stages of development. ©Paul McCrorie, David Walker, Anne Ellaway. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 30.04.2018.

Effect of culture on acceptance of telemedicine in Middle Eastern countries: case study of Jordan and Syria.

PubMed

Alajlani, Mohannad; Clarke, Malcolm

2013-04-01

We investigated issues that affect the use and adoption of telemedicine in Middle Eastern countries, taking the Hashemite Kingdom of Jordan and the Syrian Arab Republic as case studies. Our study is based on interviews with key stakeholders (including doctors, technicians, engineers, and decision makers) and questionnaires administered to key stakeholders (including patients), ensuring opinion was gained from people from a full range of backgrounds and roles in the healthcare system. We found doctor and patient resistance was a major issue preventing the adoption of telemedicine in both countries, followed by poor infrastructure, lack of funding, and lack of information technology training. Our research identifies that culture is a greater issue than technical matters for the adoption of telemedicine in Middle Eastern countries. Based on our preliminary results we developed a guideline framework for each country that might be applied to telemedicine projects at the pre-implementation phase. The proposed guideline framework was validated through a return visit to the stakeholders and seeking further opinion.

Using Citygml to Deploy Smart-City Services for Urban Ecosystems

NASA Astrophysics Data System (ADS)

Prandi, F.; De Amicis, R.; Piffer, S.; Soave, M.; Cadzow, S.; Gonzalez Boix, E.; D'Hont, E.

2013-05-01

The rapid technological evolution, which is characterizing all the disciplines involved within the wide concept of smart cities, becomes a key factor to trigger true user-driven innovation. In this context 3D city models will play an increasingly important role in our daily lives and become an essential part of the modern city information infrastructure (Spatial Data Infrastructure). The goal of this paper is to introduce the i-SCOPE (interoperable Smart City services through an Open Platform for urban Ecosystems) project methodology and implementations together with key technologies and open standards. Based on interoperable 3D CityGML UIMs, the aim of i-Scope is to deliver an open platform on top of which it possible to develop, within different domains, various "smart city" services. Moreover, in i-SCOPE different issues, transcending the mere technological domain, are being tackled, including aspects dealing with social and environmental issues. Indeed several tasks including citizen awareness, crowd source and voluntary based data collection as well as privacy issue concerning involved people should be considered.

How prevention curricula are taught under real-world conditions

PubMed Central

Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Shin, YoungJu; Graham, John; Krieger, Janice

2015-01-01

Purpose As interventions are disseminated widely, issues of fidelity and adaptation become increasingly critical to understand. This study aims to describe the types of adaptations made by teachers delivering a school-based substance use prevention curriculum and their reasons for adapting program content. Design/methodology/approach To determine the degree to which implementers adhere to a prevention curriculum, naturally adapt the curriculum, and the reasons implementers give for making adaptations, the study examined lesson adaptations made by the 31 teachers who implemented the keepin' it REAL drug prevention curriculum in 7th grade classrooms (n = 25 schools). Data were collected from teacher self-reports after each lesson and observer coding of videotaped lessons. From the total sample, 276 lesson videos were randomly selected for observational analysis. Findings Teachers self-reported adapting more than 68 percent of prevention lessons, while independent observers reported more than 97 percent of the observed lessons were adapted in some way. Types of adaptations included: altering the delivery of the lesson by revising the delivery timetable or delivery context; changing content of the lesson by removing, partially covering, revising, or adding content; and altering the designated format of the lesson (such as assigning small group activities to students as individual work). Reasons for adaptation included responding to constraints (time, institutional, personal, and technical), and responding to student needs (students' abilities to process curriculum content, to enhance student engagement with material). Research limitations/implications The study sample was limited to rural schools in the US mid-Atlantic; however, the results suggest that if programs are to be effectively implemented, program developers need a better understanding of the types of adaptations and reasons implementers provide for adapting curricula. Practical implications These descriptive data suggest that prevention curricula be developed in shorter teaching modules, developers reconsider the usefulness of homework, and implementer training and ongoing support might benefit from more attention to different implementation styles. Originality/value With nearly half of US public schools implementing some form of evidence-based substance use prevention program, issues of implementation fidelity and adaptation have become paramount in the field of prevention. The findings from this study reveal the complexity of the types of adaptations teachers make naturally in the classroom to evidence-based curricula and provide reasons for these adaptations. This information should prove useful for prevention researchers, program developers, and health educators alike. PMID:26290626

Current issues in Scandinavian acute psychiatric wards.

PubMed

Ruud, Torleif; Lindefors, Nils; Lindhardt, Anne

2006-01-01

The aim of the paper is to provide an overview of some of the most important issues faced by acute inpatient facilities in three Scandinavian countries, including reflections and critical remarks for discussion in this field. Information was drawn from scientific articles and official reports published in recent years, as well as the authors' own knowledge of acute facilities in their home countries. Acute inpatient facilities, including General Hospital Psychiatric Units (GHPUs), in all Scandinavian countries have several issues and problems in common, which include the organisation and capacity of acute services, the assessment of dangerousness and suicidality, the use of coercion and efforts to reduce coercion, the need to define and improve the quality of acute services, and the necessity to improve collaboration and continuity between acute services and other services. Although the emphasis some of these issues receive can vary across the three countries, Scandinavian mental health professionals (and policy makers) have begun to systematically share their experiences in developing a growing spirit of collaboration. Despite the role of welfare state and the deployment of substantial resources in Scandinavian countries, mental health practitioners are struggling to implement best practices in acute wards, to develop differentiated forms of acute services, and to reach the right balance and coordination between acute services and other services.

Electronic curriculum implementation at North American dental schools.

PubMed

Hendricson, William D; Panagakos, Fotinos; Eisenberg, Elise; McDonald, James; Guest, Gary; Jones, Pamela; Johnson, Lynn; Cintron, Laura

2004-10-01

Electronic curriculum, or E-curriculum, refers to computer-based learning including educational materials available on CD or DVD, online courses, electronic mechanisms to search the literature, email, and various applications of instructional technology including providing laptops to students, multimedia projection systems, and Internet-compatible classrooms. In spite of enthusiasm about the potential for E-curriculum to enhance dental education, there is minimal guidance in the literature to assist schools with implementation. The study objectives were: 1) identify U.S. and Canadian dental schools that have initiated mandatory laptop programs and assess cost, faculty development issues, extent of curricular use, problems, and qualitative perceptions; 2) determine the extent to which twenty-two other E-curriculum resources were available and used at North American dental schools; and 3) identify factors that influenced E-curriculum implementation. A twenty-six item questionnaire, known as the Electronic Curriculum Implementation Survey (ECIS), was mailed to all sixty-six North American dental schools (ten Canadian and fifty-six U.S. schools) during 2002-03 with a response rate of 100 percent. Twenty-five of the twenty-six ECIS questions employed a menu-driven, forced choice format, but respondents could provide amplifying comments. Fifty-three questionnaires were completed by associate deans for academic affairs, three by deans, and ten by instructional technology (IT) managers, IT committee chairs, or directors of dental informatics departments. The survey found that E-curriculum implementation among North American dental schools is following the classic innovation pattern in which a few early adopting institutions proceed rapidly while the majority of potential adopters make modifications slowly. Fourteen U.S. dental schools have established mandatory laptop programs for students. Ten of these laptop programs were created in the past two years; respondents reported numerous growing pains but were generally pleased with their progress. Other E-curriculum capabilities were incorporated into courses more frequently at laptop schools than the fifty-two non-laptop schools including websites, online course evaluations, and instructor use of email to communicate with students. Few dental schools use online courses, and at most schools, few faculty have received training in online instructional techniques. Virtually all North American dental schools have provided substantial instructional technology resources to their faculty, but use of twenty-two components and capabilities of E-curriculum was limited, especially at schools without laptop programs. Various faculty-related issues were reported as implementation barriers including lack of time, skill, and incentive to develop educational software. We conclude that many North American dental schools, especially those with laptop programs, are functioning at the "learn by doing" phase of initial implementation in a four-stage innovation adoption model. E-curriculum planners should pay close attention to implementation problems that occur at this stage where many innovation efforts break down.

Enhancing Credibility of Chemical Safety Studies: Emerging Consensus on Key Assessment Criteria

PubMed Central

Conrad, James W.; Becker, Richard A.

2011-01-01

Objectives We examined the extent to which consensus exists on the criteria that should be used for assessing the credibility of a scientific work, regardless of its funding source, and explored how these criteria might be implemented. Data sources Three publications, all presented at a session of the 2009 annual meeting of the Society for Risk Analysis, have proposed a range of criteria for evaluating the credibility of scientific studies. At least two other similar sets of criteria have recently been proposed elsewhere. Data extraction/synthesis In this article we review these criteria, highlight the commonalities among them, and integrate them into a list of 10 criteria. We also discuss issues inherent in any attempt to implement the criteria systematically. Conclusions Recommendations by many scientists and policy experts converge on a finite list of criteria for assessing the credibility of a scientific study without regard to funding source. These criteria should be formalized through a consensus process or a governmental initiative that includes discussion and pilot application of a system for reproducibly implementing them. Formal establishment of such a system should enable the debate regarding chemical studies to move beyond funding issues and focus on scientific merit. PMID:21163723

What does it mean to "employ" the RE-AIM model?

PubMed

Kessler, Rodger S; Purcell, E Peyton; Glasgow, Russell E; Klesges, Lisa M; Benkeser, Rachel M; Peek, C J

2013-03-01

Many grant proposals identify the use of a given evaluation model or framework but offer little about how such models are implemented. The authors discuss what it means to employ a specific model, RE-AIM, and key dimensions from this model for program planning, implementation, evaluation, and reporting. The authors report both conceptual and content specifications for the use of the RE-AIM model and a content review of 42 recent dissemination and implementation grant applications to National Institutes of Health that proposed the use of this model. Outcomes include the extent to which proposals addressed the overall RE-AIM model and specific items within the five dimensions in their methods or evaluation plans. The majority of grants used only some elements of the model (less than 10% contained thorough measures across all RE-AIM dimensions). Few met criteria for "fully developed use" of RE-AIM and the percentage of key issues addressed varied from, on average, 45% to 78% across the RE-AIM dimensions. The results and discussion of key criteria should help investigators in their use of RE-AIM and illuminate the broader issue of comprehensive use of evaluation models.

Countywide implementation of crisis intervention teams: Multiple methods, measures and sustained outcomes.

PubMed

Kubiak, Sheryl; Comartin, Erin; Milanovic, Edita; Bybee, Deborah; Tillander, Elizabeth; Rabaut, Celeste; Bisson, Heidi; Dunn, Lisa M; Bouchard, Michael J; Hill, Todd; Schneider, Steven

2017-09-01

The crisis intervention team (CIT) is a tool that can be used to foster pre-booking diversion of individuals with mental illness from the criminal justice system and into community treatment services. Although CIT is often implemented solely as the training of law enforcement officers, the model stipulates that CIT is a vehicle for collaboration with community stakeholders who share a similar philosophy, as well as expanded mental health services offering a 24 hour-seven days per week drop-off option for law enforcement officers. This case study presents the countywide implementation of CIT and expands previous findings on the prevalence of officer interaction with persons with mental health issues and CIT training outcomes, including changes in officer perception of individuals with mental health issues. Furthermore, analysis of the disposition of calls for officer assistance coded as mental health or suicide found significant increases in officer drop-offs to the mental health crisis center post-CIT training. Interrupted time series analysis determined that this change has been sustained over time, perhaps owing to the unique communication between county law enforcement and mental health staff. Implications for policy and practice are discussed. Copyright © 2017 John Wiley & Sons, Ltd.

The use of genetically-engineered animals in science: perspectives of Canadian Animal Care Committee members.

PubMed

Ormandy, Elisabeth H; Dale, Julie; Griffin, Gilly

2013-05-01

The genetic engineering of animals for their use in science challenges the implementation of refinement and reduction in several areas, including the invasiveness of the procedures involved, unanticipated welfare concerns, and the numbers of animals required. Additionally, the creation of genetically-engineered animals raises problems with the Canadian system of reporting animal numbers per Category of Invasiveness, as well as raising issues of whether ethical limits can, or should, be placed on genetic engineering. A workshop was held with the aim of bringing together Canadian animal care committee members to discuss these issues, to reflect on progress that has been made in addressing them, and to propose ways of overcoming any challenges. Although previous literature has made recommendations with regard to refinement and reduction when creating new genetically-engineered animals, the perception of the workshop participants was that some key opportunities are being missed. The participants identified the main roadblocks to the implementation of refinement and reduction alternatives as confidentiality, cost and competition. If the scientific community is to make progress concerning the implementation of refinement and reduction, particularly in the creation and use of genetically-engineered animals, addressing these roadblocks needs to be a priority. 2013 FRAME.

Barriers and facilitators to the implementation of orthodontic mini implants in clinical practice: a systematic review.

PubMed

Meursinge Reynders, Reint; Ronchi, Laura; Ladu, Luisa; Di Girolamo, Nicola; de Lange, Jan; Roberts, Nia; Mickan, Sharon

2016-09-23

Numerous surveys have shown that orthodontic mini implants (OMIs) are underused in clinical practice. To investigate this implementation issue, we conducted a systematic review to (1) identify barriers and facilitators to the implementation of OMIs for all potential stakeholders and (2) quantify these implementation constructs, i.e., record their prevalence. We also recorded the prevalence of clinicians in the eligible studies that do not use OMIs. Methods were based on our published protocol. Broad-spectrum eligibility criteria were defined. A barrier was defined as any variable that impedes or obstructs the use of OMIs and a facilitator as any variable that eases and promotes their use. Over 30 databases including gray literature were searched until 15 January 2016. The Joanna Briggs Institute tool for studies reporting prevalence and incidence data was used to critically appraise the included studies. Outcomes were qualitatively synthesized, and meta-analyses were only conducted when pre-set criteria were fulfilled. Three reviewers conducted all research procedures independently. We also contacted authors of eligible studies to obtain additional information. Three surveys fulfilled the eligibility criteria. Seventeen implementation constructs were identified in these studies and were extracted from a total of 165 patients and 1391 clinicians. Eight of the 17 constructs were scored by more than 50 % of the pertinent stakeholders. Three of these constructs overlapped between studies. Contacting of authors clarified various uncertainties but was not always successful. Limitations of the eligible studies included (1) the small number of studies; (2) not defining the research questions, i.e., the primary outcomes; (3) the research design (surveys) of the studies and the exclusive use of closed-ended questions; (4) not consulting standards for identifying implementation constructs; (5) the lack of pilot testing; (6) high heterogeneity; (7) the risk of reporting bias; and (8) additional shortcomings. Meta-analyses were not possible because of these limitations. Two eligible studies found that respectively 56.3 % (952/1691) and 40.16 % (439/1093) of clinicians do not use OMIs. Notwithstanding the limitations of the eligible studies, their findings were important because (1) 17 implementation constructs were identified of which 8 were scored by more than 50 % of the stakeholders; (2) the various shortcomings showed how to improve on future implementation studies; and (3) the underuse of OMIs in the selected studies and in the literature demonstrated the need to identify, quantify, and address implementation constructs. Prioritizing of future research questions on OMIs with all pertinent stakeholders is an important first step and could redirect research studies on OMIs towards implementation issues. Patients, clinicians, researchers, policymakers, insurance companies, implant companies, and research sponsors will all be beneficiaries.

A 20 MHz CMOS reorder buffer for a superscalar microprocessor

NASA Technical Reports Server (NTRS)

Lenell, John; Wallace, Steve; Bagherzadeh, Nader

1992-01-01

Superscalar processors can achieve increased performance by issuing instructions out-of-order from the original sequential instruction stream. Implementing an out-of-order instruction issue policy requires a hardware mechanism to prevent incorrectly executed instructions from updating register values. A reorder buffer can be used to allow a superscalar processor to issue instructions out-of-order and maintain program correctness. This paper describes the design and implementation of a 20MHz CMOS reorder buffer for superscalar processors. The reorder buffer is designed to accept and retire two instructions per cycle. A full-custom layout in 1.2 micron has been implemented, measuring 1.1058 mm by 1.3542 mm.

A geospatial soil-based DSS to reconcile landscape management and land protection

NASA Astrophysics Data System (ADS)

Manna, Piero; Basile, Angelo; Bonfante, Antonello; D'Antonio, Amedeo; De Michele, Carlo; Iamarino, Michela; Langella, Giuliano; Florindo Mileti, Antonio; Pileri, Paolo; Vingiani, Simona; Terribile, Fabio

2017-04-01

The implementation of UN Agenda 2030 may represent a great opportunity to place soil science at the hearth of many Sustainable Development Goals (e.g. SDGs 2, 3, 13, 15, 15.3, 16.7). On the other side the high complexity embedded in the factual implementation of SDG and many others ambitious objectives (e.g. FAO goals) may cause new frustrations if these policy documents will not bring real progresses. The scientific communities are asked to contribute to disentangle this complexity and possibly identifying a "way to go". This may help the large number of European directives (e.g. WFD, EIA), regulations and communications aiming to achieve a better environment but still facing large difficulties in their full implementation (e.g. COM2015/120; COM2013/683). This contribution has the motivation to provide a different perspective, thinking that the full implementation of SDGs and integrated land policies requires to challenge some key overlooked issues including full competence (and managing capability) about the landscape variability, its multi-functionalities (e.g. agriculture / environment) and its dynamic nature (many processes, including crops growth and fate of pollutants, are dynamic); moreover, it requires to support actions at a very detailed local scale since many processes and problems are site specific. The landscape and all the above issues have the soil as pulsing heart. Accordingly, we aim to demonstrate the multiple benefits in using a smart geoSpatial Decision Support System (S-DSS) grounded on soil modelling, called SOILCONSWEB (EU LIFE+ project and its extensions). It is a freely-accessible web platform based on a Geospatial Cyber-Infrastructure (GCI) and developed in Valle Telesina (South Italy) over an area of 20,000 ha. It supports a multilevel decision-making in agriculture and environment including the interaction with other land uses (such as landscape and urban planning) and thus it simultaneously delivers to SDGs 2, 3, 13, 15, 15.3, 16.7.

Best practices for preventing musculoskeletal disorders in masonry: stakeholder perspectives.

PubMed

Entzel, Pamela; Albers, Jim; Welch, Laura

2007-09-01

Brick masons and mason tenders report a high prevalence of work-related musculoskeletal disorders (WMSDs), many of which can be prevented with changes in materials, work equipment or work practices. To explore the use of "best practices" in the masonry industry, NIOSH organized a 2-day meeting of masonry stakeholders. Attendees included 30 industry representatives, 5 health and safety researchers, 4 health/safety specialists, 2 ergonomic consultants, and 2 representatives of state workers' compensation programs. Small groups discussed ergonomic interventions currently utilized in the masonry industry, including factors affecting intervention implementation and ways to promote diffusion of interventions. Meeting participants also identified various barriers to intervention implementation, including business considerations, quality concerns, design issues, supply problems, jobsite conditions and management practices that can slow or limit intervention diffusion. To be successful, future diffusion efforts must not only raise awareness of available solutions but also address these practical concerns.

Directions in implementation research methods for behavioral and social science.

PubMed

Irwin, Molly; Supplee, Lauren H

2012-10-01

There is a growing interest, by researchers, policymakers, and practitioners, in evidence-based policy and practice. As a result, more dollars are being invested in program evaluation in order to establish "what works," and in some cases, funding is specifically tied to those programs found to be effective. However, reproducing positive effects found in research requires more than simply adopting an evidence-based program. Implementation research can provide guidance on which components of an intervention matter most for program impacts and how implementation components can best be implemented. However, while the body of rigorous research on effective practices continues to grow, research on implementation lags behind. To address these issues, the Administration for Children and Families and federal partners convened a roundtable meeting entitled, Improving Implementation Research Methods for Behavioral and Social Science, in the fall of 2010. This special section of the Journal of Behavioral Health Services & Research includes papers from the roundtable and highlights the role implementation science can play in shedding light on the difficult task of taking evidence-based practices to scale.

'Virtual' central business office: how UMMS improved revenue cycle performance.

PubMed

Henciak, Bill; Fontaine, Christine; Fields, Keith; Parks, Stacy

2010-06-01

Based on its experience with implementing a virtual central business office, UMMS recommends the following steps to ensure the success of such an initiative: Define the process flow for the organization's day-today revenue cycle operations prior to implementation. Then select best practices and milestones for managing accounts. Identify any possible technology issues that could arise during implementation prior to go live. Hold a midproject debriefing with staff. Develop an organizational chart that details who is responsible for handling issues that arise during implementation and afterward.

Drivers and barriers to e-invoicing adoption in Greek large scale manufacturing industries

NASA Astrophysics Data System (ADS)

Marinagi, Catherine; Trivellas, Panagiotis; Reklitis, Panagiotis; Skourlas, Christos

2015-02-01

This paper attempts to investigate the drivers and barriers that large-scale Greek manufacturing industries experience in adopting electronic invoices (e-invoices), based on three case studies with organizations having international presence in many countries. The study focuses on the drivers that may affect the increase of the adoption and use of e-invoicing, including the customers demand for e-invoices, and sufficient know-how and adoption of e-invoicing in organizations. In addition, the study reveals important barriers that prevent the expansion of e-invoicing, such as suppliers' reluctance to implement e-invoicing, and IT infrastructures incompatibilities. Other issues examined by this study include the observed benefits from e-invoicing implementation, and the financial priorities of the organizations assumed to be supported by e-invoicing.

'We can't get anything done because...': making sense of 'barriers' to Practice-based Commissioning.

PubMed

Checkland, Kath; Coleman, Anna; Harrison, Stephen; Hiroeh, Urara

2009-01-01

To investigate the issues raised by participants as 'barriers' to the development of Practice-based Commissioning (PBC) in 'early adopter' sites in England. Detailed case studies of five PBC consortia in three Primary Care Trusts (PCTs). Data collection included interviews with a wide range of respondents (46 in total), including general practitioners, PCT employees, Local Authority employees and patient representatives, observation of many different types of meetings (68 in total), and analysis of documents tabled at meetings and circulated at other times. It has been claimed that progress in developing PBC has been slow. Our respondents articulated a number of factors that they felt were holding them back, which could have been identified as 'barriers' preventing change. The issues raised were consistent across our sites (lack of time, resources and personnel, and difficult relationships with the PCT), but observation suggested that these issues arose out of very different organizational 'sensemaking', and as a result the apparent 'barriers' had different meanings in different organizational contexts. Weick's concept of 'organizational sensemaking' provides a useful framework within which to explore the problems encountered when implementing policy. Observational methods are a powerful tool in understanding sensemaking. The variations in sensemaking that we observed suggest that the use of 'barrier' metaphors in descriptions of implementation problems risks homogenizing the portrayal of situations that differ greatly in reality. This implies that top-down or centrally driven solutions to such situations will often be inappropriate.

Factors influencing workplace health promotion intervention: a qualitative systematic review.

PubMed

Rojatz, Daniela; Merchant, Almas; Nitsch, Martina

2017-10-01

Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

GASB's New Financial Reporting Model: Implementation Project for School Districts.

ERIC Educational Resources Information Center

Bean, David; Glick, Paul

1999-01-01

In June 1999, the Governmental Accounting Standards Board (GASB) issued its statement on the structure of the basic financial reporting model for state and local governments. Explains the new financial reporting model and reviews the implementation issues that school districts will need to address. (MLF)

Comprehensive Metric Education Project: Implementing Metrics at a District Level Administrative Guide.

ERIC Educational Resources Information Center

Borelli, Michael L.

This document details the administrative issues associated with guiding a school district through its metrication efforts. Issues regarding staff development, curriculum development, and the acquisition of instructional resources are considered. Alternative solutions are offered. Finally, an overall implementation strategy is discussed with…

Supervision of community health workers in Mozambique: a qualitative study of factors influencing motivation and programme implementation.

PubMed

Ndima, Sozinho Daniel; Sidat, Mohsin; Give, Celso; Ormel, Hermen; Kok, Maryse Catelijne; Taegtmeyer, Miriam

2015-09-01

Community health workers (CHWs) in Mozambique (known as Agentes Polivalentes Elementares (APEs)) are key actors in providing health services in rural communities. Supervision of CHWs has been shown to improve their work, although details of how it is implemented are scarce. In Mozambique, APE supervision structures and scope of work are clearly outlined in policy and rely on supervisors at the health facility of reference. The aim of this study was to understand how and which aspects of supervision impact on APE motivation and programme implementation. Qualitative research methodologies were used. Twenty-nine in-depth interviews were conducted to capture experiences and perceptions of purposefully selected participants. These included APEs, health facility supervisors, district APE supervisors and community leaders. Interviews were recorded, translated and transcribed, prior to the development of a thematic framework. Supervision was structured as dictated by policy but in practice was irregular and infrequent, which participants identified as affecting APE's motivation. When it did occur, supervision was felt to focus more on fault-finding than being supportive in nature and did not address all areas of APE's work - factors that APEs identified as demotivating. Supervisors, in turn, felt unsupported and felt this negatively impacted performance. They had a high workload in health facilities, where they had multiple roles, including provision of health services, taking care of administrative issues and supervising APEs in communities. A lack of resources for supervision activities was identified, and supervisors felt caught up in administrative issues around APE allowances that they were unable to solve. Many supervisors were not trained in providing supportive supervision. Community governance and accountability mechanisms were only partially able to fill the gaps left by the supervision provided by the health system. The findings indicate the need for an improved supervision system to enhance support and motivation and ultimately performance of APEs. Our study found disconnections between the APE programme policy and its implementation, with gaps in skills, training and support of supervisors leading to sub-optimal supervision. Improved methods of supervision could be implemented including those that maximize the opportunities during face-to-face meetings and through community-monitoring mechanisms.

Linking HIV-Negative Youth to Prevention Services in 12 U.S. Cities: Barriers and Facilitators to Implementing the HIV Prevention Continuum.

PubMed

Doll, Mimi; Fortenberry, J Dennis; Roseland, Denise; McAuliff, Kathleen; Wilson, Craig M; Boyer, Cherrie B

2018-04-01

Linkage of HIV-negative youth to prevention services is increasingly important with the development of effective pre-exposure prophylaxis that complements behavioral and other prevention-focused interventions. However, effective infrastructure for delivery of prevention services does not exist, leaving many programs to address HIV prevention without data to guide program development/implementation. The objective of this study was to provide a qualitative description of barriers and facilitators of linkage to prevention services among high-risk, HIV-negative youth. Thematic analysis of structured interviews with staff implementing linkage to prevention services programs for youth aged 12-24 years. Twelve adolescent medicine HIV primary care programs as part of larger testing research program focused on young sexual minority men of color. The study included staff implementing linkage to prevention services programs along with community-based HIV testing programs. The main outcomes of the study were key barriers/facilitators to linkage to prevention services. Eight themes summarized perspectives on linkage to prevention services: (1) relationships with community partners, (2) trust between providers and youth, (3) youth capacity to navigate prevention services, (4) pre-exposure prophylaxis specific issues, (5) privacy issues, (6) gaps in health records preventing tailored services, (7) confidentiality of care for youth accessing services through parents'/caretakers' insurance, and (8) need for health-care institutions to keep pace with models that prioritize HIV prevention among at-risk youth. Themes are discussed in the context of factors that facilitated/challenged linkage to prevention services. Several evidence-based HIV prevention tools are available; infrastructures for coordinated service delivery to high-risk youth have not been developed. Implementation of such infrastructures requires attention to community-, provider-, and youth-related issues. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A common evaluation framework for the African Health Initiative

PubMed Central

2013-01-01

Background The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. Methods This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. Results and conclusions The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results. PMID:23819778

From Systems Understanding to Personalized Medicine: Lessons and Recommendations Based on a Multidisciplinary and Translational Analysis of COPD.

PubMed

Roca, Josep; Cano, Isaac; Gomez-Cabrero, David; Tegnér, Jesper

2016-01-01

Systems medicine, using and adapting methods and approaches as developed within systems biology, promises to be essential in ongoing efforts of realizing and implementing personalized medicine in clinical practice and research. Here we review and critically assess these opportunities and challenges using our work on COPD as a case study. We find that there are significant unresolved biomedical challenges in how to unravel complex multifactorial components in disease initiation and progression producing different clinical phenotypes. Yet, while such a systems understanding of COPD is necessary, there are other auxiliary challenges that need to be addressed in concert with a systems analysis of COPD. These include information and communication technology (ICT)-related issues such as data harmonization, systematic handling of knowledge, computational modeling, and importantly their translation and support of clinical practice. For example, clinical decision-support systems need a seamless integration with new models and knowledge as systems analysis of COPD continues to develop. Our experience with clinical implementation of systems medicine targeting COPD highlights the need for a change of management including design of appropriate business models and adoption of ICT providing and supporting organizational interoperability among professional teams across healthcare tiers, working around the patient. In conclusion, in our hands the scope and efforts of systems medicine need to concurrently consider these aspects of clinical implementation, which inherently drives the selection of the most relevant and urgent issues and methods that need further development in a systems analysis of disease.

NATIONAL FRAMEWORK FOR THE SUSTAINABILITY OF HEALTH KNOWLEDGE TRANSLATION INITIATIVES IN UGANDA.

PubMed

Basaza, Robert; Kinegyere, Alison; Mutatina, Boniface; Sewankambo, Nelson

2018-01-01

The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study. The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers. The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.

Biological issues in materials science and engineering: Interdisciplinarity and the bio-materials paradigm

NASA Astrophysics Data System (ADS)

Murr, L. E.

2006-07-01

Biological systems and processes have had, and continue to have, important implications and applications in materials extraction, processing, and performance. This paper illustrates some interdisciplinary, biological issues in materials science and engineering. These include metal extraction involving bacterial catalysis, galvanic couples, bacterial-assisted corrosion and degradation of materials, biosorption and bioremediation of toxic and other heavy metals, metal and material implants and prostheses and related dental and medical biomaterials developments and applications, nanomaterials health benefits and toxicity issue, and biomimetics and biologically inspired materials developments. These and other examples provide compelling evidence and arguments for emphasizing biological sicences in materials science and engineering curricula and the implementation of a bio-materials paradigm to facilitate the emergence of innovative interdisciplinarity involving the biological sciences and materials sciences and engineering.

Engaging the public on climate change issues

NASA Astrophysics Data System (ADS)

Bean, Alice

2016-03-01

As a Jefferson Science Fellow from August 2014-August 2015, Alice Bean worked with the Office of Religion and Global Affairs at the U.S. Department of State on climate change and environmental issues. The Office of Religion and Global Affairs works to implement the National Strategy on Religious Leader and Faith Community Engagement which includes building partnerships on environmental issues. With the United Nations Framework Convention on Climate Change Conference of the Parties meeting 21 in December, 2015 in Paris, there were and continue to be great opportunities for physicists to interact with policy makers and the general public. As an experimental particle physicist, much was learned about climate change science, how the public views scientists, how science can influence policy, but most especially how to communicate about science.

A lack of standardization: the basis for the ethical issues surrounding quality and performance reports.

PubMed

Suchy, Kirsten

2010-01-01

Consumers in the United States are taking advantage of the proliferation of publicly available, internet-based performance reports and quality appraisals of health plans, healthcare organizations, hospitals, and physicians to aid in their healthcare decision making. However, these appraisal practices have given rise to controversy and debate over certain distinctive ethical issues. This article advocates a standardized ethical framework to guide current and future development and implementation of performance reports. This framework, which would resolve a number of the major issues, includes the following ethical principles to guide the practice of public reporting on the Internet and facilitate enhanced quality improvement in the healthcare industry: legitimacy, data integrity and quality, transparency, informed understanding, equity, privacy and confidentiality, collaboration, accountability, and evaluation and continuous improvement.

ADA members weigh in on critical issues.

PubMed

Burgess, Karen; Ruesch, Jon D; Mikkelsen, Matthew C; Wagner, Karen Schaid

2003-01-01

Science, new technology, patient care, dental reimbursement and government regulations all affect today's dental practitioners. To find out more about how such challenges may affect current private practitioners, the American Dental Association conducted the 2000 Membership Needs and Opinions Survey. A questionnaire was sent to 6,310 ADA members in January 2000 with follow-up mailings in February, March and April 2000. Data collection was completed in July 2000. The survey included questions on critical professional issues, and on perceptions of the ADA and ADA priorities. A total of 3,558 completed surveys were received for an adjusted response rate of 59.5 percent. Members rated the identified issues' level of importance to them. The top three issues included "maintaining my ability to recommend the treatment option I feel is most appropriate for my patients," "receiving fair reimbursement for the dental services I provide," and "protecting myself, my staff and my patients from communicable diseases." New dentists found other items to be more significant to them compared with members overall. Although ADA members as a whole had similar views on critical issues facing dentistry and ADA priorities, there were significant differences regarding some issues. New dentists were far more concerned about securing funds for their practice and paying off debt than were all ADA members. Minority dentists expressed greater levels of concern about certain issues than did all ADA members. When planning and implementing ADA activities, the Association should continue to take into account members' relative rankings of professional issues and note issues of special interest to selected membership subgroups.

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model

PubMed Central

Zeigler, Bernard P.; Redding, Sarah; Leath, Brenda A.; Carter, Ernest L.; Russell, Cynthia

2016-01-01

Introduction: The Pathways Community HUB Model provides a unique strategy to effectively supplement health care services with social services needed to overcome barriers for those most at risk of poor health outcomes. Pathways are standardized measurement tools used to define and track health and social issues from identification through to a measurable completion point. The HUB use Pathways to coordinate agencies and service providers in the community to eliminate the inefficiencies and duplication that exist among them. Pathways Community HUB Model and Formalization: Experience with the Model has brought out the need for better information technology solutions to support implementation of the Pathways themselves through decision-support tools for care coordinators and other users to track activities and outcomes, and to facilitate reporting. Here we provide a basis for discussing recommendations for such a data infrastructure by developing a conceptual model that formalizes the Pathway concept underlying current implementations. Requirements for Data Architecture to Support the Pathways Community HUB Model: The main contribution is a set of core recommendations as a framework for developing and implementing a data architecture to support implementation of the Pathways Community HUB Model. The objective is to present a tool for communities interested in adopting the Model to learn from and to adapt in their own development and implementation efforts. Problems with Quality of Data Extracted from the CHAP Database: Experience with the Community Health Access Project (CHAP) data base system (the core implementation of the Model) has identified several issues and remedies that have been developed to address these issues. Based on analysis of issues and remedies, we present several key features for a data architecture meeting the just mentioned recommendations. Implementation of Features: Presentation of features is followed by a practical guide to their implementation allowing an organization to consider either tailoring off-the-shelf generic systems to meet the requirements or offerings that are specialized for community-based care coordination. Discussion: Looking to future extensions, we discuss the utility and prospects for an ontology to include care coordination in the Unified Medical Language System (UMLS) of the National Library of Medicine and other existing medical and nursing taxonomies. Conclusions and Recommendations: Pathways structures are an important principle, not only for organizing the care coordination activities, but also for structuring the data stored in electronic form in the conduct of such care. We showed how the proposed architecture encourages design of effective decision support systems for coordinated care and suggested how interested organizations can set about acquiring such systems. Although the presentation focuses on the Pathways Community HUB Model, the principles for data architecture are stated in generic form and are applicable to any health information system for improving care coordination services and population health. PMID:26870743

Implementation Issues in Federal Reform Efforts in Education: The United States and Australia.

ERIC Educational Resources Information Center

Porter, Paige

Multiple data sources are used in this study of educational change in the United States and Australia. The author considers political issues that may affect the implementation of educational reform efforts at the federal level, such as homogeneity versus heterogeneity, centralization versus decentralization, constitutional responsibility for…

From EDI to Internet Commerce: The BHP Steel Experience.

ERIC Educational Resources Information Center

Chan, Caroline; Swatman, Paula M. C.

2000-01-01

Discusses the issue of business-to-business electronic commerce implementation and the factors affecting it. Discusses electronic data interchange technology, describes the results of a case study of BHP Steel (Australia), and considers paradigm shifts in implementation issues related to electronic commerce that occur over time. (Author/LRW)

Issues Emerging from First-Year PDS Implementation.

ERIC Educational Resources Information Center

Castle, Sharon; Groth, Lois; Shaklee, Beverly

This paper focuses on a revised Professional Development School (PDS) program and what participant groups perceived to be key issues during the first year of implementation. It addresses the role of PDSs in improving the quality of beginning teachers within a non-supportive state policy environment. The George Mason University Elementary program…

75 FR 39443 - Implementation of OMB Guidance on Drug-Free Workplace Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

... (DOE) is removing its regulation implementing the Governmentwide common rule on drug-free workplace... drug legislation on November 18, 1988. Federal agencies issued an interim final common rule to... Governmentwide common rule on nonprocurement suspension and debarment. The agencies issued a final common rule...

Implementation of Service-Learning in Business Education: Issues and Challenges

ERIC Educational Resources Information Center

Poon, Patrick; Chan, Tsang Sing; Zhou, Lianxi

2011-01-01

This paper examines the issues and challenges in the implementation of service-learning in undergraduate business education. It also provides an assessment of the students' learning efficacy and outcomes over time through the service-learning participation. Service-learning is a pedagogical approach that integrates academic learning and community…

Commentary: The Tyranny of Time and the Reality Principle

ERIC Educational Resources Information Center

Gersten, Russell

2016-01-01

Each of the five articles in this special issue gets "into the weeds" in terms of studying actual classroom or school implementation of evidence-based or promising practices. Virtually all confront the issue of logistics and establishing an infrastructure for ensuring adequate implementation. In general, those studies that ask teachers…

Online and Social Media Suicide Prevention Interventions for Young People: A Focus on Implementation and Moderation

PubMed Central

Rice, Simon; Robinson, Jo; Bendall, Sarah; Hetrick, Sarah; Cox, Georgina; Bailey, Eleanor; Gleeson, John; Alvarez-Jimenez, Mario

2016-01-01

Objective: Suicide remains a major global public health issue for young people. The reach and accessibility of online and social media-based interventions herald a unique opportunity for suicide prevention. To date, the large body of research into suicide prevention has been undertaken atheoretically. This paper provides a rationale and theoretical framework (based on the interpersonal theory of suicide), and draws on our experiences of developing and testing online and social media-based interventions. Method: The implementation of three distinct online and social media-based intervention studies, undertaken with young people at risk of suicide, are discussed. We highlight the ways that these interventions can serve to bolster social connectedness in young people, and outline key aspects of intervention implementation and moderation. Results: Insights regarding the implementation of these studies include careful protocol development mindful of risk and ethical issues, establishment of suitably qualified teams to oversee development and delivery of the intervention, and utilisation of key aspects of human support (i.e., moderation) to encourage longer-term intervention engagement. Conclusions: Online and social media-based interventions provide an opportunity to enhance feelings of connectedness in young people, a key component of the interpersonal theory of suicide. Our experience has shown that such interventions can be feasibly and safely conducted with young people at risk of suicide. Further studies, with controlled designs, are required to demonstrate intervention efficacy. PMID:27274743

Online and Social Media Suicide Prevention Interventions for Young People: A Focus on Implementation and Moderation.

PubMed

Rice, Simon; Robinson, Jo; Bendall, Sarah; Hetrick, Sarah; Cox, Georgina; Bailey, Eleanor; Gleeson, John; Alvarez-Jimenez, Mario

2016-01-01

Suicide remains a major global public health issue for young people. The reach and accessibility of online and social media-based interventions herald a unique opportunity for suicide prevention. To date, the large body of research into suicide prevention has been undertaken atheoretically. This paper provides a rationale and theoretical framework (based on the interpersonal theory of suicide), and draws on our experiences of developing and testing online and social media-based interventions. The implementation of three distinct online and social media-based intervention studies, undertaken with young people at risk of suicide, are discussed. We highlight the ways that these interventions can serve to bolster social connectedness in young people, and outline key aspects of intervention implementation and moderation. Insights regarding the implementation of these studies include careful protocol development mindful of risk and ethical issues, establishment of suitably qualified teams to oversee development and delivery of the intervention, and utilisation of key aspects of human support (i.e., moderation) to encourage longer-term intervention engagement. Online and social media-based interventions provide an opportunity to enhance feelings of connectedness in young people, a key component of the interpersonal theory of suicide. Our experience has shown that such interventions can be feasibly and safely conducted with young people at risk of suicide. Further studies, with controlled designs, are required to demonstrate intervention efficacy.

Special Topic Interoperability and EHR: Combining openEHR, SNOMED, IHE, and Continua as approaches to interoperability on national eHealth.

PubMed

Beštek, Mate; Stanimirović, Dalibor

2017-08-09

The main aims of the paper comprise the characterization and examination of the potential approaches regarding interoperability. This includes openEHR, SNOMED, IHE, and Continua as combined interoperability approaches, possibilities for their incorporation into the eHealth environment, and identification of the main success factors in the field, which are necessary for achieving required interoperability, and consequently, for the successful implementation of eHealth projects in general. The paper represents an in-depth analysis regarding the potential application of openEHR, SNOMED, IHE and Continua approaches in the development and implementation process of eHealth in Slovenia. The research method used is both exploratory and deductive in nature. The methodological framework is grounded on information retrieval with a special focus on research and charting of existing experience in the field, and sources, both electronic and written, which include interoperability concepts and related implementation issues. The paper will try to answer the following inquiries that are complementing each other: 1. Scrutiny of the potential approaches, which could alleviate the pertinent interoperability issues in the Slovenian eHealth context. 2. Analyzing the possibilities (requirements) for their inclusion in the construction process for individual eHealth solutions. 3. Identification and charting the main success factors in the interoperability field that critically influence development and implementation of eHealth projects in an efficient manner. Provided insights and identified success factors could serve as a constituent of the strategic starting points for continuous integration of interoperability principles into the healthcare domain. Moreover, the general implementation of the identified success factors could facilitate better penetration of ICT into the healthcare environment and enable the eHealth-based transformation of the health system especially in the countries which are still in an early phase of eHealth planning and development and are often confronted with differing interests, requirements, and contending strategies.

How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings.

PubMed

Lorenzi, Nancy M; Kouroubali, Angelina; Detmer, Don E; Bloomrosen, Meryl

2009-02-23

Adoption of EHRs by U.S. ambulatory practices has been slow despite the perceived benefits of their use. Most evaluations of EHR implementations in the literature apply to large practice settings. While there are similarities relating to EHR implementation in large and small practice settings, the authors argue that scale is an important differentiator. Focusing on small ambulatory practices, this paper outlines the benefits and barriers to EHR use in this setting, and provides a "field guide" for these practices to facilitate successful EHR implementation. The benefits of EHRs in ambulatory practices include improved patient care and office efficiency, and potential financial benefits. Barriers to EHRs include costs; lack of standardization of EHR products and the design of vendor systems for large practice environments; resistance to change; initial difficulty of system use leading to productivity reduction; and perceived accrual of benefits to society and payers rather than providers. The authors stress the need for developing a flexible change management strategy when introducing EHRs that is relevant to the small practice environment; the strategy should acknowledge the importance of relationship management and the role of individual staff members in helping the entire staff to manage change. Practice staff must create an actionable vision outlining realistic goals for the implementation, and all staff must buy into the project. The authors detail the process of implementing EHRs through several stages: decision, selection, pre-implementation, implementation, and post-implementation. They stress the importance of identifying a champion to serve as an advocate of the value of EHRs and provide direction and encouragement for the project. Other key activities include assessing and redesigning workflow; understanding financial issues; conducting training that is well-timed and meets the needs of practice staff; and evaluating the implementation process. The EHR implementation experience depends on a variety of factors including the technology, training, leadership, the change management process, and the individual character of each ambulatory practice environment. Sound processes must support both technical and personnel-related organizational components. Additional research is needed to further refine recommendations for the small physician practice and the nuances of specific medical specialties.

Contemporary undergraduate implant dentistry education: a systematic review.

PubMed

Koole, S; De Bruyn, H

2014-03-01

Consensus reports recommend that students upon graduation should possess a significant level of knowledge and competence in implant dentistry, including basic competences in diagnostics, treatment planning, restorative, straightforward surgical and maintenance procedures. In response, undergraduate curricula need to integrate implant dentistry. This narrative review explores educational programmes in terms of competences, related research and barriers or reflections, regarding implementation in undergraduate curricula. Publications (2008-2013) were searched systematically in WoS, PubMed and ERIC and screened independently by two authors in four stages: removal of duplicates, title screening, abstract screening and full-text reading. Inclusion criteria encompassed implant dentistry in undergraduate education. Finally, 37 of 420 papers were included. Detailed information regarding programme content, number of participants, staff input, logistics/funding issues is scattered. Theoretical education is predominant, and pre-clinical/clinical training is offered minimally, often carried out in elective programmes. However, selected straightforward cases treated by undergraduates yield positive outcomes with low failure rates, few complications, high patient satisfaction and student appreciation. Barriers to implementing implant dentistry in the undergraduate curriculum include funding issues, limitations in time or staff availability/competence and lack of suitable patients. Overcoming these barriers is worthwhile as experience-based implant education affects future practice as well-informed students propose more restorative alternatives to their patients. Although implant dentistry is increasingly integrated in undergraduate curricula, challenges remain in developing strategies to implement existing competence profiles and the extent of experience-based education. To support further advancement, universities should report comprehensively on their implant programmes to allow comparison and reproduction in other environments. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Ethical questions must be considered for electronic health records.

PubMed

Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

2012-09-01

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

Show me the money: the implications of Schedule H.

PubMed

Salinsky, Eileen

2009-04-21

Responding to policymakers' concerns, the Internal Revenue Service (IRS) implemented significant new hospital community benefit reporting under Schedule H of its revised Form 990, the return used by tax-exempt organizations. This issue brief considers the policy implications of the quantitative and qualitative information that hospitals are now mandated to report through Schedule H, including the costs associated with charity care, bad debt, and the unreimbursed costs of Medicaid and Medicare. The paper examines unresolved issues related to the new reporting requirements, such as controversies regarding the scope of Schedule H, and considers the potential for these reports to influence IRS oversight activities, legislative action, and hospital policies and practices.

Optical protocols for terabit networks

NASA Technical Reports Server (NTRS)

Chua, P. L.; Lambert, J. L.; Morookian, J. M.; Bergman, L. A.

1991-01-01

This paper describes a new fiber-optic local area network technology providing 100X improvement over current technology, has full crossbar funtionality, and inherent data security. Based on optical code-division multiple access (CDMA), using spectral phase encoding/decoding of optical pulses, networking protocols are implemented entirely in the optical domain and thus conventional networking bottlenecks are avoided. Component and system issues for a proof-of-concept demonstration are discussed, as well as issues for a more practical and commercially exploitable system. Possible terrestrial and aerospace applications of this technology, and its impact on other technologies are explored. Some initial results toward realization of this concept are also included.

Regional scale hydrology with a new land surface processes model

NASA Technical Reports Server (NTRS)

Laymon, Charles; Crosson, William

1995-01-01

Through the CaPE Hydrometeorology Project, we have developed an understanding of some of the unique data quality issues involved in assimilating data of disparate types for regional-scale hydrologic modeling within a GIS framework. Among others, the issues addressed here include the development of adequate validation of the surface water budget, implementation of the STATSGO soil data set, and implementation of a remote sensing-derived landcover data set to account for surface heterogeneity. A model of land surface processes has been developed and used in studies of the sensitivity of surface fluxes and runoff to soil and landcover characterization. Results of these experiments have raised many questions about how to treat the scale-dependence of land surface-atmosphere interactions on spatial and temporal variability. In light of these questions, additional modifications are being considered for the Marshall Land Surface Processes Model. It is anticipated that these techniques can be tested and applied in conjunction with GCIP activities over regional scales.

Implementation of psychological clinical trials in epilepsy: Review and guide.

PubMed

Modi, Avani C; Wagner, Janelle; Smith, Aimee W; Kellermann, Tanja S; Michaelis, Rosa

2017-09-01

The International League Against Epilepsy (ILAE) Neuropsychiatry commission and United States Institute of Medicine report both identified cognitive and psychological comorbidities as a significant issue for individuals with epilepsy, with rates as high as 60%. However, there is a paucity of evidence-based treatments for many psychological conditions (e.g., learning disorders, cognitive disorders, behavioral disorders). Because of inherent challenges in the implementation of psychological therapy trials and specific considerations for the population with epilepsy, the focus of the current review was to provide guidance and recommendations to conduct psychological trials for individuals with epilepsy. Several key areas will be discussed, including selection of patients, trial design, psychological intervention considerations, outcomes and evaluation of results, publication of trial results, and special issues related to pediatric clinical trials. Rigorously designed psychological therapy trials will set the stage for evidence-based practice in the care of individuals with epilepsy, with the goal of improving seizures, side effects, and HRQOL. Copyright © 2017 Elsevier Inc. All rights reserved.

pyblocxs: Bayesian Low-Counts X-ray Spectral Analysis in Sherpa

NASA Astrophysics Data System (ADS)

Siemiginowska, A.; Kashyap, V.; Refsdal, B.; van Dyk, D.; Connors, A.; Park, T.

2011-07-01

Typical X-ray spectra have low counts and should be modeled using the Poisson distribution. However, χ2 statistic is often applied as an alternative and the data are assumed to follow the Gaussian distribution. A variety of weights to the statistic or a binning of the data is performed to overcome the low counts issues. However, such modifications introduce biases or/and a loss of information. Standard modeling packages such as XSPEC and Sherpa provide the Poisson likelihood and allow computation of rudimentary MCMC chains, but so far do not allow for setting a full Bayesian model. We have implemented a sophisticated Bayesian MCMC-based algorithm to carry out spectral fitting of low counts sources in the Sherpa environment. The code is a Python extension to Sherpa and allows to fit a predefined Sherpa model to high-energy X-ray spectral data and other generic data. We present the algorithm and discuss several issues related to the implementation, including flexible definition of priors and allowing for variations in the calibration information.

Management and integration of engineering and construction activities: Lessons learned from the AP1000{sup R} nuclear power plant China project

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

McCullough, M. C.; Ebeling-Koning, D.; Evans, M. C.

2012-07-01

The lessons learned during the early phase of design engineering and construction activities for the AP1000 China Project can be applied to any project involving multiple disciplines and multiple organizations. Implementation of a first-of-a-kind design to directly support construction activities utilizing resources assigned to design development and design delivery creates challenges with prioritization of activities, successful closure of issues, and communication between site organizations and the home office. To ensure successful implementation, teams were assigned and developed to directly support construction activities including prioritization of activities, site communication and ensuring closure of site emergent issues. By developing these teams, themore » organization is better suited to meet the demands of the construction schedule while continuing with design evolution of a standard plant and engineering delivery for multiple projects. For a successful project, proper resource utilization and prioritization are key for overcoming obstacles and ensuring success of the engineering organization. (authors)« less

Considerations for the retrofit of data link

NASA Technical Reports Server (NTRS)

Corwin, William H.; Mccauley, Hugo W.

1990-01-01

Human factors issues related to the retrofit of data link in commercial transport aircraft are discussed. Topics that must be considered for data link implementation include, the loss of the party line, (i.e., the availability to all aircraft of information transmitted on a common voice frequency), and the scheduling of information to the flight crew. This paper focuses primarily on the human factors issues related to retrofit of Mode S. Retrofits is a difficult task because panel space accessible to flight crew members is limited. As with all cockpit equipment, data link implementation will have to comply with Federal Aviation Regulation 25.1523, which requires the manufacturer to address the conspicuity and ease of use of the data link device, and to assess the impact on crew workload. Operational sequence diagrams are provided to illustrate a methodology that can be used to decompose the flight crew body channel utilization of candidate avionics configurations in order to optimize the pilot-vehicle interface.

An Aerodynamic Simulation Process for Iced Lifting Surfaces and Associated Issues

NASA Technical Reports Server (NTRS)

Choo, Yung K.; Vickerman, Mary B.; Hackenberg, Anthony W.; Rigby, David L.

2003-01-01

This paper discusses technologies and software tools that are being implemented in a software toolkit currently under development at NASA Glenn Research Center. Its purpose is to help study the effects of icing on airfoil performance and assist with the aerodynamic simulation process which consists of characterization and modeling of ice geometry, application of block topology and grid generation, and flow simulation. Tools and technologies for each task have been carefully chosen based on their contribution to the overall process. For the geometry characterization and modeling, we have chosen an interactive rather than automatic process in order to handle numerous ice shapes. An Appendix presents features of a software toolkit developed to support the interactive process. Approaches taken for the generation of block topology and grids, and flow simulation, though not yet implemented in the software, are discussed with reasons for why particular methods are chosen. Some of the issues that need to be addressed and discussed by the icing community are also included.

Ethical and Diversity Challenges in Ecologically Sensitive Systems-Oriented Interventions

PubMed Central

Jason, Leonard A.

2016-01-01

This article discusses ethical and diversity challenges involved in implementing ecologically sensitive, systems-oriented research. These issues are considered with reference to a series of community-based interventions dealing with stigma and chronic illness, recovery from substance-use disorders, and prevention of tobacco use. Each of these ecological interventions incorporates a systems approach, which allows an understanding of how individuals affect and are influenced by their social environments. In addition, issues of diversity with respect to underrepresented and marginalized groups are considered, including overcoming obstacles to gaining access to resources and promoting increased opportunities and empowerment. Throughout, the central importance of developing relationships with key gatekeepers and stakeholders, as well as timely and effective communications with various coalition members, is highlighted. By bringing into the research and policy process diverse citizen/participant suggestions and input regarding the need for, or design and implementation of ecologically and systems-based interventions, researchers can build collaborative relationships that fuel trust and partnerships, leading to more ethically responsible research. PMID:26618968

Evaluation of the Community Multiscale Air Quality (CMAQ) ...

EPA Pesticide Factsheets

The Community Multiscale Air Quality (CMAQ) model is a state-of-the-science air quality model that simulates the emission, transport and fate of numerous air pollutants, including ozone and particulate matter. The Computational Exposure Division (CED) of the U.S. Environmental Protection Agency develops the CMAQ model and periodically releases new versions of the model that include bug fixes and various other improvements to the modeling system. In the fall of 2016, CMAQ version 5.1.1 will be released. This new version of CMAQ will contain important bug fixes to several issues that were identified in CMAQv5.1 (the current public release version of the CMAQ model), and additionally include updates to other portions of the code. Some specific model updates include a new implementation of the wind-blown dust calculation in CMAQv5.1.1 which fixes several bugs that were identified in the current implementation of wind-blown dust in CMAQv5.1. Several other major updates to the model include an update to the calculation of aerosols; implementation of full halogen chemistry (CMAQv5.1 contains a partial implementation of halogen chemistry), which is particularly important for hemispheric applications of the CMAQ model, as halogen chemistry is need to accurately simulation the destruction of ozone over the ocean; and the new carbon bond 6 (CB6) chemical mechanism. Several annual, and numerous episodic, CMAQv5.1.1 simulations will be performed to assess the impact of these

Software Development Technologies for Reactive, Real-Time, and Hybrid Systems: Summary of Research

NASA Technical Reports Server (NTRS)

Manna, Zohar

1998-01-01

This research is directed towards the implementation of a comprehensive deductive-algorithmic environment (toolkit) for the development and verification of high assurance reactive systems, especially concurrent, real-time, and hybrid systems. For this, we have designed and implemented the STCP (Stanford Temporal Prover) verification system. Reactive systems have an ongoing interaction with their environment, and their computations are infinite sequences of states. A large number of systems can be seen as reactive systems, including hardware, concurrent programs, network protocols, and embedded systems. Temporal logic provides a convenient language for expressing properties of reactive systems. A temporal verification methodology provides procedures for proving that a given system satisfies a given temporal property. The research covered necessary theoretical foundations as well as implementation and application issues.

Supporting decision-making processes for evidence-based mental health promotion.

PubMed

Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian

2011-12-01

The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.

Research into display sharing techniques for distributed computing environments

NASA Technical Reports Server (NTRS)

Hugg, Steven B.; Fitzgerald, Paul F., Jr.; Rosson, Nina Y.; Johns, Stephen R.

1990-01-01

The X-based Display Sharing solution for distributed computing environments is described. The Display Sharing prototype includes the base functionality for telecast and display copy requirements. Since the prototype implementation is modular and the system design provided flexibility for the Mission Control Center Upgrade (MCCU) operational consideration, the prototype implementation can be the baseline for a production Display Sharing implementation. To facilitate the process the following discussions are presented: Theory of operation; System of architecture; Using the prototype; Software description; Research tools; Prototype evaluation; and Outstanding issues. The prototype is based on the concept of a dedicated central host performing the majority of the Display Sharing processing, allowing minimal impact on each individual workstation. Each workstation participating in Display Sharing hosts programs to facilitate the user's access to Display Sharing as host machine.

Implementation of real-time ultrasound in a thoracic surgery practice.

PubMed

Coonar, Aman S; Hughes, Jacqueline A; Walker, Susan; dePerrot, Marc; Waddell, Thomas K; Pierre, Andrew F; Darling, Gail E; Johnston, Michael R; Keshavjee, Shaf

2009-05-01

The purpose of this study was to implement real-time transthoracic ultrasound in a thoracic surgery and lung transplant practice. Ultrasound units that are light, small, robust, and portable are now available. Obstacles to use include demarcation issues between specialties, training, and a perception that basic ultrasound may be difficult to use. The experience of implementing this is described. After a training period, 62 studies were performed in 4 months. Patients and clinicians gave positive feedback. The learning time was short, and with ultrasonic guidance, all interventional procedures were successful at the first attempt, without any complications. Basic transthoracic ultrasound was found to be easy to learn and use by thoracic surgeons, fellows, and specialist nurses. Patients were appreciative. Real-time use may have genuine advantages to patient care.

Community action against asthma: examining the partnership process of a community-based participatory research project.

PubMed

Parker, Edith A; Israel, Barbara A; Williams, Melina; Brakefield-Caldwell, Wilma; Lewis, Toby C; Robins, Thomas; Ramirez, Erminia; Rowe, Zachary; Keeler, Gerald

2003-07-01

Community Action Against Asthma (CAAA) is a community-based participatory research (CBPR) project that assesses the effects of outdoor and indoor air quality on exacerbation of asthma in children, and tests household- and neighborhood-level interventions to reduce exposure to environmental asthma triggers. Representatives of community-based organizations, academia, an integrated health system, and the local health department work in partnership on CAAA's Steering Committee (SC) to design and implement the project. To conduct a process evaluation of the CAAA community-academic partnership. In-depth interviews containing open-ended questions were conducted with SC members. Analysis included established methods for qualitative data, including focused coding and constant comparison methods. Community setting in Detroit, Michigan. Twenty-three members of the CAAA SC. Common themes identified by SC members relating to the partnership's ability to achieve project goals and the successes and challenges facing the partnership itself. Identified partnership accomplishments included: successful implementation of a complex project, identification of children with previously undiagnosed asthma, and diverse participation and community influence in SC decisions. Challenges included ensuring all partners' influence in decision-making, the need to adjust to "a different way of doing things" in CBPR, constraints and costs of doing CBPR felt by all partners, ongoing need for communication and maintaining trust, and balancing the needs of science and the community through intervention. CBPR can enhance and facilitate basic research, but care must be given to trust issues, governance issues, organizational culture, and costs of participation for all organizations involved.