CSAPR Parallel Proposal (77 FR 10350)

EPA Pesticide Factsheets

EPA proposes additional revisions to certain portions of the Transport Rule (Federal Implementation Plans: Interstate Transport of Fine Particulate Matter and Ozone and Correction of SIP Approvals, published August 8, 2011).

CSAPR June Revisions Rule (77 FR 34830)

EPA Pesticide Factsheets

EPA takes final action on revisions to the final Transport Rule (Federal Implementation Plans: Interstate Transport of Fine Particulate Matter and Ozone and Correction of SIP Approvals, published August 8, 2011).

Implementation of a multi-professional standardized care plan in electronic health records for the care of stroke patients.

PubMed

Pöder, Ulrika; Fogelberg-Dahm, Marie; Wadensten, Barbro

2011-09-01

To compare staff opinions about standardized care plans and self-reported habits with regard to documentation, and their perceived knowledge about the evidence-based guidelines in stroke care before and after implementation of an evidence-based-standardized care plan (EB-SCP) and quality standard for stroke care. The aim was also to describe staff opinions about, and their use of, the implemented EB-SCP. To facilitate evidence-based practice (EBP), a multi-professional EB-SCP and quality standard for stroke care was implemented in the electronic health record (EHR). Quantitative, descriptive and comparative, based on questionnaires completed before and after implementation. Perceived knowledge about evidence-based guidelines in stroke care increased after implementation of the EB-SCP. The majority agreed that the EB-SCP is useful and facilitates their work. There was no change between before and after implementation with regard to opinions about standardized care plans, self-reported documentation habits or time spent on documentation. An evidence-based SCP seems to be useful in patient care and improves perceived knowledge about evidence-based guidelines in stroke care. For nursing managers, introduction of evidence-based SCP in the EHR may improve the prerequisites for promoting high-quality EBP in multi-professional care. 2011 Blackwell Publishing Ltd.

State of the science on implementation research in early child development and future directions.

PubMed

Aboud, Frances E; Yousafzai, Aisha K; Nores, Milagros

2018-05-01

We summarize the state of the field of implementation research and practice for early child development and propose recommendations. First, conclusions are drawn regarding what is generally known about the implementation of early childhood development programs, based on papers and discussions leading to a published series on the topic. Second, recommendations for short-term activities emphasize the use of newly published guidelines for reporting data collection methods and results for implementation processes; knowledge of the guidelines and a menu of measures allows for planning ahead. Additional recommendations include careful documentation of early-stage implementation, such as adapting a program to a different context and assessing feasibility, as well as the process of sustaining and scaling up a program. Using existing implementation information by building on and improving past programs and translating them into policy are recommended. Longer term goals are to identify implementation characteristics of effective programs and determinants of these characteristics. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.

Implementation of a software for REmote COMparison of PARticlE and photon treatment plans: ReCompare.

PubMed

Löck, Steffen; Roth, Klaus; Skripcak, Tomas; Worbs, Mario; Helmbrecht, Stephan; Jakobi, Annika; Just, Uwe; Krause, Mechthild; Baumann, Michael; Enghardt, Wolfgang; Lühr, Armin

2015-09-01

To guarantee equal access to optimal radiotherapy, a concept of patient assignment to photon or particle radiotherapy using remote treatment plan exchange and comparison - ReCompare - was proposed. We demonstrate the implementation of this concept and present its clinical applicability. The ReCompare concept was implemented using a client-server based software solution. A clinical workflow for the remote treatment plan exchange and comparison was defined. The steps required by the user and performed by the software for a complete plan transfer were described and an additional module for dose-response modeling was added. The ReCompare software was successfully tested in cooperation with three external partner clinics and worked meeting all required specifications. It was compatible with several standard treatment planning systems, ensured patient data protection, and integrated in the clinical workflow. The ReCompare software can be applied to support non-particle radiotherapy institutions with the patient-specific treatment decision on the optimal irradiation modality by remote treatment plan exchange and comparison. Copyright © 2015. Published by Elsevier GmbH.

Implementation status and explanatory analysis of early advance care planning for Stage IV non-small cell lung cancer patients.

PubMed

Tokito, Takaaki; Murakami, Haruyasu; Mori, Keita; Osaka, Iwao; Takahashi, Toshiaki

2015-03-01

The American Society of Clinical Oncology published the goals of individualized care including advance care planning for advanced cancer patients in 2011. However, no data are available on the implementation status of advance care planning. We retrospectively reviewed the electronic medical records and informed consent forms of consecutive Stage IV non-small cell lung cancer patients treated with chemotherapy between January 2010 and December 2012 at our institution. Two outcomes were defined to investigate the advance care planning implementation status: C-D, the duration from the last day of chemotherapy to death and D-D, that from the day of confirmed do-not-attempt-resuscitation order to death. The study included 136 eligible patients. The advance care planning implementation status in participating patients was as follows: 96 (70%) patients received information on 'incurable disease before first-line chemotherapy', 69 (50%) were informed about 'supportive care before first-line chemotherapy', whereas 43 (32%) learned about their prognosis. The do-not-attempt-resuscitation decision was reflected in 29 patients' will (21%). The median C-D was 64 days. Receipt of ≤2 chemotherapy regimens and provision of prognosis information to patients were significantly associated with long C-D in multivariate analysis. The median D-D was 25 days. Provision of information on supportive care before first-line chemotherapy and provision of prognosis information to patients were significantly associated with long D-D in multivariate analysis. Our results suggest that there is possible benefit from providing information on supportive care before first-line chemotherapy and informing patients about their prognosis in prolonging the duration of supportive care. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Frequently Asked Questions about Music Therapy

MedlinePlus

... of clients, develop and implement treatment plans, and evaluate and document clinical changes. Once the music therapy ... of the profession is published. This includes a descriptive statistical profile of the profession. Music therapists' salaries ...

CSAPR Direct Final Rule (77 FR 10342)

EPA Pesticide Factsheets

EPA takes direct final action on additional revisions to the final Transport Rule (Federal Implementation Plans: Interstate Transport of Fine Particulate Matter and Ozone and Correction of SIP Approvals published August 8, 2011).

White Sturgeon Bibliography, 1985 Final Report.

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

Fickeisen, Duane H.

1986-03-01

This bibliography presents citations to the majority of published materials on white sturgeon (Acipenser transmontanus). The purpose was to assist in planning and implementing research on white sturgeon in the Columbia River system. (ACR)

77 FR 26361 - Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-03

... services and receive Federal matching funds. As a result, States will be better able to design and tailor... design and tailor Medicaid services to better accommodate individual needs. This may result in improved... States to design and implement HCBS under the Medicaid State Plan. In April 4, 2008, we published a...

Intra-dialytic exercise training: a pragmatic approach.

PubMed

Greenwood, Sharlene A; Naish, Patrick; Clark, Rachel; O'Connor, Ellen; Pursey, Victoria A; Macdougall, Iain C; Mercer, Thomas H; Koufaki, Pelagia

2014-09-01

This continuing education paper outlines the skills and knowledge required to plan, implement and evaluate a pragmatic approach to intra-dialytic exercise training. The aim of this continuing education article is to enable the nephrology multi-disciplinary team (MDT) to plan, implement and evaluate the provision of intra-dialytic exercise training for patients receiving haemodialysis therapy. After reading this article the reader should be able to: Appreciate the level of evidence base for the clinical effectiveness of renal exercise rehabilitation and locate credible sources of research and educational information Understand and consider the need for appropriate evaluation and assessment outcomes as part of a renal rehabilitation plan Understand the components of exercise programming and prescription as part of an integrated renal rehabilitation plan Develop a sustainable longer term exercise and physical activity plan. © 2014 The Authors Journal of Renal Care published by John Wiley & Sons Ltd on behalf of European Dialysis & Transplant Nurses Association/European Renal Care Association.

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.

Impact of the lung oncology multidisciplinary team meetings on the management of patients with cancer.

PubMed

Ung, Kim Ann; Campbell, Belinda A; Duplan, Danny; Ball, David; David, Steven

2016-06-01

Multidisciplinary team (MDT) meetings are increasingly regarded as a component of multidisciplinary cancer care. We aimed to prospectively measure the impact of MDT meetings on clinicians' management plans for lung oncology patients, and the implementation rate of the meeting recommendations. Consecutive patient cases presented at the weekly lung oncology MDT meetings were prospectively enrolled. Investigators compared the clinicians' management plans pre-meeting with the consensus plans post-meeting. The meeting was considered to have an impact on management plans if ≥1 of the following changes were detected: tumor stage, histology, treatment intent or treatment modality, or if additional investigations were recommended. Investigators reviewed hospital patient records at 4 months to determine if the meeting recommendations were implemented. Reasons for non-implementation were also recorded. Of the 55 eligible cases, the MDT meeting changed management plans in 58% (CI 45-71%; P < 0.005). These changes included: additional investigations (59%), or changes in treatment modality (19%), treatment intent (9%), histology (6%) or tumor stage (6%). The meeting recommendations were implemented in 72% of cases. Reasons for non-implementation included deteriorating patient performance status, clinician's preference, the influence of new clinical information obtained after the meeting or patient decision. MDT meetings significantly impact on the management plans for lung oncology patients. The majority of MDT recommendations (72%) were implemented into patient care. These findings provide further evidence to support the role of MDT meetings as an essential part of the decision-making process for the optimal multidisciplinary management of patients with cancer. © 2014 Wiley Publishing Asia Pty Ltd.

School Meals for Healthy Children: Meeting the Dietary Guidelines for Americans and Complying with the Requirements of the Healthy Meals for Healthy Americans Act.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison. Bureau for Food and Nutrition Services.

The Healthy Meals for Healthy American Act of 1994 requires that a variety of meal-planning approaches be available for schools to plan menus. The United States Department of Agriculture (USDA) regulation "School Meals Initiative for Healthy Children," published in 1995, implements the provisions of the 1994 legislation and incorporates…

Science You Can Use Bulletin: Revisiting disturbance: A new guide for keeping dry mixed conifer forests healthy through fuel management

Treesearch

Sue Miller; Theresa Jain; Mike A. Battaglia; Han-Sup Han; Russell T. Graham; Christopher R. Keyes; Jeremy S. Fried; Jonathan E. Sandquist

2014-01-01

Planning for hazardous fuels reduction can be challenging, given that land managers must balance multiple resource objectives. To help managers with planning and implementing fuel treatments, the Rocky Mountain Research Station, with support from the Joint Fire Science Program, has published A Comprehensive Guide to Fuel Management Practices for Dry Mixed Conifer...

Role of motor vehicle emission controls in state implementation plans

DOT National Transportation Integrated Search

2000-01-01

The American Association of State Highway and Transportation Official's (AASHTO) Guide for the Design of Pavement Structures is widely used in the design of new and rehabilitated highway pavements. However, the current Design Guide, published in 1993...

A neo-strategic planning approach to enhance local tobacco control programs.

PubMed

Douglas, Malinda R; Carter, Sara Sally R; Wilson, Andrew P; Chan, Andie

2015-01-01

Research in tobacco control demonstrating best practices is widely disseminated; however, application at the local level is often difficult. Translating research into practice requires a concerted effort to develop an understanding of the evidence and how it can be applied within diverse contexts. A strategic planning infrastructure was developed to support the translation of evidence-based interventions into community practice. This paper highlights the strategic process of turning "know-what" into "know-how" to facilitate the strategic planning and implementation of tobacco control best practices at the local level. The purpose, people, process, and product strategies of knowledge management and translation provided a framework for the strategic planning infrastructure. The knowledge translation concepts of audience, motivations, and mechanisms were synergized in the neo-strategic planning component design. The participants were 20 community coalitions funded to implement local tobacco control programs. From 2004 to 2011, the strategic planners facilitated a cyclical process to translate research into practice using a trio of integrated tools, skill-building workshops on strategic planning, and grantee-driven technical assistance and consultation. In the short term, the usefulness of the strategic planning components to the programs was measured. The intermediate outcome was the successful movement of the community programs from the planning stage to the implementation stage. The achievement of community-level changes in planned tobacco control efforts was the overall outcome measure for the success of the local coalitions. Seventeen of 20 communities that began the planning process implemented strategic plans. All 17 of the programs implemented evidence-based practices, resulting in numerous tobacco-free policies, increased cessation, and increased support from the media and community. Bridging the gap between research and practice can enhance the practicality, efficiency, and effectiveness of tobacco control programs at the local level, maximizing the potential positive health impact. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Development of an implementation plan for the 6-PACK falls prevention programme as part of a randomised controlled trial: protocol for a series of preimplementation studies.

PubMed

Barker, Anna L; Morello, Renata T; Ayton, Darshini R; Hill, Keith D; Landgren, Fiona S; Brand, Caroline A

2016-12-01

Inhospital falls cause morbidity, staff burden and increased healthcare costs. It is unclear if the persistent problem of inhospital falls is due to the use of ineffective interventions or their suboptimal implementation. The 6-PACK programme appears to reduce fall injuries and a randomised controlled trial (RCT) was undertaken to confirm effects. This paper describes the protocol for the preimplementation studies that aimed to identify moderators of the effective use of the 6-PACK programme to inform the development of an implementation plan to be applied in the RCT. The 6-PACK project included five preimplementation studies: (1) a profile of safety climate; (2) review of current falls prevention practice; (3) epidemiology of inhospital falls; (4) acceptability of the 6-PACK programme; and (5) barriers and enablers to implementation of the 6-PACK programme. The Theoretical Domain Framework that includes 12 behaviour change domains informed the design of these studies that involved 540 staff and 8877 patients from 24 wards from six Australian hospitals. Qualitative and quantitative methods were applied with data collected via: structured bedside observation; daily nurse unit manager verbal report of falls; audit of medical records, incident reporting and hospital administrative data; surveys of ward nurses; focus groups with ward nurses; and key informant interviews with senior staff. Information on contextual, system, intervention, patient and provider level factors is critical to the development of an implementation plan. Information gained from these studies was used to develop a plan applied in the RCT that addressed the barriers and harnessed enablers. The RCT is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000332921. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Implementing business continuity effectively within the UK National Health Service.

PubMed

Roberts, Patrick; Molyneux, Helen

2010-11-01

Whereas major incident planning is very well established within National Health Service (NHS) organisations in the UK, business continuity management (BCM) planning, in many cases, is a relatively new activity; however, a combination of factors including the emergence of H1N1 influenza, has led to growing interest in the subject. This paper draws on both the personal experience of the authors and published research in relevant fields to make a number of specific recommendations about the effective implementation of BCM within NHS organisations. These include the need to define the BCM project properly; conduct a thorough business impact analysis considering 'back office' as well as clinical activities; define suitable command and control arrangements with clear delegated authority; and support plan development with appropriate training.

California State Implementation Plan; Navajo Nation; Salt River Pima-Maricopa Indian Community; Correcting Amendments

EPA Pesticide Factsheets

EPA published final rules in the Federal Register approving certain revisions to the California SIP. EPA included inaccurate amendatory instructions preventing incorporation of the actions into the CFR. All the errors are being corrected by this action.

[Systematization of nursing assistance: subsidies for implementation].

PubMed

Hermida, Patrícia Madalena Vieira; Araújo, Izilda Esmênia Muglia

2006-01-01

This study reviews national literature about the Systematization of Nursing Assistance in order to detect and reflect on the phases of its implementation. An electronic search of the data bases at LILACS, MEDLINE and BDENF revealed 61 published studies on this subject in nursing journals. This present study focuses on negative experiences regarding its implementation and presents a strategy for its successful implementation. The plan was observed to have various phases, but it was observed that the institution's structure, facilities and demands had to be first studied. It was concluded that the process for its implementation would be complex and difficult, but could contribute towards improving the quality of nursing care.

The Ontario Osteoporosis Strategy: implementation of a population-based osteoporosis action plan in Canada.

PubMed

Jaglal, S B; Hawker, G; Cameron, C; Canavan, J; Beaton, D; Bogoch, E; Jain, R; Papaioannou, A

2010-06-01

In the last decade, there have been a number of action plans published to highlight the importance of preventing osteoporosis and related fractures. In the province of Ontario Canada, the Ministry of Health provided funding for the Ontario Osteoporosis Strategy. The goal is to reduce morbidity, mortality, and costs from osteoporosis and related fractures through an integrated and comprehensive approach aimed at health promotion and disease management. This paper describes the components of the Ontario Osteoporosis Strategy and progress on implementation efforts as of March 2009. There are five main components: health promotion; bone mineral density testing, access, and quality; postfracture care; professional education; and research and evaluation. Responsibility for implementation of the initiatives within the components is shared across a number of professional and patient organizations and academic teaching hospitals with osteoporosis researchers. The lessons learned from each phase of the development, implementation, and evaluation of the Ontario Osteoporosis Strategy provides a tremendous opportunity to inform other jurisdictions embarking on implementing similar large-scale bone health initiatives.

50 CFR 300.66 - Prohibitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... accordance with the annual management measures published pursuant to 50 CFR 300.62. (b) Fish for halibut except in accordance with the catch sharing plans and domestic management measures implemented under... while commercial fishing or from sport fishing, as defined at § 300.61, except that persons authorized...

50 CFR 300.66 - Prohibitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... accordance with the annual management measures published pursuant to 50 CFR 300.62. (b) Fish for halibut except in accordance with the catch sharing plans and domestic management measures implemented under... while commercial fishing or from sport fishing, as defined at § 300.61, except that persons authorized...

50 CFR 300.66 - Prohibitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... accordance with the annual management measures published pursuant to 50 CFR 300.62. (b) Fish for halibut except in accordance with the catch sharing plans and domestic management measures implemented under... while commercial fishing or from sport fishing, as defined at § 300.61, except that persons authorized...

78 FR 26708 - Pacific Halibut Fisheries; Catch Sharing Plan; Correcting Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-08

... published on March 15, 2013, that implemented annual management measures governing the Pacific halibut... (78 FR 16423), included annual management measures for managing the harvest of Pacific halibut (Hippoglossus stenolepis) in the sport fishery in International Pacific Halibut Commission (IPHC) Regulatory...

Using a Software Package to Publish EAD Encoded Finding Aids: A Practical Approach and Gradual Implementation at the Archives Departementales de la Cote-d'Or, France

ERIC Educational Resources Information Center

Devarrewaere, Anthony; Roelly, Aude

2005-01-01

The Archives Departementales de la Cote-d'Or chose as a priority for its automation plan the acquisition of a search engine, to publish online archival descriptions and the library catalogue. The Archives deliberately opted for a practical approach, using for the encoding of the finding aids an automatic data export from an archival management…

CWA 15793 2011 Planning and Implementation Tool

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

Gross, Alan; Nail, George

This software, built on an open source platform called Electron (runs on Chromium and Node.js), is designed to assist organizations in the implementation of a biorisk management system consistent with the requirements of the international, publicly available guidance document CEN Workshop Agreement 15793:2011 (CWA 15793). The software includes tools for conducting organizational gap analysis against CWA 15793 requirements, planning tools to support the implementation of CWA 15793 requirements, and performance monitoring support. The gap analysis questions are based on the text of CWA 15793, and its associated guidance document, CEN Workshop Agreement 16393:2012. The authors have secured permission from themore » publisher of CWA 15793, the European Committee for Standardization (CEN), to use language from the document in the software, with the understanding that the software will be made available freely, without charge.« less

Applying the plan-do-study-act model to increase the use of kangaroo care.

PubMed

Stikes, Reetta; Barbier, Denise

2013-01-01

To increase the rate of participation in kangaroo care within a level III neonatal intensive care unit. Preterm birth typically results in initial separation of mother and infant which may disrupt the bonding process. Nurses within the neonatal intensive care unit can introduce strategies that will assist parents in overcoming fears and developing relationships with their infants. Kangaroo care is a method of skin-to-skin holding that has been shown to enhance the mother-infant relationship while also improving infant outcomes. However, kangaroo care has been used inconsistently within neonatal intensive care unit settings. The Plan-Do-Study-Act Model was used as a framework for this project. Plan-Do-Study-Act Model uses four cyclical steps for continuous quality improvement. Based upon Plan-Do-Study-Act Model, education was planned, surveys were developed and strategies implemented to overcome barriers. Four months post-implementation, the use of kangaroo care increased by 31%. Staff surveys demonstrated a decrease in the perceived barriers to kangaroo care as well as an increase in kangaroo care. Application of Plan-Do-Study-Act Model was successful in meeting the goal of increasing the use of kangaroo care. The use of the Plan-Do-Study-Act Model framework encourages learning, reflection and validation throughout implementation. Plan-Do-Study-Act Model is a strategy that can promote the effective use of innovative practices in nursing. © 2013 Blackwell Publishing Ltd.

"I sleep better at night:" How peer review of radiation treatment plans indirectly improves quality of care across radiation treatment programs.

PubMed

Brundage, Michael D; Hart, Margaret; O'Donnell, Jennifer; Reddeman, Lindsay; Gutierrez, Eric; Foxcroft, Sophie; Warde, Padraig

Peer review of radiation oncology treatment plans is increasingly recognized as an important component of quality assurance in radiation treatment planning and delivery. Peer review of treatment plans can directly improve the quality of those plans and can also have indirect effects on radiation treatment programs. We undertook a systematic, qualitative approach to describing the indirect benefits of peer review, factors that were seen to facilitate or act as barriers to the implementation of peer review, and strategies to address these barriers across a provincial jurisdiction of radiation oncology programs (ROPs). Semistructured qualitative interviews were held with radiation oncology department heads and radiation therapy managers (or delegates) in all 14 ROPs in Ontario, Canada. We used a theoretically guided phenomenological qualitative approach to design and analyze the interview content. Themes were recorded by 2 independent reviewers, and any discordance was resolved by consensus. A total of 28 interviews were completed with 32 interviewees. Twenty-two unique themes addressed perceived benefits of peer review, relating to either peer review structure (n = 3), process (n = 9), or outcome (n = 10). Of these 22 themes, 19 related to indirect benefits to ROPs. In addition, 18 themes related to factors that facilitated peer review activities and 30 themes related to key barriers to implementing peer review were identified. Findings were consistent with, and enhanced the understanding of, previous survey-based assessments of the benefits and challenges of implementing peer review programs. Although challenges and concerns regarding the implementation of peer review were evident, the indirect benefits to radiation programs are numerous, far outweigh the implementation challenges, and strongly complement the direct individual-patient benefits that result from peer review quality assurance of radiation treatment plans. Copyright © 2016. Published by Elsevier Inc.

[Management of the risks associated with allergens in school canteens in Barcelona (Spain)].

PubMed

Caballé-Gavaldà, Laura; García-Cid, Ester; Fontcuberta-Famadas, Mireia; Balfagón-Marzal, Pere; Durán-Neira, Julia

2014-01-01

To determine demand for special meals and their types for students with food allergies or intolerances (FAI) in school canteens in Barcelona (Spain) during the 2011-12 school year, and to ascertain the degree of implementation of self-assessment plans and preventive measures for the management of allergens, and the relationships between the application of such measures and other variables. A descriptive study was performed of a representative sample of schools (n=129). The dependent variables collected data on the schools and students, the level of demand for special meals, and the implementation of preventive measures. Independent variables consisted of canteen management, the number of users, and whether self-assessment plans were implemented. For those schools that prepared meals (n=92), an index was calculated from the questions on preventive measures. Student t-tests were used to compare the means of the indices with stratification by the independent variables. A total of 89% of schools served special meals for students with FAI (1,507 special meals per day, 5% of all meals) and 65% had no allergen control plan. The mean of the indices was 11.6 out of 17. Externally managed canteens, with more users and with self-assessment plans, implemented more preventive measures for allergen management (p<0.05). A high proportion of schools report carrying out preventive measures in the process of preparing and serving special meals. Those with self-assessment plans have better preventive practices. To manage this food-related risk, food hygiene inspection services should promote the implementation of allergen control plans in school canteens. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

78 FR 37719 - Interim Final Determination To Defer Sanctions; California; South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... Determination To Defer Sanctions; California; South Coast Air Quality Management District AGENCY: Environmental... Quality Management District's (SCAQMD) portion of the California State Implementation Plan (SIP) published... California submitted the ``South Coast Air Quality Management District Proposed Contingency Measures for the...

40 CFR 52.242 - Disapproved rules and regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.242 Disapproved rules and regulations. Link to an amendment published at 75 FR 37730, June 30, 2010. (a) The following Air Pollution... Air Pollution Control District. (i) Rule 118, Emergencies, submitted on March 10, 1998. (3) Imperial...

50 CFR 300.66 - Prohibitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... accordance with the annual management measures published pursuant to 50 CFR 300.62. (b) Fish for halibut except in accordance with the catch sharing plans and domestic management measures implemented under 50... while commercial fishing or from sport fishing, as defined at § 300.61, except that persons authorized...

50 CFR 300.66 - Prohibitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... accordance with the annual management measures published pursuant to 50 CFR 300.62. (b) Fish for halibut except in accordance with the catch sharing plans and domestic management measures implemented under... subsistence fishing for halibut while commercial fishing or sport fishing, as defined in § 300.61, from the...

Understanding what asthma plans mean: a linguistic analysis of terminology used in published texts.

PubMed

Ring, Nicola; Pinnock, Hilary; Wilson, Caroline; Hoskins, Gaylor; Jepson, Ruth; Wyke, Sally; Sheikh, Aziz

2011-06-01

To identify from the literature what terms are used for 'asthma plans', with what meaning, and in what context(s). Linguistic analysis of a selected body of asthma literature from 1989-2009. A wide range of asthma plan terminology was evident, with terms such as 'action plans', 'self-management plans' and 'treatment plans' being applied inconsistently and synonymously. For individual patients the term 'asthma plan' can describe a clinically-determined list of prescribed medication, an agreed plan to guide self-management of changing symptoms, or a more holistic 'living with asthma' plan. In some contexts the term 'asthma plan' was also used to describe an organisational system of care, which causes further ambiguity. Within the literature, a plethora of terms is used inconsistently and with varied meaning. This is a potential, but previously unrecognised, barrier to asthma plan implementation. A taxonomy of asthma plans and a standardised definitions of terms is required.

77 FR 5700 - Approval and Promulgation of Implementation Plans; New Hampshire: Prevention of Significant...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-06

... appropriate emission thresholds for determining which new stationary sources and modification projects become... affects major stationary sources in New Hampshire that have GHG emissions above the thresholds established... higher thresholds in the Tailoring Rule, EPA published a final rule on December 30, 2010, narrowing its...

40 CFR 52.281 - Visibility protection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Visibility protection. 52.281 Section 52.281 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.281 Visibility protection. Link to an amendment published at 76 FR 34611, June 14,...

Harnessing Technology to Support Learning

ERIC Educational Resources Information Center

Richardson, Tony; Ecclesfield, Nigel; Lewis, Christine

2008-01-01

In April 2008, one sees the start of the consultation on the second phase of the government's e-strategy for education, published in 2005 as "Harnessing technology: transforming learning and children's services." This follows hard on the heels of the progress report and implementation plan for the technology strategy for further…

Use of electrical resistivity to detect underground mine voids in Ohio : research implementation plan.

DOT National Transportation Integrated Search

2005-09-01

This project was a natural extension of the 1996-1997 void detection work completed by the USGS for : ODOT. This earlier project was entitled Detection of Underground Mine Voids in Ohio by Use of : Geophysical Methods and was published as U. S....

77 FR 23652 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Comprehensive Annual Catch Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-20

... Annual Catch Limit Amendment (Comprehensive ACL Amendment) for the Fishery Management Plan for the... the South Atlantic Fishery Management Council (Council). The Comprehensive ACL Amendment specified, in... FMP. A final rule implementing the Comprehensive ACL Amendment was published in the Federal Register...

Planning the diffusion of a neck-injury prevention programme among community rugby union coaches.

PubMed

Donaldson, Alex; Poulos, Roslyn G

2014-01-01

This paper describes the development of a theory-informed and evidence-informed, context-specific diffusion plan for the Mayday Safety Procedure (MSP) among community rugby coaches in regional New South Wales, Australia. Step 5 of Intervention Mapping was used to plan strategies to enhance MSP adoption and implementation. Coaches were identified as the primary MSP adopters and implementers within a system including administrators, players and referees. A local advisory group was established to ensure context relevance. Performance objectives (eg, attend MSP training for coaches) and determinants of adoption and implementation behaviour (eg, knowledge, beliefs, skills and environment) were identified, informed by Social Cognitive Theory. Adoption and implementation matrices were developed and change-objectives for coaches were identified (eg, skills to deliver MSP training to players). Finally, intervention methods and specific strategies (eg, coach education, social marketing and policy and by-law development) were identified based on advisory group member experience, evidence of effective coach safety behaviour-change interventions and Diffusion of Innovations theory. This is the first published example of a systematic approach to plan injury prevention programme diffusion in community sports. The key strengths of this approach were an effective researcher-practitioner partnership; actively engaging local sports administrators; targeting specific behaviour determinants, informed by theory and evidence; and taking context-related practical strengths and constraints into consideration. The major challenges were the time involved in using a systematic diffusion planning approach for the first time; and finding a planning language that was acceptable and meaningful to researchers and practitioners.

Sustained reductions in time to antibiotic delivery in febrile immunocompromised children: results of a quality improvement collaborative.

PubMed

Dandoy, Christopher E; Hariharan, Selena; Weiss, Brian; Demmel, Kathy; Timm, Nathan; Chiarenzelli, Janis; Dewald, Mary Katherine; Kennebeck, Stephanie; Langworthy, Shawna; Pomales, Jennifer; Rineair, Sylvia; Sandfoss, Erin; Volz-Noe, Pamela; Nagarajan, Rajaram; Alessandrini, Evaline

2016-02-01

Timely delivery of antibiotics to febrile immunocompromised (F&I) paediatric patients in the emergency department (ED) and outpatient clinic reduces morbidity and mortality. The aim of this quality improvement initiative was to increase the percentage of F&I patients who received antibiotics within goal in the clinic and ED from 25% to 90%. Using the Model of Improvement, we performed Plan-Do-Study-Act cycles to design, test and implement high-reliability interventions to decrease time to antibiotics. Pre-arrival interventions were tested and implemented, followed by post-arrival interventions in the ED. Many processes were spread successfully to the outpatient clinic. The Chronic Care Model was used, in addition to active family engagement, to inform and improve processes. The study period was from January 2010 to January 2015. Pre-arrival planning improved our F&I time to antibiotics in the ED from 137 to 88 min. This was sustained until October 2012, when further interventions including a pre-arrival huddle decreased the median time to <50 min. Implementation of the various processes to the clinic delivery system increased the mean percentage of patients receiving antibiotics within 60 min to >90%. In September 2014, we implemented a rapid response team to improve reliable venous access in the ED, which increased our mean percentage of patients receiving timely antibiotics to its highest rate (95%). This stepwise approach with pre-arrival planning using the Chronic Care Model, followed by standardisation of processes, created a sustainable improvement of timely antibiotic delivery in F&I patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Technique adaptation, strategic replanning, and team learning during implementation of MR-guided brachytherapy for cervical cancer.

PubMed

Skliarenko, Julia; Carlone, Marco; Tanderup, Kari; Han, Kathy; Beiki-Ardakani, Akbar; Borg, Jette; Chan, Kitty; Croke, Jennifer; Rink, Alexandra; Simeonov, Anna; Ujaimi, Reem; Xie, Jason; Fyles, Anthony; Milosevic, Michael

MR-guided brachytherapy (MRgBT) with interstitial needles is associated with improved outcomes in cervical cancer patients. However, there are implementation barriers, including magnetic resonance (MR) access, practitioner familiarity/comfort, and efficiency. This study explores a graded MRgBT implementation strategy that included the adaptive use of needles, strategic use of MR imaging/planning, and team learning. Twenty patients with cervical cancer were treated with high-dose-rate MRgBT (28 Gy in four fractions, two insertions, daily MR imaging/planning). A tandem/ring applicator alone was used for the first insertion in most patients. Needles were added for the second insertion based on evaluation of the initial dosimetry. An interdisciplinary expert team reviewed and discussed the MR images and treatment plans. Dosimetry-trigger technique adaptation with the addition of needles for the second insertion improved target coverage in all patients with suboptimal dosimetry initially without compromising organ-at-risk (OAR) sparing. Target and OAR planning objectives were achieved in most patients. There were small or no systematic differences in tumor or OAR dosimetry between imaging/planning once per insertion vs. daily and only small random variations. Peer review and discussion of images, contours, and plans promoted learning and process development. Technique adaptation based on the initial dosimetry is an efficient approach to implementing MRgBT while gaining comfort with the use of needles. MR imaging and planning once per insertion is safe in most patients as long as applicator shifts, and large anatomical changes are excluded. Team learning is essential to building individual and programmatic competencies. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

"Current topics in health sciences librarianship": a pilot program for network-based lifelong learning.

PubMed Central

Brandt, K A; Sapp, J R; Campbell, J M

1996-01-01

The long-term objective of this project is to make health sciences librarians more effective in their role by using emerging technologies to deliver timely continuing education (CE) programs to them regardless of their physical location. The goals of the one-year planning project at the William H. Welch Medical Library are to plan, implement, and evaluate a pilot CE program that includes (1) a three-day general-interest session organized in four tracks: Market Forces and Management, Information Technology and the Internet, Publishing and Copyright, and Education; (2) a one-day special topic session on the Informatics of the Human Genome Project; and (3) an electronic poster session in parallel with the general-interest session. The program will be offered in three simultaneous formats: (1) on-site, in a distance-learning classroom in Baltimore; (2) as a telecourse, in a similar classroom outside Washington, DC; and (3) online, via the World Wide Web. An electronic proceedings of the entire program will be published on the Web to serve as a continuously available CE resource for health sciences librarians. This paper gives an overview of the planning process, presents a status report on the programmatic and technical implementation of the pilot project at its midpoint, and discusses future directions for the program. PMID:8913554

The Ontario Osteoporosis Strategy: implementation of a population-based osteoporosis action plan in Canada

PubMed Central

Hawker, G.; Cameron, C.; Canavan, J.; Beaton, D.; Bogoch, E.; Jain, R.; Papaioannou, A.

2016-01-01

In the last decade, there have been a number of action plans published to highlight the importance of preventing osteoporosis and related fractures. In the province of Ontario Canada, the Ministry of Health provided funding for the Ontario Osteoporosis Strategy. The goal is to reduce morbidity, mortality, and costs from osteoporosis and related fractures through an integrated and comprehensive approach aimed at health promotion and disease management. This paper describes the components of the Ontario Osteoporosis Strategy and progress on implementation efforts as of March 2009. There are five main components: health promotion; bone mineral density testing, access, and quality; postfracture care; professional education; and research and evaluation. Responsibility for implementation of the initiatives within the components is shared across a number of professional and patient organizations and academic teaching hospitals with osteoporosis researchers. The lessons learned from each phase of the development, implementation, and evaluation of the Ontario Osteoporosis Strategy provides a tremendous opportunity to inform other jurisdictions embarking on implementing similar large-scale bone health initiatives. PMID:20309525

Implementation of HIV and Tuberculosis Diagnostics: The Importance of Context.

PubMed

Dominique, Joyelle K; Ortiz-Osorno, Alberto A; Fitzgibbon, Joseph; Gnanashanmugam, Devasena; Gilpin, Christopher; Tucker, Timothy; Peel, Sheila; Peter, Trevor; Kim, Peter; Smith, Steven

2015-10-15

Novel diagnostics have been widely applied across human immunodeficiency virus (HIV) and tuberculosis prevention and treatment programs. To achieve the greatest impact, HIV and tuberculosis diagnostic programs must carefully plan and implement within the context of a specific healthcare system and the laboratory capacity. A workshop was convened in Cape Town in September 2014. Participants included experts from laboratory and clinical practices, officials from ministries of health, and representatives from industry. The article summarizes best practices, challenges, and lessons learned from implementation experiences across sub-Saharan Africa for (1) building laboratory programs within the context of a healthcare system; (2) utilizing experience of clinicians and healthcare partners in planning and implementing the right diagnostic; and (3) evaluating the effects of new diagnostics on the healthcare system and on patient health outcomes. The successful implementation of HIV and tuberculosis diagnostics in resource-limited settings relies on careful consideration of each specific context. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Animal health and welfare planning improves udder health and cleanliness but not leg health in Austrian dairy herds.

PubMed

Tremetsberger, Lukas; Leeb, Christine; Winckler, Christoph

2015-10-01

Animal health and welfare planning is considered an important tool for herd management; however, its effectiveness is less well known. The aim of this study was to conduct animal health and welfare planning on 34 Austrian dairy farms and to evaluate changes in health and welfare after 1 yr. After an initial assessment using the Welfare Quality protocol (Welfare Quality Consortium, Lelystad, the Netherlands), results were reported back to the farmers. Health and welfare area(s) in which both the farmer and the researcher regarded improvement as important were discussed. Management practices and husbandry measures were chosen according to the respective farm situation. One year after interventions had been initiated, farms were reassessed, and the degree of implementation of improvement measures was recorded. The average implementation rate was 57% and thus relatively high when compared with other studies. High degrees of implementation were achieved related to cleanliness and udder health, at 77 and 63%, respectively. Intervention measures addressing udder health were mostly easy to incorporate in the daily routine and led to a reduced somatic cell score, whereas this score increased in herds without implementation of measures. The decrease in cows with dirty teats was more pronounced when measures were implemented compared with control farms. The implementation rate regarding leg health (46%) was comparably low in the present study, and leg health did not improve even when measures were implemented. Lying comfort, social behavior, and human-animal relationship did not require interventions and were therefore seldom chosen by farmers as part of health and welfare plans. In conclusion, the structured, participatory process of animal health and welfare planning appears to be a promising way to improve at least some animal health and welfare issues. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Military genomics: a perspective on the successes and challenges of genomic medicine in the Armed Services.

PubMed

De Castro, Mauricio J; Turner, Clesson E

2017-11-01

We describe the impact genomics has on the health and readiness of the military service member, highlight several examples of the current and future plans for genomic medicine within the military, discuss challenges to implementation and provide recommendations to address some of those challenges. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

Is an advance care planning model feasible in community palliative care? A multi-site action research approach.

PubMed

Blackford, Jeanine; Street, Annette

2012-09-01

This article reports a study to determine the feasibility of an advance care planning model developed with Australian community palliative care services. An effective advance care planning programme involves an organizational wide commitment and preparedness for health service reform to embed advance care planning into routine practice. Internationally, such programmes have been implemented predominantly in aged and acute care with more recent work in primary care. A multi-site action research was conducted over a 16-month period in 2007-2009 with three Victorian community palliative care services. Using mixed method data collection strategies to assess feasibility, we conducted a baseline audit of staff and clients; analysed relevant documents (client records, policies, procedures and quality improvement strategies) pre-implementation and post-implementation and conducted key informant interviews (n = 9). Three community palliative care services: one regional and two metropolitan services in Victoria, Australia. The services demonstrated that it was feasible to embed the Model into their organizational structures. Advance care planning conversations and involvement of family was an important outcome measure rather than completion rate of advance care planning documents in community settings. Services adapted and applied their own concept of community, which widened the impact of the model. Changes to quality audit processes were essential to consolidate the model into routine palliative care practice. An advance care planning model is feasible for community palliative care services. Quality audit processes are an essential component of the Model with documentation of advance care planning discussion established as an important outcome measure. © 2011 Blackwell Publishing Ltd.

Minimizing the Human Capital Aspect of Productivity Disruption During Implementation of an Enterprise Resource Planning (ERP) System

DTIC Science & Technology

2009-06-01

world’s largest corporations following suite. Coca - Cola , for example, has a single instance of SAP ERP that binds together 15,000 users in 45 countries...communications, but the team was not sure they would ever actually deploy so they did not advertise . Likewise, European plant locals did not believe it was...Key dates were advertised as implementation got close and milestones and training dates were published. However, most communication stopped at the

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

Chen, S; Guerrero, M; Zhang, B

Purpose: To implement a comprehensive non-measurement-based verification program for patient-specific IMRT QA Methods: Based on published guidelines, a robust IMRT QA program should assess the following components: 1) accuracy of dose calculation, 2) accuracy of data transfer from the treatment planning system (TPS) to the record-and-verify (RV) system, 3) treatment plan deliverability, and 4) accuracy of plan delivery. Results: We have implemented an IMRT QA program that consist of four components: 1) an independent re-calculation of the dose distribution in the patient anatomy with a commercial secondary dose calculation program: Mobius3D (Mobius Medical Systems, Houston, TX), with dose accuracy evaluationmore » using gamma analysis, PTV mean dose, PTV coverage to 95%, and organ-at-risk mean dose; 2) an automated in-house-developed plan comparison system that compares all relevant plan parameters such as MU, MLC position, beam iso-center position, collimator, gantry, couch, field size settings, and bolus placement, etc. between the plan and the RV system; 3) use of the RV system to check the plan deliverability and further confirm using “mode-up” function on treatment console for plans receiving warning; and 4) implementation of a comprehensive weekly MLC QA, in addition to routine accelerator monthly and daily QA. Among 1200 verifications, there were 9 cases of suspicious calculations, 5 cases of delivery failure, no data transfer errors, and no failure of weekly MLC QA. These 9 suspicious cases were due to the PTV extending to the skin or to heterogeneity correction effects, which would not have been caught using phantom measurement-based QA. The delivery failure was due to the rounding variation of MLC position between the planning system and RV system. Conclusion: A very efficient, yet comprehensive, non-measurement-based patient-specific QA program has been implemented and used clinically for about 18 months with excellent results.« less

Office of the Assistant Secretary for Preparedness and Response; HHS Public Health Emergency Medical Countermeasures Enterprise implementation plan for chemical, biological, radiological and nuclear threats. Notice.

PubMed

2007-04-23

The United States faces serious public health threats from the deliberate use of weapons of mass destruction (WMD)--chemical, biological, radiological, or nuclear (CBRN)--by hostile States or terrorists, and from naturally emerging infectious diseases that have a potential to cause illness on a scale that could adversely impact national security. Effective strategies to prevent, mitigate, and treat the consequences of CBRN threats is an integral component of our national security strategy. To that end, the United States must be able to rapidly develop, stockpile, and deploy effective medical countermeasures to protect the American people. The HHS Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) has taken a holistic, end-to-end approach that considers multiple aspects of the medical countermeasures mission including research, development, acquisition, storage, maintenance, deployment, and guidance for utilization. Phase one of this approach established the HHS PHEMCE Strategy for Chemical, Biological, Radiological, and Nuclear Threats (HHS PHEMCE Strategy). The HHS PHEMCE Strategy, published in the Federal Register on March 20, 2007, described a framework of strategic policy goals and objectives for identifying medical countermeasure requirements and establishing priorities for medical countermeasure evaluation, development and acquisition. These strategic policy goals and objectives were used to establish the Four Pillars upon which this HHS Public Health Emergency Medical Countermeasures Enterprise Implementation Plan (HHS PHEMCE Implementation Plan) is based. The HHS PHEMCE Implementation Plan considers the full spectrum of medical countermeasures-related activities, including research, development, acquisition, storage/maintenance, deployment, and utilization. The HHS PHEMCE Implementation Plan is consistent with the President's Biodefense for the 21st Century and is aligned with the National Strategy for Medical Countermeasures against Weapons of Mass Destruction.

77 FR 10350 - Revisions to Federal Implementation Plans To Reduce Interstate Transport of Fine Particulate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-21

... Matter and Ozone AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is...: Interstate Transport of Fine Particulate Matter and Ozone and Correction of SIP Approvals, published August 8... ) and sulfur dioxide (SO 2 ) that contribute harmful levels of fine particle matter and ozone in...

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... adverse comments by March 8, 2010. If adverse comments are received, EPA will publish a timely withdrawal... also included proposed revisions to NMAC 20.11.69--Pathological Waste Destructors. NMAC 20.11.69-- Pathological Waste Destructors is not currently in the EPA-approved SIP for Albuquerque-Bernalillo County. We...

77 FR 42192 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Comprehensive Annual Catch Limit...

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76 FR 20846 - Approval and Promulgation of Air Quality Implementation Plans; Indiana

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... Indiana, to resolve a complaint filed against the company in the United States District Court for the... publishing this action without prior proposal because we view this as a noncontroversial amendment and... certified as not having a significant economic impact on a substantial number of small entities under the...

75 FR 12087 - Determination of Attainment, Approval and Promulgation of Air Quality Implementation Plans; Indiana

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2010-03-12

... the Clean Air Act (CAA) affecting the Indiana portion (Lake and Porter Counties) of the Chicago-Gary... Oxides (NO X ) in Lake and Porter Counties from CAA Reasonably Available Control Technology (RACT... Lake and Porter Counties, also published in today's Federal Register, the Chicago-Gary-Lake County, IL...

A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada.

PubMed

Morgan, Steven G; Gagnon, Marc-André; Mintzes, Barbara; Lexchin, Joel

2016-08-01

Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy. Building on published research and international frameworks, we propose that pharmaceutical policies of federal, provincial and territorial governments be coordinated around a core health-focused goal. We strongly suggest policy actions be taken on four core objectives that are necessary to support the overarching health goal. If implemented, the proposed strategy would offer clear benefits to all Canadians who use medicines, federal and provincial governments and to the economy as a whole. We therefore argue that political leadership is now needed to articulate and implement such a plan on behalf of Canadians. Copyright © 2016 Longwoods Publishing.

Reducing fat intake using implementation intentions: A meta-analytic review.

PubMed

Vilà, Irene; Carrero, Isabel; Redondo, Raquel

2017-05-01

To study the efficacy of forming implementation intentions for fat intake reduction as well as possible moderating variables. Systematic review and meta-analysis of 12 empirical studies (N = 3,323) published in English and Spanish in the Web of Science (Core Collection) and MEDLINE (1990-January 2016) databases. This study found that the efficacy of planning interventions on fat consumption reduction was higher than expected, as a moderate overall effect of implementation intentions was observed (d = 0.488). Moreover, planning for a fat intake reduction seems to be more powerful for men than for women (β = -.623; p = .025) and in cases where there is no monitoring during the intervention (d = 0.671 vs. d = 0.231). Previous research was sceptical of the efficacy of planning in the case of avoiding goals in healthy eating. However, our results show that planning is an efficient intervention that can be used by health education programmes to reduce fat intake and, therefore, increase citizen well-being. These results also support the existence of a key variable in the implementation intentions process, that is, goal complexity, and the presence of two moderating variables, that is, gender and monitoring. Statement of contribution What is already known on this subject? Implementation intentions are action plans subordinate to goal intentions that specify the 'when, where, and how' of responses leading to goal attainment. In healthy eating, the average effect of forming implementation intentions is small to medium, but this efficacy changes depending on the type of intended behaviour. Past evidence shows that the effect size seems to be lower when the intervention aims at reducing unhealthy behaviours versus promoting healthy behaviours. What does this study add? Forming implementation intentions is an efficient intervention to reduce fat intake with a medium overall effect. The efficacy of this intervention is increased when men are targeted and when there is no monitoring during the process. This study introduces a new line of research focused on the study of the effect of planning on complex goals. © 2017 The British Psychological Society.

Measles and Rubella Global Strategic Plan 2012-2020 midterm review report: Background and summary.

PubMed

Orenstein, Walter A; Cairns, Lisa; Hinman, Alan; Nkowane, Benjamin; Olivé, Jean-Marc; Reingold, Arthur L

2018-01-11

Measles, a vaccine-preventable illness, is one of the most infectious diseases known to man. In 2015, an estimated 134,200 measles deaths occurred globally. Rubella, also vaccine-preventable, is a concern because infection during pregnancy can result in congenital defects in the baby. More than 100,000 babies with congenital rubella syndrome were estimated to have been born globally in 2010. Eradication of both measles and rubella is considered to be feasible, beneficial, and more cost-effective than high-level control. All six World Health Organization (WHO) regions have measles elimination goals by 2020 and two have rubella elimination goals by that year. However, the World Health Assembly has not endorsed a global eradication goal for either disease. In 2012, the Measles and Rubella Initiative published a Global Measles and Rubella Strategic Plan, 2012-2020, referred to hereafter as the Plan, which aimed to achieve measles and rubella elimination in at least five WHO regions by end-2020 through the implementation of five core strategies, with progress evaluated against 2015 milestones. When, by end-2015, none of these milestones had been met, WHO's Strategic Advisory Group of Experts on Immunization (SAGE) recommended a mid-term review of the Plan to evaluate progress toward goals, assess the quality of strategy implementation, and formulate lessons learned. A five-member team reviewed documents and conducted interviews with stakeholders as the basis for the review's conclusions and recommendations. This team concluded that, although significant progress in measles elimination had been made, progress had slowed. It recommended that countries continue to work toward elimination goals with a focus on strengthening ongoing immunization systems. In addition, it concluded that the strategies articulated in the Plan were sound, however full implementation had been impeded by inadequate country ownership and global political will, reflected in inadequate resources. Detailed recommendations for each of the Plan's five strategies as well as the areas of polio transition, governance and resource mobilization are outlined. Copyright © 2017 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

Evidence-based Peer Review for Radiation Therapy - Updated Review of the Literature with a Focus on Tumour Subsite and Treatment Modality.

PubMed

Huo, M; Gorayski, P; Poulsen, M; Thompson, K; Pinkham, M B

2017-10-01

Technological advances in radiation therapy permit steep dose gradients from the target to spare normal tissue, but increase the risk of geographic miss. Suboptimal target delineation adversely affects clinical outcomes. Prospective peer review is a method for quality assurance of oncologists' radiotherapy plans. Published surveys suggest it is widely implemented. However, it may not be feasible to review every case before commencement of radiation therapy in all departments. The rate of plan changes following peer review of cases without a specific subsite or modality is typically around 10%. Stereotactic body radiation therapy, head and neck, gynaecological, gastrointestinal, haematological and lung cases are associated with higher rates of change of around 25%. These cases could thus be prioritised for peer review. Other factors may limit peer review efficacy including organisational culture, time constraints and the physical environment in which sessions are held. Recommendations for peer review endorsed by the American Society for Radiation Oncology were made available in 2013, but a number of relevant studies have been published since. Here we review and update the literature, and provide an updated suggestion for the implementation of peer review to serve as an adjunct to published guidelines. This may help practitioners evaluate their current processes and maximise the utility and effectiveness of peer review sessions. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

77 FR 30453 - Approval and Promulgation of Air Quality Implementation Plans; Wisconsin; Milwaukee-Racine...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-23

... of Attainment for the 2006 24-Hour Fine Particle Standard AGENCY: Environmental Protection Agency... period for a proposed rule published April 24, 2012 (77 FR 24436). On April 24, 2012, EPA proposed to approve a determination of attainment for the Milwaukee-Racine, Wisconsin area for the 2006 24-hour fine...

78 FR 7705 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

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... 1997 8-hour ozone standard in the Area. EPA is also proposing to approve the motor vehicle emission... internal combustion engines. \\4\\ On May 12, 2005, EPA published the Clean Air Interstate Rule (CAIR), which... requiring inspection and maintenance of vehicles (I/M). Section 182(c)(3)requires enhanced vehicle...

77 FR 73575 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Redesignation of...

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...) and Cross State Air Pollution Rule (CSAPR or the Transport Rule) On May 12, 2005, EPA published CAIR...) for the purpose of reducing SO 2 and NO X emissions. The monitoring data used to demonstrate the Area... Source Review (NSR) permit programs; Provisions for air pollution modeling; and Provisions for public and...

76 FR 21691 - Approval and Promulgation of Implementation Plans; Washington: Extension of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-18

...; Washington: Correction'' published on March 23, 2011 at 76 FR 16365. A commenter requested additional time to review the proposal and prepare comments. In response to this request, EPA is extending the original 30-day comment period for an additional 30 days. The extended comment period will close on May 23, 2011...

78 FR 50394 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Snapper-Grouper Fishery off the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... published in the Federal Register on August 2, 2013, regarding the implementation of management measures described in Amendment 22 to the Fishery Management Plan for the Snapper-Grouper Fishery in the South... to ensure there is adequate time to submit complete responses. DATES: This correction is effective...

78 FR 27888 - Approval and Promulgation of State Implementation Plans; State of North Dakota; Interstate...

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2013-05-13

... CSAPR mean or refer to the Cross-State Air Pollution Rule. (iv) The words EPA, we, us or our mean or... Evaluation A. EPA's Approach for Evaluating Interstate Transport of Air Pollution B. EPA's Evaluation of...\\ Most recently, EPA published the final Cross State Air Pollution Rule (``CSAPR'' or ``Transport Rule...

77 FR 9956 - Announcement of Funding Awards for the Sustainable Communities Regional Planning Grant Program...

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2012-02-21

... of regional significance, use data to set and monitor progress toward performance goals, and engage... Principles; d. Use geo-coded data sets and other metrics in developing, implementing, monitoring, and... (103 Stat. 1987, 42 U.S.C. 3545), the Department is publishing the names, addresses, and amounts of the...

Ethiopia's assessment of emergency obstetric and newborn care: setting the gold standard for national facility-based assessments.

PubMed

Keyes, Emily B; Haile-Mariam, Abonesh; Belayneh, Neghist T; Gobezie, Wasihun A; Pearson, Luwei; Abdullah, Muna; Kebede, Henok

2011-10-01

To describe the methods used to implement Ethiopia's 2008 emergency obstetric and newborn care services (EmONC) assessment; highlight how the collaborative process contributed to immediate integration of results into national and subnational planning; and explain how the experience informed the development of a set of tools providing best practices and guidelines for other countries conducting similar assessments. A team of maternal and newborn health experts from the Federal Ministry of Health (FMOH), the United Nations Children's Fund (UNICEF), the World Health Organization (WHO), and the United Nations Population Fund (UNFPA), together with representatives from the Ethiopian Society of Obstetricians and Gynecologists, provided technical guidance for the 18-month process and facilitated demand for and use of the assessment results. Eighty-four trained data collectors administered 9 data collection modules in 806 public and private facilities. Field work and data were managed by a private firm who, together with the core team, implemented a multi-layered plan for data quality. Columbia University's Averting Maternal Death and Disability Program provided technical assistance. Results were published in national and regional reports and in 1-page facility factsheets informing subnational planning activities. Assessment results-which have been published in journal articles-informed water infrastructure improvements, efforts to expand access to magnesium sulfate, and FMOH and UN planning documents. The assessment also established a permanent database for future monitoring of the health system, including geographic locations of surveyed facilities. Ethiopia's assessment was successful largely because of active local leadership, a collaborative process, ample financial and technical support, and rapid integration of results into health system planning. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Systematic review of qualitative literature on occupational health and safety legislation and regulatory enforcement planning and implementation.

PubMed

MacEachen, Ellen; Kosny, Agnieszka; Ståhl, Christian; O'Hagan, Fergal; Redgrift, Lisa; Sanford, Sarah; Carrasco, Christine; Tompa, Emile; Mahood, Quenby

2016-01-01

The ability of occupational health and safety (OHS) legislation and regulatory enforcement to prevent workplace injuries and illnesses is contingent on political, economic, and organizational conditions. This systematic review of qualitative research articles considers how OHS legislation and regulatory enforcement are planned and implemented. A comprehensive search of peer-reviewed, English-language articles published between 1990 and 2013 yielded 11 947 articles. We identified 34 qualitative articles as relevant, 18 of which passed our quality assessment and proceeded to meta-ethnographic synthesis. The synthesis yielded four main themes: OHS regulation formation, regulation challenges, inspector organization, and worker representation in OHS. It illuminates how OHS legislation can be based on normative suppositions about worker and employer behavior and shaped by economic and political resources of parties. It also shows how implementation of OHS legislation is affected by "general duty" law, agency coordination, resourcing of inspectorates, and ability of workers to participate in the system. The review identifies methodological gaps and identifies promising areas for further research in "grey" zones of legislation implementation.

Youth empowerment solutions for violence prevention.

PubMed

Reischl, Thomas M; Zimmerman, Marc A; Morrel-Samuels, Susan; Franzen, Susan P; Faulk, Monique; Eisman, Andria B; Roberts, Everett

2011-12-01

The limited success of youth violence prevention interventions suggests that effective prevention needs to address causes at multiple levels of analysis and empower youth in developing and implementing prevention programs. In this article, we review published studies of youth violence prevention efforts that engage youth in developing or implementing violence prevention activities. The reviewed studies suggest the promise of youth empowerment strategies and the need for systematic outcome studies of empowerment programs. After reviewing empowerment theory applied to youth violence prevention programs, we present a case study of the Youth Empowerment Solutions (YES) for Peaceful Communities program. YES engages middle-school youth in an after-school and summer program that includes a culturally tailored character development curriculum and empowers the youth to plan and implement community improvement projects with assistance from adult neighborhood advocates. The case study focuses on outcome evaluation results and presents evidence of the YES program effects on community-level outcomes (eg, property improvements, violent crime incidents) and on individual-level outcomes (eg, conflict avoidance, victimization). The literature review and the case study suggest the promise of engaging and empowering youth to plan and implement youth violence prevention programs.

Practical experience from the Office of Adolescent Health's large scale implementation of an evidence-based Teen Pregnancy Prevention Program.

PubMed

Margolis, Amy Lynn; Roper, Allison Yvonne

2014-03-01

After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation. Published by Elsevier Inc.

Implementing AORN recommended practices for minimally invasive surgery: part I.

PubMed

Morton, Paula J

2012-09-01

This article focuses on the patient safety aspects of the revised AORN "Recommended practices for minimally invasive surgery" (MIS). Key considerations include ensuring proper fluid management practices, assessing patients for risk factors related to MIS, implementing precautions for electrosurgery, planning for risks related to MIS, and assessing patients postoperatively for potential complications related to MIS. Collaboration and collegiality among members of the surgical team are essential for ensuring all pertinent aspects of care are recognized and considered. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Successful Implementation of New Technology Using an Interdepartmental Collaborative Approach.

PubMed

Tetef, Sue

2017-06-01

The implementation of new technology is vital to the success of health care organizations. New technology provides health care organizations an opportunity to obtain new patients, increase revenue, and stay competitive. In 2014, a union hospital in Southern California successfully implemented a bronchial thermoplasty program. To implement this new technology, the administration created a strategy, identified financial risks and benefits, created an implementation model, established a plan based on Lewin's change model and Roger's diffusion of innovations theory, and recognized adult learning needs through an interdepartmental, open communication, and collaborative approach. In addition, the implementation of the bronchial thermoplasty program allowed the organization to meet the goals, mission, and vision of the organization, which is key to remaining viable and marketable. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Health care professionals' perspectives of advance care planning for people with dementia living in long-term care settings: A narrative review of the literature.

PubMed

Beck, Esther-Ruth; McIlfatrick, Sonja; Hasson, Felicity; Leavey, Gerry

2017-05-01

This paper provides an overview of the evidence on the perspective of health care professionals (HCPs) in relation to advance care planning (ACP) for people with dementia, residing in long-term care settings. A narrative approach was adopted to provide a comprehensive synthesis of previously published literature in the area. A systematic literature search identified 14 papers for inclusion. Following review of the studies four themes were identified for discussion; Early integration and planning for palliative care in dementia; HCPs ethical and moral concerns regarding ACP; Communication challenges when interacting with the person with dementia and their families and HCPs need for education and training. Despite evidence, that HCPs recognise the potential benefits of ACP, they struggle with its implementation in this setting. Greater understanding of dementia and the concept of ACP is required to improve consistency in practice. Synthesising the existing evidence will allow for further understanding of the key issues, potentially resulting in improved implementation in practice.

How to implement information technology in the operating room and the intensive care unit.

PubMed

Meyfroidt, Geert

2009-03-01

The number of operating rooms and intensive care units looking for a data management system to perform their increasingly complex tasks is rising. Although at this time only a minority is computerized, within the next few years many centres will start implementing information technology. The transition towards a computerized system is a major venture, which will have a major impact on workflow. This chapter reviews the present literature. Published papers on this subject are predominantly single- or multi-centre implementation reports. The general principles that should guide such a process are described. For healthcare institutions or individual practitioners that plan to undertake this venture, the implementation process is described in a practical, nine-step overview.

Implementing health care reform in Israel: organizational response to perceived incentives.

PubMed

Gross, Revital

2003-08-01

Devising new incentives was a main element of health care reform in Israel, which created a regulated market that embodies many principles of managed competition. This study examined sick fund directors' perceptions of the new incentives and their strategic responses to these incentives, enabling the testing of how managed competition works in practice. The methodology used was a multiple case study of Israel's four sick funds. Data were gathered through in-depth interviews with 160 senior officials, analysis of national health insurance legislation, and analysis of published and unpublished archival documents, newspaper articles, public statements of senior managers, and other published data on the sick funds' behavior. The study revealed discrepancies between planned and perceived incentives and highlighted the effect of the latter on strategy formulation. Analysis of sick fund strategies showed that their responses to managed competition incentives deviated from theoretical expectations, compromising some of the objectives of the reform. The study also shows that contextual features account for the specific model of managed competition that was implemented and for the specific strategies employed by the sick funds. The study concludes by highlighting the need to build a process that will enable policy makers to consider local contextual factors when planning and implementing reform, involving health care providers in designing incentives, continuously monitoring processes and outcomes in the reformed system, and allowing for flexibility in policy making.

Strengthening TB infection control in specialized health facilities in Romania--using a participatory approach.

PubMed

Turusbekova, N; Popa, C; Dragos, M; van der Werf, M J; Dinca, I

2016-02-01

In 2012, the tuberculosis (TB) notification rate among Romanian TB facility doctors and nurses was 7.2 times higher than in the general population. This indicates that transmission is ongoing inside TB facilities and that TB infection control measures are insufficient. To help prevent nosocomial TB transmission a project was implemented that aimed at providing nationwide tailor-made technical assistance in TB infection control (TB-IC) in TB treatment facilities, including the development of TB infection control plans. The objective of the present article is to describe the implementation of the project and to discuss successes and challenges. The project was an implementation study using two methods of evaluation: (1) a cross sectional questionnaire study; and (2) collection of information, during the training, on challenges related to infection control and to the project implementation. The project team developed a TB facility infection control (TB-IC) plan template, together with the Romanian experts. The template was discussed and agreed upon with the experts at a meeting and thereafter distributed by email to all TB facilities. Afterwards, a training of trainers (TOT) seminar was organized which included the provision of information about different training methods, as well as information about TB-IC. The TOT was followed by training for key TB-IC providers. Information about use of the TB-IC template was gathered through a self-administered questionnaire sent to all participants of the expert meeting and the training (42 people). Additionally, non-systematized discussions were held on broader challenges in TB-IC implementation during the training. Within the project 42 key TB-IC service providers were trained in TB-IC, including 9 who were trained at a TOT seminar. The trainees were specialists working at the national level, such as country TB coordinators, or at the TB facility level: TB doctors, epidemiologists, laboratory specialists and maintenance engineers. Out of 42 key TB-IC service providers who were trained, only eighteen responded to the questionnaire (no reminders were sent). Out of these, 14 had used the TB-IC plan template after the project team disseminated it to them by email. The remaining four TB-IC service providers indicated that they were planning to use the template to develop or update their facility TB-IC plans. Related to the use of TB-IC plan template, the following broader challenges in TB-IC were identified: a lack of authority of the individuals responsible for TB-IC to implement the TB-IC measures, lack of training among facility epidemiologists on TB, underdeveloped system for reporting TB in healthcare workers, difficulties with triage of the TB suspects, and poor facility infrastructure hampering implementation of TB-IC measures. Implementing TB-IC plans in Romanian health care facilities proved to be challenging, mainly due to the fact that the national infection control plan for TB was not yet adopted at the time of project implementation, and therefore there was neither a regulatory framework to support TB facility-IC planning nor any related budget allocations for the implementation of the facilities' TB-IC plans. Nonetheless, most respondents who answered the questionnaire (18 of 42 responded) indicated that they had started using the TB-IC plan template, which represents a full package of infection control measures that, when implemented effectively and in its entirety, may be expected to reduce nosocomial transmission. The study's limitations are: very low survey response rate, thus there is a likelihood of responder bias. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

COMPETITIVE BIDDING IN MEDICARE ADVANTAGE: EFFECT OF BENCHMARK CHANGES ON PLAN BIDS

PubMed Central

Song, Zirui; Landrum, Mary Beth; Chernew, Michael E.

2013-01-01

Bidding has been proposed to replace or complement the administered prices in Medicare pays to hospitals and health plans. In 2006, the Medicare Advantage program implemented a competitive bidding system to determine plan payments. In perfectly competitive models, plans bid their costs and thus bids are insensitive to the benchmark. Under many other models of competition, bids respond to changes in the benchmark. We conceptualize the bidding system and use an instrumental variable approach to study the effect of benchmark changes on bids. We use 2006–2010 plan payment data from the Centers for Medicare and Medicaid Services, published county benchmarks, actual realized fee-for-service costs, and Medicare Advantage enrollment. We find that a $1 increase in the benchmark leads to about a $0.53 increase in bids, suggesting that plans in the Medicare Advantage market have meaningful market power. PMID:24308881

Competitive bidding in Medicare Advantage: effect of benchmark changes on plan bids.

PubMed

Song, Zirui; Landrum, Mary Beth; Chernew, Michael E

2013-12-01

Bidding has been proposed to replace or complement the administered prices that Medicare pays to hospitals and health plans. In 2006, the Medicare Advantage program implemented a competitive bidding system to determine plan payments. In perfectly competitive models, plans bid their costs and thus bids are insensitive to the benchmark. Under many other models of competition, bids respond to changes in the benchmark. We conceptualize the bidding system and use an instrumental variable approach to study the effect of benchmark changes on bids. We use 2006-2010 plan payment data from the Centers for Medicare and Medicaid Services, published county benchmarks, actual realized fee-for-service costs, and Medicare Advantage enrollment. We find that a $1 increase in the benchmark leads to about a $0.53 increase in bids, suggesting that plans in the Medicare Advantage market have meaningful market power. Copyright © 2013 Elsevier B.V. All rights reserved.

[Lean logistics management in healthcare: a case study].

PubMed

Aguilar-Escobar, V G; Garrido-Vega, P

2013-01-01

To study the applicability of the principles of Lean Production to manage the supply chain of a hospital. In particular, to determine which Lean practices and principles are applicable, the benefits obtained and the main barriers for its implementation. Managing the hospital supply chain is an important issue, both for its effect on the quality of care and its impact on costs. This study is based on a case study. 2005-10. Hospital Virgen Macarena in Seville. Process of implementing a comprehensive logistics management plan based on Lean principles and technological investments. The implementation of the comprehensive plan has reduced inventory, decreased lead times and improved service quality. Also, there have been other important improvements: enhanced employee satisfaction and increased staff productivity, both dedicated to health and the logistics. The experience analysed has shown the applicability and appropriateness of Lean principles and some of its techniques in managing the logistics of hospitals. It also identifies some of the main difficulties that may arise. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

How to improve medical education website design.

PubMed

Sisson, Stephen D; Hill-Briggs, Felicia; Levine, David

2010-04-21

The Internet provides a means of disseminating medical education curricula, allowing institutions to share educational resources. Much of what is published online is poorly planned, does not meet learners' needs, or is out of date. Applying principles of curriculum development, adult learning theory and educational website design may result in improved online educational resources. Key steps in developing and implementing an education website include: 1) Follow established principles of curriculum development; 2) Perform a needs assessment and repeat the needs assessment regularly after curriculum implementation; 3) Include in the needs assessment targeted learners, educators, institutions, and society; 4) Use principles of adult learning and behavioral theory when developing content and website function; 5) Design the website and curriculum to demonstrate educational effectiveness at an individual and programmatic level; 6) Include a mechanism for sustaining website operations and updating content over a long period of time. Interactive, online education programs are effective for medical training, but require planning, implementation, and maintenance that follow established principles of curriculum development, adult learning, and behavioral theory.

Risk management for drinking water safety in low and middle income countries - cultural influences on water safety plan (WSP) implementation in urban water utilities.

PubMed

Omar, Yahya Y; Parker, Alison; Smith, Jennifer A; Pollard, Simon J T

2017-01-15

We investigated cultural influences on the implementation of water safety plans (WSPs) using case studies from WSP pilots in India, Uganda and Jamaica. A comprehensive thematic analysis of semi-structured interviews (n=150 utility customers, n=32 WSP 'implementers' and n=9 WSP 'promoters'), field observations and related documents revealed 12 cultural themes, offered as 'enabling', 'limiting', or 'neutral', that influence WSP implementation in urban water utilities to varying extents. Aspects such as a 'deliver first, safety later' mind set; supply system knowledge management and storage practices; and non-compliance are deemed influential. Emergent themes of cultural influence (ET1 to ET12) are discussed by reference to the risk management, development studies and institutional culture literatures; by reference to their positive, negative or neutral influence on WSP implementation. The results have implications for the utility endorsement of WSPs, for the impact of organisational cultures on WSP implementation; for the scale-up of pilot studies; and they support repeated calls from practitioner communities for cultural attentiveness during WSP design. Findings on organisational cultures mirror those from utilities in higher income nations implementing WSPs - leadership, advocacy among promoters and customers (not just implementers) and purposeful knowledge management are critical to WSP success. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Using action research to plan a violence prevention program for emergency departments.

PubMed

Gates, Donna; Gillespie, Gordon; Smith, Carolyn; Rode, Jennifer; Kowalenko, Terry; Smith, Barbara

2011-01-01

Although there are numerous studies that show that emergency department (ED) violence is a prevalent and serious problem for healthcare workers, there is a lack of published evaluations of interventions aimed at reducing this alarming trend. Using an action research model, the authors partnered with six hospitals to plan, implement and evaluate a violence prevention and management intervention. Phase one of this project involved gathering information from employees, managers and patients using focus groups. Ninety-seven persons participated in one of twelve focus groups. The Haddon matrix was used to develop focus group questions aimed at gathering data about the pre-assault, during assault, and post-assault time frames and to compare these findings to planned strategies. Analysis consisted of identification of themes related to intervention strategies for patients/visitors, employees, managers, and the work environment. Thematic analysis results supported the relevance, feasibility, and saliency of the planned intervention strategies. With the exception of a few items, employees and managers from the different occupational groups agreed on the interventions needed to prevent and manage violence against ED workers. Patients focused on improved staff communication and comfort measures. Results support that violence in the emergency department is increasing, that violence is a major concern for those who work in and visit emergency departments, and that interventions are needed to reduce workplace violence. The Haddon matrix along with an action research method was useful to identify intervention strategies most likely to be successfully implemented and sustained by the emergency departments. Copyright © 2011 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

PubMed Central

Damschroder, Laura J; Aron, David C; Keith, Rosalind E; Kirsh, Susan R; Alexander, Jeffery A; Lowery, Julie C

2009-01-01

Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings. PMID:19664226

Meeting CCS communication challenges head-on: Integrating communications, planning, risk assessment, and project management

USGS Publications Warehouse

Greenberg, S.; Gauvreau, L.; Hnottavange-Telleen, K.; Finley, R.; Marsteller, S.

2011-01-01

The Midwest Geological Sequestration Consortium, Schlumberger Carbon Services, and Archer Daniels Midland has implemented a comprehensive communications plan at the Illinois Basin - Decatur Project (IBDP), a one million metric tonne Carbon Capture and Storage project in Decatur, IL, USA funded by the U.S. Department of Energy's National Energy Technology Laboratory. The IBDP Communication Plan includes consortium information, funding and disclaimer citations, description of target audiences, media communications guidelines, paper and presentations guidelines, site visit information, crisis communication, on-site photography regulations, and other components. The creation, development, and implementation processes for the IBDP Communication Plan (the Plan) are shared in this paper. New communications challenges, such as how to address add-on research requests, data sharing and management, scope increase, and contract agreements have arisen since the Plan was completed in January 2009, resulting in development of new policies and procedures by project management. Integrating communications planning, risk assessment, and project management ensured that consistent, factual information was developed and incorporated into project planning, and constitutes the basis of public communications. Successful integration has allowed the IBDP to benefit from early identification and mitigation of the potential project risks, which allows more time to effectively deal with unknown and unidentified risks that may arise. Project risks and risks associated with public perception can be managed through careful planning and integration of communication strategies into project management and risk mitigation. ?? 2011 Published by Elsevier Ltd.

A Systematic Review of Published Respondent-Driven Sampling Surveys Collecting Behavioral and Biologic Data.

PubMed

Johnston, Lisa G; Hakim, Avi J; Dittrich, Samantha; Burnett, Janet; Kim, Evelyn; White, Richard G

2016-08-01

Reporting key details of respondent-driven sampling (RDS) survey implementation and analysis is essential for assessing the quality of RDS surveys. RDS is both a recruitment and analytic method and, as such, it is important to adequately describe both aspects in publications. We extracted data from peer-reviewed literature published through September, 2013 that reported collected biological specimens using RDS. We identified 151 eligible peer-reviewed articles describing 222 surveys conducted in seven regions throughout the world. Most published surveys reported basic implementation information such as survey city, country, year, population sampled, interview method, and final sample size. However, many surveys did not report essential methodological and analytical information for assessing RDS survey quality, including number of recruitment sites, seeds at start and end, maximum number of waves, and whether data were adjusted for network size. Understanding the quality of data collection and analysis in RDS is useful for effectively planning public health service delivery and funding priorities.

77 FR 52624 - Fisheries of the Northeastern United States; Scup Fishery; Adjustment to the 2012 Winter II Quota

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... Summer Flounder, Scup, and Black Sea Bass Fishery Management Plan, which established a process to allow... Management Specialist, (978) 281-9224. SUPPLEMENTARY INFORMATION: NMFS published a final rule in the Federal Register on November 3, 2003 (68 FR 62250), implementing a process, for years in which the full Winter I...

75 FR 8871 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

... quality monitoring data for the 2007-2009 ozone seasons that demonstrate that the 8-hour ozone NAAQS has... technical information and/or data that you used. 5. If you estimate potential costs or burdens, explain how... FR 23857), EPA published a final rule designating and classifying areas under the 8-hour ozone NAAQS...

[Development of integrated support software for clinical nutrition].

PubMed

Siquier Homar, Pedro; Pinteño Blanco, Manel; Calleja Hernández, Miguel Ángel; Fernández Cortés, Francisco; Martínez Sotelo, Jesús

2015-09-01

to develop an integrated computer software application for specialized nutritional support, integrated in the electronic clinical record, which detects automatically and early those undernourished patients or at risk of developing undernourishment, determining points of opportunity for improvement and evaluation of the results. the quality standards published by the Nutrition Work Group of the Spanish Society of Hospital Pharmacy (SEFH) and the recommendations by the Pharmacy Group of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) have been taken into account. According to these quality standards, the nutritional support has to include the following healthcare stages or sub-processes: nutritional screening, nutritional assessment, plan for nutritional care, prescription, preparation and administration. this software allows to conduct, in an automated way, a specific nutritional assessment for those patients with nutritional risk, implementing, if necessary, a nutritional treatment plan, conducting follow-up and traceability of outcomes derived from the implementation of improvement actions, and quantifying to what extent our practice is close to the established standard. this software allows to standardize the specialized nutritional support from a multidisciplinary point of view, introducing the concept of quality control per processes, and including patient as the main customer. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Evidence-based development of a diagnosis-dependent therapy planning system and its implementation in modern diagnostic software.

PubMed

Ahlers, M O; Jakstat, H A

2005-07-01

The prerequisite for structured individual therapy of craniomandibular dysfunctions is differential diagnostics. Suggestions for the structured recording of findings and their structured evaluation beyond the global diagnosis of "craniomandibular disorders" have been published. Only this structured approach enables computerization of the diagnostic process. The respective software is available for use in practice (CMDcheck for CMD screening, CMDfact for the differential diagnostics). Based on this structured diagnostics, knowledge-based therapy planning is also conceivable. The prerequisite for this would be a model of achieving consensus on the indicated forms of therapy related to the diagnosis. Therefore, a procedure for evidence-based achievement of consensus on suitable forms of therapy in CMD was developed first in multicentric cooperation, and then implemented in corresponding software. The clinical knowledge of experienced specialists was included consciously for the consensus achievement process. At the same time, anonymized mathematical statistical evaluations were used for control and objectification. Different examiners form different departments of several universities working independently of one another assigned the theoretically conceiveable therapeutic alternatives to the already published diagnostic scheme. After anonymization, the correlation of these assignments was then calculated mathematically. For achieving consensus in those cases for which no agreement initally existed, agreement was subsequently arrived at in the course of a consensus conference on the basis of literature evaluations and the discussion of clinical case examples. This consensus in turn finally served as the basis of a therapy planner implemented in the above-mentioned diagnostic software CMDfact. Contributing to quality assurance, the principles of programming this assistant as well as the interface for linking into the diagnostic software are documented and also published here.

From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis

PubMed Central

2017-01-01

Background: Evidence-based guidelines published by health authorities for the promotion of health-enhancing physical activity (PA), continue to be implemented unsuccessfully and demonstrate a gap between evidence and policies. This review synthesizes evidence on factors influencing delivery, adoption and implementation of PA promotion guidelines within different policy sectors (e.g., health, transport, urban planning, sport, education). Methods: Published literature was initially searched using PubMed, EBSCO, Google Scholar and continued through an iterative snowball technique. The literature review spanned the period 2002–2017. The realist synthesis approach was adopted to review the content of 39 included studies. An initial programme theory with a four-step chain from evidence emersion to implementation of guidelines was tested. Results: The synthesis furthers our understanding of the link between PA guidelines delivery and the actions of professionals responsible for implementation within health services, school departments and municipalities. The main mechanisms identified for guidance implementation were scientific legitimation, enforcement, feasibility, familiarity with concepts and PA habits. Threats emerged to the successful implementation of PA guidelines at national/local jurisdictional levels. Conclusions: The way PA guidelines are developed may influence their adoption by policy-makers and professionals. Useful lessons emerged that may inform synergies between policymaking and professional practices, promoting win-win multisectoral strategies. PMID:28991184

Practical Team-Based Learning from Planning to Implementation

PubMed Central

Bell, Edward; Eng, Marty; Fuentes, David G.; Helms, Kristen L.; Maki, Erik D.; Vyas, Deepti

2015-01-01

Team-based learning (TBL) helps instructors develop an active teaching approach for the classroom through group work. The TBL infrastructure engages students in the learning process through the Readiness Assessment Process, problem-solving through team discussions, and peer feedback to ensure accountability. This manuscript describes the benefits and barriers of TBL, and the tools necessary for developing, implementing, and critically evaluating the technique within coursework in a user-friendly method. Specifically, the manuscript describes the processes underpinning effective TBL development, preparation, implementation, assessment, and evaluation, as well as practical techniques and advice from authors’ classroom experiences. The paper also highlights published articles in the area of TBL in education, with a focus on pharmacy education. PMID:26889061

Implementing AORN recommended practices for medication safety.

PubMed

Hicks, Rodney W; Wanzer, Linda J; Denholm, Bonnie

2012-12-01

Medication errors in the perioperative setting can result in patient morbidity and mortality. The AORN "Recommended practices for medication safety" provide guidance to perioperative nurses in developing, implementing, and evaluating safe medication use practices. These practices include recognizing risk points in the medication use process, collaborating with pharmacy staff members, conducting preoperative assessments and postoperative evaluations (eg, medication reconciliation), and handling hazardous medications and pharmaceutical waste. Strategies for successful implementation of the recommended practices include promoting a basic understanding of the nurse's role in the medication use process and developing a medication management plan as well as policies and procedures that support medication safety and activities to measure compliance with safe practices. Published by Elsevier Inc.

78 FR 28776 - Approval and Promulgation of Implementation Plans; Georgia; State Implementation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... Section of this Federal Register, EPA is approving the State's implementation plan revision as a direct... Promulgation of Implementation Plans; Georgia; State Implementation Plan Miscellaneous Revisions AGENCY... State Implementation Plan (SIP) submitted by the Georgia Environmental Protection Division to EPA in...

Designing and Implementing a Distributed System Architecture for the Mars Rover Mission Planning Software (Maestro)

NASA Technical Reports Server (NTRS)

Goldgof, Gregory M.

2005-01-01

Distributed systems allow scientists from around the world to plan missions concurrently, while being updated on the revisions of their colleagues in real time. However, permitting multiple clients to simultaneously modify a single data repository can quickly lead to data corruption or inconsistent states between users. Since our message broker, the Java Message Service, does not ensure that messages will be received in the order they were published, we must implement our own numbering scheme to guarantee that changes to mission plans are performed in the correct sequence. Furthermore, distributed architectures must ensure that as new users connect to the system, they synchronize with the database without missing any messages or falling into an inconsistent state. Robust systems must also guarantee that all clients will remain synchronized with the database even in the case of multiple client failure, which can occur at any time due to lost network connections or a user's own system instability. The final design for the distributed system behind the Mars rover mission planning software fulfills all of these requirements and upon completion will be deployed to MER at the end of 2005 as well as Phoenix (2007) and MSL (2009).

76 FR 20293 - Approval and Promulgation of Implementation Plans and Designations of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... January 19, 2010, EPA published a proposed rule to reconsider the 2008 8-hour ozone NAAQS (75 FR 2938) and... the Paperwork Reduction Act (44 U.S.C. 3501 et seq.); Is certified as not having a significant economic impact on a substantial number of small entities under the Regulatory Flexibility Act (5 U.S.C...

Action Research as an Agent for Enhancing Teaching and Learning in Physical Education: A Physical Education Teacher's Perspective

ERIC Educational Resources Information Center

Keegan, Rosemary

2016-01-01

Introduction: Action research is a useful method for implementing change through its spiral of plan, act, observe, and reflect, but little research has been published on it in the area of physical education. The purpose of this intervention was to assess the effectiveness of action research as an agent of change and its impact on enhancing my…

Mississippi School Library Media Programs: A Guide for Management. A Competency Based Handbook for Certified Library Media Specialists, Administrators, and Evaluators.

ERIC Educational Resources Information Center

Mississippi State Dept. of Education, Jackson.

This new publication, which replaces A Primer for Mississippi School Librarians published in 1967, is designed for use in planning, implementing, and evaluating school library media programs. For the administrator, there are competencies which must be met to develop the library media program as an integral part of the total instructional program.…

Individualized Quality Control Plan (IQCP): Is It Value-Added for Clinical Microbiology?

PubMed Central

Miller, Melissa B.; Hindler, Janet

2015-01-01

The Center for Medicaid and Medicare Services (CMS) recently published their Individualized Quality Control Plan (IQCP [https://www.cms.gov/regulations-and-guidance/legislation/CLIA/Individualized_Quality_Control_Plan_IQCP.html]), which will be the only option for quality control (QC) starting in January 2016 if laboratories choose not to perform Clinical Laboratory Improvement Act (CLIA) [U.S. Statutes at Large 81(1967):533] default QC. Laboratories will no longer be able to use “equivalent QC” (EQC) or the Clinical and Laboratory Standards Institute (CLSI) standards alone for quality control of their microbiology systems. The implementation of IQCP in clinical microbiology laboratories will most certainly be an added burden, the benefits of which are currently unknown. PMID:26447112

Positioning pharmacists' roles in primary health care: a discourse analysis of the compensation plan in Alberta, Canada.

PubMed

Hughes, Christine A; Breault, Rene R; Hicks, Deborah; Schindel, Theresa J

2017-11-23

A comprehensive Compensation Plan for pharmacy services delivered by community pharmacists was implemented in Alberta, Canada in July 2012. Services covered by the Compensation Plan include care planning services, prescribing services such as adapting prescriptions, and administering a drug or publicly-funded vaccine by injection. Understanding how the Compensation Plan was framed and communicated provides insight into the roles of pharmacists and the potential influence of language on the implementation of services covered by the Compensation Plan by Albertan pharmacists. The objective of this study is to examine the positioning of pharmacists' roles in documents used to communicate the Compensation Plan to Albertan pharmacists and other audiences. Publicly available documents related to the Compensation Plan, such as news releases or reports, published between January 2012 and December 2015 were obtained from websites such as the Government of Alberta, Alberta Blue Cross, the Alberta College of Pharmacists, the Alberta Pharmacists' Association, and the Blueprint for Pharmacy. Searches of the Canadian Newsstand database and Google identified additional documents. Discourse analysis was performed using social positioning theory to explore how pharmacists' roles were constructed in communications about the Compensation Plan. In total, 65 publicly available documents were included in the analysis. The Compensation Plan was put forward as a framework for payment for professional services and formal legitimization of pharmacists' changing professional roles. The discourse associated with the Compensation Plan positioned pharmacists' roles as: (1) expanding to include services such as medication management for chronic diseases, (2) contributing to primary health care by providing access to services such as prescription renewals and immunizations, and (3) collaborating with other health care team members. Pharmacists' changing roles were positioned in alignment with the aims of primary health care. Social positioning theory provides a useful lens to examine the dynamic and evolving roles of pharmacists. This study provides insight into how communications regarding the Compensation Plan in Alberta, Canada positioned pharmacists' changing roles in the broader context of changes to primary health care delivery. Our findings may be useful for other jurisdictions considering implementation of remunerated clinical services provided by pharmacists.

50 CFR 600.1008 - Implementation plan and implementation regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Implementation plan and implementation... Capacity Reduction Framework § 600.1008 Implementation plan and implementation regulations. (a) As soon as... period, a proposed implementation plan and implementation regulations. During the public comment period...

Implementing AORN recommended practices for product selection.

PubMed

Conrardy, Julie A

2012-06-01

This article focuses on the revised AORN "Recommended practices for product selection in perioperative practice settings." Hospitals and ambulatory surgery facilities should have protocols in place for product evaluation that includes a multidisciplinary team approach. The process for product evaluation and selection includes gathering information; establishing consistent requirements for product evaluation; performing a financial impact analysis; investigating a plan to standardize products; conducting an environmental impact analysis; determining whether to purchase single-use, reposable, or reusable products or reprocess single-use devices; developing an evaluation process based on objective criteria; and developing and implementing a comprehensive plan to introduce and use new products. Use of an evaluation tool that is based on objective criteria is one way to obtain valuable input during product evaluations. Because of varied roles and experiences, the perioperative RN is an integral member of the product selection committee. Published by Elsevier Inc.

[Development and implementation of an outpatient clinic at an initial reception centre for asylum seekers in the German federal state of Baden-Wuerttemberg].

PubMed

Nikendei, Christoph; Huhn, Daniel; Adler, Guido; von Rose, Peta Becker; Eckstein, Torsten M; Fuchs, Birgit; Gewalt, Sandra C; Greiner, Bernhard; Günther, Thomas; Herzog, Wolfgang; Junghanss, Thomas; Krczal, Thomas; Lorenzen, Detlef; Lutz, Thomas; Manigault, Meryl A; Reinhart, Nico; Rodenberg, Michiko; Schelletter, Iris; Szecsenyi, Joachim; Steen, Rainer; Straßner, Cornelia; Thomsen, Mirjam; Wahedi, Katharina; Bozorgmehr, Kayvan

2017-10-01

In 2015, more than 890,000 asylum seekers were registered in Germany. The provision of medical and psychosocial care for asylum seekers is facing numerous obstacles. Access to health care is mostly insufficient, particularly in initial reception centres. The present article describes the development and implementation of an interdisciplinary outpatient clinic for asylum seekers at the main registration authority in the state of Baden-Wuerttemberg operated by physicians of the University Hospital of Heidelberg and the local Medical Association in Heidelberg. A steering committee was appointed to plan and implement the interdisciplinary outpatient clinic. Semi-structured interviews with nine steering committee members were conducted to elucidate perceived barriers during the planning and implementation phase. The steering committee's strong personal commitment and the health authorities' impartial management were cited as the main contributing factors to the success of the implementation process. Significant barriers were seen in the funding of personnel, equipment, and language mediation as well as in legal liability and billing-related aspects. Results are discussed with a focus on financing, administrative and legal framework as well as language mediation, documentation and further matters that are essential to ensure high-quality care. Copyright © 2017. Published by Elsevier GmbH.

A Guide for Planning and Implementing Successful Mental Health Educational Programs.

PubMed

Blanco-Vieira, Thiago; Ramos, Fernando Augusto da Cunha; Lauridsen-Ribeiro, Edith; Ribeiro, Marcos Vinícius Vieira; Meireles, Elisa Andrade; Nóbrega, Brunno Araújo; Motta Palma, Sonia Maria; Ratto, Maria de Fátima; Caetano, Sheila Cavalcante; Ribeiro, Wagner Silva; Rosário, Maria Conceição do

2018-01-01

Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. These results will be helpful for planning and improving the quality of future educational programs in mental health.

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

PubMed

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

2015-09-01

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

Improving our legacy: incorporation of adaptive management into state wildlife action plans.

PubMed

Fontaine, Joseph J

2011-05-01

The loss of biodiversity is a mounting concern, but despite numerous attempts there are few large scale conservation efforts that have proven successful in reversing current declines. Given the challenge of biodiversity conservation, there is a need to develop strategic conservation plans that address species declines even with the inherent uncertainty in managing multiple species in complex environments. In 2002, the State Wildlife Grant program was initiated to fulfill this need, and while not explicitly outlined by Congress follows the fundamental premise of adaptive management, 'Learning by doing'. When action is necessary, but basic biological information and an understanding of appropriate management strategies are lacking, adaptive management enables managers to be proactive in spite of uncertainty. However, regardless of the strengths of adaptive management, the development of an effective adaptive management framework is challenging. In a review of 53 State Wildlife Action Plans, I found a keen awareness by planners that adaptive management was an effective method for addressing biodiversity conservation, but the development and incorporation of explicit adaptive management approaches within each plan remained elusive. Only ~25% of the plans included a framework for how adaptive management would be implemented at the project level within their state. There was, however, considerable support across plans for further development and implementation of adaptive management. By furthering the incorporation of adaptive management principles in conservation plans and explicitly outlining the decision making process, states will be poised to meet the pending challenges to biodiversity conservation. Published by Elsevier Ltd.

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.

Integrating mobile devices into nursing curricula: opportunities for implementation using Rogers' Diffusion of Innovation model.

PubMed

Doyle, Glynda J; Garrett, Bernie; Currie, Leanne M

2014-05-01

To identify studies reporting mobile device integration into undergraduate and graduate nursing curricula. To explore the potential use of Rogers' Diffusion of Innovation model as a framework to guide implementation of mobile devices into nursing curricula. Literature review and thematic categorization. Literature published up until June 2013 was searched using EBSCO, PubMed, and Google Scholar. The literature was reviewed for research articles pertaining to mobile device use in nursing education. Research articles were grouped by study design, and articles were classified by: 1) strategies for individual adopters and 2) strategies for organizations. Rogers' Diffusion of Innovation theory was used to categorize reported implementation strategies. Fifty-two research studies were identified. Strategies for implementation were varied, and challenges to integrating mobile devices include lack of administrative support and time/funding to educate faculty as well as students. Overall, the use of mobile devices appears to provide benefits to nursing students; however the research evidence is limited. Anticipating challenges and ensuring a well laid out strategic plan can assist in supporting successful integration of mobile devices. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Testing the Implementation of the Veder Contact Method: A Theatre-Based Communication method in Dementia Care.

PubMed

Boersma, Petra; van Weert, Julia C M; Lissenberg-Witte, Birgit I; van Meijel, Berno; Dröes, Rose-Marie

2018-01-08

There is a lack of research on implementation of person-centered care in nursing home care. The purpose of this study was to assess the implementation of the Veder contact method (VCM), a new person-centered method using theatrical, poetic and musical communication for application in 24-hr care. Caregivers (n = 136) and residents (n = 141) participated in a 1-year quasi-experimental study. Foundation Theater Veder implemented VCM on six experimental wards and rated implementation quality. Six control wards delivered care-as-usual. Before and after implementation, caregiver behavior was assessed during observations using the Veder-observation list and Quality of Caregivers' Behavior-list. Caregiver attitude was rated with the Approaches to Dementia Questionnaire. Quality of life, behavior, and mood of the residents were measured with QUALIDEM, INTERACT and FACE. Residents' care plans were examined for person-centered background information. Significant improvements in caregivers' communicative behavior (i.e., the ability to apply VCM, establishing positive interactions) and some aspects of residents' behavior and quality of life (i.e., positive affect, social relations) were found on the experimental wards with a high implementation score, as compared to the experimental wards with a low implementation score, and the control wards. No significant differences were found between the groups in caregivers' attitudes, residents' care plans, or mood. The positive changes in caregivers' behavior and residents' well-being on the high implementation score wards confirm the partly successful VCM implementation. Distinguishing between wards with a high and low implementation score provided insight into factors which are crucial for successful implementation. © The Author(s) 2018. 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.

Clinical implementation of AXB from AAA for breast: Plan quality and subvolume analysis.

PubMed

Guebert, Alexandra; Conroy, Leigh; Weppler, Sarah; Alghamdi, Majed; Conway, Jessica; Harper, Lindsay; Phan, Tien; Olivotto, Ivo A; Smith, Wendy L; Quirk, Sarah

2018-05-01

Two dose calculation algorithms are available in Varian Eclipse software: Anisotropic Analytical Algorithm (AAA) and Acuros External Beam (AXB). Many Varian Eclipse-based centers have access to AXB; however, a thorough understanding of how it will affect plan characteristics and, subsequently, clinical practice is necessary prior to implementation. We characterized the difference in breast plan quality between AXB and AAA for dissemination to clinicians during implementation. Locoregional irradiation plans were created with AAA for 30 breast cancer patients with a prescription dose of 50 Gy to the breast and 45 Gy to the regional node, in 25 fractions. The internal mammary chain (IMC CTV ) nodes were covered by 80% of the breast dose. AXB, both dose-to-water and dose-to-medium reporting, was used to recalculate plans while maintaining constant monitor units. Target coverage and organ-at-risk doses were compared between the two algorithms using dose-volume parameters. An analysis to assess location-specific changes was performed by dividing the breast into nine subvolumes in the superior-inferior and left-right directions. There were minimal differences found between the AXB and AAA calculated plans. The median difference between AXB and AAA for breast CTV V 95% , was <2.5%. For IMC CTV , the median differences V 95% , and V 80% were <5% and 0%, respectively; indicating IMC CTV coverage only decreased when marginally covered. Mean superficial dose increased by a median of 3.2 Gy. In the subvolume analysis, the medial subvolumes were "hotter" when recalculated with AXB and the lateral subvolumes "cooler" with AXB; however, all differences were within 2 Gy. We observed minimal difference in magnitude and spatial distribution of dose when comparing the two algorithms. The largest observable differences occurred in superficial dose regions. Therefore, clinical implementation of AXB from AAA for breast radiotherapy is not expected to result in changes in clinical practice for prescribing or planning breast radiotherapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

75 FR 45568 - Approval and Promulgation of Implementation Plans and Designations of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... published a proposed rule to reconsider the 2008 8-hour ozone NAAQS (75 FR 2938) and to propose a revised... applicable Federal regulations. 42 U.S.C. 7410(k); 40 CFR 52.02(a). Thus, in reviewing SIP submissions or... burden under the provisions of the Paperwork Reduction Act (44 U.S.C. 3501 et seq.); Is certified as not...

The Impact of a Novel Curriculum on Secondary Biology Teachers' Dispositions toward Using Authentic Data and Media in Their Human Impact and Ecology Lessons

ERIC Educational Resources Information Center

Wyner, Yael

2013-01-01

This study examines how the implementation of a novel curriculum, that emphasizes the use of published scientific data and media to learn about human impact and ecological function, influenced ninth-grade biology teacher (N - 36) dispositions toward using data and media in their ecology and human impact lesson plans. It explores how integration of…

National Aerospace Leadership Initiative - Phase I

DTIC Science & Technology

2008-09-30

Devised and validated CFD code for operation of a micro-channel heat exchanger. The work was published at the 2008 AIAA Annual Meeting and Exposition...and (3) preparation to implement this algorithm in TURBO. Heat Transfer Capability In the short and medium term, the following plan has been adopted...to provide heat transfer capability to the TURBO code: • Incorporation of a constant wall temperature boundary condition. This capability will be

75 FR 58312 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... Allegan County area. In accordance with 5 U.S.C. 553(d), EPA finds there is good cause for this action to... provided by the agency for good cause found and published with the rule.'' The purpose of the 30-day.... For these reasons, EPA finds good cause under 5 U.S.C. 553(d)(3) for this action to become effective...

77 FR 43205 - Notice of Data Availability for Approval, Disapproval and Promulgation of Implementation Plans...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... Haze State Implementation Plan; Federal Implementation Plan for Regional Haze AGENCY: Environmental... (SIP) revision submitted by the State of Wyoming on January 12, 2011, that addresses regional haze...; Regional Haze State Implementation Plan; Federal Implementation Plan for Regional Haze; Proposed Rule (77...

78 FR 28775 - Approval and Promulgation of Implementation Plans; North Carolina; State Implementation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... Promulgation of Implementation Plans; North Carolina; State Implementation Plan Miscellaneous Revisions AGENCY... a revision to the North Carolina State Implementation Plan submitted on February 3, 2010, through... particulate matter found in the Code of Federal Regulations. In the Final Rules Section of this Federal...

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics.

PubMed

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A; Gill, Kathryn

2015-11-01

In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012). Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. Copyright © 2015 Longwoods Publishing.

Approved Air Quality Implementation Plans in Region 10

EPA Pesticide Factsheets

Landing page for information about EPA-approved air quality State Implementation Plans (SIPs), Tribal Implementation Plans (TIPs), and Federal Implementation Plans (FIPs) in Alaska, Idaho, Oregon, Washington.

78 FR 69625 - Approval and Promulgation of Implementation Plans; New York State Ozone Implementation Plan Revision

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

...] Approval and Promulgation of Implementation Plans; New York State Ozone Implementation Plan Revision AGENCY...) is proposing to approve a revision to the New York State Implementation Plan (SIP) for ozone... air quality standards for ozone. DATES: Comments must be received on or before December 20, 2013...

77 FR 13974 - Approval and Promulgation of Implementation Plans; New York State Ozone Implementation Plan Revision

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-08

... Promulgation of Implementation Plans; New York State Ozone Implementation Plan Revision AGENCY: Environmental... a proposed revision to the New York State Implementation Plan (SIP) for ozone concerning the control... national ambient air quality standards for ozone. DATES: Effective Date: This rule will be effective April...

Individualized Quality Control Plan (IQCP): Is It Value-Added for Clinical Microbiology?

PubMed

Sharp, Susan E; Miller, Melissa B; Hindler, Janet

2015-12-01

The Center for Medicaid and Medicare Services (CMS) recently published their Individualized Quality Control Plan (IQCP [https://www.cms.gov/regulations-and-guidance/legislation/CLIA/Individualized_Quality_Control_Plan_IQCP.html]), which will be the only option for quality control (QC) starting in January 2016 if laboratories choose not to perform Clinical Laboratory Improvement Act (CLIA) [U.S. Statutes at Large 81(1967):533] default QC. Laboratories will no longer be able to use "equivalent QC" (EQC) or the Clinical and Laboratory Standards Institute (CLSI) standards alone for quality control of their microbiology systems. The implementation of IQCP in clinical microbiology laboratories will most certainly be an added burden, the benefits of which are currently unknown. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

A Guide for Understanding Health Education and Promotion Programs.

PubMed

Kim, Richard W; Nahar, Vinayak K

2018-03-01

Planning, Implementing & Evaluating Health Promotion Programs: A Primer is a versatile and comprehensive resource on the theoretical and practical underpinnings of successful health promotion programs. The requirements for effective health promotion program development are presented with frequent use of practical planning examples, pedagogical devices, and expert rationale. Ideal for undergraduate and graduate students in health education, promotion, and planning courses, this 15-chapter textbook is organized in a manner that specifically addresses the responsibilities and competencies required of health education specialists as published in the Health Education Specialist Practice Analysis of 2015. The authors of this textbook are leaders in the field and provide readers with the skills necessary to carry out the full process of health promotion program execution, while also offering direct preparation for CHES and MCHES licensing exams.

HIPAA brings new requirements, new opportunities.

PubMed

Moynihan, J J; McLure, M L

2000-03-01

The passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) brought with it the need for Federal rules to implement the act's simplification and cost-reduction efforts. HHS has published proposed rules related to security for the electronic transmission of health information, privacy of individually identifiable health information, transactions and code sets, and national provider and employer identifiers. Additional proposed rules will be published this year for claims attachments and health plan identifiers. Although HIPAA does not require providers to conduct business electronically, the new standards give providers the opportunity to reduce healthcare administrative costs significantly and undertake electronic commerce efficiently and cost-effectively.

Update of the ACR-NEMA digital imaging and communications in medicine standard

NASA Astrophysics Data System (ADS)

Best, David E.; Horii, Steven C.; Bennett, William C.; Parisot, Charles R.

1992-07-01

The American College of Radiology and the National Electrical Manufacturers Association published the ACR-NEMA Digital Imaging and Communications Standard in 1985. Implementations are just now becoming available. Working groups of the committee have been very active. An expanded version of the Standard was published in 1988 and in a third version, to be known as Digital Imaging and Communications in Medicine (DICOM), is being prepared for publication in 1992. This paper briefly reviews the history of the Standard, describes the participation of the committee in international radiological imaging standards activities, and outlines the extensions planned for the DICOM Standard.

[Global and national strategies against antibiotic resistance].

PubMed

Abu Sin, Muna; Nahrgang, Saskia; Ziegelmann, Antina; Clarici, Alexandra; Matz, Sibylle; Tenhagen, Bernd-Alois; Eckmanns, Tim

2018-05-01

Antimicrobial resistance (AMR) is increasingly perceived as a global health problem. To tackle AMR effectively, a multisectoral one health approach is needed. We present some of the initiatives and activities at the national and global level that target the AMR challenge. The Global Action Plan on AMR, which has been developed by the World Health Organization (WHO), in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE) is considered a blueprint to combat AMR. Member states endorsed the action plan during the World Health Assembly 2015 and committed themselves to develop national action plans on AMR. The German Antibiotic Resistance Strategy (DART 2020) is based on the main objectives of the global action plan and was revised and published in 2015. Several examples of the implementation of DART 2020 are outlined here.

No. 354-Canadian HIV Pregnancy Planning Guidelines.

PubMed

Loutfy, Mona; Kennedy, V Logan; Poliquin, Vanessa; Dzineku, Frederick; Dean, Nicola L; Margolese, Shari; Symington, Alison; Money, Deborah M; Hamilton, Scot; Conway, Tracey; Khan, Sarah; Yudin, Mark H

2018-01-01

The objective of the Canadian HIV Pregnancy Planning Guidelines is to provide clinical information and recommendations for health care providers to assist Canadians affected by HIV with their fertility, preconception, and pregnancy planning decisions. These guidelines are evidence- and community-based and flexible and take into account diverse and intersecting local/population needs based on the social determinants of health. EVIDENCE: Literature searches were conducted by a librarian using the Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase databases for published articles in English and French related to HIV and pregnancy and HIV and pregnancy planning for each section of the guidelines. The full search strategy is available upon request. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the SOGC under the leadership of the principal authors, and recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care and through use of the Appraisal of Guidelines Research and Evaluation instrument for the development of clinical guidelines. Guideline implementation should assist the practitioner in developing an evidence-based approach for the prevention of unplanned pregnancy, preconception, fertility, and pregnancy planning counselling in the context of HIV infection. These guidelines have been reviewed and approved by the Infectious Disease Committee and the Executive and Council of the SOGC. Canadian Institutes of Health Research Grant Planning and Dissemination grant (Funding Reference # 137186), which funded a Development Team meeting in 2016. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

The development and implementation of a strategic and tactical planning framework at Mayo Clinic Arizona.

PubMed

Frey, Keith; Cranmer, John Jack; Kirby, Lani J; Lenko, Paul H; Vrabel, Amy Z

2005-01-01

This article describes the Mayo Arizona process for developing an information technology strategic plan. The background of organizational events that gave rise to this strategic planning process is presented. A cross-functional team of key IT stakeholders was convened; the team used a facilitated process to derive a pro forma set of IT strategic objectives from the larger organization's emerging strategic plan. A broad set of leadership interviews was conducted to further identify detailed objectives that would confirm, complement, or conflict with the "strawperson." The IT strategic objectives then were refined and published by the organization. The article also describes the annual process of reviewing the IT strategic plan and translating it to a set of tactical objectives. This includes the committee structure for project prioritization, which is guided by the IT strategic plan. The outcome of the prioritization process is a five-year IT tactical plan, which is used to communicate the IT action plan for achievement of the strategic objectives. The strategic and tactical plans have resulted in stronger ownership and advocacy of IT activities by organizational leadership and a clearer view of the impact of technology on the organization's strategic plan.

Optimization of a novel large field of view distortion phantom for MR-only treatment planning.

PubMed

Price, Ryan G; Knight, Robert A; Hwang, Ken-Pin; Bayram, Ersin; Nejad-Davarani, Siamak P; Glide-Hurst, Carri K

2017-07-01

MR-only treatment planning requires images of high geometric fidelity, particularly for large fields of view (FOV). However, the availability of large FOV distortion phantoms with analysis software is currently limited. This work sought to optimize a modular distortion phantom to accommodate multiple bore configurations and implement distortion characterization in a widely implementable solution. To determine candidate materials, 1.0 T MR and CT images were acquired of twelve urethane foam samples of various densities and strengths. Samples were precision-machined to accommodate 6 mm diameter paintballs used as landmarks. Final material candidates were selected by balancing strength, machinability, weight, and cost. Bore sizes and minimum aperture width resulting from couch position were tabulated from the literature (14 systems, 5 vendors). Bore geometry and couch position were simulated using MATLAB to generate machine-specific models to optimize the phantom build. Previously developed software for distortion characterization was modified for several magnet geometries (1.0 T, 1.5 T, 3.0 T), compared against previously published 1.0 T results, and integrated into the 3D Slicer application platform. All foam samples provided sufficient MR image contrast with paintball landmarks. Urethane foam (compressive strength ∼1000 psi, density ~20 lb/ft 3 ) was selected for its accurate machinability and weight characteristics. For smaller bores, a phantom version with the following parameters was used: 15 foam plates, 55 × 55 × 37.5 cm 3 (L×W×H), 5,082 landmarks, and weight ~30 kg. To accommodate > 70 cm wide bores, an extended build used 20 plates spanning 55 × 55 × 50 cm 3 with 7,497 landmarks and weight ~44 kg. Distortion characterization software was implemented as an external module into 3D Slicer's plugin framework and results agreed with the literature. The design and implementation of a modular, extendable distortion phantom was optimized for several bore configurations. The phantom and analysis software will be available for multi-institutional collaborations and cross-validation trials to support MR-only planning. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Reforming private drug coverage in Canada: inefficient drug benefit design and the barriers to change in unionized settings.

PubMed

O'Brady, Sean; Gagnon, Marc-André; Cassels, Alan

2015-02-01

Prescription drugs are the highest single cost component for employees' benefits packages in Canada. While industry literature considers cost-containment for prescription drug costs to be a priority for insurers and employers, the implementation of cost-containment measures for private drug plans in Canada remains more of a myth than a reality. Through 18 semi-structured phone interviews conducted with experts from private sector companies, unions, insurers and plan advisors, this study explores the reasons behind this incapacity to implement cost-containment measures by examining how private sector employers negotiate drug benefit design in unionized settings. Respondents were asked questions on how employee benefits are negotiated; the relationships between the players who influence drug benefit design; the role of these players' strategies in influencing plan design; the broad system that underpins drug benefit design; and the potential for a universal pharmacare program in Canada. The study shows that there is consensus about the need to educate employees and employers, more collaboration and data-sharing between these two sets of players, and for external intervention from government to help transform established norms in terms of private drug plan design. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

An active monitoring method for flood events

NASA Astrophysics Data System (ADS)

Chen, Zeqiang; Chen, Nengcheng; Du, Wenying; Gong, Jianya

2018-07-01

Timely and active detecting and monitoring of a flood event are critical for a quick response, effective decision-making and disaster reduction. To achieve the purpose, this paper proposes an active service framework for flood monitoring based on Sensor Web services and an active model for the concrete implementation of the active service framework. The framework consists of two core components-active warning and active planning. The active warning component is based on a publish-subscribe mechanism implemented by the Sensor Event Service. The active planning component employs the Sensor Planning Service to control the execution of the schemes and models and plans the model input data. The active model, called SMDSA, defines the quantitative calculation method for five elements, scheme, model, data, sensor, and auxiliary information, as well as their associations. Experimental monitoring of the Liangzi Lake flood in the summer of 2010 is conducted to test the proposed framework and model. The results show that 1) the proposed active service framework is efficient for timely and automated flood monitoring. 2) The active model, SMDSA, is a quantitative calculation method used to monitor floods from manual intervention to automatic computation. 3) As much preliminary work as possible should be done to take full advantage of the active service framework and the active model.

Community-based oral health promotion practices targeted at children and adolescents in Finland--developing an assessment tool.

PubMed

Blomqvist, Pia; Ojala, Ellinoora; Kettunen, Tarja; Poskiparta, Marita; Kasila, Kirsti

2014-06-01

To develop an assessment tool for evaluating oral health promotion practices and to evaluate community-based oral health promotion practices targeted at children and adolescents with this tool. A theoretical framework about health promotion planning, implementation and evaluation was made on the basis of a literature review. Then, information about Finnish community-based oral health promotion practices (n=12) targeted at children and adolescents was collected using semi-structured interviews. Also, related documents, for example action plans and reports, were collected when available. Next, an assessment tool based on the theoretical framework was developed, and the recorded and transcribed interview data and other documents were evaluated with this tool. The assessment tool proved to be practical: it pointed out the strengths and weaknesses of the practices. The tool revealed strengths in the implementation and deficiencies in the planning and evaluation of oral health promotion practices. One-quarter of the 12 practices assessed could be considered 'good practices'. There is a need to improve the planning and evaluation of oral health promotion practices. The assessment tool developed in this study might be useful for practitioners both in the field of oral health promotion and general health promotion. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of implementation of a preconception counselling resource for women with diabetes: A population based study.

PubMed

Holmes, V A; Hamill, L L; Alderdice, F A; Spence, M; Harper, R; Patterson, C C; Loughridge, S; McKenna, S; Gough, A; McCance, D R

2017-02-01

To evaluate the effect of regional implementation of a preconception counselling resource into routine diabetes care on pregnancy planning indicators. A preconception counselling DVD was distributed to women by diabetes care teams and general practices. Subsequently, in a prospective population-based study, pregnancy planning indicators were evaluated. The post-DVD cohort (n=135), including a viewed-DVD subgroup (n=58), were compared with an historical cohort (pre-DVD, n=114). Primary outcome was HbA1c at first diabetes-antenatal visit. Secondary outcomes included preconception folic acid consumption, planned pregnancy and HbA1c recorded in the 6 months preconception. Mean first visit HbA1c was lower post-DVD vs. pre-DVD: 7.5% vs. 7.8% [58.4 vs. 61.8mmol/mol]; p=0.12), although not statistically significant. 53% and 20% of women with type 1 and 2 diabetes, respectively, viewed the DVD. The viewed-DVD subgroup were significantly more likely to have lower first visit HbA1c: 6.9% vs. 7.8% [52.1 vs. 61.8mmol/mol], P<0.001; planned pregnancy (88% vs. 59%, P<0.001); taken folic acid preconception (81% vs. 43%, P=0.001); and had HbA1c recorded preconception (88% vs. 53%, P<0.001) than the pre-DVD cohort. Implementation of a preconception counselling resource was associated with improved pregnancy planning indicators. Women with type 2 diabetes are difficult to reach. Greater awareness within primary care of the importance of preconception counselling among this population is needed. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Clinical implementation and failure mode and effects analysis of HDR skin brachytherapy using Valencia and Leipzig surface applicators.

PubMed

Sayler, Elaine; Eldredge-Hindy, Harriet; Dinome, Jessie; Lockamy, Virginia; Harrison, Amy S

2015-01-01

The planning procedure for Valencia and Leipzig surface applicators (VLSAs) (Nucletron, Veenendaal, The Netherlands) differs substantially from CT-based planning; the unfamiliarity could lead to significant errors. This study applies failure modes and effects analysis (FMEA) to high-dose-rate (HDR) skin brachytherapy using VLSAs to ensure safety and quality. A multidisciplinary team created a protocol for HDR VLSA skin treatments and applied FMEA. Failure modes were identified and scored by severity, occurrence, and detectability. The clinical procedure was then revised to address high-scoring process nodes. Several key components were added to the protocol to minimize risk probability numbers. (1) Diagnosis, prescription, applicator selection, and setup are reviewed at weekly quality assurance rounds. Peer review reduces the likelihood of an inappropriate treatment regime. (2) A template for HDR skin treatments was established in the clinic's electronic medical record system to standardize treatment instructions. This reduces the chances of miscommunication between the physician and planner as well as increases the detectability of an error. (3) A screen check was implemented during the second check to increase detectability of an error. (4) To reduce error probability, the treatment plan worksheet was designed to display plan parameters in a format visually similar to the treatment console display, facilitating data entry and verification. (5) VLSAs are color coded and labeled to match the electronic medical record prescriptions, simplifying in-room selection and verification. Multidisciplinary planning and FMEA increased detectability and reduced error probability during VLSA HDR brachytherapy. This clinical model may be useful to institutions implementing similar procedures. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

State-based Marketplaces using 'clearinghouse' plan management models are associated with lower premiums.

PubMed

Krinn, Kelly; Karaca-Mandic, Pinar; Blewett, Lynn A

2015-01-01

The state-based and federally facilitated health insurance Marketplaces, or exchanges, enrolled more than eight million people during the first open enrollment period, which ended March 31, 2014. There is significant variation in how states have designed and implemented their Marketplaces. We examined how premiums varied with states' involvement in the Marketplaces through governance, plan management authority, and strategy during the first year that the exchanges have been open. State-based Marketplaces using "clearinghouse" plan management models had significantly lower adjusted average premiums for all plans within each metal level compared to state-based Marketplaces using "active purchaser" models and the federally facilitated and partnership Marketplaces. Clearinghouse management models are those in which all health plans that meet published criteria are accepted. Active purchaser models are those in which states negotiate premiums, provider networks, number of plans, and benefits. Our baseline estimates provide valuable benchmarks for evaluating future performance of states' involvement in governance, plan management, and regulatory authority of the insurance Marketplaces. Project HOPE—The People-to-People Health Foundation, Inc.

Approved Air Quality Implementation Plans in The Virgin Islands

EPA Pesticide Factsheets

This site contains information about air quality regulations called State Implementation Plans (SIPs), Federal Implementation Plans (FIPs), and Tribal Implementation Plans (TIPs) approved by EPA within the U.S. Virgin Islands.

Knowledge-based treatment planning and its potential role in the transition between treatment planning systems.

PubMed

Masi, Kathryn; Archer, Paul; Jackson, William; Sun, Yilun; Schipper, Matthew; Hamstra, Daniel; Matuszak, Martha

2017-11-22

Commissioning a new treatment planning system (TPS) involves many time-consuming tasks. We investigated the role that knowledge-based planning (KBP) can play in aiding a clinic's transition to a new TPS. Sixty clinically treated prostate/prostate bed intensity-modulated radiation therapy (IMRT) plans were exported from an in-house TPS and were used to create a KBP model in a newly implemented commercial application. To determine the benefit that KBP may have in a TPS transition, the model was tested on 2 groups of patients. Group 1 consisted of the first 10 prostate/prostate bed patients treated in the commercial TPS after the transition from the in-house TPS. Group 2 consisted of 10 patients planned in the commercial TPS after 8 months of clinical use. The KBP-generated plan was compared with the clinically used plan in terms of plan quality (ability to meet planning objectives and overall dose metrics) and planning efficiency (time required to generate clinically acceptable plans). The KBP-generated plans provided a significantly improved target coverage (p = 0.01) compared with the clinically used plans for Group 1, but yielded plans of comparable target coverage to the clinically used plans for Group 2. For the organs at risk, the KBP-generated plans produced lower doses, on average, for every normal-tissue objective except for the maximum dose to 0.1 cc of rectum. The time needed for the KBP-generated plans ranged from 6 to 15 minutes compared to 30 to 150 and 15 to 60 minutes for manual planning in Groups 1 and 2, respectively. KBP is a promising tool to aid in the transition to a new TPS. Our study indicates that high-quality treatment plans could have been generated in the newly implemented TPS more efficiently compared with not using KBP. Even after 8 months of the clinical use, KBP still showed an increase in plan quality and planning efficiency compared with manual planning. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

77 FR 48061 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-13

... Promulgation of Air Quality Implementation Plans; Pennsylvania; Regional Haze State Implementation Plan...'s limited approval of Pennsylvania's Regional Haze State Implementation Plan (SIP). DATES: Effective... announcing our limited approval of Pennsylvania's Regional Haze SIP. In this document, we inadvertently...

An Introduction to Quality Management: Selected Readings.

DTIC Science & Technology

total quality management (TQM). Through the kind permission of a number of publishers, we have been able to reproduce here some key articles about...TQM. It is not the intent of this technical note to provide a comprehensive study of quality management , but rather to aid in planning for an...implementation of the Deming approach to TQM. Although the Navy aviation community chose the Deming approach to quality management , as reflected in the selected

Integrated assessment of urban drainage system under the framework of uncertainty analysis.

PubMed

Dong, X; Chen, J; Zeng, S; Zhao, D

2008-01-01

Due to a rapid urbanization as well as the presence of large number of aging urban infrastructures in China, the urban drainage system is facing a dual pressure of construction and renovation nationwide. This leads to the need for an integrated assessment when an urban drainage system is under planning or re-design. In this paper, an integrated assessment methodology is proposed based upon the approaches of analytic hierarchy process (AHP), uncertainty analysis, mathematical simulation of urban drainage system and fuzzy assessment. To illustrate this methodology, a case study in Shenzhen City of south China has been implemented to evaluate and compare two different urban drainage system renovation plans, i.e., the distributed plan and the centralized plan. By comparing their water quality impacts, ecological impacts, technological feasibility and economic costs, the integrated performance of the distributed plan is found to be both better and robust. The proposed methodology is also found to be both effective and practical. (c) IWA Publishing 2008.

Report on milestones for care and support under the U.S. National Plan to Address Alzheimer's Disease.

PubMed

Borson, Soo; Boustani, Malaz A; Buckwalter, Kathleen C; Burgio, Louis D; Chodosh, Joshua; Fortinsky, Richard H; Gifford, David R; Gwyther, Lisa P; Koren, Mary Jane; Lynn, Joanne; Phillips, Cheryl; Roherty, Martha; Ronch, Judah; Stahl, Claudia; Rodgers, Lauren; Kim, Hye; Baumgart, Matthew; Geiger, Angela

2016-03-01

Under the U.S. national Alzheimer's plan, the National Institutes of Health identified milestones required to meet the plan's biomedical research goal (Goal 1). However, similar milestones have not been created for the goals on care (Goal 2) and support (Goal 3). The Alzheimer's Association convened a workgroup with expertise in clinical care, long-term services and supports, dementia care and support research, and public policy. The workgroup reviewed the literature on Alzheimer's care and support; reviewed how other countries are addressing the issue; and identified public policies needed over the next 10 years to achieve a more ideal care and support system. The workgroup developed and recommended 73 milestones for Goal 2 and 56 milestones for Goal 3. To advance the implementation of the U.S. national Alzheimer's plan, the U.S. government should adopt these recommended milestones, or develop similar milestones, to be incorporated into the national plan. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Do public health services in Egypt help young married women exercise their reproductive rights?

PubMed

Abdel-Tawab, Nahla; Rabie, Tamer; Boehmova, Zuzana; Hawkins, Loraine; Saher, Sally; El Shitany, Atef

2015-08-01

To assess supply and demand of family planning services from a reproductive rights perspective among young married women (YMW) in Egypt. Data sources related to family planning included structured interviews with service providers (n=216); an inventory of equipment and supplies (n=40); exit interviews with YMW (n=147); and focus group discussions (n=12) with YMW, husbands, and mothers and/or mothers in law. YMW, husbands and mothers in law were not necessarily related. Although family planning services were readily available and affordable, YMW had limited access to information and services. Shortfalls were noted regarding respect for privacy, choice of family planning method, access to fertility services, and premarital counseling. Few YMW had sufficient autonomy to make informed reproductive decisions. Effective accountability mechanisms and processes for redress were also lacking. Implementation of a rights-based approach and structural changes to family planning service delivery are recommended to empower YMW in Egypt to demand and exercise their reproductive rights. Copyright © 2015. Published by Elsevier Ireland Ltd.

Mars scientific investigations as a precursor for human exploration.

PubMed

Ahlf, P; Cantwell, E; Ostrach, L; Pline, A

2000-01-01

In the past two years, NASA has begun to develop and implement plans for investigations on robotic Mars missions which are focused toward returning data critical for planning human missions to Mars. The Mars Surveyor Program 2001 Orbiter and Lander missions will mark the first time that experiments dedicated to preparation for human exploration will be carried out. Investigations on these missions and future missions range from characterization of the physical and chemical environment of Mars, to predicting the response of biology to the Mars environment. Planning for such missions must take into account existing data from previous Mars missions which were not necessarily focused on human exploration preparation. At the same time, plans for near term missions by the international community must be considered to avoid duplication of effort. This paper reviews data requirements for human exploration and applicability of existing data. It will also describe current plans for investigations and place them within the context of related international activities. c 2000 International Astronautical Federation. Published by Elsevier Science Ltd. All rights reserved.

Mars scientific investigations as a precursor for human exploration

NASA Technical Reports Server (NTRS)

Ahlf, P.; Cantwell, E.; Ostrach, L.; Pline, A.

2000-01-01

In the past two years, NASA has begun to develop and implement plans for investigations on robotic Mars missions which are focused toward returning data critical for planning human missions to Mars. The Mars Surveyor Program 2001 Orbiter and Lander missions will mark the first time that experiments dedicated to preparation for human exploration will be carried out. Investigations on these missions and future missions range from characterization of the physical and chemical environment of Mars, to predicting the response of biology to the Mars environment. Planning for such missions must take into account existing data from previous Mars missions which were not necessarily focused on human exploration preparation. At the same time, plans for near term missions by the international community must be considered to avoid duplication of effort. This paper reviews data requirements for human exploration and applicability of existing data. It will also describe current plans for investigations and place them within the context of related international activities. c 2000 International Astronautical Federation. Published by Elsevier Science Ltd. All rights reserved.

We need to talk: an observational study of the impact of electronic medical record implementation on hospital communication.

PubMed

Taylor, Stephanie Parks; Ledford, Robert; Palmer, Victoria; Abel, Erika

2014-07-01

Increasing attention is being given to the importance of communication in the delivery of high-quality healthcare. We sought to determine whether communication improved in a hospital setting following the introduction of an electronic medical record (EMR). This pre-post cohort design enrolled 75 patient-nurse-physician triads prior to the introduction of EMR, and 123 triads after the introduction of EMR. Nurses and patients reported whether they communicated with the physician that day. Patients, nurses and physicians answered several questions about the plan of care for the day. Responses were scored for degree of agreement and compared between pre-EMR and post-EMR cohorts. The primary outcome was Total Agreement Score, calculated as the sum of the agreement responses. Chart review was performed to determine patients' actual length of stay. Although there was no difference between the frequency of nurses reporting communication with physicians before and after EMR, face-to-face communication was significantly reduced (67% vs 51%, p=0.03). Total Agreement Score was significantly lower after the implementation of EMR (p=0.03). Additionally, fewer patients accurately predicted their expected length of stay after EMR (34% vs 26%, p=0.001). The implementation of EMR was associated with a decrease in face-to-face communication between physicians and nurses, and worsened overall agreement about the plan of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Teen Pregnancy Prevention: Implementation of a Multicomponent, Community-Wide Approach.

PubMed

Mueller, Trisha; Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Romero, Lisa M; Brittain, Anna; Varanasi, Bala

2017-03-01

This article provides an overview and description of implementation activities of the multicomponent, community-wide initiatives of the Teenage Pregnancy Prevention Program initiated in 2010 by the Office of Adolescent Health and the Centers for Disease Control and Prevention. The community-wide initiatives applied the Interactive Systems Framework for dissemination and implementation through training and technical assistance on the key elements of the initiative: implementation of evidence-based teen pregnancy prevention (TPP) interventions; enhancing quality of and access to youth-friendly reproductive health services; educating stakeholders about TPP; working with youth in communities most at risk of teen pregnancy; and mobilizing the community to garner support. Of nearly 12,000 hours of training and technical assistance provided, the majority was for selecting, implementing, and evaluating an evidence-based TPP program. Real-world implementation of a community-wide approach to TPP takes time and effort. This report describes implementation within each of the components and shares lessons learned during planning and implementation phases of the initiative. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Hospital and Health Plan Partnerships: The Affordable Care Act's Impact on Promoting Health and Wellness.

PubMed

Vu, Michelle; White, Annesha; Kelley, Virginia P; Hopper, Jennifer Kuca; Liu, Cathy

2016-07-01

The Affordable Care Act (ACA) healthcare reforms, centered on achieving the Centers for Medicare & Medicaid Services (CMS) Triple Aim goals of improving patient care quality and satisfaction, improving population health, and reducing costs, have led to increasing partnerships between hospitals and insurance companies and the implementation of employee wellness programs. Hospitals and insurance companies have opted to partner to distribute the risk and resources and increase coordination of care. To examine the ACA's impact on the health and wellness programs that have resulted from the joint ventures of hospitals and health plans based on the published literature. We conducted a review of the literature to identify successful mergers and best practices of health and wellness programs. Articles published between January 2007 and January 2015 were compiled from various search engines, using the search terms "corporate," "health and wellness program," "health plan," "insurance plan," "hospital," "joint venture," and "vertical merger." Publications that described consolidations or wellness programs not tied to health insurance plans were excluded. Noteworthy characteristics of these programs were summarized and tabulated. A total of 44 eligible articles were included in the analysis. The findings showed that despite rising healthcare costs, joint ventures prevent hospitals from trading-off quality and services for cost reductions. Administrators believed that partnering would allow the companies to meet ACA standards for improving clinical outcomes at reduced costs. Before the implementation of the ACA, some employers had wellness programs, but these were not standardized and did not need to produce measurable results. The ACA encouraged improvement of employee wellness programs by providing funding for expanded health services and by mandating quality care. Successful workplace health and wellness programs have varying components, but all include monetary incentives and documented outcomes. The concurrent growth of hospital health plans (especially those emerging from vertical mergers and partnerships) and wellness programs in the United States provides a unique opportunity for employees and patient populations to promote wellness and achieve the Triple Aim goals as initiated by CMS.

Hospital and Health Plan Partnerships: The Affordable Care Act's Impact on Promoting Health and Wellness

PubMed Central

Vu, Michelle; White, Annesha; Kelley, Virginia P.; Hopper, Jennifer Kuca; Liu, Cathy

2016-01-01

Background The Affordable Care Act (ACA) healthcare reforms, centered on achieving the Centers for Medicare & Medicaid Services (CMS) Triple Aim goals of improving patient care quality and satisfaction, improving population health, and reducing costs, have led to increasing partnerships between hospitals and insurance companies and the implementation of employee wellness programs. Hospitals and insurance companies have opted to partner to distribute the risk and resources and increase coordination of care. Objective To examine the ACA's impact on the health and wellness programs that have resulted from the joint ventures of hospitals and health plans based on the published literature. Method We conducted a review of the literature to identify successful mergers and best practices of health and wellness programs. Articles published between January 2007 and January 2015 were compiled from various search engines, using the search terms “corporate,” “health and wellness program,” “health plan,” “insurance plan,” “hospital,” “joint venture,” and “vertical merger.” Publications that described consolidations or wellness programs not tied to health insurance plans were excluded. Noteworthy characteristics of these programs were summarized and tabulated. Results A total of 44 eligible articles were included in the analysis. The findings showed that despite rising healthcare costs, joint ventures prevent hospitals from trading-off quality and services for cost reductions. Administrators believed that partnering would allow the companies to meet ACA standards for improving clinical outcomes at reduced costs. Before the implementation of the ACA, some employers had wellness programs, but these were not standardized and did not need to produce measurable results. The ACA encouraged improvement of employee wellness programs by providing funding for expanded health services and by mandating quality care. Successful workplace health and wellness programs have varying components, but all include monetary incentives and documented outcomes. Conclusion The concurrent growth of hospital health plans (especially those emerging from vertical mergers and partnerships) and wellness programs in the United States provides a unique opportunity for employees and patient populations to promote wellness and achieve the Triple Aim goals as initiated by CMS. PMID:27625744

Men and family planning in Portugal.

PubMed

Vicente, A

1993-10-01

Although family planning services in Portugal are open to everybody, male and female, and they are free of charge, it is mostly women who are using the services, since family planning services have integrated maternal health care. Between 1978 and 1981, the Commission for the Portuguese Commission for Equality and Women's Rights implemented a family planning information, education, and communication project under technical and financial aid by the United Nations Population Fund. During a training course for a group of 12 women, which took place in the small town Vialonga near Lisbon in 1992, all women said that their husbands did not play any role in family planning. The choice of the method was their sole responsibility. In 1988, data were gathered by the General Direction of Primary Health Care from the local health services. 17.6% of women used the pill, and 28% practiced coitus interruptus. Condom use amounted to 5.7%. Other methods were the IUD (7.3%), natural methods (3.6%), spermicides (2.6%), the diaphragm (0.3%), and sterilization (female 3.6%; male 0.3%). In 1992, the Commission published a study on family planning, involving 638 men and 882 women, which concluded that the responsibility for family planning was no longer exclusively with women and that young, single people were in favor of family planning information sessions. The Portuguese Constitution states that the state shall promote a wider knowledge of family planning methods and responsible parenthood. The Health Secretary of State ordered the integration of family planning into the National Health Service in 1976. A 1984 law, Sex Education and Family Planning, and a 1985 Government Order constitute the legal framework for the practice of family planning. The Commission for Equality and Women's Rights has been implementing information, education, and communication activities since 1976. One of the members of the Consultative Council is the Association for Family Planning, which has also been disseminating information, training, and counselling since it was founded in 1967.

Moving survivorship care plans forward: focus on care coordination.

PubMed

Salz, Talya; Baxi, Shrujal

2016-07-01

After completing treatment for cancer, the coordination of oncology and primary care presents a challenge for cancer survivors. Many survivors need continued oncology follow-up, and all survivors require primary care. Coordinating the shared care of a cancer survivor, or facilitating an informed handoff from oncology to primary care, is essential for cancer survivors. Survivorship care plans are personalized documents that summarize cancer treatment and outline a plan of recommended ongoing care, with the goal of facilitating the coordination of post-treatment care. Despite their face validity, five trials have failed to demonstrate the effectiveness of survivorship care plans. We posit that these existing trials have critical shortcomings and do not adequately address whether survivorship care plans improve care coordination. Moving forward, we propose four criteria for future trials of survivorship care plans: focusing on high-needs survivor populations, tailoring the survivorship care plan to the care setting, facilitating implementation of the survivorship care plan in clinical practice, and selecting appropriate trial outcomes to assess care coordination. When trials meet these criteria, we can finally assess whether survivorship care plans help cancer survivors receive optimal oncology and primary care. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

[The intervention mapping protocol: A structured process to develop, implement and evaluate health promotion programs].

PubMed

Fassier, J-B; Lamort-Bouché, M; Sarnin, P; Durif-Bruckert, C; Péron, J; Letrilliart, L; Durand, M-J

2016-02-01

Health promotion programs are expected to improve population health and reduce social inequalities in health. However, their theoretical foundations are frequently ill-defined, and their implementation faces many obstacles. The aim of this article is to describe the intervention mapping protocol in health promotion programs planning, used recently in several countries. The challenges of planning health promotion programs are presented, and the six steps of the intervention mapping protocol are described with an example. Based on a literature review, the use of this protocol, its requirements and potential limitations are discussed. The intervention mapping protocol has four essential characteristics: an ecological perspective (person-environment), a participative approach, the use of theoretical models in human and social sciences and the use of scientific evidence. It comprises six steps: conduct a health needs assessment, define change objectives, select theory-based change techniques and practical applications, organize techniques and applications into an intervention program (logic model), plan for program adoption, implementation, and sustainability, and generate an evaluation plan. This protocol was used in different countries and domains such as obesity, tobacco, physical activity, cancer and occupational health. Although its utilization requires resources and a critical stance, this protocol was used to develop interventions which efficacy was demonstrated. The intervention mapping protocol is an integrated process that fits the scientific and practical challenges of health promotion. It could be tested in France as it was used in other countries, in particular to reduce social inequalities in health. Copyright © 2016. Published by Elsevier Masson SAS.

77 FR 5191 - Approval and Promulgation of Air Quality Implementation Plans; District of Columbia; Regional...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

... Promulgation of Air Quality Implementation Plans; District of Columbia; Regional Haze State Implementation Plan... of Columbia Regional Haze Plan, a revision to the District of Columbia State Implementation Plan (SIP... existing anthropogenic impairment of visibility in mandatory Class I areas through a regional haze program...

[Implementation of Italian guidelines on public health genomics in Italy: a challenging policy of the NHS].

PubMed

Boccia, Stefania; Federici, Antonio; Colotto, Marco; Villari, Paolo

2014-01-01

Genomics and related fields are becoming increasingly relevant in health care practice. Italy is the first European country that has a structured policy of Public Health Genomics. Nevertheless, what should be the role of genomics in a public health perspective and how public health professionals should engage with advances in genomics' knowledge and technology, is still not entirely clear. A description of the regulatory framework made-up by the Italian government in the last years is provided. In order to implement the national guidelines on Public Health Genomics published in 2013, key issues including the ethical, legal and social aspects within an evidence-based framework should be warranted and are herewith discussed. Genomics and predictive medicine are considered one of the main intervention areas by the National Prevention Plan 2010-2012, and dedicated guidelines were published in 2013. In order to implement such guidelines, we envisage a coordinated effort between stakeholders to guide development in genomic medicine, towards an impact on population health. There is also room to implement knowledge on how genomics can be integrated into health systems in an appropriate and sustainable way. Learning programs are needed to spread knowledge and awareness of genomics technology, in particular on genomic testing for complex diseases.

Use of nonpharmaceutical interventions to reduce transmission of 2009 pandemic influenza A (pH1N1) in Pennsylvania public schools.

PubMed

Miller, Jeffrey R; Short, Vanessa L; Wu, Henry M; Waller, Kirsten; Mead, Paul; Kahn, Emily; Bahn, Beth A; Dale, Jon W; Nasrullah, Muazzam; Walton, Sabrina E; Urdaneta, Veronica; Ostroff, Stephen; Averhoff, Francisco

2013-04-01

School-based recommendations for nonpharmaceutical interventions (NPIs) were issued in response to the threat of 2009 pandemic influenza A (pH1N1). The implementation and effectiveness of these recommendations has not been assessed. In November 2009, a Web-based survey of all Pennsylvania public schools was conducted to assess the use of recommended NPIs. Overall, 1040 (31%) of 3351 schools participated in the survey. By fall 2009, 820 (84%) of 979 respondents reported that their school had an influenza plan in place, a 44% higher proportion than in the spring 2009 (p < .01). Most schools communicated health messages (eg, staying home when sick), implemented return to school requirements, and made hand sanitizer available. Schools with a spring influenza plan (N = 568) were less likely to report substantial influenza-like illness (ILI) during the fall wave of influenza than the 299 schools without a spring influenza plan (63% vs 71%, p = .02). This association persisted after controlling for schools with substantial ILI in the spring. The reported use of NPIs in participating Pennsylvania public schools improved substantially from spring to fall and was generally consistent with issued recommendations. The proactive implementation of a number of NPIs and the early implementation of communication and education initiatives might have cumulatively reduced the impact of pH1N1 in some schools. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Evidence-based dentistry for planning restorative treatments: barriers and potential solutions.

PubMed

Afrashtehfar, K I; Eimar, H; Yassine, R; Abi-Nader, S; Tamimi, F

2017-11-01

Evidence-based dentistry (EBD) can help provide the best treatment option for every patient, however, its implementation in restorative dentistry is very limited. This study aimed at assessing the barriers preventing the implementation of EBD among dental undergraduate and graduate students in Montreal, and explore possible solutions to overcome these barriers. A cross-sectional survey was conducted by means of a paper format self-administrated questionnaire distributed among dental students. The survey assessed the barriers and potential solutions for implementation of an evidence-based practice. Sixty-one students completed the questionnaire. Forty-one percent of respondents found evidence-based literature to be the most reliable source of information for restorative treatment planning, however, only 16% used it. They considered that finding reliable information was difficult and they sometimes encountered conflicting information when consulting different sources. Dental students had positive attitudes towards the need for better access to evidence-based literature to assist learning and decision making in restorative treatment planning and to improve treatment outcomes. Even for dentists trained in EBD, online searching takes too much time, and even though it can provide information of better quality than personal intuition, it might not be enough to identify the best available evidence. Even though dental students are aware of the importance of EBD in restorative dentistry they rarely apply the concept, mainly due to time constraints. For this reason, implementation of EBD would probably require faster access to evidence-based knowledge. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Economic vulnerability of timber resources to forest fires.

PubMed

y Silva, Francisco Rodríguez; Molina, Juan Ramón; González-Cabán, Armando; Machuca, Miguel Ángel Herrera

2012-06-15

The temporal-spatial planning of activities for a territorial fire management program requires knowing the value of forest ecosystems. In this paper we extend to and apply the economic valuation principle to the concept of economic vulnerability and present a methodology for the economic valuation of the forest production ecosystems. The forest vulnerability is analyzed from criteria intrinsically associated to the forest characterization, and to the potential behavior of surface fires. Integrating a mapping process of fire potential and analytical valuation algorithms facilitates the implementation of fire prevention planning. The availability of cartography of economic vulnerability of the forest ecosystems is fundamental for budget optimization, and to help in the decision making process. Published by Elsevier Ltd.

A burn center paradigm to fulfill deferred consent public disclosure and community consultation requirements for emergency care research.

PubMed

Blackford, Martha G; Falletta, Lynn; Andrews, David A; Reed, Michael D

2012-09-01

To fulfill Food and Drug Administration and Department of Health and Human Services emergency care research informed consent requirements, our burn center planned and executed a deferred consent strategy gaining Institutional Review Board (IRB) approval to proceed with the clinical study. These federal regulations dictate public disclosure and community consultation unique to acute care research. Our regional burn center developed and implemented a deferred consent public notification and community consultation paradigm appropriate for a burn study. Published accounts of deferred consent strategies focus on acute care resuscitation practices. We adapted those strategies to design and conduct a comprehensive public notification/community consultation plan to satisfy deferred consent requirements for burn center research. To implement a robust media campaign we engaged the hospital's public relations department, distributed media materials, recruited hospital staff for speaking engagements, enlisted community volunteers, and developed initiatives to inform "hard-to-reach" populations. The hospital's IRB determined we fulfilled our obligation to notify the defined community. Our communication strategy should provide a paradigm other burn centers may appropriate and adapt when planning and executing a deferred consent initiative. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Publishing Platform for Scientific Software - Lessons Learned

NASA Astrophysics Data System (ADS)

Hammitzsch, Martin; Fritzsch, Bernadette; Reusser, Dominik; Brembs, Björn; Deinzer, Gernot; Loewe, Peter; Fenner, Martin; van Edig, Xenia; Bertelmann, Roland; Pampel, Heinz; Klump, Jens; Wächter, Joachim

2015-04-01

Scientific software has become an indispensable commodity for the production, processing and analysis of empirical data but also for modelling and simulation of complex processes. Software has a significant influence on the quality of research results. For strengthening the recognition of the academic performance of scientific software development, for increasing its visibility and for promoting the reproducibility of research results, concepts for the publication of scientific software have to be developed, tested, evaluated, and then transferred into operations. For this, the publication and citability of scientific software have to fulfil scientific criteria by means of defined processes and the use of persistent identifiers, similar to data publications. The SciForge project is addressing these challenges. Based on interviews a blueprint for a scientific software publishing platform and a systematic implementation plan has been designed. In addition, the potential of journals, software repositories and persistent identifiers have been evaluated to improve the publication and dissemination of reusable software solutions. It is important that procedures for publishing software as well as methods and tools for software engineering are reflected in the architecture of the platform, in order to improve the quality of the software and the results of research. In addition, it is necessary to work continuously on improving specific conditions that promote the adoption and sustainable utilization of scientific software publications. Among others, this would include policies for the development and publication of scientific software in the institutions but also policies for establishing the necessary competencies and skills of scientists and IT personnel. To implement the concepts developed in SciForge a combined bottom-up / top-down approach is considered that will be implemented in parallel in different scientific domains, e.g. in earth sciences, climate research and the life sciences. Based on the developed blueprints a scientific software publishing platform will be iteratively implemented, tested, and evaluated. Thus the platform should be developed continuously on the basis of gained experiences and results. The platform services will be extended one by one corresponding to the requirements of the communities. Thus the implemented platform for the publication of scientific software can be improved and stabilized incrementally as a tool with software, science, publishing, and user oriented features.

Natural disaster management: experience of an academic institution after a 7.8 magnitude earthquake in Ecuador.

PubMed

Cordero-Reyes, A M; Palacios, I; Ramia, D; West, R; Valencia, M; Ramia, N; Egas, D; Rodas, P; Bahamonde, M; Grunauer, M

2017-03-01

This case study describes the implementation of an academic institution's disaster management plan. Case study. USFQ's Medical School developed a six-phase disaster relief plan consisting of: induction, establishing a base camp, crisis management and mental health aid, creation of multidisciplinary teams and multi-agency teams, and reconstruction. Each phase uses a community-oriented approach to foster survivor autonomy and recovery. Our methodology facilitated the successful implementation of multidisciplinary interventions to manage the earthquake's aftermath on the personal, community and regional levels, treated and prevented psychological and physical morbidity among survivors and promoted healthy living conditions and independence. A multidisciplinary response team that addresses medical needs, mental health, education, food, nutrition and sanitation is highly effective in contributing to timely, effective relief efforts. The short- and long-term solutions we describe could be applicable to other academic centres' interventions in future disaster scenarios around the world. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Professional perspectives on service user and carer involvement in mental health care planning: a qualitative study.

PubMed

Bee, Penny; Brooks, Helen; Fraser, Claire; Lovell, Karina

2015-12-01

Involving users/carers in mental health care-planning is central to international policy initiatives yet users frequently report feeling excluded from the care planning process. Rigorous explorations of mental health professionals' experiences of care planning are lacking, limiting our understanding of this important translational gap. To explore professional perceptions of delivering collaborative mental health care-planning and involving service users and carers in their care. Qualitative interviews and focus groups with data combined and subjected to framework analysis. UK secondary care mental health services. 51 multi-disciplinary professionals involved in care planning and recruited via study advertisements. Emergent themes identified care-planning as a meaningful platform for user/carer involvement but revealed philosophical tensions between user involvement and professional accountability. Professionals emphasised their individual, relational skills as a core facilitator of involvement, highlighting some important deficiencies in conventional staff training programmes. Although internationally accepted on philosophical grounds, user-involved care-planning is poorly defined and lacks effective implementation support. Its full realisation demands greater recognition of both the historical and contemporary contexts in which statutory mental healthcare occurs. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Interaction dynamics: The case of the water sector skills plan in South Africa.

PubMed

Moyo, Laurane; Wehn, Uta

2017-02-01

Despite extensive and continuous efforts to strengthen the capacity of people, organizations and institutions, there is evidence of an increasing gap between the existing and required capacities within the water sector. Consensus seems to be emerging regarding the need for national strategies to improve water sector capacity development. This paper analyses the dynamics of actors' interactions and their characteristics (motivation, cognition and power) during the formulation and implementation of a specific capacity development strategy, namely the Water Sector Skills Plan (SSP) in South Africa. Based on the Contextual Interactive Theory and empirical findings, our analysis indicates slow progression and challenges with implementing the SSP, mainly due to the lack of consultation with key stakeholders during the formulation stage, a lack of data sharing among the target group (the Sector Education Training Authorities), and a lack of capacities within the key implementing organizations. These policy dynamics need to be taken into account when advocating for national capacity development strategies as a solution for challenges with water sector capacity development. The paper proposes the recommendations that are of relevance for the SSP as well as similar initiatives in other countries. Copyright © 2016. Published by Elsevier Ltd.

24 CFR 598.605 - Implementation plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Implementation plan. 598.605 Section 598.605 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... Grants § 598.605 Implementation plan. (a) Implementation plan content. An EZ must submit an...

77 FR 41279 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

... Promulgation of Air Quality Implementation Plans; Pennsylvania; Regional Haze State Implementation Plan AGENCY... the Regional Haze State Implementation Plan (SIP) (hereafter RH SIP) revision submitted by the... anthropogenic impairment of visibility in mandatory Class I areas [[Page 41280

76 FR 12945 - Instructions for Implementing Climate Change Adaptation Planning in Accordance With Executive...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-09

... COUNCIL ON ENVIRONMENTAL QUALITY Instructions for Implementing Climate Change Adaptation Planning... Availability of Climate Change Adaptation Planning Implementing Instructions. SUMMARY: The Chair of the Council... for Implementing Climate Change Adaptation Planning are now available at: http://www.whitehouse.gov...

A Case Study in the Identification of Critical Factors Leading to Successful Implementation of the Hospital Incident Command System

DTIC Science & Technology

2015-06-01

California EMSA, National Incident Management System, NIMS, hospital preparedness program, Nursing Home Incident Command System, NHICS, Hospital...The International Journal of Trauma Nursing published an article in 2007 entitled “Organization of a Hospital-based Victim Decontamination Plan...Journal of Trauma Nursing 5, no. 4 (October– November 2007): 119–123. 32 Ellen Lanser May, “Scarred but Smarter: Lessons Learned from Florida’s 2004

Bloodborne Pathogens Program

NASA Technical Reports Server (NTRS)

Blasdell, Sharon

1993-01-01

The final rule on the Occupational Exposure to Bloodborne Pathogens was published in the Federal Register on Dec. 6, 1991. This Standard, 29 CFR Part 1910.130, is expected to prevent 8,900 hepatitis B infections and nearly 200 deaths a year in healthcare workers in the U.S. The Occupational Medicine and Environmental Health Services at KSC has been planning to implement this standard for several years. Various aspects of this standard and its Bloodborne Pathogens Program at KSC are discussed.

40 CFR 52.672 - Approval of plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.672 Approval of plans. (a) Carbon Monoxide. (1) EPA approves as a revision to the Idaho State Implementation Plan, the Limited Maintenance Plan for.... [Reserved] (e) Particulate Matter. (1) EPA approves as a revision to the Idaho State Implementation Plan...

78 FR 17835 - Approval and Promulgation of Federal Implementation Plan for Oil and Natural Gas Well Production...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-22

...The EPA is taking final action to promulgate a Reservation- specific Federal Implementation Plan in order to regulate emissions from oil and natural gas production facilities located on the Fort Berthold Indian Reservation in North Dakota. The Federal Implementation Plan includes basic air quality regulations for the protection of communities in and adjacent to the Fort Berthold Indian Reservation. The Federal Implementation Plan requires owners and operators of oil and natural gas production facilities to reduce emissions of volatile organic compounds emanating from well completions, recompletions, and production and storage operations. This Federal Implementation Plan will be implemented by the EPA, or a delegated tribal authority, until replaced by a Tribal Implementation Plan. The EPA proposed a Reservation-specific Federal Implementation Plan concurrently with an interim final rule on August 15, 2012. This final Federal Implementation Plan replaces the interim final rule in all intents and purposes on the effective date of the final rule. The EPA is taking this action pursuant to the Clean Air Act (CAA).

24 CFR 598.605 - Implementation plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false Implementation plan. 598.605 Section 598.605 Housing and Urban Development Regulations Relating to Housing and Urban Development... Empowerment Zone Grants § 598.605 Implementation plan. (a) Implementation plan content. An EZ must submit an...

24 CFR 598.605 - Implementation plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Implementation plan. 598.605 Section 598.605 Housing and Urban Development Regulations Relating to Housing and Urban Development... Empowerment Zone Grants § 598.605 Implementation plan. (a) Implementation plan content. An EZ must submit an...

78 FR 68005 - Approval and Promulgation of Implementation Plans; Mississippi; Transportation Conformity SIP...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... this Federal Register, EPA is approving the State's implementation plan revision as a direct final rule...] Approval and Promulgation of Implementation Plans; Mississippi; Transportation Conformity SIP--Memorandum... proposing to approve a State Implementation Plan revision submitted by the Mississippi Department of...

Effective protection of open space: does planning matter?

PubMed

Steelman, Toddi A; Hess, George R

2009-07-01

High quality plans are considered a crucial part of good land use planning and often used as a proxy measure for success in plan implementation and goal attainment. We explored the relationship of open space plan quality to the implementation of open space plans and attainment of open space protection goals in Research Triangle, North Carolina, USA. To measure plan quality, we used a standard plan evaluation matrix that we modified to focus on open space plans. We evaluated all open space plans in the region that contained a natural resource protection element. To measure plan implementation and open space protection, we developed an online survey and administered it to open space planners charged with implementing the plans. The survey elicited each planner's perspective on aspects of open space protection in his or her organization. The empirical results (1) indicate that success in implementation and attaining goals are not related to plan quality, (2) highlight the importance of when and how stakeholders are involved in planning and implementation processes, and (3) raise questions about the relationship of planning to implementation. These results suggest that a technically excellent plan does not guarantee the long-term relationships among local land owners, political and appointed officials, and other organizations that are crucial to meeting land protection goals. A greater balance of attention to the entire decision process and building relationships might lead to more success in protecting open space.

Experiences and lessons learned for planning and supply of micronutrient powders interventions.

PubMed

Schauer, Claudia; Sunley, Nigel; Hubbell Melgarejo, Carrie; Nyhus Dhillon, Christina; Roca, Claudia; Tapia, Gustavo; Mathema, Pragya; Walton, Shelley; Situma, Ruth; Zlotkin, Stanley; Dw Klemm, Rolf

2017-09-01

Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of "The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance," 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale-up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale-up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

78 FR 41731 - Source Specific Federal Implementation Plan for Implementing Best Available Retrofit Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-11

... Federal Implementation Plan for Implementing Best Available Retrofit Technology for Four Corners Power... Implementation Plan (FIP) to implement the Best Available Retrofit Technology (BART) requirement of the Regional... given the uncertainties in the electrical market in Arizona, EPA is proposing to extend the date by...

[The effectiveness of continuing care models in patients with chronic diseases: a systematic review].

PubMed

Chen, Hsiao-Mei; Han, Tung-Chen; Chen, Ching-Min

2014-04-01

Population aging has caused significant rises in the prevalence of chronic diseases and the utilization of healthcare services in Taiwan. The current healthcare delivery system is fragmented. Integrating medical services may increase the quality of healthcare, enhance patient and patient family satisfaction with healthcare services, and better contain healthcare costs. This article introduces two continuing care models: discharge planning and case management. Further, the effectiveness and essential components of these two models are analyzed using a systematic review method. Articles included in this systematic review were all original articles on discharge-planning or case-management interventions published between February 1999 and March 2013 in any of 6 electronic databases (Medline, PubMed, Cinahl Plus with full Text, ProQuest, Cochrane Library, CEPS and Center for Chinese Studies electronic databases). Of the 70 articles retrieved, only 7 were randomized controlled trial studies. Three types of continuity-of-care models were identified: discharge planning, case management, and a hybrid of these two. All three models used logical and systematic processes to conduct assessment, planning, implementation, coordination, follow-up, and evaluation activities. Both the discharge planning model and the case management model were positively associated with improved self-care knowledge, reduced length of stay, decreased medical costs, and better quality of life. This study cross-referenced all reviewed articles in terms of target clients, content, intervention schedules, measurements, and outcome indicators. Study results may be referenced in future implementations of continuity-care models and may provide a reference for future research.

78 FR 40654 - Approval, Disapproval and Promulgation of Implementation Plans; State of Wyoming; Regional Haze...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-08

..., Disapproval and Promulgation of Implementation Plans; State of Wyoming; Regional Haze State Implementation Plan; Federal Implementation Plan for Regional Haze; Notice of Public Hearings AGENCY: Environmental...) addressing regional haze under. We are making this change in response to letters submitted by the Governor of...

78 FR 78310 - Approval and Promulgation of Implementation Plans; North Carolina; Transportation Conformity...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... Federal Register, EPA is approving the State's implementation plan revision as a direct final rule without...] Approval and Promulgation of Implementation Plans; North Carolina; Transportation Conformity Memorandum of... Implementation Plan submitted on July 12, 2013, through the North Carolina Department of Environment and Natural...

77 FR 58072 - Finding of Substantial Inadequacy of Implementation Plan; Call for California State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-19

... Substantial Inadequacy of Implementation Plan; Call for California State Implementation Plan Revision; South Coast AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: In response to a... that the California State Implementation Plan (SIP) for the Los Angeles-South Coast Air Basin (South...

78 FR 30770 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... Illinois state implementation plan (SIP) to reflect current National Ambient Air Quality Standards (NAAQS... Implementation Plan at 35 Illinois Administrative Code part 243, which updates National Ambient Air Quality...

Process evaluation of the implementation of scorecard-based antenatal risk assessment, care pathways and interdisciplinary consultation: the Healthy Pregnancy 4 All study.

PubMed

Vos, A A; van Voorst, S F; Posthumus, A G; Waelput, A J M; Denktaş, S; Steegers, E A P

2017-09-01

To evaluate the implementation of a complex intervention in the antenatal healthcare field in 14 Dutch municipalities. The intervention consisted of the implementation of a systematic scorecard-based risk assessment in pregnancy, subsequent patient-tailored care pathways, and consultations of professionals from different medical and social disciplines. Saunders's seven-step method was used for the development of a programme implementation monitoring plan, with specific attention to the setting and context of the programme. Data were triangulated from multiple sources, and prespecified criteria were applied to examine the evidence for implementation. Six out of 11 municipalities (54%) met the implementation criteria for the entire risk assessment programme, whereas three municipalities (27%) met the criteria if the three components of implementation were analysed separately. A process evaluation of implementation of a complex intervention is possible. The results can be used to improve understanding of the associations between specific programme elements and programme outcomes on effectiveness of the intervention. Additionally, the results are important for formative purposes to assess how future implementation of antenatal risk assessment can be improved in comparable contexts. Copyright © 2017. Published by Elsevier Ltd.

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

PubMed

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

2016-11-01

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

Safety evaluation report on Tennessee Valley Authority: Browns Ferry Nuclear Performance Plan

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

Not Available

1991-01-01

This safety evaluation report (SER) was prepared by the US Nuclear Regulatory Commission (NRC) staff and represents the second and last supplement (SSER 2) to the staff's original SER published as Volume 3 of NUREG-1232 in April 1989. Supplement 1 of Volume 3 of NUREG-1232 (SSER 1) was published in October 1989. Like its predecessors, SSER 2 is composed of numerous safety evaluations by the staff regarding specific elements contained in the Browns Ferry Nuclear Performance Plan (BFNPP), Volume 3 (up to and including Revision 2), submitted by the Tennessee Valley Authority (TVA) for the Browns Ferry Nuclear Plant (BFN).more » The Browns Ferry Nuclear Plant consists of three boiling-water reactors (BWRs) at a site in Limestone County, Alabama. The BFNPP describes the corrective action plans and commitments made by TVA to resolve deficiencies with its nuclear programs before the startup of Unit 2. The staff has inspected and will continue to inspect TVA's implementation of these BFNPP corrective action plans that address staff concerns about TVA's nuclear program. SSER 2 documents the NRC staff's safety evaluations and conclusions for those elements of the BFNPP that were not previously addressed by the staff or that remained open as a result of unresolved issues identified by the staff in previous SERs and inspections.« less

Local health and social care responses to implementing the national cold weather plan.

PubMed

Heffernan, C; Jones, L; Ritchie, B; Erens, B; Chalabi, Zaid; Mays, N

2017-09-18

The Cold Weather Plan (CWP) for England was launched by the Department of Health in 2011 to prevent avoidable harm to health by cold weather by enabling individuals to prepare and respond appropriately. This study sought the views of local decision makers involved in the implementation of the CWP in the winter of 2012/13 to establish the effects of the CWP on local planning. It was part of a multi-component independent evaluation of the CWP. Ten LA areas were purposively sampled which varied in level of deprivation and urbanism. Fifty-two semi-structured interviews were held with health and social care managers involved in local planning between November 2012 and May 2013. Thematic analysis revealed that the CWP was considered a useful framework to formalize working arrangements between agencies though local leadership varied across localities. There were difficulties in engaging general practitioners, differences in defining vulnerable individuals and a lack of performance monitoring mechanisms. The CWP was welcomed by local health and social care managers, and improved proactive winter preparedness. Areas for improvement include better integration with general practice, and targeting resources at socially isolated individuals in cold homes with specific interventions aimed at reducing social isolation and building community resilience. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

40 CFR 52.1392 - Federal Implementation Plan for the Billings/Laurel Area.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 4 2013-07-01 2013-07-01 false Federal Implementation Plan for the Billings/Laurel Area. 52.1392 Section 52.1392 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Montana § 52.1392 Federal Implementation Plan for...

40 CFR 52.1392 - Federal Implementation Plan for the Billings/Laurel Area.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 4 2012-07-01 2012-07-01 false Federal Implementation Plan for the Billings/Laurel Area. 52.1392 Section 52.1392 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Montana § 52.1392 Federal Implementation Plan for...

40 CFR 52.1392 - Federal Implementation Plan for the Billings/Laurel Area.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 4 2014-07-01 2014-07-01 false Federal Implementation Plan for the Billings/Laurel Area. 52.1392 Section 52.1392 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Montana § 52.1392 Federal Implementation Plan for...

40 CFR 52.1392 - Federal Implementation Plan for the Billings/Laurel Area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Federal Implementation Plan for the Billings/Laurel Area. 52.1392 Section 52.1392 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Montana § 52.1392 Federal Implementation Plan for...

77 FR 16937 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-23

... Promulgation of Air Quality Implementation Plans; West Virginia; Regional Haze State Implementation Plan AGENCY... limited disapproval of West Virginia's Regional Haze State Implementation Plan (SIP) revision. EPA is... mandatory Class I areas through a regional haze program. EPA is also approving this revision as meeting the...

77 FR 65151 - Finding of Substantial Inadequacy of Implementation Plan; Call for California State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-25

... the Federal Register on September 19, 2012. In that action, in response to a remand by the Ninth... Substantial Inadequacy of Implementation Plan; Call for California State Implementation Plan Revision; South... State Implementation Plan (SIP) for the Los Angeles-South Coast Air Basin (South Coast) is substantially...

40 CFR 93.118 - Criteria and procedures: Motor vehicle emissions budget.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PLANS Conformity to State or Federal Implementation Plans of Transportation Plans, Programs, and..., consultation among federal, State, and local agencies occurred; full implementation plan documentation was... response to comments that are required to be submitted with any implementation plan. EPA will document its...

40 CFR 93.118 - Criteria and procedures: Motor vehicle emissions budget.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PLANS Conformity to State or Federal Implementation Plans of Transportation Plans, Programs, and..., consultation among federal, State, and local agencies occurred; full implementation plan documentation was... response to comments that are required to be submitted with any implementation plan. EPA will document its...

The development of a national HIV Plan in Belgium: Achieving consensus despite institutional complexity.

PubMed

Schweikardt, Christoph; Coppieters, Yves

2015-10-01

The development of a national HIV Plan poses serious challenges to countries with a complex distribution of legal powers such as Belgium. This article explores how the Belgian national HIV Plan 2014-2019 was developed. Applying the policy streams model of John Kingdon, the analysis of the HIV Plan development process was based on published government statements, parliamentary documents, and websites of stakeholders. The Federal Ministry of Health initiative to achieve the HIV Plan was characterized by a coordinating role with a participatory approach towards the other Belgian governments and stakeholders. The 2013 protocol agreement of the Belgian governments committed them to principles, actions, and cooperation, but not to budgets, priorities, or target figures. The Federal government followed a successful strategy to create momentum and commitment to a common national vision on HIV/AIDS. The window of opportunity was not sufficient to create an implementation plan prior to the 2014 elections, and major challenges were left to the subsequent governments, including financing. The country of Belgium represents an example of a consensus strategy to achieve a national HIV Plan with its achievements and limits within institutional complexity and limited Federal legal powers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

40 CFR 49.10046 - Contents of implementation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Plan for the Cow Creek Band of Umpqua Indians of Oregon § 49.10046 Contents of implementation plan. The implementation plan for the Reservation of the Cow Creek Band of Umpqua Indians consists of the following rules...

Tobacco retail policy landscape: a longitudinal survey of US states.

PubMed

Luke, Douglas A; Sorg, Amy A; Combs, Todd; Robichaux, Christopher B; Moreland-Russell, Sarah; Ribisl, Kurt M; Henriksen, Lisa

2016-10-01

There are ∼380 000 tobacco retailers in the USA, where the largest tobacco companies spend almost $9 billion a year to promote their products. No systematic survey has been conducted of state-level activities to regulate the retail environment, thus little is known about what policies are being planned, proposed or implemented. This longitudinal study is the first US survey of state tobacco control programmes (TCPs) about retail policy activities. Surveyed in 2012 and 2014, programme managers (n=46) reported activities in multiple domains: e-cigarettes, retailer density and licensing, non-tax price increases, product placement, advertising and promotion, health warnings and other approaches. Policy activities were reported in one of five levels: no formal activity, planning or advocating, policy was proposed, policy was enacted or policy was implemented. Overall and domain-specific activity scores were calculated for each state. The average retail policy activity almost doubled between 2012 and 2014. States with the largest increase in scores included: Minnesota, which established a fee-based tobacco retail licensing system and banned self-service for e-cigarettes and all other tobacco products (OTP); Oregon, Kansas and Maine, all of which banned self-service for OTP; and West Virginia, which banned some types of flavoured OTP. Retail policy activities in US states increased dramatically in a short time. Given what is known about the impact of the retail environment on tobacco use by youth and adults, state and local TCPs may want diversify policy priorities by implementing retail policies alongside tax and smoke-free air laws. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Curricular trends in Malaysian medical schools: innovations within.

PubMed

Azila, Nor Mohd Adnan; Rogayah, Jaafar; Zabidi-Hussin, Zabidi Azhar Mohd Hussin

2006-09-01

Various curricular innovations were adopted by medical schools worldwide in an attempt to produce medical graduates that could meet future healthcare needs of society locally and globally. This paper presents findings on curricular approaches implemented in Malaysian medical schools, in trying to meet those needs. Information was obtained from published records, responses from various questionnaires, personal communication and involvement with curricular development. Curricular innovations tended to be implemented in new medical schools upon their establishment. Established medical schools seemed to implement these innovations much later. Curricular trends appear to move towards integration, student-centred and problem-based learning as well as community-oriented medical education, with the Student-centred learning, Problem-based learning, Integrated teaching, Community-based education, Electives and Systematic programme (SPICES) model used as a reference. The focus is based on the premise that although the short-term aim of undergraduate medical education in Malaysia is to prepare graduates for the pre-registration house officer year, they must be able to practise and make decisions independently and be sensitive to the needs of the country's multiracial, multi-religious, and often remote communities. In most cases, curricular planning starts with a prescriptive model where planners focus on several intended outcomes. However, as the plan is implemented and evaluated it becomes descriptive as the planners reassess the internal and external factors that affect outcomes. A common trend in community-oriented educational activities is evident, with the introduction of interesting variations, to ensure that the curriculum can be implemented, sustained and the intended outcomes achieved.

Implementing system-wide risk stratification approaches: A review of critical success and failure factors.

PubMed

Huckel Schneider, Carmen; Gillespie, James A; Wilson, Andrew

2017-05-01

Risk stratification has become a widely used tool for linking people identified at risk of health deterioration to the most appropriate evidence-based care. This article systematically reviews recent literature to determine key factors that have been identified as critical enablers and/or barriers to successful implementation of risk stratification tools at a system level. A systematic search found 23 articles and four promising protocols for inclusion in the review, covering the use to 20 different risk stratification tools. These articles reported on only a small fraction of the risk stratification tools used in health systems; suggesting that while the development and statistical validation of risk stratification algorithms is widely reported, there has been little published evaluation of how they are implemented in real-world settings. Controlled studies provided some evidence that the use of risk stratification tools in combination with a care management plan offer patient benefits and that the use of a risk stratification tool to determine components of a care management plan may contribute to reductions in hospital readmissions, patient satisfaction and improved patient outcomes. Studies with the strongest focus on implementation used qualitative and case study methods. Among these, the literature converged on four key areas of implementation that were found to be critical for overcoming barriers to success: the engagement of clinicians and safeguarding equity, both of which address barriers of acceptance; the health system context to address administrative, political and system design barriers; and data management and integration to address logistical barriers.

Reporting guidelines for implementation and operational research.

PubMed

Hales, Simon; Lesher-Trevino, Ana; Ford, Nathan; Maher, Dermot; Ramsay, Andrew; Tran, Nhan

2016-01-01

In public health, implementation research is done to improve access to interventions that have been shown to work but have not reached many of the people who could benefit from them. Researchers identify practical problems facing public health programmes and aim to find solutions that improve health outcomes. In operational research, routinely-collected programme data are used to uncover ways of delivering more effective, efficient and equitable health care. As implementation research can address many types of questions, many research designs may be appropriate. Existing reporting guidelines partially cover the methods used in implementation and operational research, so we ran a consultation through the World Health Organization (WHO), the Alliance for Health Policy & Systems Research (AHPSR) and the Special Programme for Research and Training in Tropical Diseases (TDR) and developed guidelines to facilitate the funding, conduct, review and publishing of such studies. Our intention is to provide a practical reference for funders, researchers, policymakers, implementers, reviewers and editors working with implementation and operational research. This is an evolving field, so we plan to monitor the use of these guidelines and develop future versions as required.

Implementation Strategies for Gender-Sensitive Public Health Practice: A European Workshop.

PubMed

Oertelt-Prigione, Sabine; Dalibert, Lucie; Verdonk, Petra; Stutz, Elisabeth Zemp; Klinge, Ineke

2017-11-01

Providing a robust scientific background for the focus on gender-sensitive public health and a systematic approach to its implementation. Within the FP7-EUGenMed project ( http://eugenmed.eu ) a workshop on sex and gender in public health was convened on February 2-3, 2015. The experts participated in moderated discussion rounds to (1) assemble available knowledge and (2) identify structural influences on practice implementation. The findings were summarized and analyzed in iterative rounds to define overarching strategies and principles. The participants discussed the rationale for implementing gender-sensitive public health and identified priorities and key stakeholders to engage in the process. Communication strategies and specific promotion strategies with distinct stakeholders were defined. A comprehensive list of gender-sensitive practices was established using the recently published taxonomy of the Expert Recommendations for Implementing Change (ERIC) project as a blueprint. A clearly defined implementation strategy should be mandated for all new projects in the field of gender-sensitive public health. Our tool can support researchers and practitioners with the analysis of current and past research as well as with the planning of new projects.

Implementing a Capital Plan.

ERIC Educational Resources Information Center

Daigneau, William A.

2003-01-01

Addresses four questions regarding implementation of a long-term capital plan to manage a college's facilities portfolio: When should the projects be implemented? How should the capital improvements be implemented? What will it actually cost in terms of project costs as well as operating costs? Who will implement the plan? (EV)

Development of a strategic plan by the Mozambican Association of Obstetricians and Gynaecologists: direct and indirect effects.

PubMed

Osman, Nafissa B; Almeida, Maria L; Ustá, Momade B; Bique, Cassimo; David, Ernestina

2014-10-01

The Mozambican Association of Obstetricians and Gynaecologists (AMOG) received support from the FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health (MNH) to strengthen its organizational capacity and to assume leadership in MNH through the development of a strategic plan. The planning process involved identification of key stakeholders; analysis of strengths and weaknesses; stakeholder consultation; consultation with AMOG members; and ratification at the annual general meeting. The participatory process led to the development of vision and mission statements. Furthermore, core values and strategic goals were identified: (1) to contribute to the implementation of governmental plans for improving MNH; (2) to assume leadership in advancing the practice of obstetrics and gynecology through education and training; and (3) to continue to strengthen organizational capacity. Consequently, relationships among members were reinforced and the visibility and recognition of AMOG as a key stakeholder in MNH increased. Copyright © 2014. Published by Elsevier Ireland Ltd.

Experiences and Lessons From Polio Eradication Applied to Immunization in 10 Focus Countries of the Polio Endgame Strategic Plan.

PubMed

van den Ent, Maya M V X; Mallya, Apoorva; Sandhu, Hardeep; Anya, Blanche-Philomene; Yusuf, Nasir; Ntakibirora, Marcelline; Hasman, Andreas; Fahmy, Kamal; Agbor, John; Corkum, Melissa; Sumaili, Kyandindi; Siddique, Anisur Rahman; Bammeke, Jane; Braka, Fiona; Andriamihantanirina, Rija; Ziao, Antoine-Marie C; Djumo, Clement; Yapi, Moise Desire; Sosler, Stephen; Eggers, Rudolf

2017-07-01

Nine polio areas of expertise were applied to broader immunization and mother, newborn and child health goals in ten focus countries of the Polio Eradication Endgame Strategic Plan: policy & strategy development, planning, management and oversight (accountability framework), implementation & service delivery, monitoring, communications & community engagement, disease surveillance & data analysis, technical quality & capacity building, and partnerships. Although coverage improvements depend on multiple factors and increased coverage cannot be attributed to the use of polio assets alone, 6 out of the 10 focus countries improved coverage in three doses of diphtheria tetanus pertussis containing vaccine between 2013 and 2015. Government leadership, evidence-based programming, country-driven comprehensive operational annual plans, community partnership and strong accountability systems are critical for all programs and polio eradication has illustrated these can be leveraged to increase immunization coverage and equity and enhance global health security in the focus countries. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

40 CFR 52.1973 - Approval of plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Oregon § 52.1973 Approval of plans. (a) Carbon monoxide. (1) EPA approves as a revision to the Oregon State Implementation Plan, the Second... December 27, 2004. (2) EPA approves as a revision to the Oregon State Implementation Plan, the Salem carbon...

40 CFR 52.1973 - Approval of plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Oregon § 52.1973 Approval of plans. (a) Carbon monoxide. (1) EPA approves as a revision to the Oregon State Implementation Plan, the Second... December 27, 2004. (2) EPA approves as a revision to the Oregon State Implementation Plan, the Salem carbon...

40 CFR 52.1973 - Approval of plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Oregon § 52.1973 Approval of plans. (a) Carbon monoxide. (1) EPA approves as a revision to the Oregon State Implementation Plan, the Second... December 27, 2004. (2) EPA approves as a revision to the Oregon State Implementation Plan, the Salem carbon...

40 CFR 52.1973 - Approval of plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Oregon § 52.1973 Approval of plans. (a) Carbon monoxide. (1) EPA approves as a revision to the Oregon State Implementation Plan, the Second... December 27, 2004. (2) EPA approves as a revision to the Oregon State Implementation Plan, the Salem carbon...

49 CFR 633.27 - Implementation of a project management plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Implementation of a project management plan. 633... TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.27 Implementation of a project management plan. (a) Upon approval of a project management plan by...

49 CFR 633.27 - Implementation of a project management plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Implementation of a project management plan. 633... TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.27 Implementation of a project management plan. (a) Upon approval of a project management plan by...

49 CFR 633.27 - Implementation of a project management plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Implementation of a project management plan. 633... TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.27 Implementation of a project management plan. (a) Upon approval of a project management plan by...

49 CFR 633.27 - Implementation of a project management plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Implementation of a project management plan. 633... TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.27 Implementation of a project management plan. (a) Upon approval of a project management plan by...

49 CFR 633.27 - Implementation of a project management plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Implementation of a project management plan. 633... TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.27 Implementation of a project management plan. (a) Upon approval of a project management plan by...

76 FR 9706 - Finding of Substantial Inadequacy of Implementation Plan; Call for Iowa State Implementation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... advance and available for prompt implementation once triggered. Section 110(k)(5) of the CAA provides that... Environmental protection, Air pollution control, Iowa, Particulate matter, State Implementation Plan. Dated...

Developing and Implementing a Citywide Asthma Action Plan: A Community Collaborative Partnership.

PubMed

Staudt, Amanda Marie; Alamgir, Hasanat; Long, Debra Lynn; Inscore, Stephen Curtis; Wood, Pamela Runge

2015-12-01

Asthma affects 1 in 10 children in the United States, with higher prevalence among children living in poverty. Organizations in San Antonio, Texas, partnered to design and implement a uniform, citywide asthma action plan to improve asthma management capacity in schools. The asthma action plan template was modified from that of the Global Initiative for Asthma. School personnel were trained in symptom recognition, actions to take, and use of equipment before the asthma action plan implementation. The annual Asthma Action Plan Summit was organized as a forum for school nurses, healthcare providers, and members of the community to exchange ideas and strategies on implementation, as well as to revise the plan. The asthma action plan was implemented in all 16 local school districts. Feedback received from school nurses suggests that the citywide asthma action plan resulted in improved asthma management and student health at schools. The evidence in this study suggests that community organizations can successfully collaborate to implement a citywide health initiative similar to the asthma action plan.

Georgia's Medicaid Family Planning Waiver: Working Together with Title X to Enhance Access to and Use of Contraceptive and Preventive Health Services.

PubMed

Dunlop, Anne L; Adams, Esther Kathleen; Hawley, Jonathan; Blake, Sarah C; Joski, Peter

We sought to assess the impact of Georgia's family planning demonstration waiver upon access to and use of contraceptive and preventive health services within Title X and Medicaid. Georgia Title X and Medicaid data for January 2009 through December 2013 (before and after the waiver), restricting Title X data to women targeted by the waiver (18-44 years, incomes from 25% and 50% through 200% of the federal poverty level [FPL]) was assembled by quarter and marginal effects of the changes before and after waiver implementation were derived using multivariate regression models. After implementation, there was a significant increase in the probability of Title X clients in the waiver-targeted age and income ranges who had Medicaid versus no insurance and who exited the encounter with higher effectiveness contraceptive methods, including long-acting reversible contraceptives (LARCs), and with cervical cytology and sexually transmitted infection testing. In the Medicaid data from 2009 to 2013, there was an increase in the mean number of encounters per enrollee (2.19 vs. 2.42) and in LARC users; however, the percentage of all Georgia women living under 200% of the FPL with a family planning encounter in Title X and Medicaid decreased from 19% to 15%. Our findings suggest that implementation of the Georgia family planning demonstration waiver contributed to the increased use of higher effectiveness contraceptive methods, including LARCs, within the Medicaid and Title X programs as well as the increased use of preventive screenings among Title X clients. However, when the full population of low-income Georgia women targeted by the waiver was considered, a greater percentage was not served over the demonstration period. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Interim rules for amending ERISA disclosure requirements for group health plans; approval of information collection requirements--DoL. Interim rules; approval of information collection requirements.

PubMed

1997-07-07

On April 8, 1997, the Department of Labor published interim final rules governing disclosure requirements for private sector group health plans (62 FR 16979). The rules implemented changes to made to certain provisions of the Employee Retirement Income Security Act of 1974 (ERISA), enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA). In the April 8 publication, the Department submitted its revision of the currently approved collection regarding Summary Plan Description requirements under ERISA to the Office of Management and Budget (OMB) for emergency review under the Paperwork Reduction Act of 1965 (PRA 95). This document amends the April 8 Federal Register document to properly display the OMB control number, 1210-0039.

Participatory System Dynamics Modeling: Increasing Stakeholder Engagement and Precision to Improve Implementation Planning in Systems.

PubMed

Zimmerman, Lindsey; Lounsbury, David W; Rosen, Craig S; Kimerling, Rachel; Trafton, Jodie A; Lindley, Steven E

2016-11-01

Implementation planning typically incorporates stakeholder input. Quality improvement efforts provide data-based feedback regarding progress. Participatory system dynamics modeling (PSD) triangulates stakeholder expertise, data and simulation of implementation plans prior to attempting change. Frontline staff in one VA outpatient mental health system used PSD to examine policy and procedural "mechanisms" they believe underlie local capacity to implement evidence-based psychotherapies (EBPs) for PTSD and depression. We piloted the PSD process, simulating implementation plans to improve EBP reach. Findings indicate PSD is a feasible, useful strategy for building stakeholder consensus, and may save time and effort as compared to trial-and-error EBP implementation planning.

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.

75 FR 54805 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota; Carbon Monoxide (CO...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... Promulgation of Air Quality Implementation Plans; Minnesota; Carbon Monoxide (CO) Limited Maintenance Plan for... June 16, 2010, to revise the Minnesota State Implementation Plan (SIP) for carbon monoxide (CO) under the Clean Air Act (CAA). The State has submitted a limited maintenance plan for CO showing continued...

40 CFR 49.9861 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony of Oregon § 49.9861 Identification of plan. This section and §§ 49.9862 through 49.9890 contain the implementation plan for the Burns Paiute Tribe of the Burns...

75 FR 63139 - Approval and Promulgation of Implementation Plans-Maricopa County (Phoenix) PM-10 Nonattainment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

... Promulgation of Implementation Plans--Maricopa County (Phoenix) PM-10 Nonattainment Area; Serious Area Plan for... implementation plan (SIP) revisions submitted by the State of Arizona to meet, among other requirements, section... (Maricopa area). Specifically, EPA proposed to disapprove provisions of the 189(d) plan because they do not...

The Community Connection Model: implementation of best evidence into practice for self-management of chronic diseases.

PubMed

Liddy, C; Johnston, S; Irving, H; Nash, K

2013-06-01

With chronic diseases becoming an increasing burden for healthcare systems worldwide, self-management support has gained traction in many health regions and organizations. However, the real-world application of the findings from clinical trials into actual community programming is not self-evident. The aim of this study was to present a model of programme implementation, namely the Community Connection Model. The process of implementing a chronic disease self-management programme has been documented in detail from its initial inception through to a sustainable programme. This account includes a description of the strategic activities undertaken (e.g. alignment with local policy and the formation of community partnerships) and the specific steps taken on the path to programme implementation (e.g. a scoping literature review, an environmental scan and a pilot programme with an evaluation component). Reflection on this case example suggests that a cognizance of the interactions between policy, partnership, planning and programme could act as a useful tool to guide programme implementation, evaluation and sustainability. Multiple types of self-management support have been implemented (as part of the Living Health Champlain programme), and are being evaluated and adapted in response to new evidence, shifting priorities and direction from more partners. The widespread access means that self-management support programmes are becoming part of the culture of care in the study region. Establishing a connection around an important health problem, ensuring active partnerships, adequate planning and early implementation of a programme grounded on the principles of applying best-available evidence can lead to successful solutions. The Community Connection Model is proposed as a way of conceptualizing these processes. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Critical congenital heart disease screening practices among licensed midwives in washington state.

PubMed

Evers, Patrick D; Vernon, Margaret M; Schultz, Amy H

2015-01-01

Since 2011, pulse oximetry screening for critical congenital heart disease (CCHD) has been recommended for newborns. Initial implementation guidelines focused on in-hospital births. Recent publications affirm the importance of universal screening, including for out-of-hospital births. No published data describe CCHD screening rates for out-of-hospital births. Licensed midwives in Washington state were surveyed regarding their current CCHD screening practices, volume of births attended annually, and typical newborn follow-up practices. For those who indicated they were screening, additional information was obtained about equipment used, timing of screening, and rationale for voluntarily initiating screening. For those who indicated that they were not screening, information regarding barriers to implementation was solicited. Of the 61 midwives in our sample, 98% indicated they were aware of published guidelines recommending universal newborn screening for CCHD utilizing pulse oximetry. Furthermore, 52% indicated that they were screening for CCHD currently. Ten percent stated they do not intend to screen, whereas the remaining respondents indicated that they plan to screen in the future. The primary barriers to screening were the cost of pulse oximetry equipment and inadequate training in screening technique and interpretation. Although voluntary implementation of CCHD screening by licensed midwives in Washington is increasing, it lags behind the implementation rates reported for in-hospital births. © 2015 by the American College of Nurse-Midwives.

3D treatment planning systems.

PubMed

Saw, Cheng B; Li, Sicong

2018-01-01

Three-dimensional (3D) treatment planning systems have evolved and become crucial components of modern radiation therapy. The systems are computer-aided designing or planning softwares that speed up the treatment planning processes to arrive at the best dose plans for the patients undergoing radiation therapy. Furthermore, the systems provide new technology to solve problems that would not have been considered without the use of computers such as conformal radiation therapy (CRT), intensity-modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT). The 3D treatment planning systems vary amongst the vendors and also the dose delivery systems they are designed to support. As such these systems have different planning tools to generate the treatment plans and convert the treatment plans into executable instructions that can be implemented by the dose delivery systems. The rapid advancements in computer technology and accelerators have facilitated constant upgrades and the introduction of different and unique dose delivery systems than the traditional C-arm type medical linear accelerators. The focus of this special issue is to gather relevant 3D treatment planning systems for the radiation oncology community to keep abreast of technology advancement by assess the planning tools available as well as those unique "tricks or tips" used to support the different dose delivery systems. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Design requirements for SRB production control system. Volume 4: Implementation

NASA Technical Reports Server (NTRS)

1981-01-01

The implementation plan which is presented was developed to provide the means for the successful implementation of the automated production control system. There are three factors which the implementation plan encompasses: detailed planning; phased implementation; and user involvement. The plan is detailed to the task level in terms of necessary activities as the system is developed, refined, installed, and tested. These tasks are scheduled, on a preliminary basis, over a two-and-one-half-year time frame.

Facilitators and Hindrances of Implementing Colorectal Cancer Screening Intervention Among Vietnamese Americans.

PubMed

Sin, Mo-Kyung; Yip, Mei-Po; Kimura, Amanda; Tu, Shin-Ping

Little is published about the factors that facilitate and hinder the intervention implementation process. The aim of this study was to examine factors that facilitated and hindered the implementation of a culturally appropriate colorectal cancer screening intervention targeting Vietnamese Americans in a Federally Qualified Health Center located in the Puget Sound area of Washington. Three focus group discussions (2 during the implementation phase and 1 during the maintenance phase) with the medical assistants (N = 13) who were the intervention implementation agents were conducted at the Federally Qualified Health Center. Three research team members independently analyzed the data using content analysis and then compared for agreement. We reread and recoded the transcripts until consensus was reached. The themes were clustered by similar codes and categorized into 4 groups, each including facilitators and hindrances of implementation: identification of implementation agents, implementation environment, intervention recipients, and the colorectal cancer screening intervention. Facilitators included medical assistants' high motivation with a positive attitude toward the intervention, team approach, and simplicity of the intervention, whereas hindrances included lack of time, forgetfulness, staff turnover, and language barriers. The findings emphasized the importance of supporting implementation agents to ensure effective intervention program implementation. Oncology nurses need to particularly take into consideration the evidence-based findings when planning any intervention programs.

40 CFR 256.42 - Recommendations for assuring facility development.

Code of Federal Regulations, 2014 CFR

2014-07-01

... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Facility Planning and Implementation § 256.42 Recommendations for assuring facility development. (a) The State plan... facilities, and (4) Development of schedules of implementation. (d) The State plan should encourage private...

40 CFR 256.42 - Recommendations for assuring facility development.

Code of Federal Regulations, 2012 CFR

2012-07-01

... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Facility Planning and Implementation § 256.42 Recommendations for assuring facility development. (a) The State plan... facilities, and (4) Development of schedules of implementation. (d) The State plan should encourage private...

40 CFR 256.42 - Recommendations for assuring facility development.

Code of Federal Regulations, 2013 CFR

2013-07-01

... WASTES GUIDELINES FOR DEVELOPMENT AND IMPLEMENTATION OF STATE SOLID WASTE MANAGEMENT PLANS Facility Planning and Implementation § 256.42 Recommendations for assuring facility development. (a) The State plan... facilities, and (4) Development of schedules of implementation. (d) The State plan should encourage private...

75 FR 3680 - Revisions to the California State Implementation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

... the California State Implementation Plan AGENCY: Environmental Protection Agency (EPA). ACTION... Pollution Control District (SJVAPCD) portion of the California State Implementation Plan (SIP). These... are taking comments on this proposal and plan to follow with a final action. DATES: Any comments must...

49 CFR 130.33 - Response plan implementation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Response plan implementation. 130.33 Section 130... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION OIL TRANSPORTATION OIL SPILL PREVENTION AND RESPONSE PLANS § 130.33 Response plan implementation. If, during transportation of oil subject to this part, a...

49 CFR 130.33 - Response plan implementation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Response plan implementation. 130.33 Section 130... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION OIL TRANSPORTATION OIL SPILL PREVENTION AND RESPONSE PLANS § 130.33 Response plan implementation. If, during transportation of oil subject to this part, a...

49 CFR 130.33 - Response plan implementation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Response plan implementation. 130.33 Section 130... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION OIL TRANSPORTATION OIL SPILL PREVENTION AND RESPONSE PLANS § 130.33 Response plan implementation. If, during transportation of oil subject to this part, a...

49 CFR 130.33 - Response plan implementation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Response plan implementation. 130.33 Section 130... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION OIL TRANSPORTATION OIL SPILL PREVENTION AND RESPONSE PLANS § 130.33 Response plan implementation. If, during transportation of oil subject to this part, a...

49 CFR 130.33 - Response plan implementation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Response plan implementation. 130.33 Section 130... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION OIL TRANSPORTATION OIL SPILL PREVENTION AND RESPONSE PLANS § 130.33 Response plan implementation. If, during transportation of oil subject to this part, a...

76 FR 28195 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Sunland Park 1-Hour...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... Promulgation of Air Quality Implementation Plans; New Mexico; Sunland Park 1-Hour Ozone Maintenance Plan AGENCY... the New Mexico State Implementation Plan (SIP). The revision consists of a maintenance plan for Sunland Park, New Mexico developed to ensure continued attainment of the 8-hour ozone National Ambient Air...

The implementation of a Hazard Analysis and Critical Control Point management system in a peanut butter ice cream plant.

PubMed

Hung, Yu-Ting; Liu, Chi-Te; Peng, I-Chen; Hsu, Chin; Yu, Roch-Chui; Cheng, Kuan-Chen

2015-09-01

To ensure the safety of the peanut butter ice cream manufacture, a Hazard Analysis and Critical Control Point (HACCP) plan has been designed and applied to the production process. Potential biological, chemical, and physical hazards in each manufacturing procedure were identified. Critical control points for the peanut butter ice cream were then determined as the pasteurization and freezing process. The establishment of a monitoring system, corrective actions, verification procedures, and documentation and record keeping were followed to complete the HACCP program. The results of this study indicate that implementing the HACCP system in food industries can effectively enhance food safety and quality while improving the production management. Copyright © 2015. Published by Elsevier B.V.

Three Proposed Compendia for Genesis Solar Wind Samples: Science Results, Collector Materials Characterization and Cleaning Techniques

NASA Technical Reports Server (NTRS)

Allton, J. H.; Calaway, M. J.; Nyquist, L. E.; Jurewicz, A. J. G.; Burnett, D. S.

2018-01-01

Final Paper and not the abstract is attached. Introduction: Planetary material and cosmochemistry research using Genesis solar wind samples (including the development and implementation of cleaning and analytical techniques) has matured sufficiently that compilations on several topics, if made publically accessible, would be beneficial for researchers and reviewers. We propose here three compendia based on content, organization and source of documents (e.g. published peer-reviewed, published, internal memos, archives). For planning purposes, suggestions are solicited from potential users of Genesis solar wind samples for the type of science content and/or organizational style that would be most useful to them. These compendia are proposed as living documents, periodically updated. Similar to the existing compendia described below, the curation compendia are like library or archival finding aids, they are guides to published or archival documents and should not be cited as primary sources.

Facilitators and barriers for the adoption, implementation and monitoring of child safety interventions: a multinational qualitative analysis.

PubMed

Scholtes, Beatrice; Schröder-Bäck, Peter; MacKay, J Morag; Vincenten, Joanne; Förster, Katharina; Brand, Helmut

2017-06-01

The efficiency and effectiveness of child safety interventions are determined by the quality of the implementation process. This multinational European study aimed to identify facilitators and barriers for the three phases of implementation: adoption, implementation and monitoring (AIM process). Twenty-seven participants from across the WHO European Region were invited to provide case studies of child safety interventions from their country. Cases were selected by the authors to ensure broad coverage of injury issues, age groups and governance level of implementation (eg, national, regional or local). Each participant presented their case and provided a written account according to a standardised template. Presentations and question and answer sessions were recorded. The presentation slides, written accounts and the notes taken during the workshops were analysed using thematic content analysis to elicit facilitators and barriers. Twenty-six cases (from 26 different countries) were presented and analysed. Facilitators and barriers were identified within eight general themes, applicable across the AIM process: management and collaboration; resources; leadership; nature of the intervention; political, social and cultural environment; visibility; nature of the injury problem and analysis and interpretation. The importance of the quality of the implementation process for intervention effectiveness, coupled with limited resources for child safety makes it more difficult to achieve successful actions. The findings of this study, divided by phase of the AIM process, provide practitioners with practical suggestions, where proactive planning might help increase the likelihood of effective implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Provider Adherence to Implementation of Clinical Practice Guidelines for Neurogenic Bowel in Adults With Spinal Cord Injury

PubMed Central

Goetz, Lance L; Nelson, Audrey L; Guihan, Marylou; Bosshart, Helen T; Harrow, Jeffrey J; Gerhart, Kevin D; Krasnicka, Barbara; Burns, Stephen P

2005-01-01

Background/Objectives: Clinical Practice Guidelines (CPGs) have been published on a number of topics in spinal cord injury (SCI) medicine. Research in the general medical literature shows that the distribution of CPGs has a minimal effect on physician practice without targeted implementation strategies. The purpose of this study was to determine (a) whether dissemination of an SCI CPG improved the likelihood that patients would receive CPG recommended care and (b) whether adherence to CPG recommendations could be improved through a targeted implementation strategy. Specifically, this study addressed the “Neurogenic Bowel Management in Adults with Spinal Cord Injury” Clinical Practice Guideline published in March 1998 by the Consortium for Spinal Cord Medicine Methods: CPG adherence was determined from medical record review at 6 Veterans Affairs SCI centers for 3 time periods: before guideline publication (T1), after guideline publication but before CPG implementation (T2), and after targeted CPG implementation (T3). Specific implementation strategies to enhance guideline adherence were chosen to address the barriers identified by SCI providers in focus groups before the intervention. Results: Overall adherence to recommendations related to neurogenic bowel did not change between T1 and T2 (P = not significant) but increased significantly between T2 and T3 (P < 0.001) for 3 of 6 guideline recommendations. For the other 3 guideline recommendations, adherence rates were noted to be high at T1. Conclusions: While publication of the CPG alone did not alter rates of provider adherence, the use of a targeted implementation plan resulted in increases in adherence rates with some (3 of 6) CPG recommendations for neurogenic bowel management. PMID:16869086

Picture Archiving and Communication System (PACS) implementation, integration & benefits in an integrated health system.

PubMed

Mansoori, Bahar; Erhard, Karen K; Sunshine, Jeffrey L

2012-02-01

The availability of the Picture Archiving and Communication System (PACS) has revolutionized the practice of radiology in the past two decades and has shown to eventually increase productivity in radiology and medicine. PACS implementation and integration may bring along numerous unexpected issues, particularly in a large-scale enterprise. To achieve a successful PACS implementation, identifying the critical success and failure factors is essential. This article provides an overview of the process of implementing and integrating PACS in a comprehensive health system comprising an academic core hospital and numerous community hospitals. Important issues are addressed, touching all stages from planning to operation and training. The impact of an enterprise-wide radiology information system and PACS at the academic medical center (four specialty hospitals), in six additional community hospitals, and in all associated outpatient clinics as well as the implications on the productivity and efficiency of the entire enterprise are presented. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Improving the implementation of marine monitoring in the northeast Atlantic.

PubMed

Turrell, W R

2018-03-01

Marine monitoring in the northeast Atlantic is delivered within identifiable monitoring themes, established through time and defined by the geographical area and policy drivers they serve, the sampling methodologies they use, their assessment methodologies, their funding and governance structures and the people or organisations involved in their implementation. Within a monitoring theme, essential components for effective monitoring are governance, strategy and work plan, sampling protocols, quality assurance, and data and assessment structures. This simple framework is used to analyse two monitoring theme case studies; national ecosystem health monitoring, and regional fish stock monitoring. Such essential component analyses, within marine monitoring themes, can help improve monitoring implementation by identifying gaps and overlaps. Once monitoring themes are recognised, explicitly defined and streamlined, travel towards integrated monitoring may be made easier as the current lack of clarity in thematic marine monitoring implementation is one barrier to integration at both national and regional scales. Copyright © 2018 The Author. Published by Elsevier Ltd.. All rights reserved.

Design and Implementation of the PMS Module for ’Argos’

DTIC Science & Technology

1989-12-01

designing , and implementing a fully workable Planned Maintenance System (PMS). This implementation demonstrates both the capabilities and benefits such a...analyzing, designing , and implementing a fully workable Planned Maintenance System (PMS). This implementation demonstrates both the capabilities and... design and implementation. PMS is the system developed by the navy to provide each ship, department, and supervisor with the tools needed to plan

[Comprehensive drug safety plan in a health department].

PubMed

Bujaldón-Querejeta, N; Aznar-Saliente, T; Esplá-González, S; Ruíz-Darbonnéns, S; Pons-Martínez, L; Talens-Bolos, A; Martínez-Ramírez, M; Camacho-Romera, D; Aranaz-Andrés, J M

2014-01-01

To develop and implement a comprehensive drug safety plan in a hospital for the years 2009-2011. Applying the Strengths Weaknesses/Limitations Opportunities Threats (SWOT) methodology, the baseline situation was analyzed and a broad strategy or plan was subsequently developed, defining the scope, responsibilities, objectives and strategic actions and indicators in order to measure the achievement of the results. A comprehensive drug safety plan with the main objective of identifying and reducing the medication-related problems in patients treated in the Hospital de San Juan in Alicante has been developed. The plan contains five strategic objectives, twenty strategic actions and the indicators to assess its outcomes. It also contains a timetable for its establishment and evaluation. Developing a comprehensive strategic plan allows the current situation relating to drug safety to be determined. The results obtained after its introduction will define its applicability. Due to the lack of publications of similar plans and results, the evaluation of this plan will be useful whether it is favorable or not. As a side benefit of the development, the multidisciplinary team continues to work on improving patient safety in the care process, and the safety culture continues to grow among the professionals. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Building foundations for the future: the NHS Scotland advanced practice succession planning development pathway.

PubMed

Currie, Kay; Grundy, Maggie

2011-10-01

To highlight implications for managers from the implementation of a national advanced practice succession planning development pathway within Scotland. Internationally, advanced practice posts have often developed in an ad-hoc manner, with little organizational attention to succession planning. Evaluation of a pilot national succession planning development pathway identified mechanisms which facilitate or hamper effective planning for advanced practice roles. A responsive evaluation design incorporating semi-structured questionnaires to pathway participants (n = 15) and semi-structured telephone interviews with case-site pathway participants (n = 7) and their line managers. Managers believed the development pathway was worthwhile; however, there was limited strategic planning to match individuals' development to service need. Practitioners generally perceived managers as interested in their development, although levels of practical support varied. There is concern from both managers and practitioners regarding ongoing funding for advanced practice development. The present evaluation study reiterates the need for organizational commitment to succession planning including robust service needs analysis mechanisms and adequate funding for development processes. Nurse managers are viewed as the 'gatekeepers' to opportunities for developing advanced nurse practitioners; scare resources must be targeted effectively to support succession planning through the development of selected individuals for future advanced practice posts, justified by service need. © 2011 Blackwell Publishing Ltd.

Implementation of Discharge Plans for Chronically Ill Elders Discharged Home.

ERIC Educational Resources Information Center

Proctor, Enola K.; And Others

1996-01-01

Addresses the extent to which discharge plans for elderly patients with congestive heart failure were implemented as planned, tested the consequences of implementation problems, and identified factors associated with implementation problems. Implications for hospital discharge planners and home health care are discussed. (KW)

HIV Pre-exposure Prophylaxis Program Implementation Using Intervention Mapping.

PubMed

Flash, Charlene A; Frost, Elizabeth L T; Giordano, Thomas P; Amico, K Rivet; Cully, Jeffrey A; Markham, Christine M

2018-04-01

HIV pre-exposure prophylaxis has been proven to be an effective tool in HIV prevention. However, numerous barriers still exist in pre-exposure prophylaxis implementation. The framework of Intervention Mapping was used from August 2016 to October 2017 to describe the process of adoption, implementation, and maintenance of an HIV prevention program from 2012 through 2017 in Houston, Texas, that is nested within a county health system HIV clinic. Using the tasks outlined in the Intervention Mapping framework, potential program implementers were identified, outcomes and performance objectives established, matrices of change objectives created, and methods and practical applications formed. Results include the formation of three matrices that document program outcomes, change agents involved in the process, and the determinants needed to facilitate program adoption, implementation, and maintenance. Key features that facilitated successful program adoption and implementation were obtaining leadership buy-in, leveraging existing resources, systematic evaluation of operations, ongoing education for both clinical and nonclinical staff, and attention to emergent issues during launch. The utilization of Intervention Mapping to delineate the program planning steps can provide a model for pre-exposure prophylaxis implementation in other settings. Copyright © 2018. Published by Elsevier Inc.

Integrating Climate Change into Habitat Conservation Plans Under the U.S. Endangered Species Act

NASA Astrophysics Data System (ADS)

Bernazzani, Paola; Bradley, Bethany A.; Opperman, Jeffrey J.

2012-06-01

Habitat Conservation Plans (HCPs) under the Endangered Species Act (ESA) are an important mechanism for the acquisition of land and the management of terrestrial and aquatic ecosystems. HCPs have become a vital means of protecting endangered and threatened species and their habitats throughout the United States, particularly on private land. The scientific consensus that climate is changing and that these changes will impact the viability of species has not been incorporated into the conservation strategies of recent HCPs, rendering plans vulnerable biologically. In this paper we review the regulatory context for incorporating climate change into HCPs and analyze the extent to which climate change is linked to management actions in a subset of large HCPs. We conclude that most current plans do not incorporate climate change into conservation actions, and so we provide recommendations for integrating climate change into the process of HCP development and implementation. These recommendations are distilled from the published literature as well as the practice of conservation planning and are structured to the specific needs of HCP development and implementation. We offer nine recommendations for integrating climate change into the HCP process: (1) identify species at-risk from climate change, (2) explore new strategies for reserve design, (3) increase emphasis on corridors, linkages, and connectivity, (4) develop anticipatory adaptation measures, (5) manage for diversity, (6) consider assisted migration, (7) include climate change in scenarios of water management, (8) develop future-oriented management actions, and (9) increase linkages between the conservation strategy and adaptive management/monitoring programs.

Integrating climate change into habitat conservation plans under the U.S. endangered species act.

PubMed

Bernazzani, Paola; Bradley, Bethany A; Opperman, Jeffrey J

2012-06-01

Habitat Conservation Plans (HCPs) under the Endangered Species Act (ESA) are an important mechanism for the acquisition of land and the management of terrestrial and aquatic ecosystems. HCPs have become a vital means of protecting endangered and threatened species and their habitats throughout the United States, particularly on private land. The scientific consensus that climate is changing and that these changes will impact the viability of species has not been incorporated into the conservation strategies of recent HCPs, rendering plans vulnerable biologically. In this paper we review the regulatory context for incorporating climate change into HCPs and analyze the extent to which climate change is linked to management actions in a subset of large HCPs. We conclude that most current plans do not incorporate climate change into conservation actions, and so we provide recommendations for integrating climate change into the process of HCP development and implementation. These recommendations are distilled from the published literature as well as the practice of conservation planning and are structured to the specific needs of HCP development and implementation. We offer nine recommendations for integrating climate change into the HCP process: (1) identify species at-risk from climate change, (2) explore new strategies for reserve design, (3) increase emphasis on corridors, linkages, and connectivity, (4) develop anticipatory adaptation measures, (5) manage for diversity, (6) consider assisted migration, (7) include climate change in scenarios of water management, (8) develop future-oriented management actions, and (9) increase linkages between the conservation strategy and adaptive management/monitoring programs.

Analysis of Health Sector Budget of Nepal.

PubMed

Dulal, R K; Magar, A; Karki, S D; Khatiwada, D; Hamal, P K

2014-01-01

Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency.

Development of indicators for measuring outcomes of water safety plans

PubMed Central

Lockhart, Gabriella; Oswald, William E.; Hubbard, Brian; Medlin, Elizabeth; Gelting, Richard J.

2015-01-01

Water safety plans (WSPs) are endorsed by the World Health Organization as the most effective method of protecting a water supply. With the increase in WSPs worldwide, several valuable resources have been developed to assist practitioners in the implementation of WSPs, yet there is still a need for a practical and standardized method of evaluating WSP effectiveness. In 2012, the Centers for Disease Control and Prevention (CDC) published a conceptual framework for the evaluation of WSPs, presenting four key outcomes of the WSP process: institutional, operational, financial and policy change. In this paper, we seek to operationalize this conceptual framework by providing a set of simple and practical indicators for assessing WSP outcomes. Using CDC’s WSP framework as a foundation and incorporating various existing performance monitoring indicators for water utilities, we developed a set of approximately 25 indicators of institutional, operational, financial and policy change within the WSP context. These outcome indicators hold great potential for the continued implementation and expansion of WSPs worldwide. Having a defined framework for evaluating a WSP’s effectiveness, along with a set of measurable indicators by which to carry out that evaluation, will help implementers assess key WSP outcomes internally, as well as benchmark their progress against other WSPs in their region and globally. PMID:26361540

A large-scale initiative to disseminate an evidence-based drug abuse prevention program in Italy: Lessons learned for practitioners and researchers.

PubMed

Velasco, Veronica; Griffin, Kenneth W; Antichi, Mariella; Celata, Corrado

2015-10-01

Across developed countries, experimentation with alcohol, tobacco, and other drugs often begins in the early adolescent years. Several evidence-based programs have been developed to prevent adolescent substance use. Many of the most rigorously tested and empirically supported prevention programs were initially developed and tested in the United States. Increasingly, these interventions are being adopted for use in Europe and throughout the world. This paper reports on a large-scale comprehensive initiative designed to select, adapt, implement, and sustain an evidence-based drug abuse prevention program in Italy. As part of a large-scale regionally funded collaboration in the Lombardy region of Italy, we report on processes through which a team of stakeholders selected, translated and culturally adapted, planned, implemented and evaluated the Life Skills Training (LST) school-based drug abuse prevention program, an evidence-based intervention developed in the United States. We discuss several challenges and lessons learned and implications for prevention practitioners and researchers attempting to undertake similar international dissemination projects. We review several published conceptual models designed to promote the replication and widespread dissemination of effective programs, and discuss their strengths and limitations in the context of planning and implementing a complex, large-scale real-world dissemination effort. Copyright © 2015 Elsevier Ltd. All rights reserved.

Planning and implementing a nationwide football-based health-education programme.

PubMed

Dvorak, Jiri; Fuller, Colin W; Junge, Astrid

2012-01-01

Communicable and non-communicable diseases place enormous social and economic burdens on developed and developing countries. Health education leading to changes in people's attitudes and behaviours remains the best approach for reducing the problem of communicable diseases while there is evidence that programmes providing regular physical exercise and advocating a controlled diet can reduce the prevalence of many non-communicable diseases. Hence, the delivery of health education and physical activity within a single coherent programme offers great potential for simultaneously addressing both health issues. Since 2006, FIFA has developed and tested a novel football-based health-education programme for children entitled '11 for Health', which is aimed at increasing children's levels of physical activity while also delivering 11 simple health messages. When new interventions of this type are published in the scientific literature, it is often not possible to describe important background information about the project that could assist other researchers in developing and implementing similar programmes. This paper attempts to bridge this gap by describing the aims and objectives, organisation, planning, implementation and monitoring requirements needed to deliver FIFA's '11 for Health' programme, first as a pilot project and subsequently as a nationwide project, through a tripartite arrangement between FIFA, the national Football Association and the Government Ministries in Mauritius.

Planning and implementing a nationwide football-based health-education programme

PubMed Central

Dvorak, Jiri; Fuller, Colin W; Junge, Astrid

2012-01-01

Communicable and non-communicable diseases place enormous social and economic burdens on developed and developing countries. Health education leading to changes in people's attitudes and behaviours remains the best approach for reducing the problem of communicable diseases while there is evidence that programmes providing regular physical exercise and advocating a controlled diet can reduce the prevalence of many non-communicable diseases. Hence, the delivery of health education and physical activity within a single coherent programme offers great potential for simultaneously addressing both health issues. Since 2006, FIFA has developed and tested a novel football-based health-education programme for children entitled ‘11 for Health’, which is aimed at increasing children's levels of physical activity while also delivering 11 simple health messages. When new interventions of this type are published in the scientific literature, it is often not possible to describe important background information about the project that could assist other researchers in developing and implementing similar programmes. This paper attempts to bridge this gap by describing the aims and objectives, organisation, planning, implementation and monitoring requirements needed to deliver FIFA's ‘11 for Health’ programme, first as a pilot project and subsequently as a nationwide project, through a tripartite arrangement between FIFA, the national Football Association and the Government Ministries in Mauritius. PMID:22144002

A theory of planned behaviour perspective on practitioners' beliefs toward the integration of the WIXX communication campaign messages and activities into daily practice.

PubMed

Bélanger-Gravel, A; Lottinville, S; Beaurivage, D; Laferté, M; Therrien, F; Gauvin, L

2018-01-01

To favour the dissemination and the implementation of the WIXX multimedia communication campaign, the aim of this study was to examine practitioners' beliefs towards the integration of the WIXX campaign activities into daily practice. An exploratory qualitative study. Overall, 58 community-based practitioners completed an online questionnaire based on the theory of planned behaviour guidelines pertaining to perceived advantages/disadvantages and perceived barriers/facilitators toward the campaign. A content analysis was performed by two independent coders to extract modal beliefs. Results were validated by a third coder. Local partners had a positive attitude toward the WIXX campaign, but significant barriers remained and needed to be addressed to ensure full implementation of this campaign (e.g. lack of time or resources, additional workload, complexity of the registration process and so forth). Beliefs were fragmented and diversified, indicating that they were highly context dependent. To conclude, some remaining challenges regarding the full implementation of the WIXX communication campaign were identified, suggesting that additional efforts might be needed to ensure the full adoption of the campaign by local practitioners. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

40 CFR 49.10042 - Approval status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for the Cow... Tribal rules or measures in the implementation plan for the Reservation of the Cow Creek Band of Umpqua...

Ames Research Center FY 2000 Implementation Plan: Leading Technology into the New Millennium

NASA Technical Reports Server (NTRS)

2000-01-01

This document presents the implementation plan for Ames Research Center (ARC) within the overall framework of the NASA Strategic Plan. It describes how ARC intends to implement its Center of Excellence responsibilities, Agency assigned missions, Agency and Enterprise lead programs, and other roles in support of NASA's vision and mission. All Federal agencies are required by the 1993 Government Performance and Results Act to implement a long-term strategic planning process that includes measurable outcomes and strict accountability. At NASA, this planning process is shaped by the Space Act of 1958, annual appropriations, and other external mandates, as well as by customer requirements. The resulting Strategic Plan sets the overall architecture for what we do, identifies who our customers are, and directs where we are going and why. The Strategic Plan is the basis upon which decisions regarding program implementation and resource deployment are made. Whereas the strategic planning process examines the long-term direction of the organization and identifies a specific set of goals, the implementation planning process examines the detailed performance of the organization and allocates resources toward meeting these goals. It is the purpose of this implementation document to provide the connection between the NASA Strategic Plan and the specific programs and support functions that ARC employees perform. This connection flows from the NASA Strategic Plan, through the various Strategic Enterprise plans to the ARC Center of Excellence, primary missions, Lead Center programs, program support responsibilities, and ultimately, to the role of the individual ARC employee.

77 FR 60661 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; South Bend-Elkhart...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

... Promulgation of Air Quality Implementation Plans; Indiana; South Bend-Elkhart, Indiana Ozone Maintenance Plan..., Indiana 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) by replacing the... Vehicle Emissions Simulator (MOVES) 2010a emissions model. Indiana submitted this request to EPA for...

77 FR 59356 - Approval and Promulgation of Implementation Plans; North Carolina: Approval of Rocky Mount...

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2012-09-27

... Promulgation of Implementation Plans; North Carolina: Approval of Rocky Mount Supplemental Motor Vehicle... is proposing to approve a revision to the North Carolina State Implementation Plan (SIP), submitted... supplements the original redesignation request and maintenance plan for Rocky Mount 1997 8-hour ozone area...

77 FR 30212 - Approval and Promulgation of Air Quality Implementation Plans; Vermont; Regional Haze

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2012-05-22

... Promulgation of Air Quality Implementation Plans; Vermont; Regional Haze AGENCY: Environmental Protection... Implementation Plan (SIP) that addresses regional haze for the first planning period from 2008 through 2018. The... numerous sources located over a wide geographic area (also referred to as the ``regional haze program...

77 FR 47530 - Approval and Promulgation of State Implementation Plans; Hawaii; Infrastructure Requirements for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... Promulgation of State Implementation Plans; Hawaii; Infrastructure Requirements for the 1997 8-Hour Ozone and... State Implementation Plan (SIP) revision submitted by the state of Hawaii pursuant to the requirements... FURTHER INFORMATION CONTACT: Dawn Richmond, Air Planning Office (AIR-2), U.S. Environmental Protection...

A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada

PubMed Central

Gagnon, Marc-André; Mintzes, Barbara; Lexchin, Joel

2016-01-01

Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy. Building on published research and international frameworks, we propose that pharmaceutical policies of federal, provincial and territorial governments be coordinated around a core health-focused goal. We strongly suggest policy actions be taken on four core objectives that are necessary to support the overarching health goal. If implemented, the proposed strategy would offer clear benefits to all Canadians who use medicines, federal and provincial governments and to the economy as a whole. We therefore argue that political leadership is now needed to articulate and implement such a plan on behalf of Canadians. PMID:27585023

The New Interventional Radiology Pathways: Options for Implementation.

PubMed

Recht, Michael; McKinney, J Mark; Alleman, Anthony M; Lowe, Lisa H; Spies, James B

2016-07-01

The new interventional radiology (IR) pathways have generated much discussion with articles and editorials pointing out perceived advantages and disadvantages compared to the current pathways. To briefly review, under the new system, there are three pathways to enter IR: the integrated (INT) IR residency, the independent (IND) IR residency, and the early specialization in interventional radiology (ESIR) program. The pathways have been designed to provide maximum flexibility to programs for implementation and to radiology residents for planning their subspecialty training. As a result, there are many potential permutations for these training programs, and understanding the variety of options can be a challenge at first. We offer three potential solutions, based on the different circumstances or requirements a department might face. The first two solutions involve integrated programs created through newly funded and converted diagnostic radiology slots, respectively. The third involves establishing ESIR and IND programs only. Hopefully, the examples provided will be useful for those currently planning for the future of their IR training programs. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Nurse adoption of continuous patient monitoring on acute post-surgical units: managing technology implementation.

PubMed

Jeskey, Mary; Card, Elizabeth; Nelson, Donna; Mercaldo, Nathaniel D; Sanders, Neal; Higgins, Michael S; Shi, Yaping; Michaels, Damon; Miller, Anne

2011-10-01

To report an exploratory action-research process used during the implementation of continuous patient monitoring in acute post-surgical nursing units. Substantial US Federal funding has been committed to implementing new health care technology, but failure to manage implementation processes may limit successful adoption and the realisation of proposed benefits. Effective approaches for managing barriers to new technology implementation are needed. Continuous patient monitoring was implemented in three of 13 medical/surgical units. An exploratory action-feedback approach, using time-series nurse surveys, was used to identify barriers and develop and evaluate responses. Post-hoc interviews and document analysis were used to describe the change implementation process. Significant differences were identified in night- and dayshift nurses' perceptions of technology benefits. Research nurses' facilitated the change process by evolving 'clinical nurse implementation specialist' expertise. Health information technology (HIT)-related patient outcomes are mediated through nurses' acting on new information but HIT designed for critical care may not transfer to acute care settings. Exploratory action-feedback approaches can assist nurse managers in assessing and mitigating the real-world effects of HIT implementations. It is strongly recommended that nurse managers identify stakeholders and develop comprehensive plans for monitoring the effects of HIT in their units. © 2011 Blackwell Publishing Ltd.

Planning Targets for Phase II Watershed Implementation Plans

EPA Pesticide Factsheets

On August 1, 2011, EPA provided planning targets for nitrogen, phosphorus and sediment for the Phase II Watershed Implementation Plans (WIPs) of the Chesapeake Bay TMDL. This page provides the letters containing those planning targets.

A summary of the new GINA strategy: a roadmap to asthma control

PubMed Central

Bateman, Eric D.; Becker, Allan; Boulet, Louis-Philippe; Cruz, Alvaro A.; Drazen, Jeffrey M.; Haahtela, Tari; Hurd, Suzanne S.; Inoue, Hiromasa; de Jongste, Johan C.; Lemanske, Robert F.; Levy, Mark L.; O'Byrne, Paul M.; Paggiaro, Pierluigi; Pedersen, Soren E.; Pizzichini, Emilio; Soto-Quiroz, Manuel; Szefler, Stanley J.; Wong, Gary W.K.; FitzGerald, J. Mark

2015-01-01

Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA report was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence. This article provides a summary of key changes in the GINA report, and their rationale. The changes include a revised asthma definition; tools for assessing symptom control and risk factors for adverse outcomes; expanded indications for inhaled corticosteroid therapy; a framework for targeted treatment based on phenotype, modifiable risk factors, patient preference, and practical issues; optimisation of medication effectiveness by addressing inhaler technique and adherence; revised recommendations about written asthma action plans; diagnosis and initial treatment of the asthma−chronic obstructive pulmonary disease overlap syndrome; diagnosis in wheezing pre-school children; and updated strategies for adaptation and implementation of GINA recommendations. PMID:26206872

OA38 From service delivery to community enablement: a public health approach to palliative care.

PubMed

McLoughlin, Kathleen; Rhatigan, Jim; Richardson, Marie; Lloyd, Rebecca

2015-04-01

: Milford Care Centre is the only hospice in Ireland to make a strategic decision to embrace a public health approach to palliative care, through the development, implementation and evaluation of the Compassionate Communities Project. This presentation seeks to examine why Milford made the decision to move toward a community enablement model, describes the development and implementation of the Compassionate Communities Project to date, presents key findings from recent evaluations and highlights our plans for the future. The presentation uses a reflective, story telling approach to meet it's aims, coupled with data and statistics gathered from the evaluations, and includes a new short film 'Tell Me' developed by recent Computer Science graduates for the Project to use to engage with communities during Café Conversations. The presentation will highlight the relevance of Health Promoting Palliative Care theory to the development of a three-tier model of programme activity, examine the challenges in implementing such an approach and will discuss the impact of upstream intervention to downstream service provision using case studies. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Grounding a new information technology implementation framework in behavioral science: a systematic analysis of the literature on IT use.

PubMed

Kukafka, Rita; Johnson, Stephen B; Linfante, Allison; Allegrante, John P

2003-06-01

Many interventions to improve the success of information technology (IT) implementations are grounded in behavioral science, using theories, and models to identify conditions and determinants of successful use. However, each model in the IT literature has evolved to address specific theoretical problems of particular disciplinary concerns, and each model has been tested and has evolved using, in most cases, a more or less restricted set of IT implementation procedures. Functionally, this limits the perspective for taking into account the multiple factors at the individual, group, and organizational levels that influence use behavior. While a rich body of literature has emerged, employing prominent models such as the Technology Adoption Model, Social-Cognitive Theory, and Diffusion of Innovation Theory, the complexity of defining a suitable multi-level intervention has largely been overlooked. A gap exists between the implementation of IT and the integration of theories and models that can be utilized to develop multi-level approaches to identify factors that impede usage behavior. We present a novel framework that is intended to guide synthesis of more than one theoretical perspective for the purpose of planning multi-level interventions to enhance IT use. This integrative framework is adapted from PRECEDE/PROCEDE, a conceptual framework used by health planners in hundreds of published studies to direct interventions that account for the multiple determinants of behavior. Since we claim that the literature on IT use behavior does not now include a multi-level approach, we undertook a systematic literature analysis to confirm this assertion. Our framework facilitated organizing this literature synthesis and our analysis was aimed at determining if the IT implementation approaches in the published literature were characterized by an approach that considered at least two levels of IT usage determinants. We found that while 61% of studies mentioned or referred to theory, none considered two or more levels. In other words, although the researchers employ behavioral theory, they omit two fundamental propositions: (1) IT usage is influenced by multiple factors and (2) interventions must be multi-dimensional. Our literature synthesis may provide additional insight into the reason for high failure rates associated with underutilized systems, and underscores the need to move beyond the current dominant approach that employs a single model to guide IT implementation plans that aim to address factors associated with IT acceptance and subsequent positive use behavior.

Building robust conservation plans.

PubMed

Visconti, Piero; Joppa, Lucas

2015-04-01

Systematic conservation planning optimizes trade-offs between biodiversity conservation and human activities by accounting for socioeconomic costs while aiming to achieve prescribed conservation objectives. However, the most cost-efficient conservation plan can be very dissimilar to any other plan achieving the set of conservation objectives. This is problematic under conditions of implementation uncertainty (e.g., if all or part of the plan becomes unattainable). We determined through simulations of parallel implementation of conservation plans and habitat loss the conditions under which optimal plans have limited chances of implementation and where implementation attempts would fail to meet objectives. We then devised a new, flexible method for identifying conservation priorities and scheduling conservation actions. This method entails generating a number of alternative plans, calculating the similarity in site composition among all plans, and selecting the plan with the highest density of neighboring plans in similarity space. We compared our method with the classic method that maximizes cost efficiency with synthetic and real data sets. When implementation was uncertain--a common reality--our method provided higher likelihood of achieving conservation targets. We found that χ, a measure of the shortfall in objectives achieved by a conservation plan if the plan could not be implemented entirely, was the main factor determining the relative performance of a flexibility enhanced approach to conservation prioritization. Our findings should help planning authorities prioritize conservation efforts in the face of uncertainty about future condition and availability of sites. © 2014 Society for Conservation Biology.

76 FR 15 - Approval and Promulgation of Implementation Plans; Texas; Emissions Banking and Trading of...

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2011-01-03

... Promulgation of Implementation Plans; Texas; Emissions Banking and Trading of Allowances Program AGENCY... to the Texas State Implementation Plan (SIP) that create and amend the Emissions Banking and Trading... hard copy at the Air Planning Section (6PD-L), Environmental Protection Agency, 1445 Ross Avenue, Suite...

78 FR 33784 - Approval and Promulgation of Implementation Plans; Kentucky: Kentucky Portion of Cincinnati...

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2013-06-05

... Promulgation of Implementation Plans; Kentucky: Kentucky Portion of Cincinnati-Hamilton, Supplement Motor.... SUMMARY: EPA is proposing to approve a revision to the Kentucky State Implementation Plan (SIP), submitted... maintenance plan for the Kentucky portion of the Cincinnati-Hamilton, OH-KY-IN, maintenance area for the 1997...

78 FR 34903 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; 1997 8-Hour Ozone...

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2013-06-11

... Promulgation of Air Quality Implementation Plans; Ohio; 1997 8-Hour Ozone Maintenance Plan Revision; Motor... request by Ohio to revise the 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) to... area with budgets developed using EPA's Motor Vehicle Emissions Simulator (MOVES) emissions model. Ohio...

78 FR 16826 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Cleveland-Akron-Lorain and...

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2013-03-19

...-9790-1] Approval and Promulgation of Air Quality Implementation Plans; Ohio; Cleveland-Akron-Lorain and Columbus 1997 8-Hour Ozone Maintenance Plan Revisions to Approved Motor Vehicle Emissions Budgets AGENCY... quality State Implementation Plans (SIPs) under the Clean Air Act to replace the previously approved motor...

78 FR 28497 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Canton-Massillon 1997 8-Hour...

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2013-05-15

... Promulgation of Air Quality Implementation Plans; Ohio; Canton-Massillon 1997 8-Hour Ozone Maintenance Plan... the Canton-Massillon, Ohio 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP... using EPA's Motor Vehicle Emissions Simulator (MOVES) emissions model. Ohio submitted the SIP revision...

78 FR 28551 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Canton-Massillon 1997 8-Hour...

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2013-05-15

... Promulgation of Air Quality Implementation Plans; Ohio; Canton-Massillon 1997 8-Hour Ozone Maintenance Plan..., Ohio, 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) under the Clean Air Act... Motor Vehicle Emissions Simulator (MOVES) emissions model. Ohio submitted the SIP revision request to...

77 FR 30214 - Approval and Promulgation of Air Quality Implementation Plans; Rhode Island; Regional Haze

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2012-05-22

... Promulgation of Air Quality Implementation Plans; Rhode Island; Regional Haze AGENCY: Environmental Protection... Implementation Plan (SIP) that addresses regional haze for the first planning period from 2008 through 2018. The... geographic area (also referred to as the ``regional haze program''). DATES: Effective Date: This rule is...

76 FR 43149 - Approval and Promulgation of Air Quality Implementation Plans; State of California; Regional Haze...

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2011-07-20

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0131, FRL-9317-9] Approval and Promulgation of Air Quality Implementation Plans; State of California; Regional Haze State Implementation Plan and Interstate Transport Plan; Interference With Visibility Requirement Correction In rule document...

76 FR 57013 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Revised Motor...

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2011-09-15

... Promulgation of Air Quality Implementation Plans; West Virginia; Revised Motor Vehicle Emission Budgets for the... Implementation Plan (SIP) revision submitted by the State of West Virginia for the purpose of amending the 8-hour ozone maintenance plan for the Charleston, Huntington, Parkersburg, Weirton, and Wheeling 8-hour ozone...

Implementing graduate entry registration for nursing in England: a scope review.

PubMed

DeBell, Diane; Branson, Kathy

2009-07-01

A graduate entry workforce for nurse registration has been approved for England by 2010/11. The aim of this research was to discover the immediate tasks facing nurse managers in implementing that change. Previous research has focused on making the case for change rather than on implementation. Similar to the implementation of Project 2000, this change in nurse education and employment will raise questions for employers and for higher education institutions. It will also raise questions about nurse recruitment numbers, workforce development, and the profiles of entrants to a changing workforce. In preparation for these changes, we conducted a scope review of published and grey literature in the English language. We also reviewed the earlier experiences of transfer to graduate status amongst other workforces such as teaching and social work and we investigated reported practice in other industrialised countries. The education provider changes necessary for such a large professional workforce will need considerable leadership skills from within nursing and nurse management. At present, there are too many employers and education providers in England who appear to be relatively unaware of the changes facing nurse education and professional practice and the urgency needed to lead that change. Education, training and development as well as employer/commissioner practice will rely on leadership from within the nurse profession itself. For nurse managers, this requires a rapid planning process in order to ensure smooth implementation. The danger is that either education providers or commissioners of nursing services will react rather than proactively plan for the changes that are already in progress.

40 CFR 109.5 - Development and implementation criteria for State, local and regional oil removal contingency plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OIL REMOVAL CONTINGENCY PLANS § 109.5 Development and implementation criteria for State, local and regional oil removal contingency plans. Criteria for the development and implementation of State, local and... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Development and implementation...

77 FR 65125 - Approval and Promulgation of Implementation Plans; Georgia 110(a)(1) and (2) Infrastructure...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-25

... controls are enforced through the associated SIP rules or Federal Implementation Plans (FIPs). Any purchase... Promulgation of Implementation Plans; Georgia 110(a)(1) and (2) Infrastructure Requirements for the 1997 and... Agency (EPA). ACTION: Final rule. SUMMARY: EPA is taking final action to approve the State Implementation...

Implementing corporate wellness programs: a business approach to program planning.

PubMed

Helmer, D C; Dunn, L M; Eaton, K; Macedonio, C; Lubritz, L

1995-11-01

1. Support of key decision makers is critical to the successful implementation of a corporate wellness program. Therefore, the program implementation plan must be communicated in a format and language readily understood by business people. 2. A business approach to corporate wellness program planning provides a standardized way to communicate the implementation plan. 3. A business approach incorporates the program planning components in a format that ranges from general to specific. This approach allows for flexibility and responsiveness to changes in program planning. 4. Components of the business approach are the executive summary, purpose, background, ground rules, approach, requirements, scope of work, schedule, and financials.

[Transition from pediatric to adult health care services for adolescents with chronic diseases: Recommendations from the Adolescent Branch from Sociedad Chilena de Pediatría].

PubMed

Zubarew, Tamara; Correa, Loreto; Bedregal, Paula; Besoain, Carolina; Reinoso, Alejandro; Velarde, Macarena; Valenzuela, María Teresa; Inostroza, Carolina

2017-01-01

The Adolescent Branch from Sociedad Chilena de Pediatría supports the implementation of planned programs for transition from child to adult health centers, oriented to adolescents with chronic diseases, in order to ensure an appropriate follow-up and a high-quality health care. Recommendations for care are set out in the FONIS and VRI PUC project carried out by the Division of Pediatrics of the Universidad Católica de Chile: “Transition process from pediatric to adult services: perspectives of adolescents with chronic diseases, caregivers and health professionals”, whose goal was to describe the experience, barriers, critical points, and facilitators in the transition process. Critical points detected in this study were: existence of a strong bond between adolescents, caregivers and the pediatric team, resistance to transition, difficulty developing autonomy and self-management among adolescents; invisibility of the process of adolescence; and lack of communication between pediatric and adult team during the transfer. According to these needs, barriers and critical points, and based on published international experiences, recommendations are made for implementation of gradual and planned transition processes, with emphasis on the design and implementation of transition policies, establishment of multidisciplinary teams and transition planning. We discuss aspects related to coordination of teams, transfer timing, self-care and autonomy, transition records, adolescent and family participation, need for emotional support, ethical aspects involved, importance of confidentiality, need for professional training, and the need for evaluation and further research on the subject.

Multidisciplinary cancer care in Australia: a national audit highlights gaps in care and medico-legal risk for clinicians.

PubMed

Wilcoxon, Heidi; Luxford, Karen; Saunders, Christobel; Peterson, Janice; Zorbas, Helen

2011-03-01

Multidisciplinary care (MDC) is accepted as best practice in cancer treatment planning and care. Despite recognition of the importance of a team approach, limited data are available about the extent to which MDC has been implemented in Australia. The aim of the audit was to investigate the implementation of MDC for five main cancer types across Australia in line with best practice. A sample of 155 hospitals was surveyed to investigate the status of MDC for cancer treatment planning in Australia across five cancer types (breast, gynecological, lung, prostate and colorectal). The survey investigated team structure, meetings, patient consent, documentation of team recommendations and communication with the patient. Two-thirds of hospitals surveyed did not have a multidisciplinary team. Of those with such a team; in one-third patients were not informed their case would be discussed by the team, in half patient consent was not sought for all cases discussed by the team, in one-quarter the team's recommended treatment plan was not noted in the patient record. Less than 1% of teams reported routine attendance by the tumour-specific minimum core team. MDC is not being implemented in line with best practice or applied consistently across Australia. This audit has highlighted gaps in care delivery, despite national recommendations about MDC. Areas being neglected can affect the quality of care provided and may put clinicians at medico-legal risk. Recommendations to improve uptake and effectiveness of MDC are provided. © 2011 Blackwell Publishing Asia Pty Ltd.

A practical guide to self-sustaining point-of-care ultrasound education programs in resource-limited settings.

PubMed

Henwood, Patricia C; Mackenzie, David C; Rempell, Joshua S; Murray, Alice F; Leo, Megan M; Dean, Anthony J; Liteplo, Andrew S; Noble, Vicki E

2014-09-01

The value of point-of-care ultrasound education in resource-limited settings is increasingly recognized, though little guidance exists on how to best construct a sustainable training program. Herein we offer a practical overview of core factors to consider when developing and implementing a point-of-care ultrasound education program in a resource-limited setting. Considerations include analysis of needs assessment findings, development of locally relevant curriculum, access to ultrasound machines and related technological and financial resources, quality assurance and follow-up plans, strategic partnerships, and outcomes measures. Well-planned education programs in these settings increase the potential for long-term influence on clinician skills and patient care. Copyright © 2014 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

40 CFR 49.10050 - Federally-promulgated regulations and Federal implementation plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

...-Region X Implementation Plan for the Cow Creek Band of Umpqua Indians of Oregon § 49.10050 Federally... part of the implementation plan for the Reservation of the Cow Creek Band of Umpqua Indians: (a...

Planning for strategic change? A participative planning approach for community hospitals.

PubMed

MacDonald, S K; Beange, J E; Blachford, P C

1992-01-01

Strategic planning is becoming to hospitals what business case analysis is to private corporations. In fact, this type of planning is becoming essential for the professional management of Ontario hospitals. The participative strategic planning process at Toronto East General Hospital (TEGH) is an example of how a professionally structured and implemented strategic planning process can be successfully developed and implemented in a community hospital. In this article, the environmental factors driving planning are reviewed and the critical success factors for the development and implementation of a strategic plan are examined in the context of TEGH's experience.

COPDESS (Coalition for Publishing Data in the Earth & Space Sciences): An Update on Progress and Next Steps

NASA Astrophysics Data System (ADS)

Lehnert, Kerstin; Hanson, Brooks; Sallans, Andrew; Elger, Kirsten

2016-04-01

The Coalition for Publishing Data in the Earth and Space Sciences (http://www.copdess.org/) formed in October 2014 to provide an organizational framework for Earth and space science publishers and data facilities to jointly implement and promote common policies and procedures for the publication and citation of data across Earth Science journals. Since inception, it has worked to develop and promote adoption of data citation standards (e.g. FORCE11 Joint Declaration of Data Citation Principles), integrate community tools and services for greater discovery and adoption (e.g. COPDESS Directory of Repositories, https://copdessdirectory.osf.io/), and connect with related community efforts for greater transparency in research community (e.g. the Transparency and Openness Promotion Guidelines, http://cos.io/top). Following a second COPDESS workshop in Fall 2015, COPDESS is undertaking several concrete steps to increase participation and integration of efforts more deeply into the publishing and data facility workflows and to expand international participation. This talk will focus on details of specific initiatives, collection of feedback, and a call for new members. Specifically, we will present progress on the development of guidelines that aim to standardize publishers' recommended best practices by establishing "Best practices for best practices" that will allow a journal or data facility to tailor these practices to the sub-disciplines that they serve. COPDESS will further work to advance implementation of these best practices through increased outreach to and education of editors and authors. COPDESS plans to offer a Town Hall meeting at the EGU General Assembly as a forum for further information and discussion.

Implementing national strategies on antimicrobial resistance in Thailand: potential challenges and solutions.

PubMed

Sommanustweechai, A; Tangcharoensathien, V; Malathum, K; Sumpradit, N; Kiatying-Angsulee, N; Janejai, N; Jaroenpoj, S

2018-04-01

Thailand has developed a national strategic plan on antimicrobial resistance (NSP-AMR) and endorsed by the Cabinet in August 2016. This study reviewed the main contents of the NSP-AMR and the mandates of relevant implementing agencies and identified challenges and recommends actions to mitigate implementation gaps. This study analysed the contents of NSP-AMR, reviewed institutional mandates and assessed the implementation gaps among agencies responsible for NSP-AMR. Two of six strategies are related to monitoring and surveillance of AMR and antimicrobial consumption in human and animal. Two other strategies aim to improve antibiotic stewardship and control the spread of AMR in both clinical and farm settings. The remaining two strategies aim to increase knowledge and public awareness on AMR and establish national governance for inter-sectoral actions. Strategies to overcome implementation challenges are sustaining cross-sectoral policy commitments, effective cross-sectoral coordination using One Health approach, generating evidence which guides policy implementation, and improving enforcement capacities in regulatory authorities. To address AMR, Thailand requires significant improvements in implementation capacities in two dimensions. First, technical capacities among implementing agencies are needed to translate policies into practice. Second, governance and organizational capacities enable effective multi-sectoral actions across human, animal, and environmental sectors. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

78 FR 34965 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Lima 1997 8-Hour Ozone...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... Promulgation of Air Quality Implementation Plans; Ohio; Lima 1997 8-Hour Ozone Maintenance Plan Revision; Motor... 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) to replace the previously... Simulator (MOVES) emissions model. Ohio submitted the SIP revision request to EPA on January 11, 2013. DATES...

78 FR 34965 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; 1997 8-Hour Ozone...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... Promulgation of Air Quality Implementation Plans; Ohio; 1997 8-Hour Ozone Maintenance Plan Revision; Motor... request by Ohio to revise the 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP...) emissions model. Ohio submitted the SIP revision request to EPA on December 7, 2012. DATES: Comments must be...

78 FR 34906 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Lima 1997 8-Hour Ozone...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... Promulgation of Air Quality Implementation Plans; Ohio; Lima 1997 8-Hour Ozone Maintenance Plan Revision to... Lima, Ohio 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) to replace motor... (MOVES) emissions model. Ohio submitted the SIP revision request to EPA on January 11, 2013. DATES: This...

Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation.

PubMed

Yen, Po-Yin; McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

2017-09-07

In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. ©Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 07.09.2017.

Workplace safety and health for the veterinary health care team.

PubMed

Gibbins, John D; MacMahon, Kathleen

2015-03-01

Veterinary clinic employers have a legal and ethical responsibility to provide a safe and healthy workplace. Clinic members are responsible for consistently using safe practices and procedures set up by their employer. Development and implementation of a customized comprehensive workplace safety and health program is emphasized, including an infection control plan. Occupational safety and health regulations are reviewed. The hazards of sharps, animal bites and scratches, and drugs are discussed. Strategies to prevent or minimize adverse health effects and resources for training and education are provided. Published by Elsevier Inc.

78 FR 12243 - Interim Final Determination To Stay and Defer Sanctions, Placer County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

...EPA is making an interim final determination to stay the imposition of offset sanctions and to defer the imposition of highway sanctions based on a proposed approval of a revision to the Placer County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD) portion of the California State Implementation Plan (SIP) published elsewhere in this Federal Register. The SIP revision concerns two permitting rules submitted by the PCAPCD and FRAQMD, respectively: Rule 502, New Source Review, and Rule 10.1, New Source Review.

The documentation of pain management during aeromedical evacuation missions.

PubMed

Lamb, Di

2010-06-01

Modern warfare has generated a significant increase in blast injuries, which demand careful management during planning and while undertaking air transfer. Pain management following multiple injuries can be challenging even when a patient is cared for in a stationary health care setting; this is further complicated by the additional stressors of flight. This article describes health care governance initiatives implemented by the Aeromedical Evacuation Squadron, based at Royal Air Force (RAF), United Kingdom. It focuses on quality and performance improvements via a program of clinical-effectiveness auditing. Copyright (c) 2010. Published by Elsevier Inc.

Value-based integrated (renal) care: setting a development agenda for research and implementation strategies.

PubMed

Valentijn, Pim P; Biermann, Claus; Bruijnzeels, Marc A

2016-08-02

Integrated care services are considered a vital strategy for improving the Triple Aim values for people with chronic kidney disease. However, a solid scholarly explanation of how to develop, implement and evaluate such value-based integrated renal care services is limited. The aim of this study was to develop a framework to identify the strategies and outcomes for the implementation of value-based integrated renal care. First, the theoretical foundations of the Rainbow Model of Integrated Care and the Triple Aim were united into one overarching framework through an iterative process of key-informant consultations. Second, a rapid review approach was conducted to identify the published research on integrated renal care, and the Cochrane Library, Medline, Scopus, and Business Source Premier databases were searched for pertinent articles published between 2000 and 2015. Based on the framework, a coding schema was developed to synthesis the included articles. The overarching framework distinguishes the integrated care domains: 1) type of integration, 2) enablers of integration and the interrelated outcome domains, 3) experience of care, 4) population health and 5) costs. The literature synthesis indicated that integrated renal care implementation strategies have particularly focused on micro clinical processes and physical outcomes, while little emphasis has been placed on meso organisational as well as macro system integration processes. In addition, evidence regarding patients' perceived outcomes and economic outcomes has been weak. These results underscore that the future challenge for researchers is to explore which integrated care implementation strategies achieve better health and improved experience of care at a lower cost within a specific context. For this purpose, this study's framework and evidence synthesis have set a developmental agenda for both integrated renal care practice and research. Accordingly, we plan further work to develop an implementation model for value-based integrated renal services.

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

PubMed

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

2018-06-11

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

Measuring the Implementation Fidelity of Student Affairs Programs: A Critical Component of the Outcomes Assessment Cycle

ERIC Educational Resources Information Center

Gerstner, Jerusha J.; Finney, Sara J.

2013-01-01

Implementation fidelity assessment provides a means of measuring the alignment between the planned program and the implemented program. Unfortunately, the implemented program can differ from the planned program, resulting in ambiguous inferences about the planned program's effectiveness (i.e., it is uncertain if poor results are due to an…

75 FR 10449 - Approval and Promulgation of Implementation Plans; Texas; Revisions to Chapter 116 Which Relate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... Promulgation of Implementation Plans; Texas; Revisions to Chapter 116 Which Relate to the Application Review... approve revisions to the Texas State Implementation Plan (SIP) submitted by the State of Texas to EPA on... implements the requirements of House Bill 3732, 80th Legislature (2007), and the Texas Health and Safety Code...

Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update).

PubMed

Ross, Jamie; Stevenson, Fiona; Lau, Rosa; Murray, Elizabeth

2016-10-26

There is a significant potential for e-health to deliver cost-effective, quality health care, and spending on e-health systems by governments and healthcare systems is increasing worldwide. However, there remains a tension between the use of e-health in this way and implementation. Furthermore, the large body of reviews in the e-health implementation field, often based on one particular technology, setting or health condition make it difficult to access a comprehensive and comprehensible summary of available evidence to help plan and undertake implementation. This review provides an update and re-analysis of a systematic review of the e-health implementation literature culminating in a set of accessible and usable recommendations for anyone involved or interested in the implementation of e-health. MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library were searched for studies published between 2009 and 2014. Studies were included if they were systematic reviews of the implementation of e-health. Data from included studies were synthesised using the principles of meta-ethnography, and categorisation of the data was informed by the Consolidated Framework for Implementation Research (CFIR). Forty-four reviews mainly from North America and Europe were included. A range of e-health technologies including electronic medical records and clinical decision support systems were represented. Healthcare settings included primary care, secondary care and home care. Factors important for implementation were identified at the levels of the following: the individual e-health technology, the outer setting, the inner setting and the individual health professionals as well as the process of implementation. This systematic review of reviews provides a synthesis of the literature that both acknowledges the multi-level complexity of e-health implementation and provides an accessible and useful guide for those planning implementation. New interpretations of a large amount of data across e-health systems and healthcare settings have been generated and synthesised into a set of useable recommendations for practice. This review provides a further empirical test of the CFIR and identifies areas where additional research is necessary. PROSPERO, CRD42015017661.

Metropolitan Boston air quality control region: transportation control plan

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

Not Available

1975-02-28

The EPA is considering a number of amendments to the transportation control plan which it promulgated Nov. 8, 1973 for the Metropolitan Boston Intrastate Air Quality Control Region. Included in the proposed amendments is a revised regulation for reduction of commuter travel which would include students and employees. This program would be implemented in conjunction with the carpool matching program being developed by the Commonwealth of Massachusetts and the employee pass program offered by the Massachusetts Bay Transportation Authority. A new provision for limiting overall hydrocarbon emissions from major users of organic compounds is included. Also published are a proposalmore » for encouraging bicycle use, new proposals for controlling carbon monoxide levels outside the Boston core area, and a new procedure for periodic monitoring and updating of the plan. Other features of the original plan are retained with modifications in areas including the ceiling on the level of commercial parking spaces in the so-called ''freeze'' area, limitations of on-street commuter parking, a semiannual inspection and maintenance program, a retrofit program, and incentives for carpool and transit use.« less

Vouchers for family planning and sexual and reproductive health services: a review of voucher programs involving Marie Stopes International among 11 Asian and African countries.

PubMed

Eva, Gillian; Quinn, Andrew; Ngo, Thoai D

2015-08-01

To evaluate provision of vouchers for family planning and sexual and reproductive health (SRH) services. A review was conducted to assess the effects of 24 voucher programs in Marie Stopes International programs across 11 countries in Asia and Africa between 2005 and the present. The outcome measures were uptake of services; service use among specific subgroups; user satisfaction with service quality; and efficiency of service delivery. Twelve of the 24 programs covered family planning only, whereas the other 12 programs covered family planning and/or SRH. Service uptake increased following implementation, although voucher redemption rates varied by program (44.1%-92.4%). Most programs were successful in reaching subgroups, such as the poor and young (under 25years), although this outcome depended on the targeting approach. Most programs recorded high user satisfaction; however, the evidence regarding efficiency was mixed. Vouchers increased uptake of services and, in some cases, improved service quality and reach to specific groups. Nevertheless, robust evaluation designs are required to measure efficiency. Copyright © 2015. Published by Elsevier Ireland Ltd.

[Managing a health research institute: towards research excellence through continuous improvement].

PubMed

Olmedo, Carmen; Buño, Ismael; Plá, Rosa; Lomba, Irene; Bardinet, Thierry; Bañares, Rafael

2015-01-01

Health research institutes are a strategic commitment considered the ideal environment to develop excellence in translational research. Achieving quality research requires not only a powerful scientific and research structure but also the quality and integrity of management systems that support it. The essential instruments in our institution were solid strategic planning integrated into and consistent with the system of quality management, systematic evaluation through periodic indicators, measurement of key user satisfaction and internal audits, and implementation of an innovative information management tool. The implemented management tools have provided a strategic thrust to our institute while ensuring a level of quality and efficiency in the development and management of research that allows progress towards excellence in biomedical research. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

24 CFR 598.605 - Implementation plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES: ROUND TWO AND THREE DESIGNATIONS Empowerment Zone Grants § 598.605 Implementation plan. (a) Implementation plan content. An EZ must submit an... requirements that the state and local governments, as Empowerment Zone designees, have agreed to meet as...

An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals.

PubMed

Sadeghifar, Jamil; Tofighi, Shahram; Roshani, Mohamad; Toulideh, Zahra; Mohsenpour, Seyedramezan; Jafari, Mehdi

2017-01-01

To assess the implementation and evaluation phases of strategic plans in selected hospitals. We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital's priorities was the most important advantage of a strategic plan. There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning.

The Best Laid Plans: An Examination of School Plan Quality and Implementation in a School Improvement Initiative

ERIC Educational Resources Information Center

Strunk, Katharine O.; Marsh, Julie A.; Bush-Mecenas, Susan C.; Duque, Matthew R.

2016-01-01

Purpose: A common strategy used in school improvement efforts is a mandated process of formal planning, yet little is known about the quality of plans or the relationship between plan quality and implementation. This mixed-methods article investigates plan quality, factors associated with plan quality, and the relationship between plan quality and…

Clinical practice guidelines for delirium management: potential application in palliative care.

PubMed

Bush, Shirley H; Bruera, Eduardo; Lawlor, Peter G; Kanji, Salmaan; Davis, Daniel H J; Agar, Meera; Wright, David Kenneth; Hartwick, Michael; Currow, David C; Gagnon, Bruno; Simon, Jessica; Pereira, José L

2014-08-01

Delirium occurs in patients across a wide array of health care settings. The extent to which formal management guidelines exist or are adaptable to palliative care is unclear. This review aims to 1) source published delirium management guidelines with potential relevance to palliative care settings, 2) discuss the process of guideline development, 3) appraise their clinical utility, and 4) outline the processes of their implementation and evaluation and make recommendations for future guideline development. We searched PubMed (1990-2013), Scopus, U.S. National Guideline Clearinghouse, Google, and relevant reference lists to identify published guidelines for the management of delirium. This was supplemented with multidisciplinary input from delirium researchers and other relevant stakeholders at an international delirium study planning meeting. There is a paucity of high-level evidence for pharmacological and non-pharmacological interventions in the management of delirium in palliative care. However, multiple delirium guidelines for clinical practice have been developed, with recommendations derived from "expert opinion" for areas where research evidence is lacking. In addition to their potential benefits, limitations of clinical guidelines warrant consideration. Guidelines should be appraised and then adapted for use in a particular setting before implementation. Further research is needed on the evaluation of guidelines, as disseminated and implemented in a clinical setting, focusing on measurable outcomes in addition to their impact on quality of care. Delirium clinical guidelines are available but the level of evidence is limited. More robust evidence is required for future guideline development. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Sample-Based Motion Planning in High-Dimensional and Differentially-Constrained Systems

DTIC Science & Technology

2010-02-01

Reachable Set . . . 88 6-1 LittleDog Robot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 6-2 Dog bounding up stairs ...planning algorithm implemented on LittleDog, a quadruped robot . The motion planning algorithm successfully planned bounding trajectories over extremely...a motion planning algorithm implemented on LittleDog, a quadruped robot . The motion planning algorithm successfully planned bounding trajectories

Strategic planning, implementation, and evaluation processes in hospital systems: a survey from Iran.

PubMed

Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

2014-09-28

Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. All the investigated hospitals had a strategic plan. The obtained percentages for the items "the rate of the compliance to requirements" and "the quantity of planning facilitators" (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved.

Strategic Planning, Implementation, and Evaluation Processes in Hospital Systems: A Survey From Iran

PubMed Central

Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

2015-01-01

Aim & Background: Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. Methods: The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. Results: All the investigated hospitals had a strategic plan. The obtained percentages for the items “the rate of the compliance to requirements” and “the quantity of planning facilitators” (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). Conclusion: According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved. PMID:25716385

75 FR 61369 - Revisions to the California State Implementation Plan; Sacramento Metropolitan Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-05

... the California State Implementation Plan; Sacramento Metropolitan Air Quality Management District... approve a revision to the Sacramento Metropolitan Air Quality Management District's portion of the... Metropolitan Air Quality Management District (SMAQMD) adopted the ``Ozone State Implementation Plan Revision...

76 FR 48006 - Limited Federal Implementation Plan; Prevention of Significant Deterioration; California; North...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... Implementation Plan; Prevention of Significant Deterioration; California; North Coast Unified Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is finalizing a limited Federal Implementation Plan (FIP) for the North Coast Unified Air Quality Management...

76 FR 34630 - Approval and Promulgation of Implementation Plans; New Hampshire: Prevention of Significant...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... Promulgation of Implementation Plans; New Hampshire: Prevention of Significant Deterioration; Greenhouse Gas... greenhouse gas (GHG) emissions. This rule clarifies the applicable thresholds in the New Hampshire SIP... Significant Deterioration Provisions Concerning Greenhouse Gas Emitting-Sources in State Implementation Plans...

75 FR 2090 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Volatile Organic Compound...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-14

... Promulgation of Air Quality Implementation Plans; Indiana; Volatile Organic Compound Automobile Refinishing... automobile refinishing rule for approval into its State Implementation Plan (SIP). These rule revisions extend the applicability of Indiana's approved volatile organic compound (VOC) automobile refinishing...

Advance care planning in a multi-cultural family-centric community: A qualitative study of healthcare professionals', patients' and caregivers' perspectives.

PubMed

Menon, Sumytra; Kars, Marijke; Malhotra, Chetna; Campbell, Alastair V; van Delden, J J M

2018-05-15

Advance care planning has been shown to improve end-of-life care but it was developed in the USA and most research has been conducted in western communities. We aimed to study the attitudes and perceptions of patients with life-limiting illnesses, informal caregivers, doctors, nurses and medical social workers regarding advance care planning in a multi-cultural family-centric community. We conducted an explorative qualitative study, using focus groups and individual in-depth interviews. We used purposive sampling techniques to recruit 61 adults (15 doctors, 13 nurses, 5 medical social workers, 15 patients and 13 caregivers) from multiple healthcare settings across the country. The participants are genuinely anxious about the implementation of advance care planning. They had positive and negative expectations of advance care planning. Many were confused about the legal framework for healthcare decision-making and expected advance care planning to be of limited value because family members, rather than the patient, were usually the key decision-makers. A nuanced approach to advance care planning which considers the family network is required in multi-cultural family centric communities. Policies should be reconciled to create a more consistent message that respects patients, the family, and is legally coherent. Further research could focus on adaptations of advance care planning to promote its acceptance in such communities. Copyright © 2018. Published by Elsevier Inc.

Addressing the evidence to practice gap for complex interventions in primary care: a systematic review of reviews protocol.

PubMed

Lau, Rosa; Stevenson, Fiona; Ong, Bie Nio; Dziedzic, Krysia; Eldridge, Sandra; Everitt, Hazel; Kennedy, Anne; Kontopantelis, Evangelos; Little, Paul; Qureshi, Nadeem; Rogers, Anne; Treweek, Shaun; Peacock, Richard; Murray, Elizabeth

2014-06-23

Getting the results of research implemented into routine healthcare is often a challenge. The disconnect between the development and implementation of evidence into practice is called the 'second translational gap' and is particularly apparent in primary care. To address this gap, we plan to identify, summarise and synthesise currently available evidence by undertaking a systematic review of reviews to: (1) explore barriers and facilitators of implementation of research evidence or complex interventions, and (2) assess the effectiveness of strategies in facilitating implementation of complex interventions in primary care. This is a protocol for a systematic review of reviews. We will search MEDLINE, EMBASE, the Cochrane Library, CINAHL and PsycINFO up until December 2013. We will check reference lists of included studies for further studies. Two authors will independently screen the titles and abstracts identified from the search; any discrepancies will be resolved by discussion and consensus. Full-text papers will be obtained and relevant reviews will be selected against inclusion criteria. Eligible reviews have to be based on predominantly primary care in developed countries and examine either factors to implementation or, the effectiveness of strategies to optimise implementation. Data from eligible reviews will be extracted using standardised data abstraction forms. For barriers and facilitators, data will be synthesised using an interpretative meta-synthesis approach. For implementation strategies, findings will be summarised and described narratively and synthesised using a framework approach. All findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Ethical approval is not required. The review findings will inform the work of the design and implementation of future studies and will be of interest to a wide audience including health professionals, researchers, health service or commissioning managers and policymakers. Protocol registration number (PROSPERO CRD42014009410). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Climate Action Planning Process | Climate Neutral Research Campuses | NREL

Science.gov Websites

Action Planning Process Climate Action Planning Process For research campuses, NREL has developed a five-step process to develop and implement climate action plans: Determine baseline energy consumption Analyze technology options Prepare a plan and set priorities Implement the climate action plan Measure and

An external dosimetry audit programme to credential static and rotational IMRT delivery for clinical trials quality assurance.

PubMed

Eaton, David J; Tyler, Justine; Backshall, Alex; Bernstein, David; Carver, Antony; Gasnier, Anne; Henderson, Julia; Lee, Jonathan; Patel, Rushil; Tsang, Yatman; Yang, Huiqi; Zotova, Rada; Wells, Emma

2017-03-01

External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems. Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array. A total of 54 measurement sessions were performed between May 2014 and June 2016 at 28 UK institutions, reflecting the different combinations of planning and delivery systems used at each institution. Average ratio of measured output between auditor and host was 1.002±0.006. Average point dose agreement for clinical plans was -0.3±1.8%. Average (and 95% lower confidence intervals) of gamma pass rates at 2%/2mm, 3%/2mm and 3%/3mm respectively were: 92% (80%), 96% (90%) and 98% (94%). Moderately significant differences were seen between fixed gantry angle and rotational IMRT, and between combination of planning systems and linac manufacturer, but not between anatomical treatment site or beam energy. An external audit programme has been implemented for universal and efficient credentialing of IMRT treatments in clinical trials. Good agreement was found between measured and expected doses, with few outliers, leading to a simple table of optimal and mandatory tolerances for approval of dosimetry audit results. Feedback was given to some centres leading to improved clinical practice. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Feasibility and efficacy of menu planning combined with individual counselling to improve health outcomes and dietary adherence in people with type 2 diabetes: a pilot study.

PubMed

Soria-Contreras, Diana C; Bell, Rhonda C; McCargar, Linda J; Chan, Catherine B

2014-10-01

The purpose of this study was to test the feasibility and efficacy of implementing a 4-week menu plan combined with individual counselling among people with type 2 diabetes. A 12-week pilot study with a pretest and post-test design was conducted among 15 participants with type 2 diabetes. The menu plan incorporated the overall recommendations of the Canadian Diabetes Association nutrition therapy guidelines and considered factors such as the accessibility, availability and acceptability of foods. Change in glycated hemoglobin (A1C) was the primary outcome, and secondary outcomes were changes in serum lipid, anthropometric and dietary measures. Mean (±SD) age of the participants was 59.3±9.9 years, and duration of diabetes was 8.1±8.3 years. After the program, A1C decreased by 1.0%±0.86% (p<0.05). There were significant reductions (p<0.05) in weight, body mass index, waist circumference and fat mass and increased high-density lipoprotein cholesterol. No significant changes were observed in dietary measures except for perceived dietary adherence score, which increased significantly (p<0.05). Participants reported using the menu plan an average of 5.0±1.9 days a week and attended, on average, 4 of 6 counselling sessions. Menu planning and individual counselling were demonstrated to be feasible and effective for diabetes management, and they represent a simple and practical approach to implement the nutritional recommendations for diabetes in Canada. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Changes in muscle activation following balance and technique training and a season of Australian football.

PubMed

Donnelly, C J; Elliott, B C; Doyle, T L A; Finch, C F; Dempsey, A R; Lloyd, D G

2015-05-01

Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Randomized Control Trial. Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n=12; 'sham' training, n=16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p=0.023) and semimembranosus (p=0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p=0.022) during unplanned sidestepping when compared with pre-planned sidestepping. When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Some Methods for Evaluating Program Implementation.

ERIC Educational Resources Information Center

Hardy, Roy A.

An approach to evaluating program implementation is described. This approach includes the development of a project description which includes a structure matrix, sampling from the structure matrix, and preparing an implementation evaluation plan. The implementation evaluation plan should include: (1) verification of implementation of planned…

Interval Management: Development and Implementation of an Airborne Spacing Concept

NASA Technical Reports Server (NTRS)

Barmore, Bryan E.; Penhallegon, William J.; Weitz, Lesley A.; Bone, Randall S.; Levitt, Ian; Flores Kriegsfeld, Julia A.; Arbuckle, Doug; Johnson, William C.

2016-01-01

Interval Management is a suite of ADS-B-enabled applications that allows the air traffic controller to instruct a flight crew to achieve and maintain a desired spacing relative to another aircraft. The flight crew, assisted by automation, manages the speed of their aircraft to deliver more precise inter-aircraft spacing than is otherwise possible, which increases traffic throughput at the same or higher levels of safety. Interval Management has evolved from a long history of research and is now seen as a core NextGen capability. With avionics standards recently published, completion of an Investment Analysis Readiness Decision by the FAA, and multiple flight tests planned, Interval Management will soon be part of everyday use in the National Airspace System. Second generation, Advanced Interval Management capabilities are being planned to provide a wider range of operations and improved performance and benefits. This paper briefly reviews the evolution of Interval Management and describes current development and deployment plans. It also reviews concepts under development as the next generation of applications.

ABA Southern Region Burn disaster plan: the process of creating and experience with the ABA southern region burn disaster plan.

PubMed

Kearns, Randy D; Cairns, Bruce A; Hickerson, William L; Holmes, James H

2014-01-01

The Southern Region of the American Burn Association began to craft a regional plan to address a surge of burn-injured patients after a mass casualty event in 2004. Published in 2006, this plan has been tested through modeling, exercise, and actual events. This article focuses on the process of how the plan was created, how it was tested, and how it interfaces with other ongoing efforts on preparedness. One key to success regarding how people respond to a disaster can be traced to preexisting relationships and collaborations. These activities would include training or working together and building trust long before the crisis. Knowing who you can call and rely on when you need help, within the context of your plan, can be pivotal in successfully managing a disaster. This article describes how a coalition of burn center leaders came together. Their ongoing personal association has facilitated the development of planning activities and has kept the process dynamic. This article also includes several of the building blocks for developing a plan from creation to composition, implementation, and testing. The plan discussed here is an example of linking leadership, relationships, process, and documentation together. On the basis of these experiences, the authors believe these elements are present in other regions. The intent of this work is to share an experience and to offer it as a guide to aid others in their regional burn disaster planning efforts.

78 FR 16825 - Approval of Air Quality Implementation Plans; Navajo Nation; Regional Haze Requirements for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

... Quality Implementation Plans; Navajo Nation; Regional Haze Requirements for Navajo Generating Station... source-specific federal implementation plan (FIP) requiring the Navajo Generating Station (NGS), located... . SUPPLEMENTARY INFORMATION: Throughout this document, ``we'', ``us'', and ``our'' refer to EPA. Table of Contents...

33 CFR 385.30 - Master Implementation Sequencing Plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Master Implementation Sequencing... Incorporating New Information Into the Plan § 385.30 Master Implementation Sequencing Plan. (a) Not later than... of Environmental Protection, and other Federal, State, and local agencies, develop a Master...

33 CFR 385.30 - Master Implementation Sequencing Plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Master Implementation Sequencing... Incorporating New Information Into the Plan § 385.30 Master Implementation Sequencing Plan. (a) Not later than... of Environmental Protection, and other Federal, State, and local agencies, develop a Master...

33 CFR 385.30 - Master Implementation Sequencing Plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Master Implementation Sequencing... Incorporating New Information Into the Plan § 385.30 Master Implementation Sequencing Plan. (a) Not later than... of Environmental Protection, and other Federal, State, and local agencies, develop a Master...

78 FR 52485 - Revisions to the Arizona State Implementation Plan, Maricopa County Area

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

...] Revisions to the Arizona State Implementation Plan, Maricopa County Area AGENCY: Environmental Protection... County Area portion of the Arizona State Implementation Plan (SIP). These revisions concern particulate matter (PM) emissions from fugitive dust sources. We are approving local statutes that regulate these...

78 FR 63383 - Approval and Promulgation of Air Quality Implementation Plans; Rhode Island: Prevention of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-24

...] Approval and Promulgation of Air Quality Implementation Plans; Rhode Island: Prevention of Significant... revisions to the Rhode Island State Implementation Plan (SIP) primarily relating to regulation of Greenhouse Gases (GHGs) under Rhode Island's Prevention of Significant Deterioration (PSD) preconstruction...

76 FR 4835 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Volatile Organic Compound...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-27

... Promulgation of Air Quality Implementation Plans; Ohio; Volatile Organic Compound Reinforced Plastics...) emissions from reinforced plastic composites production operations to Ohio's State Implementation plan (SIP). This rule applies to any facility that has reinforced plastic composites production operations. This...

75 FR 24404 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Volatile Organic Compound...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... Promulgation of Air Quality Implementation Plans; Indiana; Volatile Organic Compound Automobile Refinishing... approving into the Indiana State Implementation Plan (SIP) amendments to Indiana's automobile refinishing... (VOC) automobile refinishing rules to all persons in Indiana who sell or manufacture automobile...

77 FR 24160 - Revisions to the Hawaii State Implementation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... the Hawaii State Implementation Plan AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Hawaii State Implementation Plan (SIP... Hawaii SIP in 1983. DATES: Any comments on this proposal must arrive by May 23, 2012. ADDRESSES: Submit...

76 FR 5203 - Draft Environmental Impact Statement, Stehekin River Corridor Implementation Plan, North Cascades...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... Statement, Stehekin River Corridor Implementation Plan, North Cascades National Park Service Complex; Chelan... public comment period. SUMMARY: The National Park Service, in cooperation with the Federal Highway Administration, has prepared a combined Stehekin River Corridor Implementation Plan, Lake Chelan National...

75 FR 34669 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Transportation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... Promulgation of Air Quality Implementation Plans; Maryland; Transportation Conformity Regulations AGENCY... Implementation Plan (SIP) revision submitted by Maryland for Transportation Conformity Regulations. In the Final Rules section of this Federal Register, EPA is approving the State's SIP submittal as a direct final...

76 FR 59344 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Transportation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-26

... Promulgation of Air Quality Implementation Plans; Maryland; Transportation Conformity Regulations AGENCY... Implementation Plan (SIP) revision submitted by Maryland to establish transportation conformity regulations. In the Final Rules section of this Federal Register, EPA is approving the State's SIP submittal as a...

40 CFR 93.120 - Consequences of control strategy implementation plan failures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Consequences of control strategy implementation plan failures. 93.120 Section 93.120 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Consequences of control strategy implementation plan failures. (a) Disapprovals. (1) If EPA disapproves any...

76 FR 53369 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Adhesives and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... Promulgation of Air Quality Implementation Plans; Pennsylvania; Adhesives and Sealants Rule AGENCY... Implementation Plan (SIP) revision submitted by the Commonwealth of Pennsylvania. The SIP revision pertains to... volatile organic compounds (VOC) from the manufacture, sale, use, or application of adhesives, sealants...

An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals

PubMed Central

Sadeghifar, Jamil; Tofighi, Shahram; Roshani, Mohamad; Toulideh, Zahra; Mohsenpour, Seyedramezan; Jafari, Mehdi

2017-01-01

Objectives: To assess the implementation and evaluation phases of strategic plans in selected hospitals. Methods: We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Results: Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital’s priorities was the most important advantage of a strategic plan. Conclusion: There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning. PMID:29085637

40 CFR 49.148-49.150 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions Federal Implementation Plan for Oil and Natural Gas Production Facilities, Fort Berthold Indian...

40 CFR 49.148-49.150 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT General Federal Implementation Plan Provisions Federal Implementation Plan for Oil and Natural Gas Production Facilities, Fort Berthold Indian...

Computer-supported implant planning and guided surgery: a narrative review.

PubMed

Vercruyssen, Marjolein; Laleman, Isabelle; Jacobs, Reinhilde; Quirynen, Marc

2015-09-01

To give an overview of the workflow from examination to planning and execution, including possible errors and pitfalls, in order to justify the indications for guided surgery. An electronic literature search of the PubMed database was performed with the intention of collecting relevant information on computer-supported implant planning and guided surgery. Currently, different computer-supported systems are available to optimize and facilitate implant surgery. The transfer of the implant planning (in a software program) to the operative field remains however the most difficult part. Guided implant surgery clearly reduces the inaccuracy, defined as the deviation between the planned and the final position of the implant in the mouth. It might be recommended for the following clinical indications: need for minimal invasive surgery, optimization of implant planning and positioning (i.e. aesthetic cases), and immediate restoration. The digital technology rapidly evolves and new developments have resulted in further improvement of the accuracy. Future developments include the reduction of the number of steps needed from the preoperative examination of the patient to the actual execution of the guided surgery. The latter will become easier with the implementation of optical scans and 3D-printing. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A whole school approach: collaborative development of school health policies, processes, and practices.

PubMed

Hunt, Pete; Barrios, Lisa; Telljohann, Susan K; Mazyck, Donna

2015-11-01

The Whole School, Whole Community, Whole Child (WSCC) model shows the interrelationship between health and learning and the potential for improving educational outcomes by improving health outcomes. However, current descriptions do not explain how to implement the model. The existing literature, including scientific articles, programmatic guidance, and publications by national agencies and organizations, was reviewed and synthesized to describe an overview of interrelatedness of learning and health and the 10 components of the WSCC model. The literature suggests potential benefits of applying the WSCC model at the district and school level. But, the model lacks specific guidance as to how this might be made actionable. A collaborative approach to health and learning is suggested, including a 10-step systematic process to help schools and districts develop an action plan for improving health and education outcomes. Essential preliminary actions are suggested to minimize the impact of the challenges that commonly derail systematic planning processes and program implementation, such as lack of readiness, personnel shortages, insufficient resources, and competing priorities. All new models require testing and evidence to confirm their value. District and schools will need to test this model and put plans into action to show that significant, substantial, and sustainable health and academic outcomes can be achieved. © 2015 The Authors. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

40 CFR 52.2673 - Original identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Original identification of plan. 52... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2673 Original identification of plan. (a) This section identified the original “Implementation Plan for Compliance With the...

40 CFR 52.2823 - Original identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Original identification of plan. 52... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) American Samoa § 52.2823 Original identification of plan. (a) This section identified the original “Implementation Plan for Compliance With the...

A Model for Implementing a Career Education System.

ERIC Educational Resources Information Center

Ryan, T. Antoinette

The model for career education implementation defines three major functions which constitute the essential elements in the implementation process: planning, implementation, and evaluation. Emphasis is placed on the interrelatedness of implementation to both planning and evaluation of career education. The 11 subsystems involved in implementing…

Disadvantages of publishing biomedical research articles in English for non-native speakers of English

PubMed Central

Rezaeian, Mohsen

2015-01-01

OBJECTIVES: English has become the most frequently used language for scientific communication in the biomedical field. Therefore, scholars from all over the world try to publish their findings in English. This trend has a number of advantages, along with several disadvantages. METHODS: In the current article, the most important disadvantages of publishing biomedical research articles in English for non-native speakers of English are reviewed. RESULTS: The most important disadvantages of publishing biomedical research articles in English for non-native speakers may include: Overlooking, either unintentionally or even deliberately, the most important local health problems; failure to carry out groundbreaking research due to limited medical research budgets; violating generally accepted codes of publication ethics and committing research misconduct and publications in open-access scam/predatory journals rather than prestigious journals. CONCLUSIONS: The above mentioned disadvantages could eventually result in academic establishments becoming irresponsible or, even worse, corrupt. In order to avoid this, scientists, scientific organizations, academic institutions, and scientific associations all over the world should design and implement a wider range of collaborative and comprehensive plans. PMID:25968115

Disadvantages of publishing biomedical research articles in English for non-native speakers of English.

PubMed

Rezaeian, Mohsen

2015-01-01

English has become the most frequently used language for scientific communication in the biomedical field. Therefore, scholars from all over the world try to publish their findings in English. This trend has a number of advantages, along with several disadvantages. In the current article, the most important disadvantages of publishing biomedical research articles in English for non-native speakers of English are reviewed. The most important disadvantages of publishing biomedical research articles in English for non-native speakers may include: Overlooking, either unintentionally or even deliberately, the most important local health problems; failure to carry out groundbreaking research due to limited medical research budgets; violating generally accepted codes of publication ethics and committing research misconduct and publications in open-access scam/predatory journals rather than prestigious journals. The above mentioned disadvantages could eventually result in academic establishments becoming irresponsible or, even worse, corrupt. In order to avoid this, scientists, scientific organizations, academic institutions, and scientific associations all over the world should design and implement a wider range of collaborative and comprehensive plans.

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…

77 FR 24399 - Approval and Promulgation of Implementation Plans; Georgia; Atlanta; Ozone 2002 Base Year...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... Promulgation of Implementation Plans; Georgia; Atlanta; Ozone 2002 Base Year Emissions Inventory AGENCY... approve the ozone 2002 base year emissions inventory, portion of the state implementation plan (SIP... Atlanta, Georgia (hereafter referred to as ``the Atlanta Area'' or ``Area''), ozone attainment...

75 FR 39365 - Revisions to the California State Implementation Plan, Imperial County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... Implementation Plan, Imperial County Air Pollution Control District; Final Rule #0;#0;Federal Register / Vol. 75... Implementation Plan, Imperial County Air Pollution Control District AGENCY: Environmental Protection Agency (EPA... the Imperial County Air Pollution Control District (ICAPCD or the District) portion of the California...

75 FR 72963 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control of Volatile...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-29

... Promulgation of Air Quality Implementation Plans; Maryland; Control of Volatile Organic Compound Emissions From Industrial Solvent Cleaning Operations; Withdrawal of Direct Final Rule AGENCY: Environmental Protection... withdrawing the direct final rule to approve revisions to Maryland's State Implementation Plan (SIP). This SIP...

75 FR 25775 - Disapproval of State Implementation Plan Revisions, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2009-0573; FRL-9146-5] Disapproval of State Implementation Plan Revisions, South Coast Air Quality Management District AGENCY: Environmental... South Coast Air Quality Management District (SCAQMD) portion of the California State Implementation Plan...

76 FR 55621 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-08

... California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY: Environmental...-Solano Air Quality Management District portion of the California State Implementation Plan (SIP). This... the following local rule: Yolo-Solano Air Quality Management District Rule 2.41, Expandable...

76 FR 47094 - Revisions to the California State Implementation Plan; South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... the California State Implementation Plan; South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan... following local rule: South Coast Air Quality Management District Rule 1175, Control of Emissions from the...

77 FR 52277 - Approval of Air Quality Implementation Plans; California; South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... Quality Implementation Plans; California; South Coast Air Quality Management District; Prevention of... rule. SUMMARY: EPA is proposing approval of a permitting rule submitted for the South Coast Air Quality Management District (District) portion of the California State Implementation Plan (SIP). The State is...

76 FR 72142 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-22

... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan... Office of Management and Budget under Executive Order 12866 (58 FR 51735, October 4, 1993); Does not...

75 FR 43114 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Revisions to Emissions...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... Promulgation of Air Quality Implementation Plans; Texas; Revisions to Emissions Inventory Reporting... Consistent With the Cross Media Electronic Reporting Rule AGENCY: Environmental Protection Agency (EPA... revisions to the Texas State Implementation Plan (SIP) submitted by the Governor of Texas and by the Texas...

76 FR 4597 - Approval and Promulgation of Air Quality Implementation Plans; Kentucky; Disapproval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... intention to complete a rule to address interstate pollution transport in the eastern half of the... and Promulgation of Air Quality Implementation Plans; Kentucky; Disapproval of Interstate Transport... Kentucky's State implementation plan (SIP) meets the interstate transport requirements with regard to the...

78 FR 22785 - Approval and Promulgation of Air Quality Implementation Plans; Delaware, State Board Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-17

... Promulgation of Air Quality Implementation Plans; Delaware, State Board Requirements AGENCY: Environmental... revision to the Delaware State Implementation Plan (SIP) submitted by the Delaware Department of Natural Resources and Environmental Control (DNREC) on January 11, 2013. The SIP revision addresses requirements of...

77 FR 36442 - Approval and Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations AGENCY: Environmental Protection... Significant Deterioration (PSD) construction permit program of State of Michigan's State Implementation Plan (SIP) to meet the Clean Air Act (CAA) requirements for PSD in Class I Areas attaining the National...

75 FR 69909 - Approval and Promulgation of Implementation Plans; Texas; Emissions Banking and Trading of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

... Promulgation of Implementation Plans; Texas; Emissions Banking and Trading of Allowances Program AGENCY... four revisions to the Texas State Implementation Plan (SIP) that create and amend the Emissions Banking... reached via electronic mail at [email protected] . SUPPLEMENTARY INFORMATION: In the final rules section...

76 FR 508 - Approval and Promulgation of Implementation Plans; Idaho

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... Promulgation of Implementation Plans; Idaho AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the Idaho State Implementation Plan (SIP) that were submitted to EPA by the State of Idaho on April 16, 2007. This SIP submittal includes new and...

77 FR 18990 - Approval and Promulgation of Implementation Plans; New Mexico; Construction Permit Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-29

... reviewing and acting on specific air quality construction permit applications received by the New Mexico... Promulgation of Implementation Plans; New Mexico; Construction Permit Fees AGENCY: Environmental Protection... replace existing rules, and revisions to the applicable State Implementation Plan (SIP) for New Mexico...

75 FR 20942 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Transportation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... Promulgation of Air Quality Implementation Plans; New Mexico; Transportation Conformity Requirement for... proposing to approve a revision to the New Mexico State Implementation Plan (SIP) at New Mexico Administrative Code 20.11.3, concerning transportation conformity rules for Bernalillo County, New Mexico. The...

75 FR 59180 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control Technique...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... Promulgation of Air Quality Implementation Plans; Maryland; Control Technique Guidelines for Paper, Film, and... Technique Guidelines (CTG) for paper, film, and foil coatings. These amendments will reduce volatile organic... Promulgation of Air Quality Implementation Plans; Maryland; Control Technique Guidelines for Paper, Film, and...

77 FR 66945 - Approval and Promulgation of Air Quality Implementation Plans; New Hampshire; Reasonably...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

... and Promulgation of Air Quality Implementation Plans; New Hampshire; Reasonably Available Control... Implementation Plan (SIP) revision submitted by the State of New Hampshire. The revision establishes Reasonably... intended effect of this action is to approve these requirements into the New Hampshire SIP. This action is...

12 CFR 1291.3 - AHP Implementation Plan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false AHP Implementation Plan. 1291.3 Section 1291.3 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS... AHP Implementation Plan without first consulting its Advisory Council. The Bank's board of directors...

40 CFR 49.9862 - Approval status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony of Oregon § 49.9862 Approval status. There are currently no EPA-approved Tribal rules or measures in the implementation plan for the Reservation of the Burns...

76 FR 68103 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-03

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the San Joaquin Valley Unified Air Pollution Control District (SJVUAPCD) portion of the... State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District Rule 4692...

40 CFR 49.9986 - Contents of implementation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for emissions detrimental to public health or welfare. (i) Section 49.137Rule for air pollution episodes. (j) Section 49.138Rule for the registration of air pollution sources and the reporting of... ASSISTANCE TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for...

40 CFR 49.9956 - Contents of implementation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... detrimental to public health or welfare. (k) Section 49.137Rule for air pollution episodes. (l) Section 49.138Rule for the registration of air pollution sources and the reporting of emissions. (m) Section 49... ASSISTANCE TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for...

40 CFR 49.9926 - Contents of implementation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... open burning. (h) Section 49.135Rule for emissions detrimental to public health or welfare. (i) Section 49.137Rule for air pollution episodes. (j) Section 49.138Rule for the registration of air pollution... ASSISTANCE TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for...

40 CFR 49.9896 - Contents of implementation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... open burning. (h) Section 49.135Rule for emissions detrimental to public health or welfare. (i) Section 49.137Rule for air pollution episodes. (j) Section 49.138Rule for the registration of air pollution... ASSISTANCE TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for...

78 FR 63878 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Revised Ambient Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

...] Approval and Promulgation of Air Quality Implementation Plans; Virginia; Revised Ambient Air Quality... State Implementation Plan (SIP). The revisions add ambient air quality standards and associated... Ambient Air Quality Standards (NAAQS) for PM 2.5 . EPA is approving these revisions in accordance with the...

78 FR 30829 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... the Illinois State Implementation Plan (SIP) to reflect current national ambient air quality standards...) 692-2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U...

77 FR 73320 - Approval of Air Quality Implementation Plans; California; South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-10

... Quality Implementation Plans; California; South Coast Air Quality Management District; Prevention of... Implementation Plan (SIP) revision for the South Coast Air Quality Management District (SCAQMD or District... in a August 15, 2012 letter from the South Coast Air Quality Management District regarding specific...

75 FR 19886 - Approval and Promulgation of Air Quality Implementation Plans; Wyoming; Revisions to the Wyoming...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... Promulgation of Air Quality Implementation Plans; Wyoming; Revisions to the Wyoming Air Quality Standards and.... Wyoming has revised its Air Quality Standards and Regulations, specifically Chapter 1, Section 5... Wyoming's State Implementation Plan (SIP). These revisions amend Wyoming's Air Quality Standards and...

78 FR 50369 - Approval and Promulgation of Air Quality Implementation Plans; Michigan

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

...] Approval and Promulgation of Air Quality Implementation Plans; Michigan AGENCY: Environmental Protection... the State of Michigan's Clean Air Act State Implementation Plan (SIP) that Michigan had submitted on March 24, 2009. Michigan's submittal included revisions to Part 1, Definitions; Part 2, Air Use Approval...

78 FR 23524 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Particulate Matter...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

... Promulgation of Air Quality Implementation Plans; Indiana; Particulate Matter Ambient Air Quality Standards... revise the Indiana State Implementation Plan (SIP) for particulate matter under the Clean Air Act. This submission contains the 24-hour fine particle National Ambient Air Quality Standards (NAAQS) promulgated by...

Managers' use of nursing workforce planning and deployment technologies: protocol for a realist synthesis of implementation and impact.

PubMed

Burton, Christopher; Rycroft-Malone, Jo; Williams, Lynne; Davies, Siân; McBride, Anne; Hall, Beth; Rowlands, Anne-M; Jones, Adrian

2016-08-26

Nursing staffing levels in hospitals appear to be associated with improved patient outcomes. National guidance indicates that the triangulation of information from workforce planning and deployment technologies (WPTs; eg, the Safer Nursing Care Tool) and 'local knowledge' is important for managers to achieve appropriate staffing levels for better patient outcomes. Although WPTs provide managers with predictive information about future staffing requirements, ensuring patient safety and quality care also requires the consideration of information from other sources in real time. Yet little attention has been given to how to support managers to implement WPTs in practice. Given this lack of understanding, this evidence synthesis is designed to address the research question: managers' use of WPTs and their impacts on nurse staffing and patient care: what works, for whom, how and in what circumstances? To explain how WPTs may work and in what contexts, we will conduct a realist evidence synthesis through sourcing relevant evidence, and consulting with stakeholders about the impacts of WPTs on health and relevant public service fields. The review will be in 4 phases over 18 months. Phase 1: we will construct an initial theoretical framework that provides plausible explanations of what works about WPTs. Phase 2: evidence retrieval, review and synthesis guided by the theoretical framework; phase 3: testing and refining of programme theories, to determine their relevance; phase 4: formulating actionable recommendations about how WPTs should be implemented in clinical practice. Ethical approval has been gained from the study's institutional sponsors. Ethical review from the National Health Service (NHS) is not required; however research and development permissions will be obtained. Findings will be disseminated through stakeholder engagement and knowledge mobilisation activities. The synthesis will develop an explanatory programme theory of the implementation and impact of nursing WPTs, and practical guidance for nurse managers. CRD42016038132. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribing.

PubMed

Grant, Aileen; Dreischulte, Tobias; Guthrie, Bruce

2017-03-10

To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Ten (30%) primary care practices participating in the trial from Scotland, UK. Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. NCT01425502. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

40 CFR 52.622 - Original identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Original identification of plan. 52.622... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Hawaii § 52.622 Original identification of plan. (a) This section identified the original “State of Hawaii Air Pollution Control Implementation Plan...

Overcoming the obstacles of implementing infection prevention and control guidelines.

PubMed

Birgand, G; Johansson, A; Szilagyi, E; Lucet, J-C

2015-12-01

Reasons for a successful or unsuccessful implementation of infection prevention and control (IPC) guidelines are often multiple and interconnected. This article reviews key elements from the national to the individual level that contribute to the success of the implementation of IPC measures and gives perspectives for improvement. Governance approaches, modes of communication and formats of guidelines are discussed with a view to improve collaboration and transparency among actors. The culture of IPC influences practices and varies according to countries, specialties and healthcare providers. We describe important contextual aspects, such as relationships between actors and resources and behavioural features including professional background or experience. Behaviour change techniques providing goal-setting, feedback and action planning have proved effective in mobilizing participants and may be key to trigger social movements of implementation. The leadership of international societies in coordinating actions at international, national and institutional levels using multidisciplinary approaches and fostering collaboration among clinical microbiology, infectious diseases and IPC will be essential for success. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

"The largest Lean transformation in the world": the implementation and evaluation of lean in Saskatchewan healthcare.

PubMed

Kinsman, Leigh; Rotter, Thomas; Stevenson, Katherine; Bath, Brenna; Goodridge, Donna; Harrison, Liz; Dobson, Roy; Sari, Nazmi; Jeffery, Cathy; Bourassa, Carrie; Westhorp, Gill

2014-01-01

The Saskatchewan Ministry of Health has committed to a multi-million dollar investment toward the implementation of Lean methodology across the province's healthcare system. Originating as a production line discipline (the Toyota Production System), Lean has evolved to encompass process improvements including inventory management, waste reduction and quality improvement techniques. With an initial focus on leadership, strategic alignment, training and the creation of a supportive infrastructure (Lean promotion offices), the goal in Saskatchewan is a whole health system transformation that produces "better health, better value, better care, and better teams." Given the scope and scale of the initiative and the commitment of resources, it is vital that a comprehensive, longitudinal evaluation plan be implemented to support ongoing decision-making and program design. The nature of the initiative also offers a unique opportunity to contribute to health quality improvement science by advancing our understanding of the implementation and evaluation of complex, large-scale healthcare interventions. The purpose of this article is to summarize the background to Lean in Saskatchewan and the proposed evaluation methods. Copyright © 2014 Longwoods Publishing.

Implementing Student Information Systems

ERIC Educational Resources Information Center

Sullivan, Laurie; Porter, Rebecca

2006-01-01

Implementing an enterprise resource planning system is a complex undertaking. Careful planning, management, communication, and staffing can make the difference between a successful and unsuccessful implementation. (Contains 3 tables.)

Competence Center for Earth & Environmental Data (KomFor)

NASA Astrophysics Data System (ADS)

Diepenbroek, M.; Bernonville, S.; Bertelmann, R.; Bittner, M.; Brase, J.; Grobe, H.; Hoeck, H.; Klump, J.; Lautenschlager, M.; Schindler, U.; Sens, I.; Peters, S.; Toussaint, F.; Ulbricht, D.; Ziedorn, F.

2012-04-01

The Competence Center is planned as link between Geoscientific facilities and an existing archive network for earth and environmental data in Germany. KomFor generally aims at improving the overall availability and quality of data in a sustainable way. Practically from the users view the project will create a unique instance which accompanies scientific facilities, projects, and groups in all questions of data management - from the planning phase via data production, QA/QC, registration and long term storage to publication of data; the latter also including science publishers. In addition KomFor will supply systems and interfaces for accessing data comprising a data portal, services which allow downloading data for analysis and visualization tools (added value services), components for cross-referencing data and science articles as well as a broker function into superior global networks. KomFor is based on ICSU World Data Centers and Services located in Germany, which are collaborating in a national cluster since 2003 - the WDC Climate (WDC-C, DKRZ), WDC for Remote Sensing (WDC-RSAT, DLR), the German Research Centre for Geosciences (GfZ), and the Data Publisher for Earth & Environmental Science (PANGAEA, AWI/Marum). The cluster is complemented by the German National Library of Science and Technology (TIB). The consortium is well embedded into the international environment (WDS, IPCC, ESA, NASA, CEOS, GMES, GEOSS, INSPIRE, ESFRI, WMO, IODP, ICDP, IOC etc.) and is engaged since years in the development of standards as well as organizational structures and infrastructures for research data. Amongst others the consortium has implemented a registry service for scientific data which meanwhile is supported by an international association of libraries and is used worldwide (DataCite). A milestone was also the implementation of a web service for dynamically cross-referencing science articles with related data, initially used by Elsevier and now increasingly used by further publishers.

Promoting health workers' ownership of infection prevention and control: using Normalization Process Theory as an interpretive framework.

PubMed

Gould, D J; Hale, R; Waters, E; Allen, D

2016-12-01

All health workers should take responsibility for infection prevention and control (IPC). Recent reduction in key reported healthcare-associated infections in the UK is impressive, but the determinants of success are unknown. It is imperative to understand how IPC strategies operate as new challenges arise and threats of antimicrobial resistance increase. The authors undertook a retrospective, independent evaluation of an action plan to enhance IPC and 'ownership' (individual accountability) for IPC introduced throughout a healthcare organization. Twenty purposively selected informants were interviewed. Data were analysed inductively. Normalization Process Theory (NPT) was applied to interpret the findings and explain how the action plan was operating. Six themes emerged through inductive analysis. Theme 1: 'Ability to make sense of ownership' provided evidence of the first element of NPT (coherence). Regardless of occupational group or seniority, informants understood the importance of IPC ownership and described what it entailed. They identified three prerequisites: 'Always being vigilant' (Theme 2), 'Importance of access to information' (Theme 3) and 'Being able to learn together in a no-blame culture' (Theme 4). Data relating to each theme provided evidence of the other elements of NPT that are required to embed change: planning implementation (cognitive participation), undertaking the work necessary to achieve change (collective action), and reflection on what else is needed to promote change as part of continuous quality improvement (reflexive monitoring). Informants identified barriers (e.g. workload) and facilitators (clear lines of communication and expectations for IPC). Eighteen months after implementing the action plan incorporating IPC ownership, there was evidence of continuous service improvement and significant reduction in infection rates. Applying a theory that identifies factors that promote/inhibit routine incorporation ('normalization') of IPC into everyday health care can help explain the success of IPC initiatives and inform implementation. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Implementing the United Kingdom Government's 10-Year Teenage Pregnancy Strategy for England (1999-2010): Applicable Lessons for Other Countries.

PubMed

Hadley, Alison; Chandra-Mouli, Venkatraman; Ingham, Roger

2016-07-01

Teenage pregnancy is an issue of inequality affecting the health, well-being, and life chances of young women, young men, and their children. Consequently, high levels of teenage pregnancy are of concern to an increasing number of developing and developed countries. The UK Labour Government's Teenage Pregnancy Strategy for England was one of the very few examples of a nationally led, locally implemented evidence-based strategy, resourced over a long duration, with an associated reduction of 51% in the under-18 conception rate. This article seeks to identify the lessons applicable to other countries. The article focuses on the prevention program. Drawing on the detailed documentation of the 10-year strategy, it analyzes the factors that helped and hindered implementation against the World Health Organization (WHO) ExpandNet Framework. The Framework strives to improve the planning and management of the process of scaling-up of successful pilot programs with a focus on sexual and reproductive health, making it particularly suited for an analysis of England's teenage pregnancy strategy. The development and implementation of the strategy matches the Framework's key attributes for successful planning and scaling up of sexual and reproductive health programs. It also matched the attributes identified by the Centre for Global Development for scaled up approaches to complex public health issues. Although the strategy was implemented in a high-income country, analysis against the WHO-ExpandNet Framework identifies many lessons which are transferable to low- and medium-income countries seeking to address high teenage pregnancy rates. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Implementing AORN recommended practices for a safe environment of care, part II.

PubMed

Kennedy, Lynne

2014-09-01

Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN "Recommended practices for a safe environment of care, part II" provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distractions. Whether the OR suite evolves through construction, reconstruction, or remodeling, a multidisciplinary team of construction experts and health care professionals should create a functional plan and communicate at every stage of the project to maintain a safe environment and achieve a well-designed outcome. Emergency preparedness, a facility-wide security plan, and minimization of noise and distractions in the OR also help enhance the safety of the perioperative environment. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Advancing drug availability-experiences from Africa.

PubMed

Powell, Richard A; Kaye, Richard Mugula; Ddungu, Henry; Mwangi-Powell, Faith

2010-07-01

International health and drug regulatory authorities acknowledge that analgesics (especially opioids) are insufficiently available for pain management in many countries. In Africa, reported morphine consumption is far below the global mean, with multiple factors hampering opioid supply. Since 2006, the African Palliative Care Association has hosted three regional drug availability workshops across the continent to address this issue. Using an interactive format, the workshops have identified country-specific barriers to opioid and other essential medication accessibility before supporting participants to develop action plans to address recognized impediments. Despite multiple challenges, a number of successes have arisen from the implementation of the plans. However, key issues remain, including the introduction of supportive policy environments, effective educational initiatives, and measures to address supply-chain obstacles impeding drug availability. Copyright 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

40 CFR 49.4169-49.5510 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT Implementation Plans for Tribes-Region VIII Federal Implementation Plan for Oil and Natural Gas Well Production Facilities; Fort Berthold Indian...

40 CFR 49.4169-49.5510 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... ASSISTANCE INDIAN COUNTRY: AIR QUALITY PLANNING AND MANAGEMENT Implementation Plans for Tribes-Region VIII Federal Implementation Plan for Oil and Natural Gas Well Production Facilities; Fort Berthold Indian...

Healthcare Managers' Experiences of Leading the Implementation of Video Conferencing in Discharge Planning Sessions: An Interview Study.

PubMed

Hofflander, Malin; Nilsson, Lina; Eriksén, Sara; Borg, Christel

2016-03-01

This article describes healthcare managers' experiences of leading the implementation of video conferencing in discharge planning sessions as a new tool in everyday practice. Data collection took place through individual interviews and the interviews were analyzed using qualitative content analysis with an inductive approach. The results indicate that managers identified two distinct leadership perspectives when they reflected on the implementation process. They described a desired way of leading the implementation and communicating about the upcoming change, understanding and securing support for decisions, as well as ensuring that sufficient time is available throughout the change process. They also, however, described how they perceived that the implementation process was actually taking place, highlighting the lack of planning and preparation as well as the need for support and to be supportive, and having the courage to adopt and lead the implementation. It is suggested that managers at all levels require more information and training in how to encourage staff to become involved in designing their everyday work and in the implementation process. Managers, too, need ongoing organizational support for good leadership throughout the implementation of video conferencing in discharge planning sessions, including planning, start-up, implementation, and evaluation.

International Society for Medical Publication Professionals (ISMPP) position statement: the role of the professional medical writer.

PubMed

Norris, Robert; Bowman, Aly; Fagan, Jean M; Gallagher, Eileen R; Geraci, Anna B; Gertel, Art; Hirsch, Laurence; Ross, Philip D; Stossel, Thomas P; Veitch, Keith; Woods, David

2007-08-01

The International Society for Medical Publication Professionals (ISMPP) is an independent, nonprofit professional association with members from the pharmaceutical, medical device, and biotechnology industries; publication planning and medical communications companies; academia; and medical journal staffs, including editors and publishers. ISMPP's mission is to support the educational needs of medical publication professionals by providing a forum to facilitate awareness and development of best practices in publication planning and implementation, and fostering consensus policies related to medical publishing. This position statement reflects our concern about the current climate of mistrust regarding the use of professional medical writers in the preparation of manuscripts. We acknowledge the skills and training of medical writing professionals and support their role in working with research teams to develop clear and concise manuscripts in a timely fashion. Further, we support complete and transparent disclosure of the role of the medical writer and the source of funding for the writing initiative in order to build awareness of, and trust in, the appropriate use of medical writing professionals. ISMPP endorses use of the contributorship model, which offers detailed information on the roles of all who participated in planning, conducting, developing, and publishing medical research. Further, we propose that this model be integrated into the standard operating procedures of the diverse organizations that comprise our membership because the responsibility for authorship disclosure is shared by sponsors, authors, study investigators, and medical writers. Finally, we commend the many organizations that have worked to increase recognition and understanding of the legitimate role of the medical writer, and are eager to work in concert with them to ensure the rigorous maintenance of all ethical standards for reporting the results of medical research.

Understanding risk evaluation and mitigation strategies in organ transplantation.

PubMed

Gabardi, Steven

2011-07-01

The United States Food and Drug Administration (FDA) Amendments Act of 2007 mandated that Risk Evaluation and Mitigation Strategies (REMS) be required of manufacturers. These REMS are strategies implemented to manage known or potential risks associated with drugs and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product, including once the product becomes available as generic. The elements of an individual REMS program consist of three levels: medication guide or patient package insert, communication plan, and elements to assure safe use (ETASU). A medication guide or patient package insert is used to help prevent serious adverse events, aid in patient decision making, and enhance drug adherence. Communication plans are used to educate health care providers and to encourage their compliance with REMS. The ETASU is a restrictive process that is implemented when it is deemed necessary to ensure that patients have safe access to products with known serious risks that would otherwise be unavailable. To review the components of REMS and specifically assess their impact on health care providers practicing within the organ transplantation arena, a literature search of the MEDLINE database (January 2007-December 2010) was performed, and published materials from the FDA and its Web site were also reviewed. In transplantation, REMS programs exist for both everolimus (medication guide and communication plan) and sirolimus (medication guide). The FDA has stated that all mycophenolic acid derivatives will be subject to a proposed REMS that has not yet been approved; however, both branded mycophenolic acid agents already have approved medication guides. The REMS are a permanent fixture in the development and marketing of pharmaceutical agents, and their further implementation in solid organ transplantation is inevitable. Transplantation providers should take a proactive role in patient education and implementation of REMS within the therapeutic area. It is imperative for health care providers to realize that the ultimate goals of REMS are to reduce the potential for serious risks and to make outcomes from the treatment of disease more predictable.

Communications, Immunization, and Polio Vaccines: Lessons From a Global Perspective on Generating Political Will, Informing Decision-Making and Planning, and Engaging Local Support.

PubMed

Menning, Lisa; Garg, Gaurav; Pokharel, Deepa; Thrush, Elizabeth; Farrell, Margaret; Kodio, Frederic Kunjbe; Veira, Chantal Laroche; Wanyoike, Sarah; Malik, Suleman; Patel, Manish; Rosenbauer, Oliver

2017-07-01

The requirements under objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018-to introduce at least 1 dose of inactivated poliomyelitis vaccine (IPV); withdraw oral poliomyelitis vaccine (OPV), starting with the type 2 component; and strengthen routine immunization programs-set an ambitious series of targets for countries. Effective implementation of IPV introduction and the switch from trivalent OPV (containing types 1, 2, and 3 poliovirus) to bivalent OPV (containing types 1 and 3 poliovirus) called for intense global communications and coordination on an unprecedented scale from 2014 to 2016, involving global public health technical agencies and donors, vaccine manufacturers, World Health Organization and United Nations Children's Fund regional offices, and national governments. At the outset, the new program requirements were perceived as challenging to communicate, difficult to understand, unrealistic in terms of timelines, and potentially infeasible for logistical implementation. In this context, a number of core areas of work for communications were established: (1) generating awareness and political commitment via global communications and advocacy; (2) informing national decision-making, planning, and implementation; and (3) in-country program communications and capacity building, to ensure acceptance of IPV and continued uptake of OPV. Central to the communications function in driving progress for objective 2 was its ability to generate a meaningful policy dialogue about polio vaccines and routine immunization at multiple levels. This included efforts to facilitate stakeholder engagement and ownership, strengthen coordination at all levels, and ensure an iterative process of feedback and learning. This article provides an overview of the global efforts and challenges in successfully implementing the communications activities to support objective 2. Lessons from the achievements by countries and partners will likely be drawn upon when all OPVs are completely withdrawn after polio eradication, but also may offer a useful model for other global health initiatives. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

ISS Payload Operations: The Need for and Benefit of Responsive Planning

NASA Technical Reports Server (NTRS)

Nahay, Ed; Boster, Mandee

2000-01-01

International Space Station (ISS) payload operations are controlled through implementation of a payload operations plan. This plan, which represents the defined approach to payload operations in general, can vary in terms of level of definition. The detailed plan provides the specific sequence and timing of each component of a payload's operations. Such an approach to planning was implemented in the Spacelab program. The responsive plan provides a flexible approach to payload operations through generalization. A responsive approach to planning was implemented in the NASA/Mir Phase 1 program, and was identified as a need during the Skylab program. The current approach to ISS payload operations planning and control tends toward detailed planning, rather than responsive planning. The use of detailed plans provides for the efficient use of limited resources onboard the ISS. It restricts flexibility in payload operations, which is inconsistent with the dynamic nature of the ISS science program, and it restricts crew desires for flexibility and autonomy. Also, detailed planning is manpower intensive. The development and implementation of a responsive plan provides for a more dynamic, more accommodating, and less manpower intensive approach to planning. The science program becomes more dynamic and responsive as the plan provides flexibility to accommodate real-time science accomplishments. Communications limitations and the crew desire for flexibility and autonomy in plan implementation are readily accommodated with responsive planning. Manpower efficiencies are accomplished through a reduction in requirements collection and coordination, plan development, and maintenance. Through examples and assessments, this paper identifies the need to transition from detailed to responsive plans for ISS payload operations. Examples depict specific characteristics of the plans. Assessments identify the following: the means by which responsive plans accommodate the dynamic nature of science programs and the crew desire for flexibility; the means by which responsive plans readily accommodate ISS communications constraints; manpower efficiencies to be achieved through use of responsive plans; and the implications of responsive planning relative to resource utilization efficiency.

Planning an integrated agriculture and health program and designing its evaluation: Experience from Western Kenya.

PubMed

Cole, Donald C; Levin, Carol; Loechl, Cornelia; Thiele, Graham; Grant, Frederick; Girard, Aimee Webb; Sindi, Kirimi; Low, Jan

2016-06-01

Multi-sectoral programs that involve stakeholders in agriculture, nutrition and health care are essential for responding to nutrition problems such as vitamin A deficiency among pregnant and lactating women and their infants in many poor areas of lower income countries. Yet planning such multi-sectoral programs and designing appropriate evaluations, to respond to different disciplinary cultures of evidence, remain a challenge. We describe the context, program development process, and evaluation design of the Mama SASHA project (Sweetpotato Action for Security and Health in Africa) which promoted production and consumption of a bio-fortified, orange-fleshed sweetpotato (OFSP). In planning the program we drew upon information from needs assessments, stakeholder consultations, and a first round of the implementation evaluation of a pilot project. The multi-disciplinary team worked with partner organizations to develop a program theory of change and an impact pathway which identified aspects of the program that would be monitored and established evaluation methods. Responding to the growing demand for greater rigour in impact evaluations, we carried out quasi-experimental allocation by health facility catchment area, repeat village surveys for assessment of change in intervention and control areas, and longitudinal tracking of individual mother-child pairs. Mid-course corrections in program implementation were informed by program monitoring, regular feedback from implementers and partners' meetings. To assess economic efficiency and provide evidence for scaling we collected data on resources used and project expenses. Managing the multi-sectoral program and the mixed methods evaluation involved bargaining and trade-offs that were deemed essential to respond to the array of stakeholders, program funders and disciplines involved. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

78 FR 9596 - Approval and Promulgation of Implementation Plans; New Jersey and New York Ozone Attainment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... Promulgation of Implementation Plans; New Jersey and New York Ozone Attainment Demonstrations AGENCY... approving the ozone attainment demonstration portion of comprehensive State Implementation Plan revisions submitted by New Jersey and New York to meet Clean Air Act requirements for attaining the 1997 8-hour ozone...

78 FR 5346 - Approval and Promulgation of Air Quality Implementation Plans; Massachusetts and New Hampshire...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

...-FRL-9754-7] Approval and Promulgation of Air Quality Implementation Plans; Massachusetts and New... (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve State Implementation Plan (SIP... repair network for an on-board diagnostic (OBD2) testing program for model year 1996 and newer vehicles...

78 FR 78263 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Update of the Motor...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

...] Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Update of the Motor Vehicle... Implementation Plan (SIP). The revisions consist of an update to the SIP-approved Motor Vehicle Emissions Budgets... operation, and special arrangements should be made for deliveries of boxed information. Instructions: Direct...

77 FR 23193 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0180; FRL-9652-3] Revisions to the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District portion of the California State Implementation Plan...

78 FR 7703 - Revisions to the California State Implementation Plan, South Coast Air Quality Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... the California State Implementation Plan, South Coast Air Quality Management District, Proposed Rule... approve a revision to the South Coast Air Quality Management District (SCAQMD) portion of the California... digesters. Rule 1127 was designed to implement the 2003 Air Quality Management Plan (AQMP) control measure...

77 FR 32483 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9670-9] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan...

75 FR 32353 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0276; FRL-9139-8] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan...

76 FR 54384 - California State Implementation Plan, South Coast Air Quality Management District; Withdrawal of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-01

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0537; FRL-9457-6] California State Implementation Plan, South Coast Air Quality Management District; Withdrawal of Direct Final Rule... Implementation Plan (SIP). This revision concerned South Coast Air Quality Management District (SCAQMD) Rule 1143...

77 FR 39180 - Withdrawal of Direct Final Rule Revising the California State Implementation Plan, South Coast...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9690-9] Withdrawal of Direct Final Rule Revising the California State Implementation Plan, South Coast Air Quality Management... State Implementation Plan (SIP). This revision concerned South Coast Air Quality Management District...

76 FR 42557 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... Promulgation of Air Quality Implementation Plans; Delaware; Regional Haze State Implementation Plan AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is approving the Delaware Regional Haze... visibility in mandatory Class I areas through a regional haze program. EPA is also approving this revision...

75 FR 81471 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota; Sulfur Dioxide SIP...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... Promulgation of Air Quality Implementation Plans; Minnesota; Sulfur Dioxide SIP Revision for Marathon Petroleum... October 6, 2009, Minnesota submitted a request for a sulfur dioxide State Implementation Plan revision for... installation of new boilers and a sulfur recovery unit and changes to three existing heaters. Overall, this...

40 CFR 52.63 - PM10 State Implementation Plan development in group II areas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... development in group II areas. 52.63 Section 52.63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.63 PM10 State Implementation Plan development in group II areas. On March 15, 1989, the State submitted a...

40 CFR 52.881 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... development in group II areas. 52.881 Section 52.881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kansas § 52.881 PM10 State implementation plan development in group II areas. The state has submitted a committal SIP for...

40 CFR 52.63 - PM10 State Implementation Plan development in group II areas.

Code of Federal Regulations, 2010 CFR

2010-07-01

... development in group II areas. 52.63 Section 52.63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.63 PM10 State Implementation Plan development in group II areas. On March 15, 1989, the State submitted a...

40 CFR 52.63 - PM10 State Implementation Plan development in group II areas.

Code of Federal Regulations, 2011 CFR

2011-07-01

... development in group II areas. 52.63 Section 52.63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.63 PM10 State Implementation Plan development in group II areas. On March 15, 1989, the State submitted a...

40 CFR 52.935 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2010 CFR

2010-07-01

... development in group II areas. 52.935 Section 52.935 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kentucky § 52.935 PM10 State implementation plan development in group II areas. On July 7, 1988, the State submitted a...

40 CFR 52.935 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... development in group II areas. 52.935 Section 52.935 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kentucky § 52.935 PM10 State implementation plan development in group II areas. On July 7, 1988, the State submitted a...

40 CFR 52.935 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... development in group II areas. 52.935 Section 52.935 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kentucky § 52.935 PM10 State implementation plan development in group II areas. On July 7, 1988, the State submitted a...

40 CFR 52.881 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2010 CFR

2010-07-01

... development in group II areas. 52.881 Section 52.881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kansas § 52.881 PM10 State implementation plan development in group II areas. The state has submitted a committal SIP for...

40 CFR 52.935 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2011 CFR

2011-07-01

... development in group II areas. 52.935 Section 52.935 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kentucky § 52.935 PM10 State implementation plan development in group II areas. On July 7, 1988, the State submitted a...

40 CFR 52.881 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2011 CFR

2011-07-01

... development in group II areas. 52.881 Section 52.881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kansas § 52.881 PM10 State implementation plan development in group II areas. The state has submitted a committal SIP for...

40 CFR 52.881 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... development in group II areas. 52.881 Section 52.881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kansas § 52.881 PM10 State implementation plan development in group II areas. The state has submitted a committal SIP for...

40 CFR 52.63 - PM10 State Implementation Plan development in group II areas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... development in group II areas. 52.63 Section 52.63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.63 PM10 State Implementation Plan development in group II areas. On March 15, 1989, the State submitted a...

40 CFR 52.63 - PM10 State Implementation Plan development in group II areas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... development in group II areas. 52.63 Section 52.63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Alabama § 52.63 PM10 State Implementation Plan development in group II areas. On March 15, 1989, the State submitted a...

40 CFR 52.881 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... development in group II areas. 52.881 Section 52.881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kansas § 52.881 PM10 State implementation plan development in group II areas. The state has submitted a committal SIP for...

40 CFR 52.935 - PM10 State implementation plan development in group II areas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... development in group II areas. 52.935 Section 52.935 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Kentucky § 52.935 PM10 State implementation plan development in group II areas. On July 7, 1988, the State submitted a...

75 FR 73026 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Clean Air Interstate Rule

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-29

... Promulgation of Air Quality Implementation Plans; Indiana; Clean Air Interstate Rule AGENCY: Environmental... State Implementation Plan (SIP) under the Clean Air Act (CAA). The State has submitted amendments to the Indiana Administrative Code (IAC), which supplement Indiana's Clean Air Interstate Rule (CAIR), for which...

75 FR 55978 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Revisions to the New Source...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... Implementation Plan (SIP); Prevention of Significant Deterioration (PSD) AGENCY: Environmental Protection Agency... Texas PSD State Implementation Plan (SIP). EPA is approving a SIP revision submitted February 1, 2006... Texas PSD SIP; it merely approves reorganization and renumbering of the Texas PSD SIP rules. Further...

78 FR 54813 - Approval and Promulgation of Air Quality Implementation Plans; Maine; Oxides of Nitrogen...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 52 [EPA-R01-OAR-2012-0895; FRL- 9900-85-Region1] Approval and Promulgation of Air Quality Implementation Plans; Maine; Oxides of Nitrogen Exemption and... proposed Approval and Promulgation of Air Quality Implementation Plans; Maine; Oxides of Nitrogen Exemption...

77 FR 50660 - Limited Approval and Disapproval of Air Quality Implementation Plans; Nevada; Clark County...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

... Approval and Disapproval of Air Quality Implementation Plans; Nevada; Clark County; Stationary Source... Clark County, Nevada. DATES: Any comments on this proposal must arrive by September 7, 2012. ADDRESSES... regulations submitted for approval into the Clark County portion of the Nevada State Implementation Plan (SIP...

75 FR 9373 - Approval and Promulgation of Implementation Plans; New York State Implementation Plan Revision

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... for State Implementation Plan (SIP) Submissions? In 1997, EPA revised the health-based national... that ozone causes adverse health effects at lower ozone concentrations and over longer periods of time... standard would be more protective of human health, especially with regard to children and adults who are...

75 FR 48894 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Revisions to Emissions...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

... Promulgation of Air Quality Implementation Plans; New Mexico; Revisions to Emissions Inventory Reporting.... SUMMARY: The EPA is proposing to approve revisions to the New Mexico State Implementation Plan (SIP... Quality Standards that EPA has established for criteria pollutants such as ozone, particulate matter, and...

Generic Fortran Containers (GFC)

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

Liakh, Dmitry

2016-09-01

The Fortran language does not provide a standard library that implements generic containers, like linked lists, trees, dictionaries, etc. The GFC software provides an implementation of generic Fortran containers natively written in Fortran 2003/2008 language. The following containers are either already implemented or planned: Stack (done), Linked list (done), Tree (done), Dictionary (done), Queue (planned), Priority queue (planned).

77 FR 24148 - Revision to the Hawaii State Implementation Plan, Minor New Source Review Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... Hawaii State Implementation Plan, Minor New Source Review Program AGENCY: Environmental Protection Agency... final action to approve revisions to the Hawaii State Implementation Plan (SIP). These revisions would update and replace the minor new source review rules that EPA approved into the Hawaii SIP in 1983. DATES...

76 FR 8330 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Revision to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-14

... Promulgation of Air Quality Implementation Plans; Virginia; Revision to the Definition of Volatile Organic... approve the State Implementation Plan (SIP) revision submitted by the Commonwealth of Virginia consisting... section of this Federal Register, EPA is approving Virginia's SIP submittal as a direct final rule without...

75 FR 8575 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Revisions to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-25

... Promulgation of Air Quality Implementation Plans; Virginia; Revisions to the Definition of Volatile Organic... proposes to approve the State Implementation Plan (SIP) revision submitted by the Commonwealth of Virginia... (VOC). In the Final Rules section of this Federal Register, EPA is approving Virginia's SIP submittal...

77 FR 58312 - Revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control District... revisions to the California State Implementation Plan, San Joaquin Valley Unified Air Pollution Control... section 307(b)(2)). List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...

75 FR 81555 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota; Sulfur Dioxide SIP...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2009-0808; FRL-9243-4] Approval and Promulgation of Air Quality Implementation Plans; Minnesota; Sulfur Dioxide SIP Revision for Marathon Petroleum... proposing to approve a sulfur dioxide State Implementation Plan revision request for Marathon Petroleum in...

40 CFR 49.9866 - Contents of implementation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... health or welfare. (i) Section 49.137Rule for air pollution episodes. (j) Section 49.138Rule for the registration of air pollution sources and the reporting of emissions. (k) Section 49.139Rule for non-Title V... ASSISTANCE TRIBAL CLEAN AIR ACT AUTHORITY Implementation Plans for Tribes-Region X Implementation Plan for...

76 FR 14602 - Approval and Promulgation of Air Quality Implementation Plans; Louisiana; Revisions To Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... Promulgation of Air Quality Implementation Plans; Louisiana; Revisions To Control Volatile Organic Compound...: Proposed rule. SUMMARY: EPA is proposing to approve State Implementation Plan (SIP) revisions for control... submitted to EPA on August 31, 2010. EPA is also proposing to approve a SIP revision for control of emission...

78 FR 28173 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Sulfur Dioxide and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

...-9811-5] Approval and Promulgation of Air Quality Implementation Plans; Indiana; Sulfur Dioxide and Nitrogen Dioxide Ambient Air Quality Standards AGENCY: Environmental Protection Agency (EPA). ACTION... implementation plan (SIP) for nitrogen dioxide (NO 2 ) and sulfur dioxide (SO 2 ) under the Clean Air Act. This...

75 FR 65594 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards AGENCY... the Ohio Administrative Code (OAC) relating to the consolidation of Ohio's Ambient Air Quality Standards (AAQS) into Ohio's State Implementation Plan (SIP) under the Clean Air Act. On April 8, 2009, and...

77 FR 12524 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Lead Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... Promulgation of Air Quality Implementation Plans; Indiana; Lead Ambient Air Quality Standards AGENCY... Indiana State Implementation Plan (SIP) for lead (Pb) under the Clean Air Act (CAA). This submittal incorporates the National Ambient Air Quality Standards (NAAQS) for Pb promulgated by EPA in 2008. DATES...

75 FR 10416 - Approval and Promulgation of Implementation Plans; Texas; Revisions to Chapter 116 Which Relate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... Promulgation of Implementation Plans; Texas; Revisions to Chapter 116 Which Relate to the Application Review... direct final action to approve revisions to the applicable State Implementation Plan (SIP) for the State... Texas Health and Safety Code, section 382.0566, concerning specific deadlines for review and issuance of...

Actor coalitions and implementation in strategic delta planning: Opening the Haringvliet sluices in the Netherlands

NASA Astrophysics Data System (ADS)

Vermoolen, Myrthe; Hermans, Leon

2016-04-01

The sustained development of urbanizing deltas is influenced by natural and societal processes. These processes are characterized by their long time span, in which conflicting interests of different stakeholders have to be reconciled. Reaching consent between actors is a challenge itself, but maintaining this consent throughout different stages of strategic planning - from advocacy and agenda setting to implementation - over these long periods of time is even more difficult. The implementation stage still includes many different actors involved, some of which are different than the ones who agreed before, due to both the long run of the strategic delta planning, and to a shift of tasks and responsibilities. Thus, implementation of strategic plans often features delays, deviations of agreed plans and unintended outcomes. A key question therefore is how coalition dynamics in (pre-)planning stages influence and are influenced by the coalition dynamics during implementation. The different stages in strategic planning are often studied from either a plan formulation or an implementation perspective, but the connection between the two proves an important bottleneck for strategic planning in deltas. For instance, many building with nature solutions are still in their pilot-phase, and their upscaling can profit from lessons concerning past implementation efforts. The proposed contribution will use the case of the management of the Dutch Haringvliet sluices and the decision ('Kierbesluit') in 2000 to put these sluices ajar, to study the link between the different strategic delta planning stages and the role of the formation and change of actor coalitions herein. With the completion of the Haringvliet dam with outlet sluices in 1970, the Haringvliet estuary of the rivers Rhine and Meuse was closed off from the sea, creating a fresh water lake. This was done to make the Dutch Southwest delta safe from flooding, and had positive effects for agricultural water supply and drinking water, but negative consequences for the ecological quality and biodiversity. In the 1980s environmental awareness increased. To restore natural processes, it was decided in 2000 to put the sluices 'ajar' as a first step towards the strategic long-term vision of tidal restoration and major rehabilitation of the Rhine-Meuse estuary. First planning was to have the Kierbesluit implemented in 2005. However, this has been put off again and again, and since the actual implementation started in 2013, planning is to have the infrastructures ready to start opening the sluices in 2018 - 13 years later. What was supposed to be the first step towards full estuarine recovery has become an end goal itself, with implementing actors strictly focusing on putting the sluices ajar and compensating for fresh water loss, dismissing building with nature possibilities behind the dam. The Advocacy Coalition Framework is used as a starting point for analysis, and will be altered and detailed with insights from implementation literature to identify lessons regarding the role and dynamics of actor coalitions from the planning to implementation stage of strategic delta planning.

Participatory approach in planning for low carbon and eco-village: A case of Felda Taib Andak

NASA Astrophysics Data System (ADS)

Ngah, I.; Zulkifli, A. S.

2014-02-01

Participatory approaches have becoming an important tool in planning of sustainable communities. Although participation is conceived as a malleable concept there are certain methods that planners can adopt to ensure a meaningful participation. This paper will provide some experiences and lessons on how participatory planning could be carried out with local people, the role of planners in the process of plan preparation, implementation and the outcome. This paper first explores some of the meanings of participation, the criteria of participation and the approaches of participation in planning for sustainable community. The second part is a description and discussion of how participatory approach in planning was applied in planning for low carbon and eco-village in Iskandar Malaysia based on a case study of planning of Felda Taib Andak scheme. The participatory approach involved a series of meetings, site visit and focus group discussions with representative of the Felda Village to come out with action plan and actual implementation. From focus group discussions a roadmap consisted of a vision and objectives and a dozen actions were formulated and adopted. In the process of implementation the main implementation & coordination committee was form in which the author (planner) is one of its members to look into fund raising & implementation strategies together with the local people. Several task forces or sub committees responsible to implement the dozen actions were also formed. The outcome was encouraging in which some of the actions such as planting of bamboo trees, reduction of pollution from oil palm factory and bicycling activities has been implemented and shown progress. The paper also highlights some of the issues and challenges in participatory planning.

From Classification to Causality: Advancing Understanding of Mechanisms of Change in Implementation Science.

PubMed

Lewis, Cara C; Klasnja, Predrag; Powell, Byron J; Lyon, Aaron R; Tuzzio, Leah; Jones, Salene; Walsh-Bailey, Callie; Weiner, Bryan

2018-01-01

The science of implementation has offered little toward understanding how different implementation strategies work. To improve outcomes of implementation efforts, the field needs precise, testable theories that describe the causal pathways through which implementation strategies function. In this perspective piece, we describe a four-step approach to developing causal pathway models for implementation strategies. First, it is important to ensure that implementation strategies are appropriately specified. Some strategies in published compilations are well defined but may not be specified in terms of its core component that can have a reliable and measureable impact. Second, linkages between strategies and mechanisms need to be generated. Existing compilations do not offer mechanisms by which strategies act, or the processes or events through which an implementation strategy operates to affect desired implementation outcomes. Third, it is critical to identify proximal and distal outcomes the strategy is theorized to impact, with the former being direct, measurable products of the strategy and the latter being one of eight implementation outcomes (1). Finally, articulating effect modifiers, like preconditions and moderators, allow for an understanding of where, when, and why strategies have an effect on outcomes of interest. We argue for greater precision in use of terms for factors implicated in implementation processes; development of guidelines for selecting research design and study plans that account for practical constructs and allow for the study of mechanisms; psychometrically strong and pragmatic measures of mechanisms; and more robust curation of evidence for knowledge transfer and use.

An introduction to implementation science for the non-specialist.

PubMed

Bauer, Mark S; Damschroder, Laura; Hagedorn, Hildi; Smith, Jeffrey; Kilbourne, Amy M

2015-09-16

The movement of evidence-based practices (EBPs) into routine clinical usage is not spontaneous, but requires focused efforts. The field of implementation science has developed to facilitate the spread of EBPs, including both psychosocial and medical interventions for mental and physical health concerns. The authors aim to introduce implementation science principles to non-specialist investigators, administrators, and policymakers seeking to become familiar with this emerging field. This introduction is based on published literature and the authors' experience as researchers in the field, as well as extensive service as implementation science grant reviewers. Implementation science is "the scientific study of methods to promote the systematic uptake of research findings and other EBPs into routine practice, and, hence, to improve the quality and effectiveness of health services." Implementation science is distinct from, but shares characteristics with, both quality improvement and dissemination methods. Implementation studies can be either assess naturalistic variability or measure change in response to planned intervention. Implementation studies typically employ mixed quantitative-qualitative designs, identifying factors that impact uptake across multiple levels, including patient, provider, clinic, facility, organization, and often the broader community and policy environment. Accordingly, implementation science requires a solid grounding in theory and the involvement of trans-disciplinary research teams. The business case for implementation science is clear: As healthcare systems work under increasingly dynamic and resource-constrained conditions, evidence-based strategies are essential in order to ensure that research investments maximize healthcare value and improve public health. Implementation science plays a critical role in supporting these efforts.

77 FR 35873 - Approval, Disapproval and Promulgation of Air Quality Implementation Plan; Utah; Maintenance Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... change the maintenance plan's trigger for contingency measures. Instead of a defined trigger, the revised plan would allow the State to consider several factors in deciding whether contingency measures should... the maintenance plan, the State must commit to implement one or more contingency measures within a set...

76 FR 55541 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia: Kentucky; Ohio...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

... Cabell and Wayne Counties in their entireties and a portion of Mason County (Graham Tax District) in West... reasonable further progress (RFP) plan, contingency measures, and other planning State Implementation Plan... Regulatory Development Section, Air Planning Branch, Air, Pesticides and Toxics Management Division, U.S...

40 CFR 49.9861 - Identification of plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Implementation Plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony of Oregon § 49.9861 Identification of plan. This section and §§ 49.9862 through 49.9890 contain the implementation plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony. This plan consists of a combination of Tribal rules and...

40 CFR 49.9861 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Implementation Plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony of Oregon § 49.9861 Identification of plan. This section and §§ 49.9862 through 49.9890 contain the implementation plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony. This plan consists of a combination of Tribal rules and...

40 CFR 49.9861 - Identification of plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Implementation Plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony of Oregon § 49.9861 Identification of plan. This section and §§ 49.9862 through 49.9890 contain the implementation plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony. This plan consists of a combination of Tribal rules and...

40 CFR 49.9861 - Identification of plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Implementation Plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony of Oregon § 49.9861 Identification of plan. This section and §§ 49.9862 through 49.9890 contain the implementation plan for the Burns Paiute Tribe of the Burns Paiute Indian Colony. This plan consists of a combination of Tribal rules and...

40 CFR 62.8870 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) APPROVAL AND PROMULGATION OF STATE PLANS FOR DESIGNATED FACILITIES AND POLLUTANTS Ohio Landfill Gas Emissions from Existing Municipal Solid Waste Landfills § 62.8870 Identification of plan. The Ohio State Implementation Plan for implementing the Federal Municipal Solid Waste Landfill Emission Guidelines including...

Manual for Preparing Individualized Education Programs.

ERIC Educational Resources Information Center

Baylor, Terrill D.

Presented are guidelines for developing an individualized program and services plan, an individual implementation plan, and daily activity and strategy plans for handicapped students. Instructions are outlined for utilizing forms related to planning and implementation of individualized education programs. Appended are sample forms. (SBH)

Continuous quality improvement in substance abuse treatment facilities: How much does it cost?

PubMed

Hunt, Priscillia; Hunter, Sarah B; Levan, Deborah

2017-06-01

Continuous quality improvement (CQI) has grown in the U.S. since the 1970s, yet little is known about the costs to implement CQI in substance abuse treatment facilities. This paper is part of a larger group randomized control trial in a large urban county evaluating the impact of Plan-Study-Do-Act (PDSA)-CQI designed for community service organizations (Hunter, Ober, Paddock, Hunt, & Levan, 2014). Operated by one umbrella organization, each of the eight facilities of the study, four residential and four outpatient substance abuse treatment facilities, selected their own CQI Actions, including administrative- and clinical care-related Actions. Using an activity-based costing approach, we collected labor and supplies and equipment costs directly attributable to CQI Actions over a 12-month trial period. Our study finds implementation of CQI and meeting costs of this trial per facility were approximately $2000 to $10,500 per year ($4500 on average), or $10 to $60 per admitted client. We provide a description of the sources of variation in these costs, including differing intensity of the CQI Actions selected, which should help decision makers plan use of PDSA-CQI. Copyright © 2017. Published by Elsevier Inc.

Desktop Publishing: Organizational Considerations for Adoption and Implementation. TDC Research Report No. 6.

ERIC Educational Resources Information Center

Lee, Paul

This report explores the implementation of desktop publishing in the Minnesota Extension Service (MES) and provides a framework for its implementation in other organizations. The document begins with historical background on the development of desktop publishing. Criteria for deciding whether to purchase a desktop publishing system, advantages and…

Executive summary for the Micronutrient Powders Consultation: Lessons Learned for Operational Guidance.

PubMed

Nyhus Dhillon, Christina; Sarkar, Danya; Klemm, Rolf Dw; Neufeld, Lynnette M; Rawat, Rahul; Tumilowicz, Alison; Namaste, Sorrel Ml

2017-09-01

Iron deficiency anaemia is estimated to be the leading cause of years lived with disability among children. Young children's diets are often inadequate in iron and other micronutrients, and provision of essential vitamin and minerals has long been recommended. With the limited programmatic success of iron drop/syrup interventions, interest in micronutrient powders (MNP) has increased. MNP are a mixture of vitamins and minerals, enclosed in single-dose sachets, which are stirred into a child's portion of food immediately before consumption. MNP are an efficacious intervention for reducing iron deficiency anaemia and filling important nutrient gaps in children 6-23 months of age. As of 2014, 50 countries have implemented MNP programmes including 9 at a national level. This paper provides an overview of a 3-paper series, based on findings from the "Micronutrient Powders Consultation: Lessons Learned for Operational Guidance" held by the USAID-funded Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. The objectives of the Consultation were to identify and summarize the most recent MNP programme experiences and lessons learned for operationalizing MNP for young children and prioritize an implementation research agenda. The Consultation was composed of 3 working groups that used the following methods: deliberations among 49 MNP programme implementers and experts, a review of published and grey literature, questionnaires, and key informant interviews, described in this overview. The following articles summarize findings in 3 broad programme areas: planning, implementation, and continual programme improvement. The papers also outline priorities for implementation research to inform improved operationalization of MNP. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Enabling digital pathology in the diagnostic setting: navigating through the implementation journey in an academic medical centre.

PubMed

Cheng, Chee Leong; Azhar, Rafay; Sng, Shi Hui Adeline; Chua, Yong Quan; Hwang, Jacqueline Siok Gek; Chin, Jennifer Poi Fun; Seah, Waih Khuen; Loke, Janel Chui Ling; Ang, Roy Hang Leng; Tan, Puay Hoon

2016-09-01

As digital pathology (DP) and whole slide imaging (WSI) technology advance and mature, there is an increasing drive to incorporate DP into the diagnostic environment. However, integration of DP into the diagnostic laboratory is a non-trivial task and filled with unexpected challenges unlike standalone implementations. We share our journey of implementing DP in the diagnostic laboratory setting, highlighting seven key guiding principles that drive the progression through implementation into deployment and beyond. The DP implementation with laboratory information system integration was completed in 8 months, including validation of the solution for diagnostic use in accordance with College of American Pathologists guidelines. We also conducted prospective validation via paired delivery of glass slides and WSI to our pathologists postdeployment. Common themes in our guiding principles included emphasis on workflow and being comprehensive in the approach, looking beyond pathologist user champions and expanding into an extended project team involving laboratory technicians, clerical/data room staff and archival staff. Concordance between glass slides and WSI ranged from 93% to 100% among various applications on validation. We also provided equal opportunities for every pathologist throughout the department to be competent and confident with DP through prospective validation, with overall concordance of 96% compared with glass slides, allowing appreciation of the advantages and limitations of WSI, hence enabling the use of DP as a useful diagnostic modality. Smooth integration of DP into the diagnostic laboratory is possible with careful planning, discipline and a systematic approach adhering to our guiding principles. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Chicago-St. Louis high speed rail plan

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

Stead, M.E.

1994-12-31

The Illinois Department of Transportation (IDOT), in cooperation with Amtrak, undertook the Chicago-St. Louis High Speed Rail Financial and Implementation Plan study in order to develop a realistic and achievable blueprint for implementation of high speed rail in the Chicago-St. Louis corridor. This report presents a summary of the Price Waterhouse Project Team`s analysis and the Financial and Implementation Plan for implementing high speed rail service in the Chicago-St. Louis corridor.

Medicaid and Children's Health Insurance Programs: Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Other Provisions Related to Eligibility and Enrollment for Medicaid and CHIP. Final rule.

PubMed

2016-11-30

This final rule implements provisions of the Affordable Care Act that expand access to health coverage through improvements in Medicaid and coordination between Medicaid, CHIP, and Exchanges. This rule finalizes most of the remaining provisions from the "Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing; Proposed Rule" that we published in the January 22, 2013, Federal Register. This final rule continues our efforts to assist states in implementing Medicaid and CHIP eligibility, appeals, and enrollment changes required by the Affordable Care Act.

Shared decision making in Australia in 2017.

PubMed

Trevena, Lyndal; Shepherd, Heather L; Bonner, Carissa; Jansen, Jesse; Cust, Anne E; Leask, Julie; Shadbolt, Narelle; Del Mar, Chris; McCaffery, Kirsten; Hoffmann, Tammy

2017-06-01

Shared decision making (SDM) is now firmly established within national clinical standards for accrediting hospitals, day procedure services, public dental services and medical education in Australia, with plans to align general practice, aged care and disability service. Implementation of these standards and training of health professionals is a key challenge for the Australian health sector at this time. Consumer involvement in health research, policy and clinical service governance has also increased, with a major focus on encouraging patients to ask questions during their clinical care. Tools to support shared decision making are increasingly used but there is a need for more systemic approaches to their development, cultural adaptation and implementation. Sustainable solutions to ensure tools are kept up-to-date with the best available evidence will be important for the future. Copyright © 2017. Published by Elsevier GmbH.

Urban family physician plan in Iran: challenges of implementation in Kerman.

PubMed

Dehnavieh, Reza; Kalantari, Ali Reza; Jafari Sirizi, Mohammad

2015-01-01

The Family Physician Plan has recently been implemented in three provinces of Iran on a pilot basis and is going to be implemented throughout Iran in the future. Through a qualitative design, this study aims to determine probable implementation challenges of Family Physician Plan in Kerman. This study was conducted in Kerman in 2013. Data were collected through interviews with 21 experts in the field. Sampling continued until data saturation level was achieved. All interviews were recorded and then analyzed, and main themes and subgroups were extracted from them based on a framework analysis model. most prevalent establishment challenges of Family Physician Plan were classified into policy-making, financial supply, laws and resources. The urban Family Physician Plan can be carried out more effectively by implementing this plan step by step, highlighting the relationships between the related organizations, using new payment mechanisms e.g Per Capita, DRG, make national commitment and proper educational programs for providers, development the health electronic Record, justifying providers and community about advantages of this plan, clarifying regulatory status about providers' Duties and most importantly considering a specific funding source.

A detailed description of the implementation of inpatient insulin orders with a commercial electronic health record system.

PubMed

Neinstein, Aaron; MacMaster, Heidemarie Windham; Sullivan, Mary M; Rushakoff, Robert

2014-07-01

In the setting of Meaningful Use laws and professional society guidelines, hospitals are rapidly implementing electronic glycemic management order sets. There are a number of best practices established in the literature for glycemic management protocols and programs. We believe that this is the first published account of the detailed steps to be taken to design, implement, and optimize glycemic management protocols in a commercial computerized provider order entry (CPOE) system. Prior to CPOE implementation, our hospital already had a mature glycemic management program. To transition to CPOE, we underwent the following 4 steps: (1) preparation and requirements gathering, (2) design and build, (3) implementation and dissemination, and (4) optimization. These steps required more than 2 years of coordinated work between physicians, nurses, pharmacists, and programmers. With the move to CPOE, our complex glycemic management order sets were successfully implemented without any significant interruptions in care. With feedback from users, we have continued to refine the order sets, and this remains an ongoing process. Successful implementation of glycemic management protocols in CPOE is dependent on broad stakeholder input and buy-in. When using a commercial CPOE system, there may be limitations of the system, necessitating workarounds. There should be an upfront plan to apply resources for continuous process improvement and optimization after implementation. © 2014 Diabetes Technology Society.

The Switch From Trivalent to Bivalent Oral Poliovirus Vaccine in the South-East Asia Region.

PubMed

Bahl, Sunil; Hasman, Andreas; Eltayeb, Abu Obeida; James Noble, Douglas; Thapa, Arun

2017-07-01

This analysis describes an innovative and successful approach to risk identification and mitigation in relation to the switch from trivalent to bivalent oral polio vaccine (OPV) in the 11 countries of the World Health Organization's (WHO's) South-East Asia Region (SEAR) in April 2016.The strong commitment of governments and immunization professionals to polio eradication and an exemplary partnership between the WHO, United Nations Children's Fund (UNICEF), and other partners and stakeholders in the region and globally were significant contributors to the success of the OPV switch in the SEAR. Robust national switch plans were developed and country-specific innovations were planned and implemented by the country teams. Close monitoring and tracking of the activities and milestones through dashboards and review meetings were undertaken at the regional level to ensure that implementation time lines were met, barriers identified, and solutions for overcoming challenges were discussed and implemented.The SEAR was the first WHO Region globally to complete the switch and declare the successful withdrawal of trivalent OPV from all countries on 17 May 2016.A number of activities implemented during the switch process are likely to contribute positively to existing immunization practices and to similar initiatives in the future. These activities include better vaccine supply chain management, improved mechanisms for disposal of vaccination-related waste materials, and a closer collaboration with drug regulators, vaccine manufacturers, and the private sector for immunization-related initiatives. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Identification of seniors at risk (ISAR) screening tool in the emergency department: implementation using the plan-do-study-act model and validation results.

PubMed

Asomaning, Nana; Loftus, Carla

2014-07-01

To better meet the needs of older adults in the emergency department, Senior Friendly care processes, such as high-risk screening are recommended. The identification of Seniors at Risk (ISAR) tool is a 6-item validated screening tool for identifying elderly patients at risk of the adverse outcomes post-ED visit. This paper describes the implementation of the tool in the Mount Sinai Hospital emergency department using a Plan-Do-Study-Act model; and demonstrates whether the tool predicts adverse outcomes. An observational study tracked tool implementation. A retrospective chart audit was completed to collect data about elderly ED patients during 2 time periods in 2010 and 2011. Data analysis compared the characteristics of patients with positive and negative screening tool results. The identification of Seniors at Risk tool was completed for 51.6% of eligible patients, with 61.2% of patients having a positive result. Patients with positive screening results were more likely to be over age 79 (P = .003); be admitted to hospital (P < .001); have a longer mean ED length of stay (P < .001). For patients admitted to hospital, those with positive screening results had a longer mean inpatient stay (P = .012). Implementing the Idenfitication of Seniors at Risk tool was challenged by problematic compliance with tool completion. Strategies to address this included tool adaptation; and providing staff with knowledge of ED and inpatient geriatric resources and feedback on completion rates. Positive screening results predicted adverse outcomes in elderly Mount Sinai Hospital ED patients. © 2014. Published by Elsevier Inc. All rights reserved.

Evaluating a novel health system intervention for chronic kidney disease care using the RE-AIM framework: Insights after two years.

PubMed

Hynes, Denise M; Fischer, Michael J; Schiffer, Linda A; Gallardo, Rani; Chukwudozie, Ifeanyi Beverly; Porter, Anna; Berbaum, Michael; Earheart, Jennifer; Fitzgibbon, Marian L

2017-01-01

Using a quasi-experimental design, we implemented the Patient-Centered Medical Home for Kidney Disease (PCMH-KD), a comprehensive, multidisciplinary care team to improve quality of life and healthcare coordination for adult chronic hemodialysis (CHD) patients. This paper highlights our experience in the first two years of the study. We focus on the process dimensions of Reach, Adoption, and Implementation within the context of the RE-AIM framework. We established a new PCMH-KD model at two outpatient dialysis centers. During the intervention phase, adult patients were recruited for participation and data collection. We monitored RE-AIM measures to identify areas for potential adaptation of the care model. During the start-up phase, we engaged patients and stakeholders in planning the intervention, established the new PCMH-KD team, and trained new and continuing clinicians and staff at two dialysis centers. In the intervention phase we recruited 155 patients to participate. Patients had individual visits with the PCP (40%) and the CHWs (92%) (Reach). Patient feedback informed procedures for appointment scheduling (Adoption). The new PCMH-KD team members were consistent in their roles. With staff changes, some responsibilities were adapted for cross coverage (Implementation). After one year of start-up and one year of intervention, active monitoring of Reach, Implementation and Adoption measures have facilitated necessary adaptions in the planned intervention to accommodate scheduling demands and patient feedback in the PCMH-KD model. Insights from this trial may inform care of CHD patients more broadly. Copyright © 2016. Published by Elsevier Inc.

Development and Implementation of the DHAPP Military eHealth Information Network System.

PubMed

Kratz, Mary; Thomas, Anne; Hora, Ricardo; Vera, Delphis; Lutz, Mickey; Johnson, Mark D

2017-01-01

As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards. DHAPP worked with the private sector to develop a commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including patient demographic information, clinical notes for general medical care, HIV encounters, voluntary medical male circumcision, and tuberculosis screening information. The COTS software approach provided a zero-dollar software license and focused on sharing a single version of the EMR across countries, so that all countries could benefit from software enhancements and new features over time. DHAPP also worked with the public sector to modify open source disease surveillance tools and open access of HIV training materials. Important lessons highlight challenges to eHealth implementation, including a paucity of technology infrastructure, military leadership rotations, and the need for basic computer skills building. While not simple, eHealth systems can be built and maintained with requisite security, flexibility, and reporting capabilities that provide critical information to improve the health of individuals and organizations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

40 CFR 52.1119 - Identification of plan-conditional approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Implementation Plan Revision for a Small Business Technical and Environmental Compliance Assistance Program dated... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Identification of plan-conditional... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Massachusetts § 52.1119...

40 CFR 52.1519 - Identification of plan-conditional approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Implementation Plan Revision for a Small Business Technical and Environmental compliance Assistance Program dated... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Identification of plan-conditional... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New Hampshire § 52.1519...

40 CFR 52.670 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.670 Identification of plan. Link to an..., 2011. (a) Purpose and scope. This section sets forth the applicable State implementation plan for Idaho.... (c) EPA approved regulations. EPA—Approved Idaho Regulations State citation Title/subject State...

40 CFR 52.670 - Identification of plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.670 Identification of plan. (a) Purpose and scope. This section sets forth the applicable State implementation plan for Idaho under section 110 of..._locations.html. (c) EPA approved regulations. EPA—APPROVED IDAHO REGULATIONS AND STATUTES State citation...

40 CFR 52.670 - Identification of plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.670 Identification of plan. (a) Purpose and scope. This section sets forth the applicable State implementation plan for Idaho under section 110 of.... (c) EPA approved regulations. EPA—Approved Idaho Regulations State citation Title/subject State...

40 CFR 52.670 - Identification of plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.670 Identification of plan. (a) Purpose and scope. This section sets forth the applicable State implementation plan for Idaho under section 110 of..._locations.html. (c) EPA approved regulations. EPA—APPROVED IDAHO REGULATIONS AND STATUTES State citation...

40 CFR 52.1870 - Identification of plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Title of plan: “Implementation Plan for the Control of Suspended Particulates, Sulfur Dioxide, Carbon... 20, 1972, by the Ohio Air Pollution Control Board. (2) State provisions for making emissions data... Quality Control Region” and the “Implementation Plan to Achieve Ambient Air Quality Standard for...

40 CFR 52.620 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Hawaii § 52.620 Identification of plan. (a) Purpose and scope. This section sets forth the applicable State implementation plan for State of Hawaii under...-Approved State of Hawaii Regulations State citation Title/subject Effective date EPA approval date...

Image guided adaptive external beam radiation therapy for cervix cancer: Evaluation of a clinically implemented plan-of-the-day technique.

PubMed

Buschmann, Martin; Majercakova, Katarina; Sturdza, Alina; Smet, Stephanie; Najjari, Dina; Daniel, Michaela; Pötter, Richard; Georg, Dietmar; Seppenwoolde, Yvette

2017-10-12

Radiotherapy for cervix cancer is challenging in patients exhibiting large daily changes in the pelvic anatomy, therefore adaptive treatments (ART) have been proposed. The aim of this study was the clinical implementation and subsequent evaluation of plan-of-the-day (POTD)-ART for cervix cancer in supine positioning. The described workflow was based on standard commercial equipment and current quality assurance (QA) methods. A POTD strategy, which employs a VMAT plan library consisting of an empty bladder plan, a full bladder plan and a motion robust backup plan, was developed. Daily adaption was guided by cone beam computed tomography (CBCT) imaging after which the best plan from the library was selected. Sixteen patients were recruited in a clinical study on ART, for nine POTD was applied due to their large organ motion derived from two computed tomography (CT) scans with variable bladder filling. All patients were treated to 45Gy in 25 fractions. Plan selection frequencies over the treatment course were analyzed. Daily doses in the rectum, bladder and cervix-uterus target (CTV-T) were derived and compared to a simulated non-adapted treatment (non-ART), which employed the robust plan for each fraction. Additionally, the adaption consistency was determined by repeating the plan selection procedure one month after treatment by a group of experts. ART-specific QA methods are presented. 225 ART fractions with CBCTs were analyzed. The empty bladder plan was delivered in 49% of the fractions in the first treatment week and this number increased to 78% in the fifth week. The daily coverage of the CTV-T was equivalent between ART and the non-ART simulation, while the daily total irradiated volume V42.75Gy (95% of prescription dose) was reduced by a median of 87cm 3 . The median delivered V42.75Gy was 1782cm 3 . Daily delivered doses (V42.75Gy, V40Gy, V30G) to the organs at risk were statistically significantly reduced by ART, with a median difference in daily V42.75Gy in rectum and bladder of 3.2% and 1.1%, respectively. The daily bladder V42.75Gy and V40Gy were decreased by more than 10 percent points in 30% and 24% of all fractions, respectively, through ART. The agreement between delivered plans and retrospective expert-group plan selections was 84%. A POTD-ART technique for cervix cancer was successfully and safely implemented in the clinic and evaluated. Improved normal tissue sparing compared to a simulated non-ART treatment could be demonstrated. Future developments should focus on commercial automated software solutions to allow for a more widespread adoption and to keep the increased workload manageable. Copyright © 2017. Published by Elsevier GmbH.

We have the programme, what next? Planning the implementation of an injury prevention programme

PubMed Central

Donaldson, Alex; Lloyd, David G; Gabbe, Belinda J; Cook, Jill

2017-01-01

Background and aim The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. Methods An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. Results An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. Conclusions A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context. PMID:26787739

Increasing In-Service Teacher Implementation of Classroom Management Practices through Consultation, Implementation Planning, and Participant Modeling

ERIC Educational Resources Information Center

Hagermoser Sanetti, Lisa M.; Williamson, Kathleen M.; Long, Anna C. J.; Kratochwill, Thomas R.

2018-01-01

Numerous evidence-based classroom management strategies to prevent and respond to problem behavior have been identified, but research consistently indicates teachers rarely implement them with sufficient implementation fidelity. The purpose of this study was to evaluate the effectiveness of implementation planning, a strategy involving logistical…

33 CFR 385.13 - Projects implemented under additional program authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Implementation Report is prepared and approved in accordance with § 385.26; and (3) Not exceed a total cost of... RESTORATION PLAN CERP Implementation Processes § 385.13 Projects implemented under additional program authority. (a) To expedite implementation of the Plan, the Corps of Engineers and non-Federal sponsors may...

Making change easy: A peer-to-peer guide on transitioning to new hand hygiene products.

PubMed

Amirov, Chingiz M; Candon, Heather L; Jacob, Latha

2017-01-01

This report summarizes our experiences planning and implementing the transition to a new commercial line of hand hygiene products and their dispensing systems in a large academic health care facility in Toronto, Canada. Our lessons learned are organized into a practical guide made available in 2 different formats: this article and an illustrated peer-to-peer guide (http://www.baycrest.org/wp-content/uploads/HCE-PROG-HH_HighQuality.pdf). Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.