Selected Technology Lab Activities Implementation Guide.

ERIC Educational Resources Information Center

Portland Public Schools, OR.

These materials supplement state guides for junior high or middle school technology education programs. The materials show instructors how to implement 81 hours of new technology-related activities into existing programs. Introductory materials include a rationale, philosophy, and goals for technology education. Areas of instruction are as…

Participatory redesign of work organisation in hospital nursing: A study of the implementation process.

PubMed

Stab, Nicole; Hacker, Winfried

2018-05-01

The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. © 2018 John Wiley & Sons Ltd.

Physically active academic lessons: acceptance, barriers and facilitators for implementation.

PubMed

Dyrstad, Sindre M; Kvalø, Silje E; Alstveit, Marianne; Skage, Ingrid

2018-03-06

To improve health and academic learning in schoolchildren, the Active School programme in Stavanger, Norway has introduced physically active academic lessons. This is a teaching method combining physical activity with academic content. The purpose of this paper was to evaluate the response to the physically active lessons and identify facilitators and barriers for implementation of such an intervention. Five school leaders (principals or vice-principals), 13 teachers and 30 children from the five intervention schools were interviewed about their experiences with the 10-month intervention, which consisted of weekly minimum 2 × 45 minutes of physically active academic lessons, and the factors affecting its implementation. All interviews were transcribed and analysed using the qualitative data analysis program NVivo 10 (QSR international, London, UK). In addition, weekly teacher's intervention delivery logs were collected and analysed. On average, the physically active academic lessons in 18 of the 34 weeks (53%) were reported in the teacher logs. The number of delivered physically active academic lessons covered 73% of the schools' planned activity. Physically active lessons were well received among school leaders, teachers and children. The main facilitators for implementation of the physically active lessons were active leadership and teacher support, high self-efficacy regarding mastering the intervention, ease of organizing physically active lessons, inclusion of physically active lessons into the lesson curricula, and children's positive reception of the intervention. The main barriers were unclear expectations, lack of knowledge and time to plan the physiclly active lessons, and the length of the physically active lessons (15-20 min lessons were preferred over the 45 min lessons). Physically active academic lessons were considered an appropriate pedagogical method for creating positive variation, and were highly appreciated among both teachers and

Teacher-implemented joint attention intervention: pilot randomized controlled study for preschoolers with autism.

PubMed

Lawton, Kathy; Kasari, Connie

2012-08-01

The vast majority of children with an autism spectrum disorder (ASD) attend public preschools at some point in their childhood. Community preschool practices often are not evidence based, and almost none target the prelinguistic core deficits of ASD. This study investigated the effectiveness of public preschool teachers implementing a validated intervention (the Joint Attention and Symbolic Play/Engagement and Regulation intervention; JASP/ER) on a core deficit of autism, initiating joint attention. Sixteen dyads (preschoolers with ASD and the public school teachers who worked in the child's classroom) were randomly assigned to the 6-week JASP/ER intervention or a control group. At the end of the intervention, JASP/ER teachers used more JASP/ER strategies than the control teachers, and JASP/ER preschoolers used more joint attention in their classroom than control children. Additionally, JASP/ER children spent more time in supported engagement and less time in object engagement than control preschoolers on a taped play interaction. Findings suggest that teachers were able to improve a core deficit of children with ASD in a public preschool context. © 2012 American Psychological Association

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

PubMed

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

2008-09-01

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

Development and Implementation of a Mental Health Work Rehabilitation Program: Results of a Developmental Evaluation.

PubMed

Sylvain, Chantal; Durand, Marie-José; Velasquez Sanchez, Astrid; Lessard, Nathalie; Maillette, Pascale

2018-05-23

Purpose Long-term work disability due to common mental disorders (CMDs) is a growing problem. Yet optimal interventions remain unclear and little is known about implementation challenges in everyday practice. This study aimed to support and evaluate, in real time, the development and implementation of a work rehabilitation program (WRP) designed to promote post-CMD return-to-work (RTW). Methods A 2-year developmental evaluation was performed using a participatory approach. At program outset, the researchers held five work meetings to revise the program's logic model and discuss its underlying change theory with clinicians. Data collection tools used throughout the study period were structured charts of activities conducted with workers (n = 41); in-depth interviews with program clinicians and managers (n = 9); and participant observation during work meetings. Quantitative data were analyzed using descriptive statistics. Qualitative data underwent thematic analysis using a processual approach. Results Three types of activity were developed and implemented: individual and group interventions targeting workers, and joint activities targeting partners (physicians, employers, others). While worker-targeted activities were generally implemented as planned, joint activities were sporadic. Analysis of the implementation process revealed five challenges faced by clinicians. Determinants included clinicians, host organization, sociopolitical context and resources provided by the evaluation. Conclusion The program studied is original in that it is based on the best available scientific knowledge, yet adapted to contextual particularities. The identified implementation challenges highlight the need for greater importance to be placed on the external, non-program context to ensure sustainable implementation in everyday practice.

Captivate: Building Blocks for Implementing Active Learning

ERIC Educational Resources Information Center

Kitchens, Brent; Means, Tawnya; Tan, Yinliang

2018-01-01

In this study, the authors propose a set of key elements that impact the success of an active learning implementation: content delivery, active learning methods, physical environment, technology enhancement, incentive alignment, and educator investment. Through a range of metrics the authors present preliminary evidence that students in courses…

25 CFR 217.7 - Implementation of decision.

Code of Federal Regulations, 2010 CFR

2010-04-01

... expendient to implement the decisions of the joint managers, insofar as such issuance is authorized by law, and he shall execute and/or approve such documents for and on behalf of the joint managers, or either... to execute an instrument on behalf of one or both of the joint managers and to approve the same...

76 FR 23221 - Joint Public Roundtable on Issues Related to the Schedule for Implementing Final Rules for Swaps...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-26

... submissions will be reviewed jointly by the Agencies. All comments must be in English or be accompanied by an English translation. All submissions provided to either Agency in any electronic form or on paper will be... of CFTC Commissioner Scott D. O'Malia; Implementation Roundtable Seriatim; Certainty & Transparency I...

75 FR 81454 - Privacy Act of 1974; Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... JOINT BOARD FOR ENROLLMENT OF ACTUARIES 20 CFR Part 903 Privacy Act of 1974; Implementation AGENCY... requirements of the Privacy Act of 1974, as amended, the Joint Board for the Enrollment of Actuaries (Joint... Privacy Act, from certain of the Privacy Act's provisions, to revise language that incorrectly implies...

77 FR 30900 - Approval and Promulgation of Implementation Plans; New Mexico; Albuquerque/Bernalillo County...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... in implementing the New Mexico Air Quality Control Act, the joint Air Quality Control Board (AQCB... Department in implementing the New Mexico Air Quality Control Act, the joint Air Quality Control Board (AQCB... Promulgation of Implementation Plans; New Mexico; Albuquerque/Bernalillo County; Fees for Permits and...

Novel strategy to implement active-space coupled-cluster methods

NASA Astrophysics Data System (ADS)

Rolik, Zoltán; Kállay, Mihály

2018-03-01

A new approach is presented for the efficient implementation of coupled-cluster (CC) methods including higher excitations based on a molecular orbital space partitioned into active and inactive orbitals. In the new framework, the string representation of amplitudes and intermediates is used as long as it is beneficial, but the contractions are evaluated as matrix products. Using a new diagrammatic technique, the CC equations are represented in a compact form due to the string notations we introduced. As an application of these ideas, a new automated implementation of the single-reference-based multi-reference CC equations is presented for arbitrary excitation levels. The new program can be considered as an improvement over the previous implementations in many respects; e.g., diagram contributions are evaluated by efficient vectorized subroutines. Timings for test calculations for various complete active-space problems are presented. As an application of the new code, the weak interactions in the Be dimer were studied.

A Review of Implementation Outcome Measures of School-based Physical Activity Interventions

ERIC Educational Resources Information Center

Shah, Sonam; Allison, Kenneth R.; Schoueri-Mychasiw, Nour; Pach, Beata; Manson, Heather; Vu-Nguyen, Karen

2017-01-01

Background: Measuring the implementation of school-based physical activity (PA) interventions is an important prerequisite in assessing their impact. Prior to conducting a study to assess the implementation of the daily physical activity (DPA) policy in Ontario, Canada, a literature review was conducted to identify existing survey instruments to…

Empowering nurses to handle the guideline implementation process: identification of implementation competencies.

PubMed

Holleman, Gerda; van Tol, Marjo; Schoonhoven, Lisette; Mintjes-de Groot, Joke; van Achterberg, Theo

2014-01-01

Employing nurses as opinion leaders to implement guidelines may be a promising implementation activity. Until now, insight into necessary competencies of nurse opinion leaders is lacking. We studied and supported aspiring nurse opinion leaders, using a training program based on social influence and implementation theory. Twenty-one competencies were identified, of which the most important were cooperating, communicating, delegating, giving feedback, networking, and information processing. Understanding and addressing these competencies may support the implementation of evidence-based guidelines.

Factors influencing implementation of a preschool-based physical activity intervention

PubMed Central

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

2017-01-01

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

Implementation of Perioperative Music Using the Consolidated Framework for Implementation Research.

PubMed

Carter, Jessica E; Pyati, Srinivas; Kanach, Frances A; Maxwell, Ann Miller W; Belden, Charles M; Shea, Christopher M; Van de Ven, Thomas; Thompson, Jillian; Hoenig, Helen; Raghunathan, Karthik

2018-06-12

Complementary integrative health therapies have a perioperative role in the reduction of pain, analgesic use, and anxiety, and increasing patient satisfaction. However, long implementation lags have been quantified. The Consolidated Framework for Implementation Research (CFIR) can help mitigate this translational problem. We reviewed evidence for several nonpharmacological treatments (CFIR domain: characteristics of interventions) and studied external context and organizational readiness for change by surveying providers at 11 Veterans Affairs (VA) hospitals (domains: outer and inner settings). We asked patients about their willingness to receive music and studied the association between this and known risk factors for opioid use (domain: characteristics of individuals). We implemented a protocol for the perioperative use of digital music players loaded with veteran-preferred playlists and evaluated its penetration in a subgroup of patients undergoing joint replacements over a 6-month period (domain: process of implementation). We then extracted data on postoperative recovery time and other outcomes, comparing them with historic and contemporary cohorts. Evidence varied from strong and direct for perioperative music and acupuncture, to modest or weak and indirect for mindfulness, yoga, and tai chi, respectively. Readiness for change surveys completed by 97 perioperative providers showed overall positive scores (mean >0 on a scale from -2 to +2, equivalent to >2.5 on the 5-point Likert scale). Readiness was higher at Durham (+0.47) versus most other VA hospitals (range +0.05 to +0.63). Of 3307 veterans asked about willingness to receive music, approximately 68% (n = 2252) answered "yes." In multivariable analyses, a positive response (acceptability) was independently predicted by younger age and higher mean preoperative pain scores (>4 out of 10 over 90 days before admission), factors associated with opioid overuse. Penetration was modest in the targeted subset (39

Implementation of lung cancer CT screening in the Nordic countries.

PubMed

Pedersen, Jesper Holst; Sørensen, Jens Benn; Saghir, Zaigham; Fløtten, Øystein; Brustugun, Odd Terje; Ashraf, Haseem; Strand, Trond-Eirik; Friesland, Signe; Koyi, Hirsh; Ek, Lars; Nyrén, Sven; Bergman, Per; Jekunen, Antti; Nieminen, Eeva-Maija; Gudbjartsson, Tomas

2017-10-01

We review the current knowledge of CT screening for lung cancer and present an expert-based, joint protocol for the proper implementation of screening in the Nordic countries. Experts representing all the Nordic countries performed literature review and concensus for a joint protocol for lung cancer screening. Areas of concern and caution are presented and discussed. We suggest to perform CT screening pilot studies in the Nordic countries in order to gain experience and develop specific and safe protocols for the implementation of such a program.

Control algorithm implementation for a redundant degree of freedom manipulator

NASA Technical Reports Server (NTRS)

Cohan, Steve

1991-01-01

This project's purpose is to develop and implement control algorithms for a kinematically redundant robotic manipulator. The manipulator is being developed concurrently by Odetics Inc., under internal research and development funding. This SBIR contract supports algorithm conception, development, and simulation, as well as software implementation and integration with the manipulator hardware. The Odetics Dexterous Manipulator is a lightweight, high strength, modular manipulator being developed for space and commercial applications. It has seven fully active degrees of freedom, is electrically powered, and is fully operational in 1 G. The manipulator consists of five self-contained modules. These modules join via simple quick-disconnect couplings and self-mating connectors which allow rapid assembly/disassembly for reconfiguration, transport, or servicing. Each joint incorporates a unique drive train design which provides zero backlash operation, is insensitive to wear, and is single fault tolerant to motor or servo amplifier failure. The sensing system is also designed to be single fault tolerant. Although the initial prototype is not space qualified, the design is well-suited to meeting space qualification requirements. The control algorithm design approach is to develop a hierarchical system with well defined access and interfaces at each level. The high level endpoint/configuration control algorithm transforms manipulator endpoint position/orientation commands to joint angle commands, providing task space motion. At the same time, the kinematic redundancy is resolved by controlling the configuration (pose) of the manipulator, using several different optimizing criteria. The center level of the hierarchy servos the joints to their commanded trajectories using both linear feedback and model-based nonlinear control techniques. The lowest control level uses sensed joint torque to close torque servo loops, with the goal of improving the manipulator dynamic behavior

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.

Physical Activity Promotion in Schools: Which Strategies Do Schools (Not) Implement and Which Socioecological Factors Are Associated with Implementation?

ERIC Educational Resources Information Center

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

2012-01-01

We studied the implementation and associated factors of strategies (e.g. sports after school and during lunch break, active schoolyards, active school commuting) and organizational principles (e.g. safe bike racks, pupil involvement) that facilitate the physical activity (PA)-promoting role of schools. Key representatives of 111 elementary and 125…

Project WET: Facilitator Handbook for Implementation of Activities in Virginia.

ERIC Educational Resources Information Center

Sevebeck, Kathryn P.

This handbook features ideas for implementing Project WET activities in Virginia. Project WET activities are designed for a variety of educational programs and can be used to complement existing curricula while addressing curricular objectives and educational standards nationwide. Activities include: (1) "Life Systems"; (2)…

Implementation of Active Support in Victoria, Australia: An Exploratory Study

ERIC Educational Resources Information Center

Mansell, Jim; Beadle-Brown, Julie; Bigby, Christine

2013-01-01

Background: Active support is an effective intervention to support engagement of residents with intellectual disability in group homes. This survey explored resident characteristics of the people supported by organisations implementing active support, the provision of active support, its procedures and systems, and resident engagement in…

From policy to practice: implementation of physical activity and food policies in schools

PubMed Central

2013-01-01

Purpose Public policies targeting the school setting are increasingly being used to address childhood obesity; however, their effectiveness depends on their implementation. This study explores the factors which impeded or facilitated the implementation of publicly mandated school-based physical activity and nutrition guidelines in the province of British Columbia (BC), Canada. Methods Semi-structured interviews were conducted with 50 school informants (17 principals - 33 teacher/school informants) to examine the factors associated with the implementation of the mandated Daily Physical Activity (DPA) and Food and Beverage Sales in Schools (FBSS) guidelines. Coding used a constructivist grounded theory approach. The first five transcripts and every fifth transcript thereafter were coded by two independent coders with discrepancies reconciled by a third coder. Data was coded and analysed in the NVivo 9 software. Concept maps were developed and current theoretical perspectives were integrated in the later stages of analysis. Results The Diffusion of Innovations Model provided an organizing framework to present emergent themes. With the exception of triability (not relevant in the context of mandated guidelines/policies), the key attributes of the Diffusion of Innovations Model (relative advantage, compatibility, complexity, and observability) provided a robust framework for understanding themes associated with implementation of mandated guidelines. Specifically, implementation of the DPA and FBSS guidelines was facilitated by perceptions that they: were relatively advantageous compared to status quo; were compatible with school mandates and teaching philosophies; had observable positive impacts and impeded when perceived as complex to understand and implement. In addition, a number of contextual factors including availability of resources facilitated implementation. Conclusions The enactment of mandated policies/guidelines for schools is considered an essential step in

From policy to practice: implementation of physical activity and food policies in schools.

PubMed

Mâsse, Louise C; Naiman, Daniel; Naylor, Patti-Jean

2013-06-03

Public policies targeting the school setting are increasingly being used to address childhood obesity; however, their effectiveness depends on their implementation. This study explores the factors which impeded or facilitated the implementation of publicly mandated school-based physical activity and nutrition guidelines in the province of British Columbia (BC), Canada. Semi-structured interviews were conducted with 50 school informants (17 principals - 33 teacher/school informants) to examine the factors associated with the implementation of the mandated Daily Physical Activity (DPA) and Food and Beverage Sales in Schools (FBSS) guidelines. Coding used a constructivist grounded theory approach. The first five transcripts and every fifth transcript thereafter were coded by two independent coders with discrepancies reconciled by a third coder. Data was coded and analysed in the NVivo 9 software. Concept maps were developed and current theoretical perspectives were integrated in the later stages of analysis. The Diffusion of Innovations Model provided an organizing framework to present emergent themes. With the exception of triability (not relevant in the context of mandated guidelines/policies), the key attributes of the Diffusion of Innovations Model (relative advantage, compatibility, complexity, and observability) provided a robust framework for understanding themes associated with implementation of mandated guidelines. Specifically, implementation of the DPA and FBSS guidelines was facilitated by perceptions that they: were relatively advantageous compared to status quo; were compatible with school mandates and teaching philosophies; had observable positive impacts and impeded when perceived as complex to understand and implement. In addition, a number of contextual factors including availability of resources facilitated implementation. The enactment of mandated policies/guidelines for schools is considered an essential step in improving physical activity and

Barriers and facilitators to the implementation of physical activity policies in schools: A systematic review.

PubMed

Nathan, Nicole; Elton, Ben; Babic, Mark; McCarthy, Nicole; Sutherland, Rachel; Presseau, Justin; Seward, Kirsty; Hodder, Rebecca; Booth, Debbie; Yoong, Sze Lin; Wolfenden, Luke

2018-02-01

Research consistently indicates that schools fail to implement mandatory physical activity policies. This review aimed to describe factors (barriers and facilitators) that may influence the implementation of school physical activity policies which specify the time or intensity that physical activity should be implemented and to map these factors to a theoretical framework. A systematic search was undertaken in six databases for quantitative or qualitative studies published between 1995-March 2016 that examined teachers', principals' or school administrators' reported barriers and/or facilitators to implementing mandated school physical activity policies. Two independent reviewers screened texts, extracted and coded data from identified articles using the Theoretical Domains Framework (TDF). Of the 10,346 articles identified, 17 studies met the inclusion criteria (8 quantitative, 9 qualitative). Barriers and facilitators identified in qualitative studies covered 9 and 10 TDF domains respectively. Barriers and facilitators reported in quantitative studies covered 8 TDF domains each. The most common domains identified were: 'environmental context and resources' (e.g., availability of equipment, time or staff), 'goals' (e.g., the perceived priority of the policy in the school), 'social influences' (e.g., support from school boards), and 'skills' (e.g., teachers' ability to implement the policy). Implementation support strategies that target these factors may represent promising means to improve implementation of physical activity policies and increase physical activity among school-aged children. Future studies assessing factors that influence school implementation of physical activity policies would benefit from using a comprehensive framework to help identify if any domains have been overlooked in the current literature. This review was prospectively registered with PROSPERO (CRD42016051649) on the 8th December 2016. Copyright © 2017 Elsevier Inc. All rights

How TSPSM Implementation has Evolved at AV-8B

DTIC Science & Technology

2008-05-01

How TSPSM Implementation Has Evolved at AV-8B Chris Rickets AV-8B Joint Systems/Software Support Activity (JSSA) Brad Hodgins NAVAIR Systems...members need to be involved) NAVAIR Software/Systems Support Center (NSSC) Slide 40 Contact Information • Chris Rickets (AV-8B Sr. Software Engr...phone: (760) 939-5838 – e-mail: chris rickets @navy mil . . • Brad Hodgins (NAVAIR TSP Coach supporting AV-8B ) – phone: (760) 939-0666/4446 – e

Implementation and evaluation of a community-based interprofessional learning activity.

PubMed

Luebbers, Ellen L; Dolansky, Mary A; Vehovec, Anton; Petty, Gayle

2017-01-01

Implementation of large-scale, meaningful interprofessional learning activities for pre-licensure students has significant barriers and requires novel approaches to ensure success. To accomplish this goal, faculty at Case Western Reserve University, Ohio, USA, used the Ottawa Model of Research Use (OMRU) framework to create, improve, and sustain a community-based interprofessional learning activity for large numbers of medical students (N = 177) and nursing students (N = 154). The model guided the process and included identification of context-specific barriers and facilitators, continual monitoring and improvement using data, and evaluation of student learning outcomes as well as programme outcomes. First year Case Western Reserve University medical students and undergraduate nursing students participated in team-structured prevention screening clinics in the Cleveland Metropolitan Public School District. Identification of barriers and facilitators assisted with overcoming logistic and scheduling issues, large class size, differing ages and skill levels of students and creating sustainability. Continual monitoring led to three distinct phases of improvement and resulted in the creation of an authentic team structure, role clarification, and relevance for students. Evaluation of student learning included both qualitative and quantitative methods, resulting in statistically significant findings and qualitative themes of learner outcomes. The OMRU implementation model provided a useful framework for successful implementation resulting in a sustainable interprofessional learning activity.

Benchmarking progress in the implementation of the Fourth Joint Societies' Task Force Guidelines on the Prevention of Cardiovascular Disease in Clinical Practice.

PubMed

Morgan, Karen; Burke, Helen; McGee, Hannah

2013-02-01

The Fourth Joint Societies' Task Force (4th JTF) Guidelines on Cardiovascular Disease Prevention in Clinical Practice are agreed, evidence-based standards of care across European countries and professions. In advance of the publication of the 5th JTF Guidelines in 2012, this work assesses the extent to which the 4th JTF guidelines have been implemented. Qualitative study of guideline implementation in 13 European countries, focusing on the themes of guideline implementation structures, processes, and outcomes. Key personnel in 13 selected countries completed interviews or comparable questionnaires: they were national coordinators for CVD prevention (n = 14) and representatives of the national cardiac society (n = 9), heart foundations (n = 11), health ministry (n = 8), and service providers (n = 3). Interview and service-related data from each country were compiled to provide a detailed overview. Ten of the 13 countries used European Society of Cardiology (ESC) guidelines on prevention at a national level, where three broad approaches to implementation were identified. In all 10 countries, multidisciplinary alliances oversaw implementation, but ongoing promotion of the guidelines was not evident, with just two of the 10 countries conducting evaluation of implementation. Barriers to implementation included weak health authority support, the unwieldy nature of the guidelines, guideline fatigue, and the lesser role of prevention in national healthcare systems. Substantial progress had been made in implementing the guidelines, but countries struggled with the task. Some rebalancing of the ESC focus may be warranted so that part of the effort dedicated to improving guidelines might be redirected at translating them into practice.

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...

The Application of an Implementation Science Framework to Comprehensive School Physical Activity Programs: Be a Champion!

PubMed Central

Moore, Justin B.; Carson, Russell L.; Webster, Collin A.; Singletary, Camelia R.; Castelli, Darla M.; Pate, Russell R.; Beets, Michael W.; Beighle, Aaron

2018-01-01

Comprehensive school physical activity programs (CSPAPs) have been endorsed as a promising strategy to increase youth physical activity (PA) in school settings. A CSPAP is a five-component approach, which includes opportunities before, during, and after school for PA. Extensive resources are available to public health practitioners and school officials regarding what should be implemented, but little guidance and few resources are available regarding how to effectively implement a CSPAP. Implementation science provides a number of conceptual frameworks that can guide implementation of a CSPAP, but few published studies have employed an implementation science framework to a CSPAP. Therefore, we developed Be a Champion! (BAC), which represents a synthesis of implementation science strategies, modified for application to CSPAPs implementation in schools while allowing for local tailoring of the approach. This article describes BAC while providing examples from the implementation of a CSPAP in three rural elementary schools. PMID:29354631

Developing, implementing, and evaluating a condom promotion program targeting sexually active adolescents.

PubMed

Alstead, M; Campsmith, M; Halley, C S; Hartfield, K; Goldbaum, G; Wood, R W

1999-12-01

This article describes the development, implementation, and evaluation of the Condom Campaign, a 1995 HIV prevention program promoting condom use among sexually active adolescents in three King County, Washington, urban communities. This program employed three main strategies: (a) mobilizing all levels of the target communities to support and guide program development and implementation; (b) creating and implementing a mass media campaign targeting sexually active teenagers that promoted correct condom use and favorable attitudes toward condoms; and (c) recruiting public agencies, community organizations, and businesses to distribute condoms from bins and vending machines. We evaluated the program through a series of cross-sectional interviews conducted in the three communities chosen for their elevated levels of adolescent sexual risk behavior. Overall, 73% of target youth reported exposure to the Condom Campaign; exposure did not differ by age, gender, race, or level of sexual experience. Levels of sexual activity remained stable throughout the media campaign.

Understanding real-world implementation quality and "active ingredients" of PBIS.

PubMed

Molloy, Lauren E; Moore, Julia E; Trail, Jessica; Van Epps, John James; Hopfer, Suellen

2013-12-01

Programs delivered in the "real world" often look substantially different from what was originally intended by program developers. Depending on which components of a program are being trimmed or altered, such modifications may seriously undermine the effectiveness of a program. In the present study, these issues are explored within a widely used school-based, non-curricular intervention, Positive Behavioral Intervention and Supports. The present study takes advantage of a uniquely large dataset to gain a better understanding of the "real-world" implementation quality of PBIS and to take a first step toward identifying the components of PBIS that "matter most" for student outcomes. Data from 27,689 students and 166 public primary and secondary schools across seven states included school and student demographics, indices of PBIS implementation quality, and reports of problem behaviors for any student who received an office discipline referral during the 2007-2008 school year. Results of the present study identify three key components of PBIS that many schools are failing to implement properly, three program components that were most related to lower rates of problem behavior (i.e., three "active ingredients" of PBIS), and several school characteristics that help to account for differences across schools in the quality of PBIS implementation. Overall, findings highlight the importance of assessing implementation quality in "real-world" settings, and the need to continue improving understanding of how and why programs work. Findings are discussed in terms of their implications for policy.

Report of the 2016-17 Academic Affairs Standing Committee: Entrustable Professional Activities Implementation Roadmap.

PubMed

Pittenger, Amy L; Copeland, Debra A; Lacroix, Matthew M; Masuda, Quamrun N; Mbi, Peter; Medina, Melissa S; Miller, Susan M; Stolte, Scott K; Plaza, Cecilia M

2017-06-01

The purpose of this report is to: 1) Identify linkages across the EPA statements, Center for the Advancement of Pharmacy Education 2013 Educational Outcomes (CAPE 2013) and the Joint Commission of Pharmacy Practitioners' Pharmacist Patient Care Process (PPCP); 2) Provide ways EPA statements can be used to communicate core skills that are part of the entry-level pharmacist identity; 3) Suggest a potential roadmap for AACP members on how to implement EPA statements.

Implementation of the EU-policy framework WFD and GWD in Europe - Activities of CIS Working Group Groundwater

NASA Astrophysics Data System (ADS)

Grath, Johannes; Ward, Rob; Hall, Anna

2013-04-01

At the European level, the basic elements for groundwater management and protection are laid down in the Water Framework Directive (WFD) (2000/60/EC) and the Groundwater Daughter Directive (2006/118/EC). EU Member States, Norway and the European Commission (EC) have jointly developed a common strategy for supporting the implementation of the WFD. The main aim of this Common Implementation Strategy (CIS) is to ensure the coherent and harmonious implementation of the directives through the clarification of a number of methodological questions enabling a common understanding to be reached on the technical and scientific implications of the WFD (European Communities, 2008). Groundwater specific issues are dealt with in Working Group C Groundwater. Members of the working group are experts nominated by Member states, Norway, Switzerland and Accession Countries (from administrative bodies, research institutes, …) and representatives from relevant stakeholders and NGOs. Working Group C Groundwater has produced numerous guidance documents and technical reports that have been endorsed by EU Water Directors to support and enable Member States to implement the directives. All the documents are published by the EC. Access is available via the following link: http://ec.europa.eu/environment/water/water-framework/groundwater/activities.htm Having addressed implementations issues during the 1st river basin planning cycle, WG C Groundwater is currently focussing on the following issues: groundwater dependent ecosystems, and climate change and groundwater. In the future, the outcome and recommendations of the "Blueprint" - to safeguard Europe's water resources - which was recently published by the EC will be of utmost importance in setting the agenda for the group. Most likely this will include water pricing, water demand management and water abstraction. Complementory to the particular working groups, a Science Policy Interface (SPI) activity has been established. Its purpose is

NAAQS IMPLEMENTATION

EPA Science Inventory

The Clean Air Act requires EPA to set National Ambient Air Quality Standards (NAAQS) for six criteria pollutants (lead, carbon monoxide, sulfur dioxide, nitrous oxides, ozone, and particulate matter). After setting NAAQS, there are several activities required to implement the st...

Implementation and de-implementation: two sides of the same coin?

PubMed

van Bodegom-Vos, Leti; Davidoff, Frank; Marang-van de Mheen, Perla J

2017-06-01

Avoiding low value care received increasing attention in many countries, as with the Choosing Wisely campaign and other initiatives to abandon care that wastes resources or delivers no benefit to patients. While an extensive literature characterises approaches to implementing evidence-based care, we have limited understanding of the process of de-implementation, such as abandoning existing low value practices. To learn more about the differences between implementation and de-implementation, we explored the literature and analysed data from two published studies (one implementation and one de-implementation) by the same orthopaedic surgeons. We defined 'leaders' as those orthopaedic surgeons who implemented, or de-implemented, the target processes of care and laggards as those who did not. Our findings suggest that leaders in implementation share some characteristics with leaders in de-implementation when comparing them with laggards, such as more open to new evidence, younger and less time in clinical practice. However, leaders in de-implementation and implementation differed in some other characteristics and were not the same persons. Thus, leading in implementation or de-implementation may depend to some degree on the type of intervention rather than entirely reflecting personal characteristics. De-implementation seemed to be hampered by motivational factors such as department priorities, and economic and political factors such as cost-benefit considerations in care delivery, whereas organisational factors were associated only with implementation. The only barrier or facilitator common to both implementation and de-implementation consisted of outcome expectancy (ie, the perceived net benefit to patients). Future studies need to test the hypotheses generated from this study and improve our understanding of differences between the processes of implementation and de-implementation in the people who are most likely to lead (or resist) these efforts. Published by the

Design and implementation of active members for precision space structures

NASA Technical Reports Server (NTRS)

Webster, M. S.; Fanson, J. L.; Lurie, B. J.; O'Brien, J. F.

1992-01-01

This paper describes the development and implementation of an active member in a precision truss structure. The active member utilizes a piezoelectric actuator motor imbedded in a steel case with built-in displacement sensor. This active member is used in structural quieting. Collocated active damping control loops are designed in order to impedance match piezoelectric active members to the structure. Results from application of these controllers and actuators to the JPL Phase B testbed are given.

Evolution of an Implementation-Ready Interprofessional Pain Assessment Reference Model

PubMed Central

Collins, Sarah A; Bavuso, Karen; Swenson, Mary; Suchecki, Christine; Mar, Perry; Rocha, Roberto A.

2017-01-01

Standards to increase consistency of comprehensive pain assessments are important for safety, quality, and analytics activities, including meeting Joint Commission requirements and learning the best management strategies and interventions for the current prescription Opioid epidemic. In this study we describe the development and validation of a Pain Assessment Reference Model ready for implementation on EHR forms and flowsheets. Our process resulted in 5 successive revisions of the reference model, which more than doubled the number of data elements to 47. The organization of the model evolved during validation sessions with panels totaling 48 subject matter experts (SMEs) to include 9 sets of data elements, with one set recommended as a minimal data set. The reference model also evolved when implemented into EHR forms and flowsheets, indicating specifications such as cascading logic that are important to inform secondary use of data. PMID:29854125

Active Implementation Frameworks for Program Success: How to Use Implementation Science to Improve Outcomes for Children

ERIC Educational Resources Information Center

Metz, Allison; Bartley, Leah

2012-01-01

Over the past decade the science related to developing and identifying evidence-based programs and practices for children and families has improved significantly. However, the science related to implementing these programs in early childhood settings has lagged far behind. In this article, the authors outline how the science of implementation and…

Implementation Science for the Environment.

PubMed

Hering, Janet G

2018-05-15

The establishment of the field of implementation science was motivated by the understanding that medical and health research alone is insufficient to generate better health outcomes. With strong support from funding agencies for medical research, implementation science promotes the application of a structured framework or model in the implementation of research-based results, specifically evidence-based practices (EBPs). Furthermore, explicit consideration is given to the context of EBP implementation (i.e., socio-economic, political, cultural, and institutional factors that could affect the implementation process). Finally, implementation is monitored in a robust and rigorous way. Today, the field of implementation science supports conferences and professional societies as well as one dedicated journal and numerous others with related content. The goal of these various activities is to reduce the estimated, average "bench to bedside" time lag of 17 years for uptake of EBPs from health research into routine practice. Despite similar time lags and impediments to uptake in the environmental domain, a parallel field of implementation science for the environment has not (yet) emerged. Although some parallels in needs and opportunities can easily be drawn between the health and environmental domains, a detailed mapping exercise is needed to understand which aspects of implementation science could be applied in the environmental domain either directly or in a modified form. This would allow an accelerated development of implementation science for the environment.

77 FR 76012 - Agency Information Collection Activities; Comment Request; Study of Implementation and Outcomes...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... DEPARTMENT OF EDUCATION [Docket No. ED-2012-ICCD-0071] Agency Information Collection Activities; Comment Request; Study of Implementation and Outcomes in Upward Bound and Other TRIO Programs AGENCY... of Collection: Study of Implementation and Outcomes in Upward Bound and other TRIO Programs. OMB...

Practical implementation science: developing and piloting the quality implementation tool.

PubMed

Meyers, Duncan C; Katz, Jason; Chien, Victoria; Wandersman, Abraham; Scaccia, Jonathan P; Wright, Annie

2012-12-01

According to the Interactive Systems Framework for Dissemination and Implementation, implementation is a major mechanism and concern in bridging research and practice. The growing number of implementation frameworks need to be synthesized and translated so that the science and practice of quality implementation can be furthered. In this article, we: (1) use the synthesis of frameworks developed by Meyers et al. (Am J Commun Psychol, 2012) and translate the results into a practical implementation science tool to use for improving quality of implementation (i.e., the Quality Implementation Tool; QIT), and (2) present some of the benefits and limitations of the tool by describing how the QIT was implemented in two different pilot projects. We discuss how the QIT can be used to guide collaborative planning, monitoring, and evaluation of how an innovation is implemented.

Challenges of Implementing a Communication-and-Resolution Program Where Multiple Organizations Must Cooperate.

PubMed

Mello, Michelle M; Armstrong, Sarah J; Greenberg, Yelena; McCotter, Patricia I; Gallagher, Thomas H

2016-12-01

To implement a communication-and-resolution program (CRP) in a setting in which liability insurers and health care facilities must collaborate to resolve incidents involving a facility and separately insured clinicians. Six hospitals and clinics and a liability insurer in Washington State. Sites designed and implemented CRPs and contributed information about cases and operational challenges over 20 months. Data were qualitatively analyzed. Data from interviews with personnel responsible for CRP implementation were triangulated with data on program cases collected by sites and notes recorded during meetings with sites and among project team members. Sites experienced small victories in resolving particular cases and streamlining some working relationships, but they were unable to successfully implement a collaborative CRP. Barriers included the insurer's distance from the point of care, passive rather than active support from top leaders, coordinating across departments and organizations, workload, nonparticipation by some physicians, and overcoming distrust. Operating CRPs where multiple organizations must collaborate can be highly challenging. Success likely requires several preconditions, including preexisting trust among organizations, active leadership engagement, physicians' commitment to participate, mechanisms for quickly transmitting information to insurers, tolerance for missteps, and clear protocols for joint investigations and resolutions. © Health Research and Educational Trust.

Multi-atlas segmentation with joint label fusion and corrective learning—an open source implementation

PubMed Central

Wang, Hongzhi; Yushkevich, Paul A.

2013-01-01

Label fusion based multi-atlas segmentation has proven to be one of the most competitive techniques for medical image segmentation. This technique transfers segmentations from expert-labeled images, called atlases, to a novel image using deformable image registration. Errors produced by label transfer are further reduced by label fusion that combines the results produced by all atlases into a consensus solution. Among the proposed label fusion strategies, weighted voting with spatially varying weight distributions derived from atlas-target intensity similarity is a simple and highly effective label fusion technique. However, one limitation of most weighted voting methods is that the weights are computed independently for each atlas, without taking into account the fact that different atlases may produce similar label errors. To address this problem, we recently developed the joint label fusion technique and the corrective learning technique, which won the first place of the 2012 MICCAI Multi-Atlas Labeling Challenge and was one of the top performers in 2013 MICCAI Segmentation: Algorithms, Theory and Applications (SATA) challenge. To make our techniques more accessible to the scientific research community, we describe an Insight-Toolkit based open source implementation of our label fusion methods. Our implementation extends our methods to work with multi-modality imaging data and is more suitable for segmentation problems with multiple labels. We demonstrate the usage of our tools through applying them to the 2012 MICCAI Multi-Atlas Labeling Challenge brain image dataset and the 2013 SATA challenge canine leg image dataset. We report the best results on these two datasets so far. PMID:24319427

An easily implemented static condensation method for structural sensitivity analysis

NASA Technical Reports Server (NTRS)

Gangadharan, S. N.; Haftka, R. T.; Nikolaidis, E.

1990-01-01

A black-box approach to static condensation for sensitivity analysis is presented with illustrative examples of a cube and a car structure. The sensitivity of the structural response with respect to joint stiffness parameter is calculated using the direct method, forward-difference, and central-difference schemes. The efficiency of the various methods for identifying joint stiffness parameters from measured static deflections of these structures is compared. The results indicate that the use of static condensation can reduce computation times significantly and the black-box approach is only slightly less efficient than the standard implementation of static condensation. The ease of implementation of the black-box approach recommends it for use with general-purpose finite element codes that do not have a built-in facility for static condensation.

Implementing Policies to Enhance Physical Education and Physical Activity in Schools

ERIC Educational Resources Information Center

Cooper, Kenneth H.; Greenberg, Jayne D.; Castelli, Darla M.; Barton, Mitch; Martin, Scott B.; Morrow, James R., Jr.

2016-01-01

The purpose of this commentary is to provide an overview of national physical activity recommendations and policies (e.g., from the Institute of Medicine, National Physical Activity Plan, and Centers for Disease Control and Prevention) and to discuss how these important initiatives can be implemented in local schools. Successful policies are…

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

PubMed

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

2017-12-01

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

Implementation of the NEAMTWS in Portugal

NASA Astrophysics Data System (ADS)

Matias, L. M.; Annunziato, A.; Carrilho, F.; Baptista, M.

2008-12-01

In this paper we present the ongoing implementation of a national tsunami warning system in Portugal. After the Sumatra event in December 2004, the UNESCO, through its International Oceanographic Commission, recognized the need for an end to end global tsunami warning system and International Coordination Groups have been established for different areas around the globe: Indian, Caribbean, Atlantic and Mediterranean ocean basins. This system is the natural response to the historical and recent instrumental events generated along the western segment of the Eurasia and Nubian plates, which eastern end corresponds to the Gulf of Cadiz. The TWS includes three main components: the seismic detection, the tsunami detection and the issue of warnings/alerts. In Portugal the automatic earthquake processing is installed at IM (Instituto de Meteorologia) which is the only national institution operating on a 24x7 basis. This makes IM the natural candidate to host the Portuguese tsunami warning system. The TWS under implementation has several key points: definition of the tsunami scenarios, tsunami detection, and tsunami protocol messages. The system will also be able to predict tsunami potential impact along the coast, wave-heights and arrival times at pre-defined locations along the coast. In this study we present the recent results on definition of tsunami scenarios, establishment of the scenario database and the tsunami analysis tool. This work is a joint effort between Instituto de Meteorologia (Portugal), the Joint Research Center, JRC- ISPRA, Italy and the coordination of the Portuguese Group for the implementation of NEAMTWS in the area. This work has been financed by different European projects as NEAREST and TRANSFER, and also by the JRC, the IM and CGUL/IDL institutions.

Implementing active-learning strategies to improve physics learning in Latin America

NASA Astrophysics Data System (ADS)

Alarcon, Hugo; Zavala, G.; Fernandez, R.; Benegas, J.

2006-12-01

It is evident that the most effective active-learning strategies to improve physics learning at the college level have been developed in the United States. Recently, some universities in Latin America have begun adopting such methods as a part of institutional projects, or motivated by national projects led by education authorities. In this work we will present two cases, a large-scale implementation of Tutorials in Introductory Physics (1) in Mexico supported by the institution as a part of a change in its educational model, and a medium-scale implementation of this method in Chile supported by the national government. In both experiences, the professors involved in the educational experience have previously participated in a training workshop that prepared them for implementing this strategy in the classroom. The training workshop, described elsewhere (2), was designed also under active learning premises, so teachers completed the proposed activities in the same way as their students will do. We will present the first results of these two projects. References: (1) McDermott, L. C., Shaffer, P. S., & PER (1998). "Tutorials in Introductory Physics", Prentice Hall, translated as "Tutoriales para Física Introductoria" (2001) Prentice Hall, Buenos Aires.. (2) Zavala, G., Alarcón, H. and Benegas, J. (2005). "Innovative training of in-service teachers for active learning: A short teacher development course based on Physics Education Research", accepted for publication, J. of Sc. Teach. Ed. This work has been partially supported by Tecnológico de Monterrey through the Chair in Physics Education Research and by MECE Educación Superior Program (Chile).

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

PubMed

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

2015-04-01

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

Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

PubMed

Jankowski, Irene M; Nadzam, Deborah Morris

2011-06-01

Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

Understanding Real-World Implementation Quality and “Active Ingredients” of PBIS

PubMed Central

Molloy, Lauren E.; Moore, Julia E.; Trail, Jessica; Van Epps, John James; Hopfer, Suellen

2014-01-01

Programs delivered in the “real world” often look substantially different from what was originally intended by program developers. Depending on which components of a program are being trimmed or altered, such modifications may seriously undermine the effectiveness of a program. In the present study, these issues are explored within a widely used school-based, non-curricular intervention, Positive Behavioral Intervention and Supports. The present study takes advantage of a uniquely large dataset to gain a better understanding of the “real-world” implementation quality of PBIS, and to take a first step toward identifying the components of PBIS that “matter most” for student outcomes. Data from 27,689 students and 166 public primary and secondary schools across seven states included school and student demographics, indices of PBIS implementation quality, and reports of problem behaviors for any student who received an office discipline referral (ODR) during the 2007-2008 school year. Results of the present study identify three key components of PBIS that many schools are failing to implement properly, three program components that were most related to lower rates of problem behavior (i.e., three “active ingredients” of PBIS), and several school characteristics that help to account for differences across schools in the quality of PBIS implementation. Overall, findings highlight the importance of assessing implementation quality in “real-world” settings, and the need to continue improving understanding of how and why programs work. Findings are discussed in terms of their implications for policy. PMID:23408283

Development, Implementation, and Evaluation of Active Lions: A Campaign to Promote Active Travel to a University Campus.

PubMed

Bopp, Melissa; Sims, Dangaia; Matthews, Stephen A; Rovniak, Liza S; Poole, Erika; Colgan, Joanna

2018-03-01

To outline the development, implementation, and evaluation of a multistrategy intervention to promote active transportation, on a large university campus. Single group pilot study. A large university in the Northeastern United States. University students (n = 563), faculty and staff (employees, n = 999) were included in the study. The Active Lions campaign aimed to increase active transportation to campus for all students and employees. The campaign targeted active transport participation through the development of a smartphone application and the implementation of supporting social marketing and social media components. Component-specific measures included app user statistics, social media engagement, and reach of social marketing strategies. Overall evaluation included cross-sectional online surveys preintervention and postintervention of student and employee travel patterns and campaign awareness. Number of active trips to campus were summed, and the percentage of trips as active was calculated. T tests compared the differences in outcomes from preintervention to postintervention. Students had a higher percentage of active trips postintervention (64.2%) than preintervention (49.2%; t = 3.32, P = .001), although there were no differences for employees (7.9% and 8.91%). Greater awareness of Active Lions was associated with greater active travel. This multistrategy approach to increase active transportation on a college campus provided insight on the process of developing and implementing a campaign with the potential for impacting health behaviors among campus members.

Improvements in Students' Understanding from Increased Implementation of Active Learning Strategies

NASA Astrophysics Data System (ADS)

Hayes-Gehrke, Melissa N.; Prather, E. E.; Rudolph, A. L.; Collaboration of Astronomy Teaching Scholars CATS

2011-01-01

Many instructors are hesitant to implement active learning strategies in their introductory astronomy classrooms because they are not sure which techniques they should use, how to implement those techniques, and question whether the investment in changing their course will really bring the advertised learning gains. We present an example illustrating how thoughtful and systematic implementation of active learning strategies into a traditionally taught Astro 101 class can translate into significant increases in students' understanding. We detail the journey of one instructor, over several years, as she changes the instruction and design of her course from one that focuses almost exclusively on lecture to a course that provides an integrated use of several active learning techniques such as Lecture-Tutorials and Think-Pair-Share questions. The students in the initial lecture-only course achieved a low normalized gain score of only 0.2 on the Light and Spectroscopy Concept Inventory (LSCI), while the students in the re-designed learner-centered course achieved a significantly better normalized gain of 0.43. This material is based upon work supported by the National Science Foundation under Grant No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS), and Grant No. 0847170, a PAARE Grant for the Calfornia-Arizona Minority Partnership for Astronomy Research and Education (CAMPARE). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

For support of USAMRMC Biological Weapons Convention, treaty and statement implementation activities. Final report, 1 March 1996-28 February 1997

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

Fox, J.

Program of work to provide support to the Biological Arms Control Treaty Office (BACTO) of the U.S. Army Medical Research and Material Command (USAMRMC), in the development of Army and U.S. Government negotiation, implementation and compliance policies and preparations regarding potential verification and confidence measures for the 1975 Biological Weapons Convention (BWC) and related biological weapons agreements. Support services provided included the preparation of Army installations and commands for implementation of visits pursuant to the U.S./UK/Russian Trilateral Statement on BW. Support included site assistance visit, development of required facility documentation and briefings, identification of additional facilities potentially subject to access,more » and support to DOD development of guidelines, procedures, documentation, and other materials for the conduct of visits. Specific tasks under this contract included: identification and delineation of `Military Biological Facilities` and related activities at Army installations; development of visit implementation documentation for the Army; assessment of potentially at-risk equities and sensitivities at relevant facilities; facility staff training and preparation; and review and modification of facility inputs to annual BWC Confidence Building Measure Declarations. Also supported the provision of timely and critical technical support to the Joint Staff and OSD in the development of DoD negotiation biological arms control positions.« less

Implementation plans included in World Health Organisation guidelines.

PubMed

Wang, Zhicheng; Norris, Susan L; Bero, Lisa

2016-05-20

The implementation of high-quality guidelines is essential to improve clinical practice and public health. The World Health Organisation (WHO) develops evidence-based public health and other guidelines that are used or adapted by countries around the world. Detailed implementation plans are often necessary for local policymakers to properly use the guidelines developed by WHO. This paper describes the plans for guideline implementation reported in WHO guidelines and indicates which of these plans are evidence-based. We conducted a content analysis of the implementation sections of WHO guidelines approved by the WHO guideline review committee between December 2007 and May 2015. The implementation techniques reported in each guideline were coded according to the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) taxonomy and classified as passive, active or policy strategies. The frequencies of implementation techniques are reported. The WHO guidelines (n = 123) analysed mentioned implementation techniques 800 times, although most mentioned implementation techniques very briefly, if at all. Passive strategies (21 %, 167/800) and general policy strategies (62 %, 496/800) occurred most often. Evidence-based active implementation methods were generally neglected with no guideline mentioning reminders (computerised or paper) and only one mentioning a multifaceted approach. Many guidelines contained implementation sections that were identical to those used in older guidelines produced by the same WHO technical unit. The prevalence of passive and policy-based implementation techniques as opposed to evidence-based active techniques suggests that WHO guidelines should contain stronger guidance for implementation. This could include structured and increased detail on implementation considerations, accompanying or linked documents that provide information on what is needed to contextualise or adapt a guideline and specific options from among

75 FR 69630 - Impact of Implementation of the Chemical Weapons Convention on Commercial Activities Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... Implementation of the Chemical Weapons Convention on Commercial Activities Involving ``Schedule 1'' Chemicals, Including Production of Schedule 1 Chemicals as Intermediates, Through Calendar Year 2010 AGENCY: Bureau of... (BIS) is seeking public comments on the impact that implementation of the Chemical Weapons Convention...

Implementation Guide: Leading School Change

ERIC Educational Resources Information Center

Whitaker, Todd

2010-01-01

This two-part "Implementation Guide" will help to deepen your understanding and sharpen your ability to implement each of the strategies discussed in "Leading School Change: Nine Strategies to Bring Everybody on Board" (ED509821). Part One offers discussion questions and activities which focus on each of the nine strategies. They can be completed…

Implementing a Nutrition and Physical Activity Curriculum in Head Start Through an Academic-Community Partnership.

PubMed

Zahnd, Whitney E; Smith, Tracey; Ryherd, Susan J; Cleer, Melissa; Rogers, Valerie; Steward, David E

2017-06-01

Schools may be an effective avenue for interventions that prevent childhood obesity. I am Moving I am Learning/Choosy Kids © (IMIL/CK) is a curriculum recommended by Head Start (HS) for education in nutrition, physical activity, and healthy lifestyle habits. We formed an academic-community partnership (ACP), the Springfield Collaborative for Active Child Health, to promote prevention of childhood obesity, in part, to implement the IMIL/CK curriculum in local HS sites. The ACP included a medical school, HS program, public school district, and state health department. Community-based participatory research principles helped identify and organize important implementation activities: community engagement, curriculum support, professional teacher training, and evaluation. IMIL/CK was piloted in 1 school then implemented in all local HS sites. All sites were engaged in IMIL/CK professional teacher training, classroom curriculum delivery, and child physical activity assessments. Local HS policy changed to include IMIL/CK in lesson plans and additional avenues of collaboration were initiated. Furthermore, improvements in physical activity and/or maintenance or improvement of healthy weight prevalence was seen in 4 of the 5 years evaluated. An ACP is an effective vehicle to implement and evaluate childhood obesity prevention programming in HS sites. © 2017, American School Health Association.

[Implementing evidence and implementation research: two different and prime realities].

PubMed

Rumbo Prieto, José María; Martínez Ques, Ángel Alfredo; Sobrido Prieto, María; Raña Lama, Camilo Daniel; Vázquez Campo, Miriam; Braña Marcos, Beatriz

Scientific research can contribute to more efficient health care, enhance care quality and safety of persons. In order for this to happen, the knowledge gained must be put into practice. Implementation is known as the introduction of a change or innovation to daily practice, which requires effective communication and the elimination of barriers that hinder this process. Best practice implementation experiences are being used increasingly in the field of nursing. The difficulty in identifying the factors that indicate the success or failure of implementation has led to increased studies to build a body of differentiated knowledge, recognized as implementation science or implementation research. Implementation research is the scientific study whose objective is the adoption and systematic incorporation of research findings into clinical practice to improve the quality and efficiency of health services. The purpose of implementation research is to improve the health of the population through equitable and effective implementation of rigorously evaluated scientific knowledge, which involves gathering the evidence that has a positive impact on the health of the community. In this text, we set out the characteristics of nursing implementation research, providing a synthesis of different methods, theories, key frameworks and implementation strategies, along with the terminology proposed for greater conceptual clarity. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Research Implementation.

ERIC Educational Resources Information Center

Trochim, William M. K.

Investigated is the topic of research implementation and how it can affect evaluation results. Even when evaluations are well planned, the obtained results can be misleading if the conscientiously-constructed research plan is not correctly implemented in practice. In virtually every research arena, one finds major difficulties in implementing the…

Implementing and Assessing 4-H Educational Activity Kits for Children

ERIC Educational Resources Information Center

Scheer, Scott D.; Yeske, Janine; Zimmer, Bruce

2011-01-01

Educational activity kits were developed and implemented through a statewide effort for 4-H Youth Development Extension programs serving 5-8 year-old children. The purpose of the kits was to promote life skills in children and assess the learning environment. Data was collected based on the observations of 577 children across 22 counties. Findings…

Implementation: Measuring and Explaining the Fidelity of CSR Implementation

ERIC Educational Resources Information Center

Kurki, Anja; Boyle, Andrea; Aladjem, Daniel K.

2006-01-01

Comprehensive school reform (CSR) is only as effective as its implementation. By using data collected for the National Longitudinal Evaluation of Comprehensive School Reform (NLECSR), this article explores the factors that predict CSR model implementation and the ways that CSR model implementation varies. We found little difference in the fidelity…

The case for implementing activity based costing.

PubMed

Monge, Paul H; Bolinger-Perez, Nicole; Boysen, Kent

2012-01-01

ABC identifies profitable volumes to give managers information to better manage volumes. Managers must balance the demand for service while maintaining a reasonable profit margin. Disparate systems work extremely well for their intended purposes, but they do not communicate with one another. The strength of the data they hold individually may be leveraged when implementing ABC methodology. Mayo Clinic in Rochester, Minnesota implemented a pilot of ABC to evaluate CT services where there is a high volume, multiple service location for cost comparison, variety of patient acuity and service mix, and large capital investments.The goal was to reveal the actual cost of CT services at the procedural level.

Active Learning in the Middle Grades Classroom: Overcoming the Barriers to Implementation

ERIC Educational Resources Information Center

Edwards, Susan

2015-01-01

The Association for Middle Level Education advocates for instruction that incorporates active learning and multiple learning approaches in middle grades classrooms. The aim of this qualitative study was to examine middle level teachers who are able to implement active learning and multiple learning approaches within the standardized testing and…

Multi-Center Implementation of NPR 7123.1A: A Collaborative Effort

NASA Technical Reports Server (NTRS)

Hall, Phillip B.; McNelis, Nancy B.

2011-01-01

Collaboration efforts between MSFC and GRC Engineering Directorates to implement the NASA Systems Engineering (SE) Engine have expanded over the past year to include other NASA Centers. Sharing information on designing, developing, and deploying SE processes has sparked further interest based on the realization that there is relative consistency in implementing SE processes at the institutional level. This presentation will provide a status on the ongoing multi-center collaboration and provide insight into how these NPR 7123.1A SE-aligned directives are being implemented and managed to better support the needs of NASA programs and projects. NPR 7123.1A, NASA Systems Engineering Processes and Requirements, was released on March 26, 2007 to clearly articulate and establish the requirements on the implementing organization for performing, supporting, and evaluating SE activities. In early 2009, MSFC and GRC Engineering Directorates undertook a collaborative opportunity to share their research and work associated with developing, updating and revising their SE process policy to comply and align with NPR 7123.1A. The goal is to develop instructions, checklists, templates, and procedures for each of the 17 SE process requirements so that systems engineers will be a position to define work that is process-driven. Greater efficiency and more effective technical management will be achieved due to consistency and repeatability of SE process implementation across and throughout each of the NASA centers. An added benefit will be to encourage NASA centers to pursue and collaborate on joint projects as a result of using common or similar processes, methods, tools, and techniques.

Implementation notes on bdes(1). [data encryption implementation

NASA Technical Reports Server (NTRS)

Bishop, Matt

1991-01-01

This note describes the implementation of bdes, the file encryption program being distributed in the 4.4 release of the Berkeley Software Distribution. It implements all modes of the Data Encryption Standard program.

Core Implementation Components

ERIC Educational Resources Information Center

Fixsen, Dean L.; Blase, Karen A.; Naoom, Sandra F.; Wallace, Frances

2009-01-01

The failure of better science to readily produce better services has led to increasing interest in the science and practice of implementation. The results of recent reviews of implementation literature and best practices are summarized in this article. Two frameworks related to implementation stages and core implementation components are described…

Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.

PubMed

Ward, Marcia M; Baloh, Jure; Zhu, Xi; Stewart, Greg L

A particularly useful model for examining implementation of quality improvement interventions in health care settings is the PARIHS (Promoting Action on Research Implementation in Health Services) framework developed by Kitson and colleagues. The PARIHS framework proposes three elements (evidence, context, and facilitation) that are related to successful implementation. An evidence-based program focused on quality enhancement in health care, termed TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), has been widely promoted by the Agency for Healthcare Research and Quality, but research is needed to better understand its implementation. We apply the PARIHS framework in studying TeamSTEPPS implementation to identify elements that are most closely related to successful implementation. Quarterly interviews were conducted over a 9-month period in 13 small rural hospitals that implemented TeamSTEPPS. Interview quotes that were related to each of the PARIHS elements were identified using directed content analysis. Transcripts were also scored quantitatively, and bivariate regression analysis was employed to explore relationships between PARIHS elements and successful implementation related to planning activities. The current findings provide support for the PARIHS framework and identified two of the three PARIHS elements (context and facilitation) as important contributors to successful implementation. This study applies the PARIHS framework to TeamSTEPPS, a widely used quality initiative focused on improving health care quality and patient safety. By focusing on small rural hospitals that undertook this quality improvement activity of their own accord, our findings represent effectiveness research in an understudied segment of the health care delivery system. By identifying context and facilitation as the most important contributors to successful implementation, these analyses provide a focus for efficient and effective sustainment of Team

77 FR 75145 - Impact of the Implementation of the Chemical Weapons Convention (CWC) on Commercial Activities...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... the Implementation of the Chemical Weapons Convention (CWC) on Commercial Activities Involving ``Schedule 1'' Chemicals (Including Schedule 1 Chemicals Produced as Intermediates) Through Calendar Year... Chemical Weapons Convention (CWC), through the Chemical Weapons Convention Implementation Act (CWCIA) and...

Teachers' Beliefs and Implementation of Competitive Activities for Multicultural Students

ERIC Educational Resources Information Center

Bernstein, Eve; Lysniak, Ulana

2017-01-01

Physical education teachers' (N = 9) beliefs and implementation of competitive activities for middle school multicultural student populations (Grades 6-8) in physical education class in the Greater New York area were examined. Data were collected by nonparticipant observation and field notes, two semistructured interviews, and postobservation…

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

PubMed Central

Logan, Jessica R.; Damschroder, Laura

2015-01-01

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

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

PubMed

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

2015-12-01

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

Activity-Based Management System Implementation in Higher Education Institution: Benefits and Challenges

ERIC Educational Resources Information Center

Ismail, Noor Azizi

2010-01-01

Purpose: The purpose of this paper is to discuss how activity-based costing (ABC) technique can be applied in the context of higher education institutions. It also discusses the obstacles and challenges to the successful implementation of activity-based management (ABM) in the higher education environment. Design/methodology/approach: This paper…

Report: EPA Prepared to Implement Strategic Human Capital Management Activities But Challenges Remain

EPA Pesticide Factsheets

Report #2004-P-00024, September 20, 2004. EPA’s headquarters and regional offices are prepared to implement strategic human capital management activities, but an alignment of office-level activities to the Agency’s Strategy for Human Capital is lacking.

Multiscale implementation of infinite-swap replica exchange molecular dynamics.

PubMed

Yu, Tang-Qing; Lu, Jianfeng; Abrams, Cameron F; Vanden-Eijnden, Eric

2016-10-18

Replica exchange molecular dynamics (REMD) is a popular method to accelerate conformational sampling of complex molecular systems. The idea is to run several replicas of the system in parallel at different temperatures that are swapped periodically. These swaps are typically attempted every few MD steps and accepted or rejected according to a Metropolis-Hastings criterion. This guarantees that the joint distribution of the composite system of replicas is the normalized sum of the symmetrized product of the canonical distributions of these replicas at the different temperatures. Here we propose a different implementation of REMD in which (i) the swaps obey a continuous-time Markov jump process implemented via Gillespie's stochastic simulation algorithm (SSA), which also samples exactly the aforementioned joint distribution and has the advantage of being rejection free, and (ii) this REMD-SSA is combined with the heterogeneous multiscale method to accelerate the rate of the swaps and reach the so-called infinite-swap limit that is known to optimize sampling efficiency. The method is easy to implement and can be trivially parallelized. Here we illustrate its accuracy and efficiency on the examples of alanine dipeptide in vacuum and C-terminal β-hairpin of protein G in explicit solvent. In this latter example, our results indicate that the landscape of the protein is a triple funnel with two folded structures and one misfolded structure that are stabilized by H-bonds.

Implementation Approach for Plug-in Electric Vehicles at Joint Base Lewis McChord. Task 4

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

Schey, Stephen; Francfort, Jim

2014-12-01

This study focused on Joint Base Lewis McChord (JBLM), which is located in Washington State. Task 1 consisted of a survey of the non-tactical fleet of vehicles at JBLM to begin the review of vehicle mission assignments and the types of vehicles in service. In Task 2, daily operational characteristics of select vehicles were identified and vehicle movements were recorded in data loggers in order to characterize the vehicles’ missions. In Task 3, the results of the data analysis and observations were provided. Individual observations of the selected vehicles provided the basis for recommendations related to PEV adoption (i.e., whethermore » a battery electric vehicle or plug-in hybrid electric vehicle [collectively referred to as PEVs] can fulfill the mission requirements0, as well as the basis for recommendations related to placement of PEV charging infrastructure. This report focuses on an implementation plan for the near-term adoption of PEVs into the JBLM fleet.« less

Joint carrier phase and frequency-offset estimation with parallel implementation for dual-polarization coherent receiver.

PubMed

Lu, Jianing; Li, Xiang; Fu, Songnian; Luo, Ming; Xiang, Meng; Zhou, Huibin; Tang, Ming; Liu, Deming

2017-03-06

We present dual-polarization complex-weighted, decision-aided, maximum-likelihood algorithm with superscalar parallelization (SSP-DP-CW-DA-ML) for joint carrier phase and frequency-offset estimation (FOE) in coherent optical receivers. By pre-compensation of the phase offset between signals in dual polarizations, the performance can be substantially improved. Meanwhile, with the help of modified SSP-based parallel implementation, the acquisition time of FO and the required number of training symbols are reduced by transferring the complex weights of the filters between adjacent buffers, where differential coding/decoding is not required. Simulation results show that the laser linewidth tolerance of our proposed algorithm is comparable to traditional blind phase search (BPS), while a complete FOE range of ± symbol rate/2 can be achieved. Finally, performance of our proposed algorithm is experimentally verified under the scenario of back-to-back (B2B) transmission using 10 Gbaud DP-16/32-QAM formats.

Cochrane Qualitative and Implementation Methods Group guidance series-paper 4: methods for assessing evidence on intervention implementation.

PubMed

Cargo, Margaret; Harris, Janet; Pantoja, Tomas; Booth, Andrew; Harden, Angela; Hannes, Karin; Thomas, James; Flemming, Kate; Garside, Ruth; Noyes, Jane

2018-05-01

This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation. Strategies, tools, and methods are applied to the systematic review process to illustrate how process and implementation can be addressed using quantitative, qualitative, and other sources of evidence (i.e., descriptive textual and nonempirical). Reviewers can take steps to navigate the heterogeneity and level of uncertainty present in the concepts, measures, and methods used to assess implementation. Activities can be undertaken in advance of a Cochrane quantitative review to develop program theory and logic models that situate implementation in the causal chain. Four search strategies are offered to retrieve process and implementation evidence. Recommendations are made for addressing rigor or risk of bias in process evaluation or implementation evidence. Strategies are recommended for locating and extracting data from primary studies. The basic logic is presented to assist reviewers to make initial review-level judgments about implementation failure and theory failure. Although strategies, tools, and methods can assist reviewers to address process and implementation using quantitative, qualitative, and other forms of evidence, few exemplar reviews exist. There is a need for further methodological development and trialing of proposed approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

Implementation of a Proficiency-Based Diploma System in Maine: Phase II--District Level Analysis

ERIC Educational Resources Information Center

Silvernail, David L.; Stump, Erika K.; McCafferty, Anita Stewart; Hawes, Kathryn M.

2014-01-01

This report describes the findings from Phase II of a study of Maine's implementation of a proficiency-based diploma system. At the request of the Joint Standing Committee on Education and Cultural Affairs of the Maine Legislature, the Maine Policy Research Institute (MEPRI) has conducted a two-phased study of the implementation of Maine law…

Like a Chameleon: A Beginning Teacher's Journey to Implement Active Learning

ERIC Educational Resources Information Center

Edwards, Susan

2017-01-01

The purpose of this study was to follow the learning trajectory of a beginning teacher attempting to implement active learning instructional methods in a middle grades classroom. The study utilized a qualitative case study methodological approach with the researcher in the role of participant observer. Three research questions were explored: the…

Implementing Physical Activity Recommendations in a Tri-ethnic Rural Community through a Community-University Partnership

PubMed Central

Davis, Sally M.; Cruz, Theresa; Hess, Julia Meredith; Kozoll, Richard; Page-Reeves, Janet

2016-01-01

Background A tri-ethnic rural community with limited resources and a university Prevention Research Center developed a partnership to promote evidence-based physical activity. Objective The purpose of this study was to investigate how a community-university partnership can disseminate and implement The Community Guide’s recommendations for increasing physical activity and create a model for other under-resourced communities experiencing high rates of chronic disease. Methods Qualitative data collected through 47 semi-structured interviews, meeting minutes, and local newspaper articles were coded for themes and analyzed for patterns across the data. Results Implementation resulted in the creation of new paths and trails, increased walkability throughout the community, local park enhancements, and a community-wide campaign. Lessons learned included the importance of community-defined goals and outcomes, leadership, volunteerism, mutually beneficial goals, synergy, and having non-traditional partners. Conclusion This research provides a community-university partnership model for implementing evidence-based strategies to increase physical activity in rural communities. PMID:28736407

Iowa High School High Tech: Promoting Careers in Technology for Students with Disabilities. Final Report and Implementation Manual.

ERIC Educational Resources Information Center

McQuillen, Terry; Nietupski, John; Berg, Deana Duncan; Daugherty, Vicki; Bildstein, Stephanie

This final report and implementation manual describes the activities and outcomes of Iowa's High School High Tech (HSHT) program, a joint effort of Grant Wood Area Education Agency and Goodwill Industries of Southeast Iowa to inspire students with disabilities to pursue high tech careers. The program provides opportunities for students to learn…

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

PubMed

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

2016-01-01

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

Agile Implementation: A Blueprint for Implementing Evidence-Based Healthcare Solutions.

PubMed

Boustani, Malaz; Alder, Catherine A; Solid, Craig A

2018-03-07

To describe the essential components of an Agile Implementation (AI) process, which rapidly and effectively implements evidence-based healthcare solutions, and present a case study demonstrating its utility. Case demonstration study. Integrated, safety net healthcare delivery system in Indianapolis. Interdisciplinary team of clinicians and administrators. Reduction in dementia symptoms and caregiver burden; inpatient and outpatient care expenditures. Implementation scientists were able to implement a collaborative care model for dementia care and sustain it for more than 9 years. The model was implemented and sustained by using the elements of the AI process: proactive surveillance and confirmation of clinical opportunities, selection of the right evidence-based healthcare solution, localization (i.e., tailoring to the local environment) of the selected solution, development of an evaluation plan and performance feedback loop, development of a minimally standardized operation manual, and updating such manual annually. The AI process provides an effective model to implement and sustain evidence-based healthcare solutions. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Self-powered suspension criterion and energy regeneration implementation scheme of motor-driven active suspension

NASA Astrophysics Data System (ADS)

Yan, Shuai; Sun, Weichao

2017-09-01

Active suspension systems have advantages on mitigating the effects of vehicle vibration caused by road roughness, which are one of the most important component parts in influencing the performances of vehicles. However, high amount of energy consumption restricts the application of active suspension systems. From the point of energy saving, this paper presents a self-powered criterion of the active suspension system to judge whether a motor-driven suspension can be self-powered or not, and then a motor parameter condition is developed as a reference to design a self-powered suspension. An energy regeneration implementation scheme is subsequently proposed to make the active suspension which has the potential to be self-powered achieve energy-saving target in the real application. In this implementation scheme, operating electric circuits are designed based on different working status of the actuator and power source and it is realizable to accumulate energy from road vibration and supply energy to the actuator by switching corresponding electric circuits. To apply the self-powered suspension criterion and energy regeneration implementation scheme, an active suspension system is designed with a constrained H∞ controller and calculation results indicate that it has the capability to be self-powered. Simulation results show that the performances of the self-powered active suspension are nearly the same as those of the active suspension with an external energy source and can achieve energy regeneration at the same time.

E-consult implementation: lessons learned using consolidated framework for implementation research.

PubMed

Haverhals, Leah M; Sayre, George; Helfrich, Christian D; Battaglia, Catherine; Aron, David; Stevenson, Lauren D; Kirsh, Susan; Ho, Michael; Lowery, Julie

2015-12-01

In 2011, the Veterans Health Administration (VHA) implemented electronic consults (e-consults) as an alternative to in-person specialty visits to improve access and reduce travel for veterans. We conducted an evaluation to understand variation in the use of the new e-consult mechanism and the causes of variable implementation, guided by the Consolidated Framework for Implementation Research (CFIR). Qualitative case studies of 3 high- and 5 low-implementation e-consult pilot sites. Participants included e-consult site leaders, primary care providers, specialists, and support staff identified using a modified snowball sample. We used a 3-step approach, with a structured survey of e-consult site leaders to identify key constructs, based on the CFIR. We then conducted open-ended interviews, focused on key constructs, with all participants. Finally, we produced structured, site-level ratings of CFIR constructs and compared them between high- and low-implementation sites. Site leaders identified 14 initial constructs. We conducted 37 interviews, from which 4 CFIR constructs distinguished high implementation e-consult sites: compatibility, networks and communications, training, and access to knowledge and information. For example, illustrating compatibility, a specialist at a high-implementation site reported that the site changed the order of consult options so that all specialties listed e-consults first to maintain consistency. High-implementation sites also exhibited greater agreement on constructs. By using the CFIR to analyze results, we facilitate future synthesis with other findings, and we better identify common patterns of implementation determinants common across settings.

Tuberculosis active case finding in Cambodia: a pragmatic, cost-effectiveness comparison of three implementation models.

PubMed

James, Richard; Khim, Keovathanak; Boudarene, Lydia; Yoong, Joanne; Phalla, Chea; Saint, Saly; Koeut, Pichenda; Mao, Tan Eang; Coker, Richard; Khan, Mishal Sameer

2017-08-22

Globally, almost 40% of tuberculosis (TB) patients remain undiagnosed, and those that are diagnosed often experience prolonged delays before initiating correct treatment, leading to ongoing transmission. While there is a push for active case finding (ACF) to improve early detection and treatment of TB, there is extremely limited evidence about the relative cost-effectiveness of different ACF implementation models. Cambodia presents a unique opportunity for addressing this gap in evidence as ACF has been implemented using different models, but no comparisons have been conducted. The objective of our study is to contribute to knowledge and methodology on comparing cost-effectiveness of alternative ACF implementation models from the health service perspective, using programmatic data, in order to inform national policy and practice. We retrospectively compared three distinct ACF implementation models - door to door symptom screening in urban slums, checking contacts of TB patients, and door to door symptom screening focusing on rural populations aged above 55 - in terms of the number of new bacteriologically-positive pulmonary TB cases diagnosed and the cost of implementation assuming activities are conducted by the national TB program of Cambodia. We calculated the cost per additional case detected using the alternative ACF models. Our analysis, which is the first of its kind for TB, revealed that the ACF model based on door to door screening in poor urban areas of Phnom Penh was the most cost-effective (249 USD per case detected, 737 cases diagnosed), followed by the model based on testing contacts of TB patients (308 USD per case detected, 807 cases diagnosed), and symptomatic screening of older rural populations (316 USD per case detected, 397 cases diagnosed). Our study provides new evidence on the relative effectiveness and economics of three implementation models for enhanced TB case finding, in line with calls for data from 'routine conditions' to be included

Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation.

PubMed

Shiffman, Richard N; Michel, George; Essaihi, Abdelwaheb; Thornquist, Elizabeth

2004-01-01

A gap exists between the information contained in published clinical practice guidelines and the knowledge and information that are necessary to implement them. This work describes a process to systematize and make explicit the translation of document-based knowledge into workflow-integrated clinical decision support systems. This approach uses the Guideline Elements Model (GEM) to represent the guideline knowledge. Implementation requires a number of steps to translate the knowledge contained in guideline text into a computable format and to integrate the information into clinical workflow. The steps include: (1) selection of a guideline and specific recommendations for implementation, (2) markup of the guideline text, (3) atomization, (4) deabstraction and (5) disambiguation of recommendation concepts, (6) verification of rule set completeness, (7) addition of explanations, (8) building executable statements, (9) specification of origins of decision variables and insertions of recommended actions, (10) definition of action types and selection of associated beneficial services, (11) choice of interface components, and (12) creation of requirement specification. The authors illustrate these component processes using examples drawn from recent experience translating recommendations from the National Heart, Lung, and Blood Institute's guideline on management of chronic asthma into a workflow-integrated decision support system that operates within the Logician electronic health record system. Using the guideline document as a knowledge source promotes authentic translation of domain knowledge and reduces the overall complexity of the implementation task. From this framework, we believe that a better understanding of activities involved in guideline implementation will emerge.

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

PubMed

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

2013-06-10

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

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

PubMed Central

2013-01-01

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

Diet and physical activity in schools: perspectives from the implementation of the WHO global strategy on diet, physical activity and health.

PubMed

Candeias, Vanessa; Armstrong, Timothy P; Xuereb, Godfrey C

2010-01-01

Non-communicable diseases (NCD), such as heart disease, stroke, cancer and diabetes, are by far the leading cause of mortality in the world, representing 60% of all deaths. Unhealthy diets and physical inactivity are well-established risk factors for overweight and the major NCD. In response to the rapid global growth of the NCD burden, the 2008 Action Plan on Prevention and Control of NCD and the 2004 Global Strategy on Diet, Physical Activity and Health (DPAS) have been developed and endorsed as key international policy instruments. As part of the work of the World Health Organization (WHO) to implement these resolutions, a framework describing the core elements for the development and implementation of a national school policy focused on diet and physical activity has been developed. This framework is included in the "DPAS implementation tool box", and it aims to guide policy-makers in the development and implementation of policies that promote healthy eating and physical activity in the school setting through changes in environment, behaviour and education. The article describes the key elements of the framework and details how this tool is integrated into other WHO activities to provide leadership, guidance, capacity building, evidence-based recommendations and advocacy for action to improve dietary practices and increase physical activity globally.

NSF final project report planning and implementation of the U.S. Joint Global Ocean Flux Study (U.S. JGOFS)

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

Livingston, Hugh D.

1996-07-01

Conducted planning and implementation of ocean carbon dioxide hydrographic surveys ocean process studies, time-series studies of Bermuda and Hawaii, and sponsored scientific workshops for those activities.

Ohio Route 50 joint sealant experiment : research implementation plan.

DOT National Transportation Integrated Search

2005-05-01

Research in the state of Wisconsin over the past forty years has found no noticeable difference in : performance between jointed concrete pavement (JCP) constructed with a sealed contraction joint and : JCP constructed with a single, narrow, unsealed...

Uncovering middle managers' role in healthcare innovation implementation.

PubMed

Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J

2012-04-03

Middle managers have received little attention in extant health services research, yet they may have a key role in healthcare innovation implementation. The gap between evidence of effective care and practice may be attributed in part to poor healthcare innovation implementation. Investigating middle managers' role in healthcare innovation implementation may reveal an opportunity for improvement. In this paper, we present a theory of middle managers' role in healthcare innovation implementation to fill the gap in the literature and to stimulate research that empirically examines middle managers' influence on innovation implementation in healthcare organizations. Extant healthcare innovation implementation research has primarily focused on the roles of physicians and top managers. Largely overlooked is the role of middle managers. We suggest that middle managers influence healthcare innovation implementation by diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. Teamwork designs have become popular in healthcare organizations. Because middle managers oversee these team initiatives, their potential to influence innovation implementation has grown. Future research should investigate middle managers' role in healthcare innovation implementation. Findings may aid top managers in leveraging middle managers' influence to improve the effectiveness of healthcare innovation implementation.

Bridging the Guideline Implementation Gap: A Systematic, Document-Centered Approach to Guideline Implementation

PubMed Central

Shiffman, Richard N.; Michel, George; Essaihi, Abdelwaheb; Thornquist, Elizabeth

2004-01-01

Objective: A gap exists between the information contained in published clinical practice guidelines and the knowledge and information that are necessary to implement them. This work describes a process to systematize and make explicit the translation of document-based knowledge into workflow-integrated clinical decision support systems. Design: This approach uses the Guideline Elements Model (GEM) to represent the guideline knowledge. Implementation requires a number of steps to translate the knowledge contained in guideline text into a computable format and to integrate the information into clinical workflow. The steps include: (1) selection of a guideline and specific recommendations for implementation, (2) markup of the guideline text, (3) atomization, (4) deabstraction and (5) disambiguation of recommendation concepts, (6) verification of rule set completeness, (7) addition of explanations, (8) building executable statements, (9) specification of origins of decision variables and insertions of recommended actions, (10) definition of action types and selection of associated beneficial services, (11) choice of interface components, and (12) creation of requirement specification. Results: The authors illustrate these component processes using examples drawn from recent experience translating recommendations from the National Heart, Lung, and Blood Institute's guideline on management of chronic asthma into a workflow-integrated decision support system that operates within the Logician electronic health record system. Conclusion: Using the guideline document as a knowledge source promotes authentic translation of domain knowledge and reduces the overall complexity of the implementation task. From this framework, we believe that a better understanding of activities involved in guideline implementation will emerge. PMID:15187061

Uncovering middle managers' role in healthcare innovation implementation

PubMed Central

2012-01-01

Background Middle managers have received little attention in extant health services research, yet they may have a key role in healthcare innovation implementation. The gap between evidence of effective care and practice may be attributed in part to poor healthcare innovation implementation. Investigating middle managers' role in healthcare innovation implementation may reveal an opportunity for improvement. In this paper, we present a theory of middle managers' role in healthcare innovation implementation to fill the gap in the literature and to stimulate research that empirically examines middle managers' influence on innovation implementation in healthcare organizations. Discussion Extant healthcare innovation implementation research has primarily focused on the roles of physicians and top managers. Largely overlooked is the role of middle managers. We suggest that middle managers influence healthcare innovation implementation by diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. Summary Teamwork designs have become popular in healthcare organizations. Because middle managers oversee these team initiatives, their potential to influence innovation implementation has grown. Future research should investigate middle managers' role in healthcare innovation implementation. Findings may aid top managers in leveraging middle managers' influence to improve the effectiveness of healthcare innovation implementation. PMID:22472001

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...

Perspectives on the institutional needs of joint implementation projects for China, Egypt, India, Mexico, and Thailand

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

Mabel, M.; Watt, E.; Sathaye, J.

One avenue for reducing the net emissions of greenhouse gases (GHG) under the Framework Convention on Climate Change (FCCC) is the joint implementation (JI) of policies and projects to the Convention. Although debate on the practical aspects of JI projects is relatively young, it already includes issues concerning the ability of governments to accept JI projects as well as the project participants` capacity to monitor, evaluate, and verify the financial and GHG benefits. The focus of this paper is an in-depth, country-by-country analysis of current and conceivable institutions in potential host countries. To understand these concerns better, in August 1994more » the authors asked colleagues in five developing countries to evaluate their countries` institutional capacity for JI projects. Their perspectives are presented here as individual country case studies. The five countries--Mexico, Egypt, Thailand, India, and China--were chosen because each has significant potential for JI projects.« less

Implementation of behavior change techniques in mobile applications for physical activity.

PubMed

Yang, Chih-Hsiang; Maher, Jaclyn P; Conroy, David E

2015-04-01

Mobile applications (apps) for physical activity are popular and hold promise for promoting behavior change and reducing non-communicable disease risk. App marketing materials describe a limited number of behavior change techniques (BCTs), but apps may include unmarketed BCTs, which are important as well. To characterize the extent to which BCTs have been implemented in apps from a systematic user inspection of apps. Top-ranked physical activity apps (N=100) were identified in November 2013 and analyzed in 2014. BCTs were coded using a contemporary taxonomy following a user inspection of apps. Users identified an average of 6.6 BCTs per app and most BCTs in the taxonomy were not represented in any apps. The most common BCTs involved providing social support, information about others' approval, instructions on how to perform a behavior, demonstrations of the behavior, and feedback on the behavior. A latent class analysis of BCT configurations revealed that apps focused on providing support and feedback as well as support and education. Contemporary physical activity apps have implemented a limited number of BCTs and have favored BCTs with a modest evidence base over others with more established evidence of efficacy (e.g., social media integration for providing social support versus active self-monitoring by users). Social support is a ubiquitous feature of contemporary physical activity apps and differences between apps lie primarily in whether the limited BCTs provide education or feedback about physical activity. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

[Clarifying the implementation of nursing care systematization].

PubMed

Hermida, Patricia Madalena Vieira

2004-01-01

This study has reviewed the national literature regarding nursing assistance systematization (NAS), with the aim of identifying the difficulties implementing this practice and the factors that interfere with and harm its implementation. The MEDLINE, LILACS, and BDENF databases have been utilized and six studies published in nursing periodicals in the last five years have been surveyed. The results indicate several difficulties implementing the NAS and several factors that interfere negatively with its implementation. Considering the importance of this assistance methodology for valuing professional nursing, it is necessary to reflect on/discuss its practical difficulties so that we can overcome them, making it a pleasurable activity capable of providing nurses with autonomy and providing patients with quality assistance.

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)

Cross-Shear Implementation in Sliding-Distance-Coupled Finite Element Analysis of Wear in Metal-on-Polyethylene Total Joint Arthroplasty: Intervertebral Total Disc Replacement as an Illustrative Application

PubMed Central

Goreham-Voss, Curtis M.; Hyde, Philip J.; Hall, Richard M.; Fisher, John; Brown, Thomas D.

2010-01-01

Computational simulations of wear of orthopaedic total joint replacement implants have proven to valuably complement laboratory physical simulators, for pre-clinical estimation of abrasive/adhesive wear propensity. This class of numerical formulations has primarily involved implementation of the Archard/Lancaster relationship, with local wear computed as the product of (finite element) contact stress, sliding speed, and a bearing-couple-dependent wear factor. The present study introduces an augmentation, whereby the influence of interface cross-shearing motion transverse to the prevailing molecular orientation of the polyethylene articular surface is taken into account in assigning the instantaneous local wear factor. The formulation augment is implemented within a widely-utilized commercial finite element software environment (ABAQUS). Using a contemporary metal-on-polyethylene total disc replacement (ProDisc-L) as an illustrative implant, physically validated computational results are presented to document the role of cross-shearing effects in alternative laboratory consensus testing protocols. Going forward, this formulation permits systematically accounting for cross-shear effects in parametric computational wear studies of metal-on-polyethylene joint replacements, heretofore a substantial limitation of such analyses. PMID:20399432

Tracking implementation strategies: a description of a practical approach and early findings.

PubMed

Bunger, Alicia C; Powell, Byron J; Robertson, Hillary A; MacDowell, Hannah; Birken, Sarah A; Shea, Christopher

2017-02-23

Published descriptions of implementation strategies often lack precision and consistency, limiting replicability and slowing accumulation of knowledge. Recent publication guidelines for implementation strategies call for improved description of the activities, dose, rationale and expected outcome(s) of strategies. However, capturing implementation strategies with this level of detail can be challenging, as responsibility for implementation is often diffuse and strategies may be flexibly applied as barriers and challenges emerge. We describe and demonstrate the development and application of a practical approach to identifying implementation strategies used in research and practice that could be used to guide their description and specification. An approach to tracking implementation strategies using activity logs completed by project personnel was developed to facilitate identification of discrete strategies. This approach was piloted in the context of a multi-component project to improve children's access to behavioural health services in a county-based child welfare agency. Key project personnel completed monthly activity logs that gathered data on strategies used over 17 months. Logs collected information about implementation activities, intent, duration and individuals involved. Using a consensus approach, two sets of coders categorised each activity based upon Powell et al.'s (Med Care Res Rev 69:123-57, 2012) taxonomy of implementation strategies. Participants reported on 473 activities, which represent 45 unique strategies. Initial implementation was characterised by planning strategies followed by educational strategies. After project launch, quality management strategies predominated, suggesting a progression of implementation over time. Together, these strategies accounted for 1594 person-hours, many of which were reported by the leadership team that was responsible for project design, implementation and oversight. This approach allows for identifying

Implementing interorganizational cooperation in labour market reintegration: a case study.

PubMed

Ståhl, Christian

2012-06-01

To bring people with complex medical, social and vocational needs back to the labour market, interorganizational cooperation is often needed. Yet, studies of processes and strategies for achieving sustainable interorganizational cooperation are sparse. The aim of this study was to analyse the implementation processes of Swedish legislation on financial coordination, with specific focus on different strategies for and perspectives on implementing interorganizational cooperation. A multiple-case study was used, where two local associations for financial coordination were studied in order to elucidate and compare the development of cooperative work in two settings. The material, collected during a 3-year period, consisted of documents, individual interviews with managers, and focus groups with officials. Two different implementation strategies were identified. In case 1, a linear strategy was used to implement cooperative projects, which led to difficulties in maintaining cooperative work forms due to a fragmented and time-limited implementation process. In case 2, an interactive strategy was used, where managers and politicians were continuously involved in developing a central cooperation team that became a central part of a developing structure for interorganizational cooperation. An interactive cooperation strategy with long-term joint financing was here shown to be successful in overcoming organizational barriers to cooperation. It is suggested that a strategy based on adaptation to local conditions, flexibility and constant evaluation is preferred for developing sustainable interorganizational cooperation when implementing policies or legislation affecting interorganizational relationships.

Going above and beyond for implementation: the development and validity testing of the Implementation Citizenship Behavior Scale (ICBS).

PubMed

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

2015-05-07

In line with recent research on the role of the inner context of organizations in implementation effectiveness, this study extends research on organizational citizenship behavior (OCB) to the domain of evidence-based practice (EBP) implementation. OCB encompasses those behaviors that go beyond what is required for a given job that contribute to greater organizational effectiveness. The goal of this study was to develop and test a measure of implementation citizenship behavior (ICB) or those behaviors that employees perform that go above and beyond what is required in order to support EBP implementation. The primary participants were 68 supervisors from ten mental health agencies throughout California. Items measuring ICB were developed based on past research on OCB and in consultation with experts on EBP implementation in mental health settings. Supervisors rated 357 of their subordinates on ICB and implementation success. In addition, 292 of the subordinates provided data on self-rated performance, attitudes towards EBPs, work experience, and full-time status. The supervisor sample was randomly split, with half used for exploratory factor analyses and the other half for confirmatory factor analyses. The entire sample of supervisors and subordinates was utilized for analyses assessing the reliability and construct validity of the measure. Exploratory factor analyses supported the proposed two-factor structure of the Implementation Citizenship Behavior Scale (ICBS): (1) Helping Others and (2) Keeping Informed. Confirmatory factor analyses with the other half of the sample supported the factor structure. Additional analyses supported the reliability and construct validity for the ICBS. The ICBS is a pragmatic brief measure (six items) that captures critical behaviors employees perform to go above and beyond the call of duty to support EBP implementation, including helping their fellow employees on implementation-related activities and keeping informed about issues

10 CFR 850 Implementation of Requirements

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

Lee, S

2012-01-05

10 CFR 850 defines a contractor as any entity, including affiliated entities, such as a parent corporation, under contract with DOE, including a subcontractor at any tier, with responsibility for performing work at a DOE site in furtherance of a DOE mission. The Chronic Beryllium Disease Prevention Program (CBDPP) applies to beryllium-related activities that are performed at the Lawrence Livermore National Laboratory (LLNL). The CBDPP or Beryllium Safety Program is integrated into the LLNL Worker Safety and Health Program and, thus, implementation documents and responsibilities are integrated in various documents and organizational structures. Program development and management of the CBDPPmore » is delegated to the Environment, Safety and Health (ES&H) Directorate, Worker Safety and Health Functional Area. As per 10 CFR 850, Lawrence Livermore National Security, LLC (LLNS) periodically submits a CBDPP to the National Nuclear Security Administration/Livermore Site Office (NNSA/LSO). The requirements of this plan are communicated to LLNS workers through ES&H Manual Document 14.4, 'Working Safely with Beryllium.' 10 CFR 850 is implemented by the LLNL CBDPP, which integrates the safety and health standards required by the regulation, components of the LLNL Integrated Safety Management System (ISMS), and incorporates other components of the LLNL ES&H Program. As described in the regulation, and to fully comply with the regulation, specific portions of existing programs and additional requirements are identified in the CBDPP. The CBDPP is implemented by documents that interface with the workers, principally through ES&H Manual Document 14.4. This document contains information on how the management practices prescribed by the LLNL ISMS are implemented, how beryllium hazards that are associated with LLNL work activities are controlled, and who is responsible for implementing the controls. Adherence to the requirements and processes described in the ES&H Manual ensures

Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services.

PubMed

Wolfenden, Luke; Jones, Jannah; Williams, Christopher M; Finch, Meghan; Wyse, Rebecca J; Kingsland, Melanie; Tzelepis, Flora; Wiggers, John; Williams, Amanda J; Seward, Kirsty; Small, Tameka; Welch, Vivian; Booth, Debbie; Yoong, Sze Lin

2016-10-04

Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. The primary aim of the review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention. The secondary aims of the review were to:1. describe the impact of such strategies on childcare service staff knowledge, skills or attitudes;2. describe the cost or cost-effectiveness of such strategies;3. describe any adverse effects of such strategies on childcare services, service staff or children;4. examine the effect of such strategies on child diet, physical activity or weight status. We searched the following electronic databases on 3 August 2015: the Cochrane Central Register of Controlled trials (CENTRAL), MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, ERIC, CINAHL and SCOPUS. We also searched reference lists of included trials, handsearched two international implementation science journals and searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/) and ClinicalTrials.gov (www.clinicaltrials.gov). We included any study (randomised or non-randomised) with a parallel control group that compared any strategy to improve the implementation of a healthy eating, physical activity or obesity prevention policy, practice or programme by staff of centre-based childcare services to no intervention, 'usual' practice or an alternative strategy. The review authors independently screened abstracts and titles, extracted trial data and assessed risk of bias in pairs; we resolved discrepancies via consensus. Heterogeneity across studies precluded pooling of data and undertaking quantitative

[Cost management: the implementation of the activity-based costing method in sterile processing department].

PubMed

Jericó, Marli de Carvalho; Castilho, Valéria

2010-09-01

This exploratory case study was performed aiming at implementing the Activity-based Costing (ABC) method in a sterile processing department (SPD) of a major teaching hospital. Data collection was performed throughout 2006. Documentary research techniques and non participant closed observation were used. The ABC implementation allowed for learning the activity-based costing of both the chemical and physical disinfection cycle/load: (dollar 9.95) and (dollar 12.63), respectively; as well as the cost for sterilization by steam under pressure (autoclave) (dollar 31.37) and low temperature steam and gaseous formaldehyde sterilization (LTSF) (dollar 255.28). The information provided by the ABC method has optimized the overall understanding of the cost driver process and provided the foundation for assessing performance and improvement in the SPD processes.

Implementation intentions for physical activity behavior in older adult women: an examination of executive function as a moderator of treatment effects.

PubMed

Hall, Peter A; Zehr, Christopher; Paulitzki, Jeffrey; Rhodes, Ryan

2014-08-01

Implementation intentions are effective for enhancing physical activity, but it is unknown how well these effects extend to older adults and/or are modified by cognitive variables. Our objective is to examine (1) the efficacy of an implementation intentions intervention for physical activity in older adult women and (2) to examine the moderating effects of executive function. Participants (N = 75, M age = 73.72) completed measures of executive function and were randomly assigned to weekly implementation intentions for physical activity (experimental condition), implementation intentions for an unrelated behavior (control condition), or no treatment. Baseline activity was measured by accelerometer and self-report; follow-up activity was measured by weekly self-report. Findings indicated a significant treatment effect for the experimental condition and a treatment by executive function interaction. Specifically, participants with relatively stronger executive function benefited most from the experimental intervention. Implementation intentions are effective for enhancing physical activity among older adult women, and the effects may be especially pronounced for those with relatively stronger executive function.

Planning and implementing forest operations to achieve sustainable forests: Proceedings of papers presented at the joint meeting of the Council on Forest Engineering and International Union of Forest Research Organizations.

Treesearch

Charles R. Blinn; Michael A. Thompson

1996-01-01

Contains a variety of papers presented at the joint meeting of the Council on Forest Engineering and International Union of Forest Research Organizations Subject Group S3.04 and that support the meeting theme "Planning and Implementing Forest Operations to Achieve Sustainable Forests."

[The implementation of innovations in public health].

PubMed

Systerova, A A; Totskaia, E G

2012-01-01

Nowadays, the innovative activities are considered as the mechanism of implementation of public policy to increase effectiveness of public health system on the basis of achievements of modern medicine and technical sciences. The development, elaboration and implementation of products being in line with corresponding to criteria of innovation, promote the concurrency of medical institutions at the medical services market. The administrators of health departments and medical science professionals are to become aware about the problems of implementation of innovations into medical practice to develop the mechanisms of overcoming these issues.

Implementing living room theatre activities for people with dementia on nursing home wards: a process evaluation study.

PubMed

van Haeften-van Dijk, A Marijke; van Weert, Julia C M; Dröes, Rose-Marie

2015-01-01

A new communication method, the 'Veder Method', was implemented in the Netherlands. This method uses theatrical stimuli in combination with proven person-centred communication methods. Care staff was trained to apply the Veder Method in a 'living room theatre activity' for people with dementia. This study evaluates the implementation of the Veder Method on psychogeriatric nursing home wards. Facilitators and barriers to train staff and implement the Veder Method in psychogeriatric nursing homes were identified by conducting semi-structured interviews with 12 stakeholders who were involved in the implementation, and five focus groups with 35 trained care staff. The interviews and focus groups were transcribed verbatim, and two independent researchers analysed the content of the transcripts. The Implementation Process Evaluation (IPE) Framework was used to categorize the data and the 7s-model to contextualize the qualitative findings. A structured overview of facilitators and barriers in different stages of the implementation process is presented. Positive reactions in residents and more reciprocity in caregiver-resident contact motivated trained care staff to work with the Veder Method. An action plan, executive support, the visibility of the method in the organization and a pioneer group that initiated implementation were essential for successful implementation. High work pressure for the care staff was a hindering factor. Respondents experienced the added value of the Veder Method. The facilitators and barriers to implementation we identified in this study can help to implement and disseminate the successful Veder Method and other person-centred communication methods in psychogeriatric nursing homes effectively.

24 CFR 572.215 - Implementation grants-eligible activities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... related to implementing the affirmative fair housing marketing strategy required under § 572.110. (k...) Homebuyer outreach and selection. Reasonable and necessary costs of marketing the program to potential...

TMDL Implementation: Lessons Learned

EPA Pesticide Factsheets

Virginia Tech Center for TMDL and Watershed Studies provided state TMDL implementation information and reviewed ongoing TMDL implementation efforts across the country to identify factors that contribute to successful implementation.

Experiential learning implementation based on joint responsibility in women's cooperative development (Case study on Farmer Women Cooperative, Sumedang, West Java)

NASA Astrophysics Data System (ADS)

Suseno, Gijanto Purbo; Nataliningsih

2017-09-01

Cooperative extension is one form of non-formal education. The follow up of cooperative extension is a coaching that aims to cooperative boards and members apply the knowledge and skills acquired during extension. Learning from the experience (experience learning) of others combined with the concept of joint responsibility is expected to develop the participation of cooperative members as indicated by the repayment of loans on time. The research was conducted at Sumedang Farmer Women Cooperative of West Java with the stages of cooperative extension and coaching for 6 months so it can be evaluated its impact. The results showed that from 30 extension participants who stated willingness to be a member of joint responsibility group as many as 15 people (50%), which then divided into 3 groups of mutual responsibility with member of each group is 5 people. The result of impact evaluation showed the development of group dynamics of the joint liability shown by 9 people (60%) developing business, 3 people (20%) business stagnant and 3 (20%) less profitable business. Implementation of experiental learning based on the concept of mutual responsibility encourages the improvement of entrepreneurship and cooperative skills and the ability of members to pay loan installments on cooperatives in a timely manner.

78 FR 18415 - Connected Vehicle Reference Implementation Architecture Workshop; Notice of Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-26

... DEPARTMENT OF TRANSPORTATION Connected Vehicle Reference Implementation Architecture Workshop...) Intelligent Transportation System Joint Program Office (ITS JPO) will host a free Connected Vehicle Reference... manufacturing, developing, deploying, operating, or maintaining the connected [[Page 18416

Teacher change in implementing a research-developed representation construction pedagogy

NASA Astrophysics Data System (ADS)

Hubber, Peter; Chittleborough, Gail

2016-05-01

The Representations in Learning Science (RiLS) project developed a representation construction approach to teaching and learning in science, which has successfully demonstrated enhanced student learning through sustained engagement with ideas, and enhancement of teachers' pedagogical knowledge and understandings of how knowledge in science is developed and communicated. The current Constructing Representations in Science Pedagogy (CRISP) project aims at wider scale implementation of the representation construction approach. This paper explores a range of issues that confronted four Year-8 teachers in implementing this research-developed approach, such as: preparedness of the teacher in terms of epistemological positioning and positioning as a learner, significant support for planning and modelling by the university expert, and a team ethos where teachers share ideas and plan jointly. The Year-8 teachers implemented a representation construction approach to the teaching of the topic of astronomy. The Interconnected Model of Teacher Growth (IMTG) (Clarke and Hollingworth, Teach. Educ., 18 (2001) 947) was used to analyse the teachers' experience in planning and delivering the teaching sequence. This model was found to be flexible in identifying the experiences of teachers in different situations and useful in identifying issues for implementation of a research-developed pedagogy.

76 FR 6130 - Agency Information Collection Activities: Proposed Collection; Comment Request; Implementation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-03

... Activities: Proposed Collection; Comment Request; Implementation of the Oil Pollution Act Facility Response... collection techniques or other forms of information technology, e.g., permitting electronic submission of... Oil Pollution Prevention regulation (40 CFR part 112) and which, because of their location, could...

The implementation research institute: training mental health implementation researchers in the United States

PubMed Central

2013-01-01

Background The Implementation Research Institute (IRI) provides two years of training in mental health implementation science for 10 new fellows each year. The IRI is supported by a National Institute of Mental Health (NIMH) R25 grant and the Department of Veterans Affairs (VA). Fellows attend two annual week-long trainings at Washington University in St. Louis. Training is provided through a rigorous curriculum, local and national mentoring, a ‘learning site visit’ to a federally funded implementation research project, pilot research, and grant writing. Methods This paper describes the rationale, components, outcomes to date, and participant experiences with IRI. Results IRI outcomes include 31 newly trained implementation researchers, their new grant proposals, contributions to other national dissemination and implementation research training, and publications in implementation science authored by the Core Faculty and fellows. Former fellows have obtained independent research funding in implementation science and are beginning to serve as mentors for more junior investigators. Conclusions Based on the number of implementation research grant proposals and papers produced by fellows to date, the IRI is proving successful in preparing new researchers who can inform the process of making evidence-based mental healthcare more available through real-world settings of care and who are advancing the field of implementation science. PMID:24007290

Implementation of activity-based costing (ABC) to drive cost reduction efforts in a semiconductor manufacturing operation

NASA Astrophysics Data System (ADS)

Naguib, Hussein; Bol, Igor I.; Lora, J.; Chowdhry, R.

1994-09-01

This paper presents a case study on the implementation of ABC to calculate the cost per wafer and to drive cost reduction efforts for a new IC product line. The cost reduction activities were conducted through the efforts of 11 cross-functional teams which included members of the finance, purchasing, technology development, process engineering, equipment engineering, production control, and facility groups. The activities of these cross functional teams were coordinated by a cost council. It will be shown that these activities have resulted in a 57% reduction in the wafer manufacturing cost of the new product line. Factors contributed to successful implementation of an ABC management system are discussed.

SANTA MONICA BAY RESTORATION PROJECT IMPLEMENTATION REVIEW 2002

EPA Science Inventory

The Santa Monica Bay Restoration Project Implementation Review (IR) summarizes the progress and challenges ahead for the Project through examination of it activities in relation to the CCMP. Contents of the IR include: implementation progress with a financing for plan implementat...

Examining the Knowledge and Capacity of Elementary Teachers to Implement Classroom Physical Activity Breaks

ERIC Educational Resources Information Center

Dinkel, Danae M.; Lee, Jung-Min; Schaffer, Connie

2016-01-01

This study examined teachers' zone of proximal development for classroom physical activity breaks by assessing teachers' knowledge and capacity for implementing classroom physical activity breaks. Five school districts of various sizes (n = 346 teachers) took part in a short online survey. Descriptive statistics were calculated and chi-square…

Methods of Implementation of Evidence-Based Stroke Care in Europe: European Implementation Score Collaboration.

PubMed

Di Carlo, Antonio; Pezzella, Francesca Romana; Fraser, Alec; Bovis, Francesca; Baeza, Juan; McKevitt, Chris; Boaz, Annette; Heuschmann, Peter; Wolfe, Charles D A; Inzitari, Domenico

2015-08-01

Differences in stroke care and outcomes reported in Europe may reflect different degrees of implementation of evidence-based interventions. We evaluated strategies for implementing research evidence into stroke care in 10 European countries. A questionnaire was developed and administered through face-to-face interviews with key informants. Implementation strategies were investigated considering 3 levels (macro, meso, and micro, eg, policy, organization, patients/professionals) identified by the framing analysis, and different settings (primary, hospital, and specialist) of stroke care. Similarities and differences among countries were evaluated using the categorical principal components analysis. Implementation methods reported by ≥7 countries included nonmandatory policies, public financial incentives, continuing professional education, distribution of educational material, educational meetings and campaigns, guidelines, opinion leaders', and stroke patients associations' activities. Audits were present in 6 countries at national level; national and regional regulations in 4 countries. Private financial incentives, reminders, and educational outreach visits were reported only in 2 countries. At national level, the first principal component of categorical principal components analysis separated England, France, Scotland, and Sweden, all with positive object scores, from the other countries. Belgium and Lithuania obtained the lowest scores. At regional level, England, France, Germany, Italy, and Sweden had positive scores in the first principal component, whereas Belgium, Lithuania, Poland, and Scotland showed negative scores. Spain was in an intermediate position. We developed a novel method to assess different domains of implementation in stroke care. Clear variations were observed among European countries. The new tool may be used elsewhere for future contributions. © 2015 American Heart Association, Inc.

Determining the predictors of innovation implementation in healthcare: a quantitative analysis of implementation effectiveness.

PubMed

Jacobs, Sara R; Weiner, Bryan J; Reeve, Bryce B; Hofmann, David A; Christian, Michael; Weinberger, Morris

2015-01-22

The failure rates for implementing complex innovations in healthcare organizations are high. Estimates range from 30% to 90% depending on the scope of the organizational change involved, the definition of failure, and the criteria to judge it. The innovation implementation framework offers a promising approach to examine the organizational factors that determine effective implementation. To date, the utility of this framework in a healthcare setting has been limited to qualitative studies and/or group level analyses. Therefore, the goal of this study was to quantitatively examine this framework among individual participants in the National Cancer Institute's Community Clinical Oncology Program using structural equation modeling. We examined the innovation implementation framework using structural equation modeling (SEM) among 481 physician participants in the National Cancer Institute's Community Clinical Oncology Program (CCOP). The data sources included the CCOP Annual Progress Reports, surveys of CCOP physician participants and administrators, and the American Medical Association Physician Masterfile. Overall the final model fit well. Our results demonstrated that not only did perceptions of implementation climate have a statistically significant direct effect on implementation effectiveness, but physicians' perceptions of implementation climate also mediated the relationship between organizational implementation policies and practices (IPP) and enrollment (p <0.05). In addition, physician factors such as CCOP PI status, age, radiological oncologists, and non-oncologist specialists significantly influenced enrollment as well as CCOP organizational size and structure, which had indirect effects on implementation effectiveness through IPP and implementation climate. Overall, our results quantitatively confirmed the main relationship postulated in the innovation implementation framework between IPP, implementation climate, and implementation effectiveness among

Implementing GNVQs. A Manual.

ERIC Educational Resources Information Center

Further Education Unit, London (England).

This manual provides a comprehensive guide to college activities associated with the implementation of General National Vocational Qualifications (GNVQs) in Britain. Part A addresses GNVQ curriculum planning and management at the college level. This part includes the following sections: description of the context; questions that need to be…

Effectiveness-implementation Hybrid Designs

PubMed Central

Curran, Geoffrey M.; Bauer, Mark; Mittman, Brian; Pyne, Jeffrey M.; Stetler, Cheryl

2013-01-01

Objectives This study proposes methods for blending design components of clinical effectiveness and implementation research. Such blending can provide benefits over pursuing these lines of research independently; for example, more rapid translational gains, more effective implementation strategies, and more useful information for decision makers. This study proposes a “hybrid effectiveness-implementation” typology, describes a rationale for their use, outlines the design decisions that must be faced, and provides several real-world examples. Results An effectiveness-implementation hybrid design is one that takes a dual focus a priori in assessing clinical effectiveness and implementation. We propose 3 hybrid types: (1) testing effects of a clinical intervention on relevant outcomes while observing and gathering information on implementation; (2) dual testing of clinical and implementation interventions/strategies; and (3) testing of an implementation strategy while observing and gathering information on the clinical intervention’s impact on relevant outcomes. Conclusions The hybrid typology proposed herein must be considered a construct still in evolution. Although traditional clinical effectiveness and implementation trials are likely to remain the most common approach to moving a clinical intervention through from efficacy research to public health impact, judicious use of the proposed hybrid designs could speed the translation of research findings into routine practice. PMID:22310560

The role of implementation intention formation in promoting hepatitis B vaccination uptake among men who have sex with men.

PubMed

Vet, Raymond; de Wit, John B F; Das, Enny

2014-02-01

This study assessed the separate and joint effects of having a goal intention and the completeness of implementation intention formation on the likelihood of attending an appointment to obtain vaccination against the hepatitis B virus among men who have sex with men (MSM) in the Netherlands. Extending previous research, it was hypothesized that to be effective in promoting vaccination, implementation intention formation not only requires a strong goal intention, but also complete details specifying when, where and how to make an appointment to obtain hepatitis B virus vaccination among MSM. MSM at risk for hepatitis B virus (N = 616), with strong or weak intentions to obtain hepatitis B virus vaccination, were randomly assigned to form an implementation intention or not. Completeness of implementation intentions was rated and hepatitis B virus uptake was assessed through data linkage with the joint vaccination registry of the collaborating Public Health Services. Having a strong goal intention to obtain hepatitis B virus vaccination and forming an implementation intention, each significantly and independently increased the likelihood of MSM obtaining hepatitis B virus vaccination. In addition, MSM who formed complete implementation intentions were more successful in obtaining vaccination (p < 0.01). The formation of complete implementation intentions was promoted by strong goal intentions (p < 0.01).

Implementing High School JROTC [Junior Reserve Officers Training Corps] Career Academies.

ERIC Educational Resources Information Center

Hanser, Lawrence M.; Robyn, Abby E.

In 1992, the U.S. Department of Defense and U.S. Department of Education jointly developed the Junior Reserve Officers Training Corps (JROTC) Career Academy model, which provides a framework for implementation of an innovative vocational education program designed to keep dropout-prone students in school. The program, which combines military…

Decision making and action implementation: evidence for an early visually triggered motor activation specific to potential actions.

PubMed

Tandonnet, Christophe; Garry, Michael I; Summers, Jeffery J

2013-07-01

To make a decision may rely on accumulating evidence in favor of one alternative until a threshold is reached. Sequential-sampling models differ by the way of accumulating evidence and the link with action implementation. Here, we tested a model's prediction of an early action implementation specific to potential actions. We assessed the dynamics of action implementation in go/no-go and between-hand choice tasks by transcranial magnetic stimulation of the motor cortex (single- or paired-pulse TMS; 3-ms interstimulus interval). Prior to implementation of the selected action, the amplitude of the motor evoked potential first increased whatever the visual stimulus but only for the hand potentially involved in the to-be-produced action. These findings suggest that visual stimuli can trigger an early motor activation specific to potential actions, consistent with race-like models with continuous transmission between decision making and action implementation. Copyright © 2013 Society for Psychophysiological Research.

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...

[A Matter of Balance: strategy for implementation in Dutch homecare organizations].

PubMed

de Jonge, M C; van der Poel, A; van Haastregt, J C M; Du Moulin, M F T M; Zijlstra, G A R; Voordouw, I

2013-02-01

The Dutch version of A Matter of Balance (AMB-NL) is a cognitive behavioral group program to reduce fear of falling and related activity avoidance in community-living older persons. This paper presents the strategy for implementation of AMB-NL in Dutch homecare organizations and the outcomes of this implementation. The aim was to implement AMB-NL in at least 50 % of 64 homecare organizations in The Netherlands in 2009 and 2010. The implementation strategy was based on the four phases of the Replicating Effective Interventions: pre-conditions, pre-implementation, implementation, and maintenance and evolution. After preparing the implementation activities, such as identifying implementation barriers, consulting stakeholders, preparing the materials involved in the implementation, and training the facilitators of the program (n = 53), AMB-NL was implemented in 16 of the 64 homecare organizations (25 %). Another five homecare organizations indicated that they would shortly include AMB-NL in their care program. These organizations conducted the intervention 19 times to a total of 178 participants. After the implementation phase another 16 facilitators were trained, and program materials were successfully disseminated. The implementation of AMB-NL was well performed. The targeted aim is not fully reached within the two-year timeframe, but the program is well received by participants, trainers and homecare organizations. Further implementation and maintenance of AMB-NL in primary health care is recommended.

Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

ERIC Educational Resources Information Center

Snyder, Patricia A; Hemmeter, Mary Louise; Fox, Lise

2015-01-01

In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

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

PubMed

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

2014-01-01

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

Factors Supporting Implementation among CDSMP Organizations.

PubMed

Paone, Deborah

2014-01-01

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

Factors Supporting Implementation among CDSMP Organizations

PubMed Central

Paone, Deborah

2015-01-01

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

A systematic review of implementation frameworks of innovations in healthcare and resulting generic implementation framework.

PubMed

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

2015-03-14

Implementation science and knowledge translation have developed across multiple disciplines with the common aim of bringing innovations to practice. Numerous implementation frameworks, models, and theories have been developed to target a diverse array of innovations. As such, it is plausible that not all frameworks include the full range of concepts now thought to be involved in implementation. Users face the decision of selecting a single or combining multiple implementation frameworks. To aid this decision, the aim of this review was to assess the comprehensiveness of existing frameworks. A systematic search was undertaken in PubMed to identify implementation frameworks of innovations in healthcare published from 2004 to May 2013. Additionally, titles and abstracts from Implementation Science journal and references from identified papers were reviewed. The orientation, type, and presence of stages and domains, along with the degree of inclusion and depth of analysis of factors, strategies, and evaluations of implementation of included frameworks were analysed. Frameworks were assessed individually and grouped according to their targeted innovation. Frameworks for particular innovations had similar settings, end-users, and 'type' (descriptive, prescriptive, explanatory, or predictive). On the whole, frameworks were descriptive and explanatory more often than prescriptive and predictive. A small number of the reviewed frameworks covered an implementation concept(s) in detail, however, overall, there was limited degree and depth of analysis of implementation concepts. The core implementation concepts across the frameworks were collated to form a Generic Implementation Framework, which includes the process of implementation (often portrayed as a series of stages and/or steps), the innovation to be implemented, the context in which the implementation is to occur (divided into a range of domains), and influencing factors, strategies, and evaluations. The selection of

The 'Direct Attack' Strategy for Poverty Removal: Implementation Methodology.

ERIC Educational Resources Information Center

Sinha, Sanjay

1981-01-01

Discusses elements of an implementation methodology for the removal of poverty in India. Includes background, methodology, aggregation of demands, economics of the strategy, complementary activities and infrastructure, mechanics of implementation, and monitoring. (CT)

Study of activity based costing implementation for palm oil production using value-added and non-value-added activity consideration in PT XYZ palm oil mill

NASA Astrophysics Data System (ADS)

Sembiring, M. T.; Wahyuni, D.; Sinaga, T. S.; Silaban, A.

2018-02-01

Cost allocation at manufacturing industry particularly in Palm Oil Mill still widely practiced based on estimation. It leads to cost distortion. Besides, processing time determined by company is not in accordance with actual processing time in work station. Hence, the purpose of this study is to eliminates non-value-added activities therefore processing time could be shortened and production cost could be reduced. Activity Based Costing Method is used in this research to calculate production cost with Value Added and Non-Value-Added Activities consideration. The result of this study is processing time decreasing for 35.75% at Weighting Bridge Station, 29.77% at Sorting Station, 5.05% at Loading Ramp Station, and 0.79% at Sterilizer Station. Cost of Manufactured for Crude Palm Oil are IDR 5.236,81/kg calculated by Traditional Method, IDR 4.583,37/kg calculated by Activity Based Costing Method before implementation of Activity Improvement and IDR 4.581,71/kg after implementation of Activity Improvement Meanwhile Cost of Manufactured for Palm Kernel are IDR 2.159,50/kg calculated by Traditional Method, IDR 4.584,63/kg calculated by Activity Based Costing Method before implementation of Activity Improvement and IDR 4.582,97/kg after implementation of Activity Improvement.

Managing Air Quality - Program Implementation

EPA Pesticide Factsheets

Describes elements for the set of activities to ensure that control strategies are put into effect and that air quality goals and standards are fulfilled, permitting programs, and additional resources related to implementation under the Clean Air Act.

A Mixed-Methods Investigation of Clicker Implementation Styles in STEM.

PubMed

Solomon, Erin D; Repice, Michelle D; Mutambuki, Jacinta M; Leonard, Denise A; Cohen, Cheryl A; Luo, Jia; Frey, Regina F

2018-06-01

Active learning with clickers is a common approach in high-enrollment, lecture-based courses in science, technology, engineering, and mathematics. In this study, we describe the procedures that faculty at one institution used when implementing clicker-based active learning, and how they situated these activities in their class sessions. Using a mixed-methods approach, we categorized faculty into four implementation styles based on quantitative observation data and conducted qualitative interviews to further understand why faculty used these styles. We found that faculty tended to use similar procedures when implementing a clicker activity, but differed on how they situated the clicker-based active learning into their courses. These variations were attributed to different faculty goals for using clicker-based active learning, with some using it to engage students at specific time points throughout their class sessions and others who selected it as the best way to teach a concept from several possible teaching techniques. Future research should continue to investigate and describe how active-learning strategies from literature may differ from what is being implemented.

Energy and Conservation Education: Activities for the Classroom, Grades 4-6. Implementation Handbook.

ERIC Educational Resources Information Center

Energy and Man's Environment, Inc., Portland, OR.

The instructional materials and classroom activities described in the document are intended to aid teachers in grades four through six develop and implement educational programs dealing with energy-related issues. The document is presented in four sections. Section I explains the organization of the document and summarizes how teachers should…

Methodology issues in implementation science.

PubMed

Newhouse, Robin; Bobay, Kathleen; Dykes, Patricia C; Stevens, Kathleen R; Titler, Marita

2013-04-01

Putting evidence into practice at the point of care delivery requires an understanding of implementation strategies that work, in what context and how. To identify methodological issues in implementation science using 4 studies as cases and make recommendations for further methods development. Four cases are presented and methodological issues identified. For each issue raised, evidence on the state of the science is described. Issues in implementation science identified include diverse conceptual frameworks, potential weaknesses in pragmatic study designs, and the paucity of standard concepts and measurement. Recommendations to advance methods in implementation include developing a core set of implementation concepts and metrics, generating standards for implementation methods including pragmatic trials, mixed methods designs, complex interventions and measurement, and endorsing reporting standards for implementation studies.

Extreme load alleviation using industrial implementation of active trailing edge flaps in a full design load basis

NASA Astrophysics Data System (ADS)

Barlas, Thanasis; Pettas, Vasilis; Gertz, Drew; Madsen, Helge A.

2016-09-01

The application of active trailing edge flaps in an industrial oriented implementation is evaluated in terms of capability of alleviating design extreme loads. A flap system with basic control functionality is implemented and tested in a realistic full Design Load Basis (DLB) for the DTU 10MW Reference Wind Turbine (RWT) model and for an upscaled rotor version in DTU's aeroelastic code HAWC2. The flap system implementation shows considerable potential in reducing extreme loads in components of interest including the blades, main bearing and tower top, with no influence on fatigue loads and power performance. In addition, an individual flap controller for fatigue load reduction in above rated power conditions is also implemented and integrated in the general controller architecture. The system is shown to be a technology enabler for rotor upscaling, by combining extreme and fatigue load reduction.

De-implementation: A concept analysis.

PubMed

Upvall, Michele J; Bourgault, Annette M

2018-04-25

The purpose of this concept analysis is to explore the meaning of de-implementation and provide a definition that can be used by researchers and clinicians to facilitate evidence-based practice. De-implementation is a relatively unknown process overshadowed by the novelty of introducing new ideas and techniques into practice. Few studies have addressed the challenge of de-implementation and the cognitive processes involved when terminating harmful or unnecessary practices. Also, confusion exists regarding the myriad of terms used to describe de-implementation processes. Walker and Avant's method (2011) for describing concepts was used to clarify de-implementation. A database search limited to academic journals yielded 281 publications representing basic research, study protocols, and editorials/commentaries from implementation science experts. After applying exclusion criterion of English language only and eliminating overlap between databases, 41 articles were selected for review. Literature review and synthesis provided a concept analysis and a distinct definition of de-implementation. De-implementation was defined as the process of identifying and removing harmful, non-cost-effective, or ineffective practices based on tradition and without adequate scientific support. The analysis provided further refinement of de-implementation as a significant concept for ongoing theory development in implementation science and clinical practice. © 2018 Wiley Periodicals, Inc.

Evaluation of a statewide dissemination and implementation of physical activity intervention in afterschool programs: a nonrandomized trial.

PubMed

Beets, Michael W; Glenn Weaver, R; Turner-McGrievy, Gabrielle; Saunders, Ruth P; Webster, Collin A; Moore, Justin B; Brazendale, Keith; Chandler, Jessica

2017-12-01

In 2015, YMCA-operated afterschool programs (ASPs) across South Carolina pledged to achieve the national standard that calls for every child to accumulate 30 min/day of moderate-to-vigorous physical activity (MVPA) during program time. This study shares the first-year findings related to the dissemination, implementation, and outcomes associated with the statewide intervention to achieve the MVPA Standard. Twenty ASPs were sampled from all YMCA-operated ASPs (N = 97) and visited at baseline (spring 2015) and first-year follow-up (spring 2016). Programs were provided standardized professional development training to increase the MVPA children accumulated while attending ASPs. The training focused on extending the scheduled time for activity opportunities and modifying commonly played games to increase MVPA. The RE-AIM framework was used to evaluate the statewide intervention. Accelerometer-derived MVPA was the primary outcome. Implementation was evaluated via direct observation. Intent-to-treat (ITT) and as-treated comparisons were conducted in summer 2016. Reach/adoption was variable, with attendance at trainings ranging from 0 to 100% across ASPs. Effectiveness of the intervention using ITT models indicated no changes from baseline in the percentage of programs meeting the MVPA standard for boys or girls. Implementation levels also varied and were related to increases in both boys' and girls' MVPA for moderate and high implementers. Findings indicate improvements in MVPA can be made from attending the trainings and implementing some or all of the training components. Additional work is necessary to identify ways to ensure staff attend trainings to implement strategies and to identify which specific factors contributed to increases in MVPA.

Patient-experienced effect of an active implementation of a disease management programme for COPD - a randomised trial.

PubMed

Smidth, Margrethe; Olesen, Frede; Fenger-Grøn, Morten; Vedsted, Peter

2013-10-03

People living with chronic disease currently account for the majority of the total healthcare costs. The Central Denmark Region implemented a disease management programme (DMP) for chronic obstructive pulmonary disease (COPD) in 2008. This presented an opportunity to examine the effect of an evidence-based, planned and proactive implementation of a DMP compared to the usual implementation strategy. We performed a block- and cluster-randomised controlled trial with two groups and an extra external control group. The primary outcome was patients' assessment of their care after using an active implementation model for a DMP for COPD measured with the Patient-Assessment-of-Chronic-Illness-Care (PACIC) instrument. At baseline, questionnaires were sent to 2,895 patients identified by an algorithm based on health registry data on lung-related contacts to the healthcare system. Patients were asked to confirm or refute their diagnosis of COPD. Of those who responded, 1,445 (72.8%) confirmed their diagnosis. PACIC data were collected at baseline and at a 12-month follow-up for 744 (51.1%) patients. Comparing the three groups after the implementation of the DMP, we found a statistically significantly higher change in the PACIC score in the intervention group than in the control groups. No statistically significant differences were found between the control and the external control groups in any of the dimensions. Reinforcing the role of general practice as coordinator for care-and self-management-support with an active implementation of a DMP for COPD made patients score higher on the PACIC instrument, which indicates a better experience of the received healthcare. NCT01228708.

PrEP implementation in the Asia-Pacific region: opportunities, implementation and barriers.

PubMed

Zablotska, Iryna; Grulich, Andrew E; Phanuphak, Nittaya; Anand, Tarandeep; Janyam, Surang; Poonkasetwattana, Midnight; Baggaley, Rachel; van Griensven, Frits; Lo, Ying-Ru

2016-01-01

HIV epidemics in the Asia-Pacific region are concentrated among men who have sex with men (MSM) and other key populations. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention and could be a potential game changer in the region. We discuss the progress towards PrEP implementation in the Asia-Pacific region, including opportunities and barriers. Awareness about PrEP in the Asia-Pacific is still low and so are its levels of use. A high proportion of MSM who are aware of PrEP are willing to use it. Key PrEP implementation barriers include poor knowledge about PrEP, limited access to PrEP, weak or non-existent HIV prevention programmes for MSM and other key populations, high cost of PrEP, stigma and discrimination against key populations and restrictive laws in some countries. Only several clinical trials, demonstration projects and a few larger-scale implementation studies have been implemented so far in Thailand and Australia. However, novel approaches to PrEP implementation have emerged: researcher-, facility- and community-led models of care, with PrEP services for fee and for free. The WHO consolidated guidelines on HIV testing, treatment and prevention call for an expanded access to PrEP worldwide and have provided guidance on PrEP implementation in the region. Some countries like Australia have released national PrEP guidelines. There are growing community leadership and consultation processes to initiate PrEP implementation in Asia and the Pacific. Countries of the Asia-Pacific region will benefit from adding PrEP to their HIV prevention packages, but for many this is a critical step that requires resourcing. Having an impact on the HIV epidemic requires investment. The next years should see the region transitioning from limited PrEP implementation projects to growing access to PrEP and expansion of HIV prevention programmes.

Examining implementation of a patient activation and self-management intervention within the context of an effectiveness trial.

PubMed

Ault-Brutus, Andrea; Lee, Catherine; Singer, Sara; Allen, Michele; Alegría, Margarita

2014-11-01

This qualitative study examines factors important for delivering a patient activation/self-management intervention in 13 mental health clinics within the context of an effectiveness trial to inform understanding of real-world implementation. Eighteen key personnel were interviewed about the following factors relative to the intervention and its delivery: alignment with organization values/patient needs; buy-in/support from leaders and providers; roles played by leaders and key personnel; and availability of organizational resources. Where supportive, these factors facilitated the delivery of the intervention; elsewhere, they presented as impediments. Findings from this study could help anticipate challenges to implementation that could be examined in a full-scale implementation study.

Examining Implementation of a Patient Activation and Self-management Intervention Within the Context of an Effectiveness Trial

PubMed Central

Lee, Catherine; Singer, Sara; Allen, Michele; Alegría, Margarita

2014-01-01

This qualitative study examines factors important for delivering a patient activation/self-management intervention in 13 mental health clinics within the context of an effectiveness trial to inform understanding of real-world implementation. Eighteen key personnel were interviewed about the following factors relative to the intervention and its delivery: alignment with organization values/patient needs; buy-in/support from leaders and providers; roles played by leaders and key personnel; and availability of organizational resources. Where supportive, these factors facilitated the delivery of the intervention; elsewhere, they presented as impediments. Findings from this study could help anticipate challenges to implementation that could be examined in a full-scale implementation study. PMID:24202066

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation.

PubMed

Alemnji, George; Edghill, Lisa; Guevara, Giselle; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. We report the development of a stepwise process for quality systems improvement in the Caribbean Region. The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called 'Laboratory Quality Management System - Stepwise Improvement Process (LQMS-SIP) Towards Accreditation' to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement.

Implementing PAT with Standards

NASA Astrophysics Data System (ADS)

Chandramohan, Laakshmana Sabari; Doolla, Suryanarayana; Khaparde, S. A.

2016-02-01

Perform Achieve Trade (PAT) is a market-based incentive mechanism to promote energy efficiency. The purpose of this work is to address the challenges inherent to inconsistent representation of business processes, and interoperability issues in PAT like cap-and-trade mechanisms especially when scaled. Studies by various agencies have highlighted that as the mechanism evolves including more industrial sectors and industries in its ambit, implementation will become more challenging. This paper analyses the major needs of PAT (namely tracking, monitoring, auditing & verifying energy-saving reports, and providing technical support & guidance to stakeholders); and how the aforesaid reasons affect them. Though current technologies can handle these challenges to an extent, standardization activities for implementation have been scanty for PAT and this work attempts to evolve them. The inconsistent modification of business processes, rules, and procedures across stakeholders, and interoperability among heterogeneous systems are addressed. This paper proposes the adoption of specifically two standards into PAT, namely Business Process Model and Notation for maintaining consistency in business process modelling, and Common Information Model (IEC 61970, 61968, 62325 combined) for information exchange. Detailed architecture and organization of these adoptions are reported. The work can be used by PAT implementing agencies, stakeholders, and standardization bodies.

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.

IPAS Implementation Handbook

ERIC Educational Resources Information Center

Brooks, D. Christopher

2014-01-01

While the use of analytics to promote student success is gaining in popularity, basic questions about what IPAS is and the issues institutions face during implementation and integration. The "IPAS Implementation Handbook" catalogs the experiences, observations, and practical advice from 19 institutions engaged in IPAS implementation…

A Concept Mapping Approach to Guide and Understand Dissemination and Implementation

PubMed Central

Green, Amy E.; Fettes, Danielle L.; Aarons, Gregory A.

2013-01-01

Many efforts to implement evidence-based programs do not reach their full potential or fail due to the variety of challenges inherent in dissemination and implementation. This article describes the use of concept mapping—a mixed method strategy—to study implementation of behavioral health innovations and evidence-based practice (EBP). The application of concept mapping to implementation research represents a practical and concise way to identify and quantify factors affecting implementation, develop conceptual models of implementation, target areas to address as part of implementation readiness and active implementation, and foster communication among stakeholders. Concept mapping is described and a case example is provided to illustrate its use in an implementation study. Implications for the use of concept mapping methods in both research and applied settings towards the dissemination and implementation of behavioral health services are discussed. PMID:22892987

A concept mapping approach to guide and understand dissemination and implementation.

PubMed

Green, Amy E; Fettes, Danielle L; Aarons, Gregory A

2012-10-01

Many efforts to implement evidence-based programs do not reach their full potential or fail due to the variety of challenges inherent in dissemination and implementation. This article describes the use of concept mapping-a mixed method strategy-to study implementation of behavioral health innovations and evidence-based practice (EBP). The application of concept mapping to implementation research represents a practical and concise way to identify and quantify factors affecting implementation, develop conceptual models of implementation, target areas to address as part of implementation readiness and active implementation, and foster communication among stakeholders. Concept mapping is described and a case example is provided to illustrate its use in an implementation study. Implications for the use of concept mapping methods in both research and applied settings towards the dissemination and implementation of behavioral health services are discussed.

Barriers and Facilitators for the Implementation of Primary Prevention and Health Promotion Activities in Primary Care: A Synthesis through Meta-Ethnography

PubMed Central

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

2014-01-01

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

Measuring the Implementation of a School Wellness Policy

ERIC Educational Resources Information Center

Snelling, Anastasia; Belson, Sarah Irvine; Watts, Erin; Malloy, Elizabeth; Van Dyke, Hugo; George, Stephanie; Schlicker, Sandra; Katz, Nancy Brenowitz

2017-01-01

Background: With the rise in childhood obesity, school policies related to nutrition and physical activity have been written and implemented. In this paper, we present a model to evaluate the degree to which state legislation for school health policies are implemented at the school level. Methods: Using Washington, DC's Healthy Schools Act (HSA)…

Implementing Replacement Cost Accounting

DTIC Science & Technology

1976-12-01

cost accounting Clickener, John Ross Monterey, California. Naval Postgraduate School http://hdl.handle.net/10945/17810 Downloaded from NPS Archive...Calhoun IMPLEMENTING REPLACEMENT COST ACCOUNTING John Ross CHckener NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS IMPLEMENTING REPLACEMENT COST ...Implementing Replacement Cost Accounting 7. AUTHORS John Ross Clickener READ INSTRUCTIONS BEFORE COMPLETING FORM 3. RECIPIENT’S CATALOG NUMBER 9. TYRE OF

Providing Feasible Implementation Support: Direct Training and Implementation Planning in Consultation

ERIC Educational Resources Information Center

Collier-Meek, Melissa A.; Sanetti, Lisa M. H.; Boyle, Ashley M.

2016-01-01

To deliver interventions completely and consistently (i.e., with adequate treatment integrity) and, thus, have a positive impact on student outcomes, implementers, such as teachers and paraprofessionals, often require support. To efficiently deliver implementation support, school psychologists could embed research-based strategies into their…

Implementing a lessons learned process at Sandia National Laboratories

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

Fosshage, Erik D.; Drewien, Celeste A.; Eras, Kenneth

2016-01-01

The Lessons Learned Process Improvement Team was tasked to gain an understanding of the existing lessons learned environment within the major programs at Sandia National Laboratories, identify opportunities for improvement in that environment as compared to desired attributes, propose alternative implementations to address existing inefficiencies, perform qualitative evaluations of alternative implementations, and recommend one or more near-term activities for prototyping and/or implementation. This report documents the work and findings of the team.

Emotional intensity influences pre-implementation and implementation of distraction and reappraisal

PubMed Central

Shafir, Roni; Schwartz, Naama; Blechert, Jens

2015-01-01

Although emotional intensity powerfully challenges regulatory strategies, its influence remains largely unexplored in affective-neuroscience. Accordingly, the present study addressed the moderating role of emotional intensity in two regulatory stages—implementation (during regulation) and pre-implementation (prior to regulation), of two major cognitive regulatory strategies—distraction and reappraisal. According to our framework, because distraction implementation involves early attentional disengagement from emotional information before it gathers force, in high-intensity it should be more effective in the short-term, relative to reappraisal, which modulates emotional processing only at a late semantic meaning phase. Supporting findings showed that in high (but not low) intensity, distraction implementation resulted in stronger modulation of negative experience, reduced neural emotional processing (centro-parietal late positive potential, LPP), with suggestive evidence for less cognitive effort (frontal-LPP), relative to reappraisal. Related pre-implementation findings confirmed that anticipating regulation of high-intensity stimuli resulted in distraction (over reappraisal) preference. In contrast, anticipating regulation of low-intensity stimuli resulted in reappraisal (over distraction) preference, which is most beneficial for long-term adaptation. Furthermore, anticipating cognitively demanding regulation, either in cases of regulating counter to these preferences or via the more effortful strategy of reappraisal, enhanced neural attentional resource allocation (Stimulus Preceding Negativity). Broad implications are discussed. PMID:25700568

Design and Implementation of a Project-Based Active/Cooperative Engineering Design Course for Freshmen

ERIC Educational Resources Information Center

Abdulaal, R. M.; Al-Bahi, A. M.; Soliman, A. Y.; Iskanderani, F. I.

2011-01-01

A project-based active/cooperative design course is planned, implemented, assessed and evaluated to achieve several desired engineering outcomes. The course allows freshman-level students to gain professional hands-on engineering design experience through an opportunity to practise teamwork, quality principles, communication skills, life-long…

The current implementation status of the integration of sports and physical activity into Dutch rehabilitation care.

PubMed

Hoekstra, Femke; Hettinga, Florentina J; Alingh, Rolinde A; Duijf, Marjo; Dekker, Rienk; van der Woude, Lucas H V; van der Schans, Cees P

2017-01-01

To describe the current status of the nationwide implementation process of a sports and physical activity stimulation programme to gain insight into how sports and physical activity were integrated into Dutch rehabilitation care. The current implementation status of a sports and physical activity stimulation programme in 12 rehabilitation centres and 5 hospitals with a rehabilitation department was described by scoring fidelity and satisfaction. Seventy-one rehabilitation professionals filled out a questionnaire on how sports and physical activity, including stimulation activities, were implemented into rehabilitation care. Total fidelity scores (in %) were calculated for each organization. Professionals' satisfaction was rated on a scale from 1 to 10. In most organizations sports and physical activity were to some extent integrated during and after rehabilitation (fidelity scores: median = 54%, IQR = 23%). Physical activity stimulation was not always embedded as standard component of a rehabilitation treatment. Professionals' satisfaction rated a median value of 8.0 (IQR = 0.0) indicating high satisfaction rates. The fidelity outcome showed that activities to stimulate sports and physical activity during and after rehabilitation were integrated into rehabilitation care, but not always delivered as standardized component. These findings have emphasized the importance to focus on integrating these activities into routines of organizations. Implications for Rehabilitation Components of an evidence-based programme to stimulate sports and physical activity during and after rehabilitation can be used to measure the current status of the integration of sports and physical activity in rehabilitation care in a structural and effective way. The method described in the current study can be used to compare the content of the rehabilitation care regarding the integration of sports and physical activity among organizations both on a national and international level

Effective Implementation of Collaborative Care for Depression: What is Needed?

PubMed Central

Whitebird, Robin R.; Solberg, Leif I.; Jaeckels, Nancy A.; Pietruszewski, Pamela B.; Hadzic, Senka; Unützer, Jürgen; Ohnsorg, Kris A.; Rossom, Rebecca C.; Beck, Arne; Joslyn, Ken; Rubenstein, Lisa V.

2014-01-01

Objective To identify the care model factors that were key for successful implementation of collaborative depression care in a statewide Minnesota primary care initiative. Study Design We used a mixed-methods design incorporating both qualitative data from clinic site visits and quantitative measures of patient activation and 6-month remission rates. Methods Care model factors identified from the site visits were tested for association with rates of activation into the program and remission rates. Results Nine factors were identified as important for successful implementation of collaborative care by the consultants who had trained and interviewed participating clinic teams. Factors correlated with higher patient activation rates were: strong leadership support (0.63), well-defined and implemented care manager roles (0.62), a strong primary care physician champion (0.60), and an on-site and accessible care manager (0.59). However, remission rates at six months were correlated with: an engaged psychiatrist (0.62), not seeing operating costs as a barrier to participation (0.56), and face-to-face communication (warm handoffs) between the care-manager and primary care physician for new patients (0.54). Conclusions Care model factors most important for successful program implementation differ for patient activation into the program versus remission at six months. Knowing which implementation factors are most important for successful implementation will be useful for those interested in adopting this evidence-based approach to improve primary care for patients with depression. PMID:25365745

Using a behaviour change techniques taxonomy to identify active ingredients within trials of implementation interventions for diabetes care.

PubMed

Presseau, Justin; Ivers, Noah M; Newham, James J; Knittle, Keegan; Danko, Kristin J; Grimshaw, Jeremy M

2015-04-23

Methodological guidelines for intervention reporting emphasise describing intervention content in detail. Despite this, systematic reviews of quality improvement (QI) implementation interventions continue to be limited by a lack of clarity and detail regarding the intervention content being evaluated. We aimed to apply the recently developed Behaviour Change Techniques Taxonomy version 1 (BCTTv1) to trials of implementation interventions for managing diabetes to assess the capacity and utility of this taxonomy for characterising active ingredients. Three psychologists independently coded a random sample of 23 trials of healthcare system, provider- and/or patient-focused implementation interventions from a systematic review that included 142 such studies. Intervention content was coded using the BCTTv1, which describes 93 behaviour change techniques (BCTs) grouped within 16 categories. We supplemented the generic coding instructions within the BCTTv1 with decision rules and examples from this literature. Less than a quarter of possible BCTs within the BCTTv1 were identified. For implementation interventions targeting providers, the most commonly identified BCTs included the following: adding objects to the environment, prompts/cues, instruction on how to perform the behaviour, credible source, goal setting (outcome), feedback on outcome of behaviour, and social support (practical). For implementation interventions also targeting patients, the most commonly identified BCTs included the following: prompts/cues, instruction on how to perform the behaviour, information about health consequences, restructuring the social environment, adding objects to the environment, social support (practical), and goal setting (behaviour). The BCTTv1 mapped well onto implementation interventions directly targeting clinicians and patients and could also be used to examine the impact of system-level interventions on clinician and patient behaviour. The BCTTv1 can be used to characterise

Design and implementation of multichannel global active structural acoustic control for a device casing

NASA Astrophysics Data System (ADS)

Mazur, Krzysztof; Wrona, Stanislaw; Pawelczyk, Marek

2018-01-01

The paper presents the idea and discussion on implementation of multichannel global active noise control systems. As a test plant an active casing is used. It has been developed by the authors to reduce device noise directly at the source by controlling vibration of its casing. To provide global acoustic effect in the whole environment, where the device operates, it requires a number of secondary sources and sensors for each casing wall, thus making the whole active control structure complicated, i.e. with a large number of interacting channels. The paper discloses all details concerning hardware setup and efficient implementation of control algorithms for the multichannel case. A new formulation is presented to introduce the distributed version of the Switched-error Filtered-reference Least Mean Squares (FXLMS) algorithm together with adaptation rate enhancement. The convergence rate of the proposed algorithm is compared with original Multiple-error FXLMS. A number of hints followed from many years of authors' experience on microprocessor control systems design and signal processing algorithms optimization are presented. They can be used for various active control and signal processing applications, both for academic research and commercialization.

PrEP implementation in the Asia-Pacific region: opportunities, implementation and barriers

PubMed Central

Zablotska, Iryna; Grulich, Andrew E; Phanuphak, Nittaya; Anand, Tarandeep; Janyam, Surang; Poonkasetwattana, Midnight; Baggaley, Rachel; van Griensven, Frits; Lo, Ying-Ru

2016-01-01

Introduction HIV epidemics in the Asia-Pacific region are concentrated among men who have sex with men (MSM) and other key populations. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention and could be a potential game changer in the region. We discuss the progress towards PrEP implementation in the Asia-Pacific region, including opportunities and barriers. Discussion Awareness about PrEP in the Asia-Pacific is still low and so are its levels of use. A high proportion of MSM who are aware of PrEP are willing to use it. Key PrEP implementation barriers include poor knowledge about PrEP, limited access to PrEP, weak or non-existent HIV prevention programmes for MSM and other key populations, high cost of PrEP, stigma and discrimination against key populations and restrictive laws in some countries. Only several clinical trials, demonstration projects and a few larger-scale implementation studies have been implemented so far in Thailand and Australia. However, novel approaches to PrEP implementation have emerged: researcher-, facility- and community-led models of care, with PrEP services for fee and for free. The WHO consolidated guidelines on HIV testing, treatment and prevention call for an expanded access to PrEP worldwide and have provided guidance on PrEP implementation in the region. Some countries like Australia have released national PrEP guidelines. There are growing community leadership and consultation processes to initiate PrEP implementation in Asia and the Pacific. Conclusions Countries of the Asia-Pacific region will benefit from adding PrEP to their HIV prevention packages, but for many this is a critical step that requires resourcing. Having an impact on the HIV epidemic requires investment. The next years should see the region transitioning from limited PrEP implementation projects to growing access to PrEP and expansion of HIV prevention programmes. PMID:27760688

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

PubMed

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

2015-09-01

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

Use of the Equity Implementation Model to Review Clinical System Implementation Efforts

PubMed Central

Lauer, Thomas W.; Joshi, Kailash; Browdy, Thomas

2000-01-01

This paper presents the equity implementation model (EIM) in the context of a case that describes the implementation of a medical scheduling system. The model is based on equity theory, a well-established theory in the social sciences that has been tested in hundreds of experimental and field studies. The predictions of equity theory have been supported in organizational, societal, family, and other social settings. Thus, the EIM helps provide a theory-based understanding for collecting and reviewing users' reactions to, and acceptance or rejection of, a new technology or system. The case study (implementation of a patient scheduling and appointment setting system in a large health maintenance organization) illustrates how the EIM can be used to examine users' reactions to the implementation of a new system. PMID:10641966

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...

Efficient parallel implementation of active appearance model fitting algorithm on GPU.

PubMed

Wang, Jinwei; Ma, Xirong; Zhu, Yuanping; Sun, Jizhou

2014-01-01

The active appearance model (AAM) is one of the most powerful model-based object detecting and tracking methods which has been widely used in various situations. However, the high-dimensional texture representation causes very time-consuming computations, which makes the AAM difficult to apply to real-time systems. The emergence of modern graphics processing units (GPUs) that feature a many-core, fine-grained parallel architecture provides new and promising solutions to overcome the computational challenge. In this paper, we propose an efficient parallel implementation of the AAM fitting algorithm on GPUs. Our design idea is fine grain parallelism in which we distribute the texture data of the AAM, in pixels, to thousands of parallel GPU threads for processing, which makes the algorithm fit better into the GPU architecture. We implement our algorithm using the compute unified device architecture (CUDA) on the Nvidia's GTX 650 GPU, which has the latest Kepler architecture. To compare the performance of our algorithm with different data sizes, we built sixteen face AAM models of different dimensional textures. The experiment results show that our parallel AAM fitting algorithm can achieve real-time performance for videos even on very high-dimensional textures.

Efficient Parallel Implementation of Active Appearance Model Fitting Algorithm on GPU

PubMed Central

Wang, Jinwei; Ma, Xirong; Zhu, Yuanping; Sun, Jizhou

2014-01-01

The active appearance model (AAM) is one of the most powerful model-based object detecting and tracking methods which has been widely used in various situations. However, the high-dimensional texture representation causes very time-consuming computations, which makes the AAM difficult to apply to real-time systems. The emergence of modern graphics processing units (GPUs) that feature a many-core, fine-grained parallel architecture provides new and promising solutions to overcome the computational challenge. In this paper, we propose an efficient parallel implementation of the AAM fitting algorithm on GPUs. Our design idea is fine grain parallelism in which we distribute the texture data of the AAM, in pixels, to thousands of parallel GPU threads for processing, which makes the algorithm fit better into the GPU architecture. We implement our algorithm using the compute unified device architecture (CUDA) on the Nvidia's GTX 650 GPU, which has the latest Kepler architecture. To compare the performance of our algorithm with different data sizes, we built sixteen face AAM models of different dimensional textures. The experiment results show that our parallel AAM fitting algorithm can achieve real-time performance for videos even on very high-dimensional textures. PMID:24723812

A network collaboration implementing technology to improve medication dispensing and administration in critical access hospitals.

PubMed

Wakefield, Douglas S; Ward, Marcia M; Loes, Jean L; O'Brien, John

2010-01-01

We report how seven independent critical access hospitals collaborated with a rural referral hospital to standardize workflow policies and procedures while jointly implementing the same health information technologies (HITs) to enhance medication care processes. The study hospitals implemented the same electronic health record, computerized provider order entry, pharmacy information systems, automated dispensing cabinets (ADC), and barcode medication administration systems. We conducted interviews and examined project documents to explore factors underlying the successful implementation of ADC and barcode medication administration across the network hospitals. These included a shared culture of collaboration; strategic sequencing of HIT component implementation; interface among HIT components; strategic placement of ADCs; disciplined use and sharing of workflow analyses linked with HIT applications; planning for workflow efficiencies; acquisition of adequate supply of HIT-related devices; and establishing metrics to monitor HIT use and outcomes.

Strengthening organizations to implement evidence-based clinical practices.

PubMed

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

2010-01-01

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

Implementation of cloud computing in higher education

NASA Astrophysics Data System (ADS)

Asniar; Budiawan, R.

2016-04-01

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

Evaluation of interactive computerized training to teach parents to implement photographic activity schedules with children with autism spectrum disorder.

PubMed

Gerencser, Kristina R; Higbee, Thomas S; Akers, Jessica S; Contreras, Bethany P

2017-07-01

Training parents of children with autism spectrum disorder can be a challenge due to limited resources, time, and money. Interactive computerized training (ICT)-a self-paced program that incorporates instructions, videos, and interactive questions-is one method professionals can use to disseminate trainings to broader populations. This study extends previous research on ICT by assessing the effect of ICT to teach three parents how to implement a photographic activity schedule using a systematic prompting procedure with their child. Following ICT, all parents increased their fidelity to implementation of an activity schedule during role-play sessions with an adult. Fidelity remained high during implementation with their child and maintained during a 2-week follow-up. © 2017 Society for the Experimental Analysis of Behavior.

Implementation of advance warning of end of green system (AWEGS) : implementation report.

DOT National Transportation Integrated Search

2008-10-01

The objective of this implementation project was to implement four AWEGS across Texas at intersections appropriate for the installation of AWEGS. After a survey across Texas, four sites were chosen in the Atlanta District, Pharr District, Odessa Dist...

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

PubMed

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

2017-03-01

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

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

PubMed

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

2014-04-14

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

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

PubMed Central

2014-01-01

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

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.)

A Pragmatic Application of the RE-AIM Framework for Evaluating the Implementation of Physical Activity as a Standard of Care in Health Systems.

PubMed

Stoutenberg, Mark; Galaviz, Karla I; Lobelo, Felipe; Joy, Elizabeth; Heath, Gregory W; Hutber, Adrian; Estabrooks, Paul

2018-05-10

Exercise is Medicine (EIM) is an initiative that seeks to integrate physical activity assessment, prescription, and patient referral as a standard in patient care. Methods to assess this integration have lagged behind its implementation. The purpose of this work is to provide a pragmatic framework to guide health care systems in assessing the implementation and impact of EIM. A working group of experts from health care, public health, and implementation science convened to develop an evaluation model based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The working group aimed to provide pragmatic guidance on operationalizing EIM across the different RE-AIM dimensions based on data typically available in health care settings. The Reach of EIM can be determined by the number and proportion of patients that were screened for physical inactivity, received brief counseling and/or a physical activity prescription, and were referred to physical activity resources. Effectiveness can be assessed through self-reported changes in physical activity, cardiometabolic biometric factors, incidence/burden of chronic disease, as well as health care utilization and costs. Adoption includes assessing the number and representativeness of health care settings that adopt any component of EIM, and Implementation involves assessing the extent to which health care teams implement EIM in their clinic. Finally, Maintenance involves assessing the long-term effectiveness (patient level) and sustained implementation (clinic level) of EIM in a given health care setting. The availability of a standardized, pragmatic, evaluation framework is critical in determining the impact of implementing EIM as a standard of care across health care systems.

Patient-experienced effect of an active implementation of a disease management programme for COPD – a randomised trial

PubMed Central

2013-01-01

Background People living with chronic disease currently account for the majority of the total healthcare costs. The Central Denmark Region implemented a disease management programme (DMP) for chronic obstructive pulmonary disease (COPD) in 2008. This presented an opportunity to examine the effect of an evidence-based, planned and proactive implementation of a DMP compared to the usual implementation strategy. Methods We performed a block- and cluster-randomised controlled trial with two groups and an extra external control group. The primary outcome was patients’ assessment of their care after using an active implementation model for a DMP for COPD measured with the Patient-Assessment-of-Chronic-Illness-Care (PACIC) instrument. At baseline, questionnaires were sent to 2,895 patients identified by an algorithm based on health registry data on lung-related contacts to the healthcare system. Patients were asked to confirm or refute their diagnosis of COPD. Of those who responded, 1,445 (72.8%) confirmed their diagnosis. PACIC data were collected at baseline and at a 12-month follow-up for 744 (51.1%) patients. Results Comparing the three groups after the implementation of the DMP, we found a statistically significantly higher change in the PACIC score in the intervention group than in the control groups. No statistically significant differences were found between the control and the external control groups in any of the dimensions. Conclusions Reinforcing the role of general practice as coordinator for care-and self-management-support with an active implementation of a DMP for COPD made patients score higher on the PACIC instrument, which indicates a better experience of the received healthcare. Trial registration NCT01228708. PMID:24088417

24 CFR 51.106 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Implementation. 51.106 Section 51.106 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... urbanized areas and on development activity. (iii) Impact on HUD-assisted projects currently in processing...

24 CFR 51.106 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Implementation. 51.106 Section 51.106 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... urbanized areas and on development activity. (iii) Impact on HUD-assisted projects currently in processing...

24 CFR 51.106 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Implementation. 51.106 Section 51.106 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... urbanized areas and on development activity. (iii) Impact on HUD-assisted projects currently in processing...

An American knowledge base in England - Alternate implementations of an expert system flight status monitor

NASA Technical Reports Server (NTRS)

Butler, G. F.; Graves, A. T.; Disbrow, J. D.; Duke, E. L.

1989-01-01

A joint activity between the Dryden Flight Research Facility of the NASA Ames Research Center (Ames-Dryden) and the Royal Aerospace Establishment (RAE) on knowledge-based systems has been agreed. Under the agreement, a flight status monitor knowledge base developed at Ames-Dryden has been implemented using the real-time AI (artificial intelligence) toolkit MUSE, which was developed in the UK. Here, the background to the cooperation is described and the details of the flight status monitor and a prototype MUSE implementation are presented. It is noted that the capabilities of the expert-system flight status monitor to monitor data downlinked from the flight test aircraft and to generate information on the state and health of the system for the test engineers provides increased safety during flight testing of new systems. Furthermore, the expert-system flight status monitor provides the systems engineers with ready access to the large amount of information required to describe a complex aircraft system.

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation

PubMed Central

Alemnji, George; Edghill, Lisa; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Background Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. Objectives We report the development of a stepwise process for quality systems improvement in the Caribbean Region. Methods The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called ‘Laboratory Quality Management System – Stepwise Improvement Process (LQMS-SIP) Towards Accreditation’ to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. Results This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. Conclusion This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement. PMID:28879149

Implementation of a National Workplace Wellness Program for Health Workers in Botswana

PubMed Central

Ledikwe, Jenny H.; Semo, Bazghina-werq; Sebego, Miram; Mpho, Maureen; Mothibedi, Heather; Mawandia, Shreshth; O’Malley, Gabrielle

2017-01-01

The Botswana workplace wellness program (WWP) for health care workers (HCWs) was initiated in 2007. WWP implementation was assessed using a sequential, explanatory, mixed methods design including a national implementation assessment (27 health districts) and in-depth interviews (n = 38). Level of implementation varied across districts with health screening, therapeutic recreation, and health promotion implemented more frequently than occupational health activities and psychosocial services. Facilitators to WWP implementation included establishment of a dedicated, diverse WWP committee; provision of administrative support, and integration of activities into organizational culture. Barriers included competing priorities related to delivery of health services to clients, limited technical ability to deliver occupation health activities and psychosocial support, receipt of health services from colleagues, and limited appreciation for personal wellness by some HCWs. Ensuring the well-being of HCWs is critical in reaching international health goals. PMID:28742763

Implementation activities for the Wisconsin Highway Research Program (WHRP).

DOT National Transportation Integrated Search

2010-03-01

The Wisconsin Highway Research Program (WHRP) Steering Committee commissioned an implementation pilot : program in 2006 to facilitate the incorporation of research results into the programs, standards, and processes of : the Wisconsin Department of T...

Active feedforward noise control and signal tracking of headsets: Electroacoustic analysis and system implementation.

PubMed

Bai, Mingsian R; Pan, Weichi; Chen, Hungyu

2018-03-01

Active noise control (ANC) of headsets is revisited in this paper. An in-depth electroacoustic analysis of the combined loudspeaker-cavity headset system is conducted on the basis of electro-mechano-acoustical analogous circuits. Model matching of the primary path and the secondary path leads to a feedforward control architecture. The ideal controller sheds some light on the key parameters that affect the noise reduction performance. Filtered-X least-mean-squares algorithm is employed to implement the feedforward controller on a digital signal processor. Since the relative delay of the primary path and the secondary path is crucial to the noise reduction performance, multirate signal processing with polyphase implementation is utilized to minimize the effective analog-digital conversion delay in the secondary path. Ad hoc decimation and interpolation filters are designed in order not to introduce excessive phase delays at the cutoff. Real-time experiments are undertaken to validate the implemented ANC system. Listening tests are also conducted to compare the fixed controller and the adaptive controller in terms of noise reduction and signal tracking performance for three noise types. The results have demonstrated that the fixed feedforward controller achieved satisfactory noise reduction performance and signal tracking quality.

The Influence of Leadership in Implementing Management Systems

NASA Astrophysics Data System (ADS)

Nae, Ilie; Solomon, Gheorghe; Severin, Irina

2014-12-01

This paper presents a new perspective of the implementation of Management Systems within organizations in order to increase the success rate. The objective is to analyse how the leadership could influence positively or negatively the implementation, according to the leadership approach chosen. It offers a method to analyse the maturity of the leadership for any organization, based on existing leadership models, completing these models with specificities of a Management System. The Maturity Grid is extended to key elements of the Organizational Leadership: Strategic Planning, Process and Performance. The results expected are to change the current understanding of leadership during a Management System implementation(leadership seen as a principle) to an active leadership, implemented at organizational level. It propose an alternative of the classic management approach, to a Performance Management approach, that integrates naturally the leadership in all processes and methods

Open SHMEM Reference Implementation

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

Pritchard, Howard; Curtis, Anthony; Welch, Aaron

2016-05-12

OpenSHMEM is an effort to create a specification for a standardized API for parallel programming in the Partitioned Global Address Space. Along with the specification the project is also creating a reference implementation of the API. This implementation attempts to be portable, to allow it to be deployed in multiple environments, and to be a starting point for implementations targeted to particular hardware platforms. It will also serve as a springboard for future development of the API.

[On practicability of implementing the speciality "podiatry" in traumatology and orthopedics].

PubMed

2011-01-01

The absence of single opinion concerning the classification of foot and ankle joint pathology does not permit to formulate universal and practical approach to the identification of pathological syndromes in case of patient foot lesion. The situation is aggravated by the unsolved issues related to the terminological definition of podiatry as a direction in orthopedics to solve the issues of foot and ankle joint pathology. In actual conditions the implementation of new technologies into the structure of traumatological orthopedics care is needed. This approach permits to combine the qualities of models of effective and optimized care to patients with foot and ankle joint pathology. The study of issue related to the systematization of podiatric pathology revealed that actually no single universal classification easy-to-use in practice exists. Hence the development of original applied working scheme of foot and ankle joint pathology is proposed.

Towards the Implementation of the GEOSS Water Strategy

NASA Astrophysics Data System (ADS)

Lawford, R. G.; Cripe, D.

2014-12-01

Early in 2014, the Group on Earth Observations (GEO) adopted the GEOSS (Global Earth Observation System of Systems) Water Strategy as a potential guide for GEO-related water activities over the next decade. The Water Strategy outlines water-related issues and opportunities that fit within the general GEOSS framework that will be developed over the next decade (2016-2025). Implementation of a water strategy within the GEOSS framework can be complex because GEO Members and Participating Organizations contribute to GEO on a voluntary basis. In spite of these limitations efforts to consolidate an implementation plan have made significant advances during the past nine months. Progress towards the final GEOSS Water Strategy Implementation Plan will be reported and gaps in the plan will be identified. Specific responses to the strategy will address the need for user engagement, the development of integrated of data products, model hierarchies and user support systems, and the research that will be needed to expand the capabilities of GEOSS and its water services. One challenge for the implementation plan involves building a framework from the diverse and wide range of activities and opportunities presented by GEO Members and Participating Organizations. The priority themes within the GEO Water Strategy are being used to provide more focus for new initiatives. New activities related to these priority areas involving projects that link water and other GEO Societal Benefit Areas, as well as initiatives related to the Water-Energy-Food nexus and the Sustainable Development Goals will be described. The presentation will also explore the needs and opportunities for new satellites and other observational and information technologies to advance the implementation of the GEOSS water strategy objectives.

Elaborating on theory with middle managers' experience implementing healthcare innovations in practice.

PubMed

Birken, Sarah A; DiMartino, Lisa D; Kirk, Meredith A; Lee, Shoou-Yih D; McClelland, Mark; Albert, Nancy M

2016-01-04

The theory of middle managers' role in implementing healthcare innovations hypothesized that middle managers influence implementation effectiveness by fulfilling the following four roles: diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. The theory also suggested several activities in which middle managers might engage to fulfill the four roles. The extent to which the theory aligns with middle managers' experience in practice is unclear. We surveyed middle managers (n = 63) who attended a nursing innovation summit to (1) assess alignment between the theory and middle managers' experience in practice and (2) elaborate on the theory with examples from middle managers' experience overseeing innovation implementation in practice. Middle managers rated all of the theory's hypothesized four roles as "extremely important" but ranked diffusing and synthesizing information as the most important and selling innovation implementation as the least important. They reported engaging in several activities that were consistent with the theory's hypothesized roles and activities such as diffusing information via meetings and training. They also reported engaging in activities not described in the theory such as appraising employee performance. Middle managers' experience aligned well with the theory and expanded definitions of the roles and activities that it hypothesized. Future studies should assess the relationship between hypothesized roles and the effectiveness with which innovations are implemented in practice. If evidence supports the theory, the theory should be leveraged to promote the fulfillment of hypothesized roles among middle managers, doing so may promote innovation implementation.

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

PubMed

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

2008-01-18

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

[Considerations on the development of nutrition-related guidelines by the World Health Organization and their implementation].

PubMed

Zamora, Gerardo; Meneses, Daniela; De-Regil, Luz Maria; Neufeld, Lynnette; Peña-Rosas, Juan Pablo; Sinisterra, Odalis Teresa

2015-03-01

The World Health Organization (WHO) follows a complex and rigorous process to develop global guidelines. With regard to nutrition-related guidelines, the joint participation of national authorities from Member States and their partners, including those of the social economy, is key to strengthening the process of evidence-informed guideline development and the subsequent implementation as part of national public health strategies. WHO puts forward a series of tools that can assist national authorities on health and social development in the elaboration of evidence-informed policies, considering their pertinence, relevance and implementability. This adoption and adaptation process must consider equity in order to avoid widening existing inequities. WHO global nutrition guidelines contribute to the effective implementation of nutrition interventions in Member States. Two experiences of implementation, one in Panama and one in Peru, exemplify this process. The paper ends by suggesting a deeper understanding and utilization of implementation research during programmes to identify what factors ensure effective interventions, appropriate scale up strategies and greater health equity.

Changes to the school food and physical activity environment after guideline implementation in British Columbia, Canada.

PubMed

Watts, Allison W; Mâsse, Louise C; Naylor, Patti-Jean

2014-04-14

High rates of childhood obesity have generated interest among policy makers to improve the school food environment and increase students' levels of physical activity. The purpose of this study was to examine school-level changes associated with implementation of the Food and Beverage Sales in Schools (FBSS) and Daily Physical Activity (DPA) guidelines in British Columbia, Canada. Elementary and middle/high school principals completed a survey on the school food and physical activity environment in 2007-08 (N=513) and 2011-12 (N=490). Hierarchical mixed effects regression was used to examine changes in: 1) availability of food and beverages; 2) minutes per day of Physical Education (PE); 3) delivery method of PE; and 4) school community support. Models controlled for school enrollment and community type, education and income. After policy implementation was expected, more elementary schools provided access to fruits and vegetables and less to 100% fruit juice. Fewer middle/high schools provided access to sugar-sweetened beverages, French fries, baked goods, salty snacks and chocolate/candy. Schools were more likely to meet 150 min/week of PE for grade 6 students, and offer more minutes of PE per week for grade 8 and 10 students including changes to PE delivery method. School community support for nutrition and physical activity policies increased over time. Positive changes to the school food environment occurred after schools were expected to implement the FBSS and DPA guidelines. Reported changes to the school environment are encouraging and provide support for guidelines and policies that focus on increasing healthy eating and physical activity in schools.

46 CFR 531.11 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 9 2014-10-01 2014-10-01 false Implementation. 531.11 Section 531.11 Shipping FEDERAL MARITIME COMMISSION REGULATIONS AFFECTING OCEAN SHIPPING IN FOREIGN COMMERCE NVOCC SERVICE ARRANGEMENTS Exceptions and Implementation § 531.11 Implementation. Generally. Performance under an NSA or amendment...

46 CFR 531.11 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 9 2011-10-01 2011-10-01 false Implementation. 531.11 Section 531.11 Shipping FEDERAL MARITIME COMMISSION REGULATIONS AFFECTING OCEAN SHIPPING IN FOREIGN COMMERCE NVOCC SERVICE ARRANGEMENTS Exceptions and Implementation § 531.11 Implementation. Generally. Performance under an NSA or amendment...

46 CFR 531.11 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 9 2012-10-01 2012-10-01 false Implementation. 531.11 Section 531.11 Shipping FEDERAL MARITIME COMMISSION REGULATIONS AFFECTING OCEAN SHIPPING IN FOREIGN COMMERCE NVOCC SERVICE ARRANGEMENTS Exceptions and Implementation § 531.11 Implementation. Generally. Performance under an NSA or amendment...

46 CFR 531.11 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 9 2010-10-01 2010-10-01 false Implementation. 531.11 Section 531.11 Shipping FEDERAL MARITIME COMMISSION REGULATIONS AFFECTING OCEAN SHIPPING IN FOREIGN COMMERCE NVOCC SERVICE ARRANGEMENTS Exceptions and Implementation § 531.11 Implementation. Generally. Performance under an NSA or amendment...

46 CFR 531.11 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 9 2013-10-01 2013-10-01 false Implementation. 531.11 Section 531.11 Shipping FEDERAL MARITIME COMMISSION REGULATIONS AFFECTING OCEAN SHIPPING IN FOREIGN COMMERCE NVOCC SERVICE ARRANGEMENTS Exceptions and Implementation § 531.11 Implementation. Generally. Performance under an NSA or amendment...

Implementing Cognitive Remediation Programs in France: The "Secret Sauce".

PubMed

Amado, Isabelle; Sederer, Lloyd I

2016-07-01

Cognitive remediation (CR) is a psychosocial therapy that seeks to restore patients' cognitive abilities by providing strategies to improve functioning in cognitive domains and helping them transfer acquired capabilities to everyday life. Since 2008, CR programs have been introduced in several regional health ministry areas in France. This column describes that implementation initiative, which includes creation of a network of the most active CR programs to conduct multicenter trials; establishment of a university degree in CR, awarded after completion of a one-year clinical training program; and implementation activities of regional health agencies. The authors describe three core elements of a "secret sauce"-a common language, timing, and leadership-that has helped ensure the success of the implementation efforts and that may be useful in other countries.

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania

PubMed Central

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki GM; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-01-01

Background A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Methods Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Results Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Conclusion Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey. PMID:19116022

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania.

PubMed

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki G M; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-12-30

A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey.

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

DOT National Transportation Integrated Search

2009-03-01

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

The Neural Correlates of Emotion Regulation by Implementation Intentions

PubMed Central

Hallam, Glyn P.; Webb, Thomas L.; Sheeran, Paschal; Miles, Eleanor; Wilkinson, Iain D.; Hunter, Michael D.; Barker, Anthony T.; Woodruff, Peter W. R.; Totterdell, Peter; Lindquist, Kristen A.; Farrow, Tom F. D.

2015-01-01

Several studies have investigated the neural basis of effortful emotion regulation (ER) but the neural basis of automatic ER has been less comprehensively explored. The present study investigated the neural basis of automatic ER supported by ‘implementation intentions’. 40 healthy participants underwent fMRI while viewing emotion-eliciting images and used either a previously-taught effortful ER strategy, in the form of a goal intention (e.g., try to take a detached perspective), or a more automatic ER strategy, in the form of an implementation intention (e.g., “If I see something disgusting, then I will think these are just pixels on the screen!”), to regulate their emotional response. Whereas goal intention ER strategies were associated with activation of brain areas previously reported to be involved in effortful ER (including dorsolateral prefrontal cortex), ER strategies based on an implementation intention strategy were associated with activation of right inferior frontal gyrus and ventro-parietal cortex, which may reflect the attentional control processes automatically captured by the cue for action contained within the implementation intention. Goal intentions were also associated with less effective modulation of left amygdala, supporting the increased efficacy of ER under implementation intention instructions, which showed coupling of orbitofrontal cortex and amygdala. The findings support previous behavioural studies in suggesting that forming an implementation intention enables people to enact goal-directed responses with less effort and more efficiency. PMID:25798822

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 6 Domestic Security 1 2012-01-01 2012-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the section 550 program in...

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 6 Domestic Security 1 2011-01-01 2011-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the section 550 program in...

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 6 Domestic Security 1 2013-01-01 2013-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the section 550 program in...

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the Section 550 program in...

6 CFR 27.115 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 6 Domestic Security 1 2014-01-01 2014-01-01 false Implementation. 27.115 Section 27.115 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.115 Implementation. The Assistant Secretary may implement the section 550 program in...

Using the Consolidated Framework for Implementation Research to implement and evaluate national surgical planning

PubMed Central

Saluja, Saurabh; Silverstein, Allison; Mukhopadhyay, Swagoto; Lin, Yihan; Raykar, Nakul; Keshavjee, Salmaan; Samad, Lubna; Meara, John G

2017-01-01

The Lancet Commission on Global Surgery defined six surgical indicators and a framework for a national surgical plan that aimed to incorporate surgical care as a part of global public health. Multiple countries have since begun national surgical planning; each faces unique challenges in doing so. Implementation science can be used to more systematically explain this heterogeneous process, guide implementation efforts and ultimately evaluate progress. We describe our intervention using the Consolidated Framework for Implementation Research. This framework requires identifying characteristics of the intervention, the individuals involved, the inner and outer setting of the intervention, and finally describing implementation processes. By hosting a consultative symposium with clinicians and policy makers from around the world, we are able to specify key aspects of each element of this framework. We define our intervention as the incorporation of surgical care into public health planning, identify local champions as the key individuals involved, and describe elements of the inner and outer settings. Ultimately we describe top-down and bottom-up models that are distinct implementation processes. With the Consolidated Framework for Implementation Research, we are able to identify specific strategic models that can be used by implementers in various settings. While the integration of surgical care into public health throughout the world may seem like an insurmountable challenge, this work adds to a growing effort that seeks to find a way forward. PMID:29225930

A Pragmatic Application of the RE-AIM Framework for Evaluating the Implementation of Physical Activity as a Standard of Care in Health Systems

PubMed Central

Galaviz, Karla I.; Lobelo, Felipe; Joy, Elizabeth; Heath, Gregory W.; Hutber, Adrian; Estabrooks, Paul

2018-01-01

Introduction Exercise is Medicine (EIM) is an initiative that seeks to integrate physical activity assessment, prescription, and patient referral as a standard in patient care. Methods to assess this integration have lagged behind its implementation. Purpose and Objectives The purpose of this work is to provide a pragmatic framework to guide health care systems in assessing the implementation and impact of EIM. Evaluation Methods A working group of experts from health care, public health, and implementation science convened to develop an evaluation model based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The working group aimed to provide pragmatic guidance on operationalizing EIM across the different RE-AIM dimensions based on data typically available in health care settings. Results The Reach of EIM can be determined by the number and proportion of patients that were screened for physical inactivity, received brief counseling and/or a physical activity prescription, and were referred to physical activity resources. Effectiveness can be assessed through self-reported changes in physical activity, cardiometabolic biometric factors, incidence/burden of chronic disease, as well as health care utilization and costs. Adoption includes assessing the number and representativeness of health care settings that adopt any component of EIM, and Implementation involves assessing the extent to which health care teams implement EIM in their clinic. Finally, Maintenance involves assessing the long-term effectiveness (patient level) and sustained implementation (clinic level) of EIM in a given health care setting. Implications for Public Health The availability of a standardized, pragmatic, evaluation framework is critical in determining the impact of implementing EIM as a standard of care across health care systems. PMID:29752803

Why sex and gender matter in implementation research.

PubMed

Tannenbaum, Cara; Greaves, Lorraine; Graham, Ian D

2016-10-27

There has been a recent swell in activity by health research funding organizations and science journal editors to increase uptake of sex and gender considerations in study design, conduct and reporting in order to ensure that research results apply to everyone. However, examination of the implementation research literature reveals that attention to sex and gender has not yet infiltrated research methods in this field. The rationale for routinely considering sex and gender in implementation research is multifold. Sex and gender are important in decision-making, communication, stakeholder engagement and preferences for the uptake of interventions. Gender roles, gender identity, gender relations, and institutionalized gender influence the way in which an implementation strategy works, for whom, under what circumstances and why. There is emerging evidence that programme theories may operate differently within and across sexes, genders and other intersectional characteristics under various circumstances. Furthermore, without proper study, implementation strategies may inadvertently exploit or ignore, rather than transform thinking about sex and gender-related factors. Techniques are described for measuring and analyzing sex and gender in implementation research using both quantitative and qualitative methods. The present paper describes the application of methods for integrating sex and gender in implementation research. Consistently asking critical questions about sex and gender will likely lead to the discovery of positive outcomes, as well as unintended consequences. The result has potential to strengthen both the practice and science of implementation, improve health outcomes and reduce gender inequities.

5 CFR 2500.11 - Implementation and review.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INFORMATION SECURITY REGULATION § 2500.11 Implementation and review. The Information Security Oversight... information security program. The chairperson shall also be responsible for conducting an active oversight...

5 CFR 2500.11 - Implementation and review.

Code of Federal Regulations, 2010 CFR

2010-01-01

... INFORMATION SECURITY REGULATION § 2500.11 Implementation and review. The Information Security Oversight... information security program. The chairperson shall also be responsible for conducting an active oversight...

Assessing implementation mechanisms for an international agreement on research and development for health products.

PubMed

Hoffman, Steven J; Røttingen, John-Arne

2012-11-01

The Member States of the World Health Organization (WHO) are currently debating the substance and form of an international agreement to improve the financing and coordination of research and development (R&D) for health products that meet the needs of developing countries. In addition to considering the content of any possible legal or political agreement, Member States may find it helpful to reflect on the full range of implementation mechanisms available to bring any agreement into effect. These include mechanisms for states to make commitments, administer activities, manage financial contributions, make subsequent decisions, monitor each other's performance and promote compliance. States can make binding or non-binding commitments through conventions, contracts, declarations or institutional reforms. States can administer activities to implement their agreements through international organizations, sub-agencies, joint ventures or self-organizing processes. Finances can be managed through specialized multilateral funds, financial institutions, membership organizations or coordinated self-management. Decisions can be made through unanimity, consensus, equal voting, modified voting or delegation. Oversight can be provided by peer review, expert review, self-reports or civil society. Together, states should select their preferred options across categories of implementation mechanisms, each of which has advantages and disadvantages. The challenge lies in choosing the most effective combinations of mechanisms for supporting an international agreement (or set of agreements) that achieves collective aspirations in a way and at a cost that are both sustainable and acceptable to those involved. In making these decisions, WHO's Member States can benefit from years of experience with these different mechanisms in health and its related sectors.

10 CFR 63.143 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Implementation. 63.143 Section 63.143 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN A GEOLOGIC REPOSITORY AT YUCCA MOUNTAIN, NEVADA Quality Assurance § 63.143 Implementation. DOE shall implement a quality assurance program...

Teacher-Implemented Joint Attention Intervention: Pilot Randomized Controlled Study for Preschoolers with Autism

ERIC Educational Resources Information Center

Lawton, Kathy; Kasari, Connie

2012-01-01

Objective: The vast majority of children with an autism spectrum disorder (ASD) attend public preschools at some point in their childhood. Community preschool practices often are not evidence based, and almost none target the prelinguistic core deficits of ASD. This study investigated the effectiveness of public preschool teachers implementing a…

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…

Implementation Fidelity in Community-Based Interventions

PubMed Central

Breitenstein, Susan M.; Gross, Deborah; Garvey, Christine; Hill, Carri; Fogg, Louis; Resnick, Barbara

2012-01-01

Implementation fidelity is the degree to which an intervention is delivered as intended and is critical to successful translation of evidence-based interventions into practice. Diminished fidelity may be why interventions that work well in highly controlled trials may fail to yield the same outcomes when applied in real life contexts. The purpose of this paper is to define implementation fidelity and describe its importance for the larger science of implementation, discuss data collection methods and current efforts in measuring implementation fidelity in community-based prevention interventions, and present future research directions for measuring implementation fidelity that will advance implementation science. PMID:20198637

IMPLEMENTATION REVIEW LETTERS, 2002

EPA Science Inventory

The following letters provide a summary of the Environmental Protection Agencys comments regarding 2002 Implementation Review of nineteen estuary programs in the National Estuary Program. Various strengths within the programs included use of implementation progress and tracking s...

Designing and implementing a balanced scorecard: lessons learned in nonprofit implementation.

PubMed

Gumbus, Andra; Wilson, Tom

2004-01-01

The balanced scorecard has been referred to as the management innovation of the century, and extensive articles have been written using case studies of organizations that use this performance measurement system. This article addresses the key issues of design and implementation with a step-by-step guide to how to design a balanced scorecard and lessons to avoid implementation problems in government and nonprofit settings.

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

PubMed

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

2016-01-01

To present overall strategies and activities for the implementation process of the recommendations contained in the clinical practice guideline for the management of adults with schizophrenia (GPC_E) published by the Colombian Ministry of Health and Welfare (MSPS). Prioritize the proposed recommendations, identify barriers and solving strategies to implement the GPC_E, and develop a monitoring and evaluation system for the key recommendations. The Guideline Developer Group (GDG) included professionals with primary dedication to implementation issues that accompanied the entire process. During the GDG meetings implementation topics were identified and discussed, and later complemented by literature reviews concerning the experience of mental health guidelines implementation at national and international level. Additionally, feedback from the discussions raised during the socialization meetings, and joint meetings with the MSPS and the Institute of Technology Assessment in Health (IETS) were included. The prioritization of recommendations was made in conjunction with the GDG, following the proposed steps in the methodological guide for the development of Clinical Practice Guidelines with Economic Evaluation in the General System of Social Security in Colombian Health (GMEGPC) using the tools 13 and 14. the conclusions and final adjustments were discussed with the GPC_E leaders. The implementation chapter includes a description of the potential barriers, solution strategies, facilitators and monitoring indicators. The identified barriers were categorized in the following 3 groups: Cultural context, health system and proposed interventions. The issues related to solving strategies and facilitating education programs include community mental health, mental health training for health workers in primary care, decentralization and integration of mental health services at the primary care level, use of technologies information and communication and telemedicine. To monitor

Effectiveness of multifaceted implementation strategies for the implementation of back and neck pain guidelines in health care: a systematic review.

PubMed

Suman, Arnela; Dikkers, Marije F; Schaafsma, Frederieke G; van Tulder, Maurits W; Anema, Johannes R

2016-09-20

For the optimal use of clinical guidelines in daily practice, mere distribution of guidelines and materials is not enough, and active implementation is needed. This review investigated the effectiveness of multifaceted implementation strategies compared to minimal, single, or no implementation strategy for the implementation of non-specific low back and/or neck pain guidelines in health care. The following electronic databases were searched from inception to June 1, 2015: MEDLINE, Embase, PsycInfo, the Cochrane Library, and CINAHL. The search strategy was restricted to low back pain, neck pain, and implementation research. Studies were included if their design was a randomized controlled trial, reporting on patients (age ≥18 years) with non-specific low back pain or neck pain (with or without radiating pain). Trials were eligible if they reported patient outcomes, measures of healthcare professional behaviour, and/or outcomes on healthcare level. The primary outcome was professional behaviour. Guidelines that were evaluated in the studies had to be implemented in a healthcare setting. No language restrictions were applied, and studies had to be published full-text in peer-reviewed journals, thus excluding abstract only publications, conference abstracts, and dissertation articles. Two researchers independently screened titles and abstract, extracted data from included studies, and performed risk of bias assessments. After removal of duplicates, the search resulted in 4750 abstracts to be screened. Of 43 full-text articles assessed for eligibility, 12 were included in this review, reporting on 9 individual studies, and separate cost-effectiveness analyses of 3 included studies. Implementation strategies varied between studies. Meta-analyses did not reveal any differences in effect between multifaceted strategies and controls. This review showed that multifaceted strategies for the implementation of neck and/or back pain guidelines in health care do not

76 FR 76935 - Impact of Implementing the Chemical Weapons Convention (CWC) on Commercial Activities Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

... DEPARTMENT OF COMMERCE Bureau of Industry and Security [Docket No. 111130706-1686-01] Impact of Implementing the Chemical Weapons Convention (CWC) on Commercial Activities Involving ``Schedule 1'' Chemicals Through Calendar Year 2011; Impact of Adding Salts of CWC ``Schedule 1'' Chemicals to ``Schedule 1...

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

PubMed

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

2017-06-01

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

Implementation of Guidelines for Effective Fieldwork Designs: Exploring Learning Activities, Learning Processes, and Student Engagement in the Classroom and the Field

ERIC Educational Resources Information Center

Remmen, Kari Beate; Frøyland, Merethe

2014-01-01

Teachers find the implementation of fieldwork challenging. Therefore, this study investigates two teachers' implementation of theoretical guidelines for student-centered fieldwork activities, following their participation in a professional development course focusing on earth science fieldwork pedagogy. Video observation and instructional…

Social network analysis for program implementation.

PubMed

Valente, Thomas W; Palinkas, Lawrence A; Czaja, Sara; Chu, Kar-Hai; Brown, C Hendricks

2015-01-01

This paper introduces the use of social network analysis theory and tools for implementation research. The social network perspective is useful for understanding, monitoring, influencing, or evaluating the implementation process when programs, policies, practices, or principles are designed and scaled up or adapted to different settings. We briefly describe common barriers to implementation success and relate them to the social networks of implementation stakeholders. We introduce a few simple measures commonly used in social network analysis and discuss how these measures can be used in program implementation. Using the four stage model of program implementation (exploration, adoption, implementation, and sustainment) proposed by Aarons and colleagues [1] and our experience in developing multi-sector partnerships involving community leaders, organizations, practitioners, and researchers, we show how network measures can be used at each stage to monitor, intervene, and improve the implementation process. Examples are provided to illustrate these concepts. We conclude with expected benefits and challenges associated with this approach.

Social Network Analysis for Program Implementation

PubMed Central

Valente, Thomas W.; Palinkas, Lawrence A.; Czaja, Sara; Chu, Kar-Hai; Brown, C. Hendricks

2015-01-01

This paper introduces the use of social network analysis theory and tools for implementation research. The social network perspective is useful for understanding, monitoring, influencing, or evaluating the implementation process when programs, policies, practices, or principles are designed and scaled up or adapted to different settings. We briefly describe common barriers to implementation success and relate them to the social networks of implementation stakeholders. We introduce a few simple measures commonly used in social network analysis and discuss how these measures can be used in program implementation. Using the four stage model of program implementation (exploration, adoption, implementation, and sustainment) proposed by Aarons and colleagues [1] and our experience in developing multi-sector partnerships involving community leaders, organizations, practitioners, and researchers, we show how network measures can be used at each stage to monitor, intervene, and improve the implementation process. Examples are provided to illustrate these concepts. We conclude with expected benefits and challenges associated with this approach. PMID:26110842

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

DOT National Transportation Integrated Search

2009-03-01

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

A multi-disciplinary approach to implementation science: the NIH-PEPFAR PMTCT implementation science alliance.

PubMed

Sturke, Rachel; Harmston, Christine; Simonds, R J; Mofenson, Lynne M; Siberry, George K; Watts, D Heather; McIntyre, James; Anand, Nalini; Guay, Laura; Castor, Delivette; Brouwers, Pim; Nagel, Joan D

2014-11-01

In resource-limited countries, interventions to prevent mother-to-child HIV transmission (PMTCT) have not yet realized their full potential health impact, illustrating the common gap between the scientific proof of an intervention's efficacy and effectiveness and its successful implementation at scale into routine health services. For PMTCT, this gap results, in part, from inadequate adaptation of PMTCT interventions to the realities of the implementation environment, including client and health care worker behaviors and preferences, health care policies and systems, and infrastructure and resource constraints. Elimination of mother-to-child HIV transmission can only be achieved through understanding of key implementation barriers and successful adaptation of scientifically proven interventions to the local environment. Central to such efforts is implementation science (IS), which aims to investigate and address major bottlenecks that impede effective implementation and to test new approaches to identifying, understanding, and overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions. Advancing IS will require deliberate and strategic efforts to facilitate collaboration, communication, and relationship-building among researchers, implementers, and policy-makers. To speed the translation of effective PMTCT interventions into practice and advance IS more broadly, the US National Institutes of Health, in collaboration with the President's Emergency Plan for AIDS Relief launched the National Institutes of Health/President's Emergency Plan for AIDS Relief PMTCT IS Alliance, comprised of IS researchers, PMTCT program implementers, and policy-makers as an innovative platform for interaction and coordination.

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.

How GPs implement clinical guidelines in everyday clinical practice--a qualitative interview study.

PubMed

Le, Jette V; Hansen, Helle P; Riisgaard, Helle; Lykkegaard, Jesper; Nexøe, Jørgen; Bro, Flemming; Søndergaard, Jens

2015-12-01

Clinical guidelines are considered to be essential for improving quality and safety of health care. However, interventions to promote implementation of guidelines have demonstrated only partial effectiveness and the reasons for this apparent failure are not yet fully understood. To investigate how GPs implement clinical guidelines in everyday clinical practice and how implementation approaches differ between practices. Individual semi-structured open-ended interviews with seven GPs who were purposefully sampled with regard to gender, age and practice form. Interviews were recorded, transcribed verbatim and then analysed using systematic text condensation. Analysis of the interviews revealed three different approaches to the implementation of guidelines in clinical practice. In some practices the GPs prioritized time and resources on collective implementation activities and organized their everyday practice to support these activities. In other practices GPs discussed guidelines collectively but left the application up to the individual GP whilst others again saw no need for discussion or collective activities depending entirely on the individual GP's decision on whether and how to manage implementation. Approaches to implementation of clinical guidelines vary substantially between practices. Supporting activities should take this into account. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Colonoscopy Quality: Metrics and Implementation

PubMed Central

Calderwood, Audrey H.; Jacobson, Brian C.

2013-01-01

Synopsis Colonoscopy is an excellent area for quality improvement 1 because it is high volume, has significant associated risk and expense, and there is evidence that variability in its performance affects outcomes. The best endpoint for validation of quality metrics in colonoscopy is colorectal cancer incidence and mortality, but because of feasibility issues, a more readily accessible metric is the adenoma detection rate (ADR). Fourteen quality metrics were proposed by the joint American Society of Gastrointestinal Endoscopy/American College of Gastroenterology Task Force on “Quality Indicators for Colonoscopy” in 2006, which are described in further detail below. Use of electronic health records and quality-oriented registries will facilitate quality measurement and reporting. Unlike traditional clinical research, implementation of quality improvement initiatives involves rapid assessments and changes on an iterative basis, and can be done at the individual, group, or facility level. PMID:23931862

Barriers and facilitators to the implementation of a school-based physical activity policy in Canada: application of the theoretical domains framework.

PubMed

Weatherson, Katie A; McKay, Rhyann; Gainforth, Heather L; Jung, Mary E

2017-10-23

In British Columbia Canada, a Daily Physical Activity (DPA) policy was mandated that requires elementary school teachers to provide students with opportunities to achieve 30 min of physical activity during the school day. However, the implementation of school-based physical activity policies is influenced by many factors. A theoretical examination of the factors that impede and enhance teachers' implementation of physical activity policies is necessary in order to develop strategies to improve policy practice and achieve desired outcomes. This study used the Theoretical Domains Framework (TDF) to understand teachers' barriers and facilitators to the implementation of the DPA policy in one school district. Additionally, barriers and facilitators were examined and compared according to how the teacher implemented the DPA policy during the instructional school day. Interviews were conducted with thirteen teachers and transcribed verbatim. One researcher performed barrier and facilitator extraction, with double extraction occurring across a third of the interview transcripts by a second researcher. A deductive and inductive analytical approach in a two-stage process was employed whereby barriers and facilitators were deductively coded using TDF domains (content analysis) and analyzed for sub-themes within each domain. Two researchers performed coding. A total of 832 items were extracted from the interview transcripts. Some items were coded into multiple TDF domains, resulting in a total of 1422 observations. The most commonly coded TDF domains accounting for 75% of the total were Environmental context and resources (ECR; n = 250), Beliefs about consequences (n = 225), Social influences (n = 193), Knowledge (n = 100), and Intentions (n = 88). Teachers who implemented DPA during instructional time differed from those who relied on non-instructional time in relation to Goals, Behavioural regulation, Social/professional role and identity, Beliefs about

10 CFR 712.12 - HRP implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false HRP implementation. 712.12 Section 712.12 Energy... Program Procedures § 712.12 HRP implementation. (a) The implementation of the HRP is the responsibility of... by April 22, 2004. (b) The HRP Management Official must: (1) Prepare an initial HRP implementation...

10 CFR 712.12 - HRP implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false HRP implementation. 712.12 Section 712.12 Energy... Program Procedures § 712.12 HRP implementation. (a) The implementation of the HRP is the responsibility of... by April 22, 2004. (b) The HRP Management Official must: (1) Prepare an initial HRP implementation...

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

ERIC Educational Resources Information Center

Ploch, Leszek

2015-01-01

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

A qualitative study of staff's perspectives on implementing an after school program promoting youth physical activity.

PubMed

Zarrett, Nicole; Skiles, Brittany; Wilson, Dawn K; McClintock, Lauren

2012-08-01

Minimal effects found across youth physical activity (PA) interventions, and increased attention to circumstances that impede adequate delivery of program components, has highlighted the importance of learning from staff what is needed to foster staff comprehension and engagement for developing, adopting, and successfully implementing PA-based youth interventions. The purpose of this study is to address this knowledge gap by conducting a qualitative assessment of school staff perspectives on the positive aspects and challenges of implementing the 17-week ACT program, an after-school intervention that integrated motivational and behavioral components to promote PA in underserved adolescents. Interviews were conducted with one school staff member from each participating school for all four trial cohorts (N=12). Transcripts were coded by independent coders (r=.84) and content analyses of themes was performed using QSR NVivo. Themes were organized into five meta-themes: (1) Logistics; (2) Essential Elements; (3) Staff and Child Challenges; (4) Staff Comprehension, Value, and Enjoyment; (5) Spill-Over Effects. Findings indicate that staff can be successful at understanding, valuing, and reaching fidelity in implementing climate-based mediation components. The insight gained from this study lays the foundation for understanding the components needed for establishing well-implemented, effective, and generalizable interventions for increasing youth PA. Copyright © 2012 Elsevier Ltd. All rights reserved.

Beyond "implementation strategies": classifying the full range of strategies used in implementation science and practice.

PubMed

Leeman, Jennifer; Birken, Sarah A; Powell, Byron J; Rohweder, Catherine; Shea, Christopher M

2017-11-03

Strategies are central to the National Institutes of Health's definition of implementation research as "the study of strategies to integrate evidence-based interventions into specific settings." Multiple scholars have proposed lists of the strategies used in implementation research and practice, which they increasingly are classifying under the single term "implementation strategies." We contend that classifying all strategies under a single term leads to confusion, impedes synthesis across studies, and limits advancement of the full range of strategies of importance to implementation. To address this concern, we offer a system for classifying implementation strategies that builds on Proctor and colleagues' (2013) reporting guidelines, which recommend that authors not only name and define their implementation strategies but also specify who enacted the strategy (i.e., the actor) and the level and determinants that were targeted (i.e., the action targets). We build on Wandersman and colleagues' Interactive Systems Framework to distinguish strategies based on whether they are enacted by actors functioning as part of a Delivery, Support, or Synthesis and Translation System. We build on Damschroder and colleague's Consolidated Framework for Implementation Research to distinguish the levels that strategies target (intervention, inner setting, outer setting, individual, and process). We then draw on numerous resources to identify determinants, which are conceptualized as modifiable factors that prevent or enable the adoption and implementation of evidence-based interventions. Identifying actors and targets resulted in five conceptually distinct classes of implementation strategies: dissemination, implementation process, integration, capacity-building, and scale-up. In our descriptions of each class, we identify the level of the Interactive System Framework at which the strategy is enacted (actors), level and determinants targeted (action targets), and outcomes used to

Design and Smartphone-Based Implementation of a Chaotic Video Communication Scheme via WAN Remote Transmission

NASA Astrophysics Data System (ADS)

Lin, Zhuosheng; Yu, Simin; Li, Chengqing; Lü, Jinhu; Wang, Qianxue

This paper proposes a chaotic secure video remote communication scheme that can perform on real WAN networks, and implements it on a smartphone hardware platform. First, a joint encryption and compression scheme is designed by embedding a chaotic encryption scheme into the MJPG-Streamer source codes. Then, multiuser smartphone communications between the sender and the receiver are implemented via WAN remote transmission. Finally, the transmitted video data are received with the given IP address and port in an Android smartphone. It should be noted that, this is the first time that chaotic video encryption schemes are implemented on such a hardware platform. The experimental results demonstrate that the technical challenges on hardware implementation of secure video communication are successfully solved, reaching a balance amongst sufficient security level, real-time processing of massive video data, and utilization of available resources in the hardware environment. The proposed scheme can serve as a good application example of chaotic secure communications for smartphone and other mobile facilities in the future.

Health-Education Policy Interface: The Implementation of the Eat Well Be Active Policies in Schools

ERIC Educational Resources Information Center

Leow, Anthony Chee Siong; Macdonald, Doune; Hay, Peter; McCuaig, Louise

2014-01-01

While grappling with their traditional core business of imbuing students with official curricular knowledge, schools have simultaneously, increasing demands to take on health promotion responsibilities. This paper examines the mandated implementation of the Eat Well Be Active (EWBA) Action Plan and its subsidiary "Smart" policies in…

Changes to the school food and physical activity environment after guideline implementation in British Columbia, Canada

PubMed Central

2014-01-01

Background High rates of childhood obesity have generated interest among policy makers to improve the school food environment and increase students’ levels of physical activity. The purpose of this study was to examine school-level changes associated with implementation of the Food and Beverage Sales in Schools (FBSS) and Daily Physical Activity (DPA) guidelines in British Columbia, Canada. Methods Elementary and middle/high school principals completed a survey on the school food and physical activity environment in 2007–08 (N = 513) and 2011–12 (N = 490). Hierarchical mixed effects regression was used to examine changes in: 1) availability of food and beverages; 2) minutes per day of Physical Education (PE); 3) delivery method of PE; and 4) school community support. Models controlled for school enrollment and community type, education and income. Results After policy implementation was expected, more elementary schools provided access to fruits and vegetables and less to 100% fruit juice. Fewer middle/high schools provided access to sugar-sweetened beverages, French fries, baked goods, salty snacks and chocolate/candy. Schools were more likely to meet 150 min/week of PE for grade 6 students, and offer more minutes of PE per week for grade 8 and 10 students including changes to PE delivery method. School community support for nutrition and physical activity policies increased over time. Conclusion Positive changes to the school food environment occurred after schools were expected to implement the FBSS and DPA guidelines. Reported changes to the school environment are encouraging and provide support for guidelines and policies that focus on increasing healthy eating and physical activity in schools. PMID:24731514

Connecting Architecture and Implementation

NASA Astrophysics Data System (ADS)

Buchgeher, Georg; Weinreich, Rainer

Software architectures are still typically defined and described independently from implementation. To avoid architectural erosion and drift, architectural representation needs to be continuously updated and synchronized with system implementation. Existing approaches for architecture representation like informal architecture documentation, UML diagrams, and Architecture Description Languages (ADLs) provide only limited support for connecting architecture descriptions and implementations. Architecture management tools like Lattix, SonarJ, and Sotoarc and UML-tools tackle this problem by extracting architecture information directly from code. This approach works for low-level architectural abstractions like classes and interfaces in object-oriented systems but fails to support architectural abstractions not found in programming languages. In this paper we present an approach for linking and continuously synchronizing a formalized architecture representation to an implementation. The approach is a synthesis of functionality provided by code-centric architecture management and UML tools and higher-level architecture analysis approaches like ADLs.

Reducing depressive symptoms through behavioral activation in churches: A Hybrid-2 randomized effectiveness-implementation design.

PubMed

Haynes, Tiffany; Turner, Jerome; Smith, Johnny; Curran, Geoffrey; Bryant-Moore, Keneshia; Ounpraseuth, Songthip T; Kramer, Teresa; Harris, Kimberly; Hutchins, Ellen; Yeary, Karen Hye-Cheon Kim

2018-01-01

Rural African Americans are disproportionately exposed to numerous stressors such as poverty that place them at risk for experiencing elevated levels of depressive symptoms. Effective treatments for decreasing depressive symptoms exist, but rural African Americans often fail to receive adequate and timely care. Churches have been used to address physical health outcomes in rural African American communities, but few have focused primarily on addressing mental health outcomes. Our partnership, consisting of faith community leaders and academic researchers, adapted an evidence-based behavioral activation intervention for use with rural African American churches. This 8-session intervention was adapted to include faith-based themes, Scripture, and other aspects of the rural African American faith culture (e.g. bible studies) This manuscript describes a Hybrid-II implementation trial that seeks to test the effectiveness of the culturally adapted evidence-based intervention (Renewed and Empowered for the Journey to Overcome in Christ: REJOICE) and gather preliminary data on the strategies necessary to support the successful implementation of this intervention in 24 rural African American churches. This study employs a randomized one-way crossover cluster design to assess effectiveness in reducing depressive symptoms and gather preliminary data regarding implementation outcomes, specifically fidelity, associated with 2 implementation strategies: training only and training+coaching calls. This project has the potential to generate knowledge that will lead to improvements in the provision of mental health interventions within the rural African American community. Further, the use of the Hybrid-II design has the potential to advance our understanding of strategies that will support the implementation of and sustainability of mental health interventions within rural African American faith communities. NCT02860741. Registered August 5, 2016. Copyright © 2017 Elsevier Inc

CDC Activities for Improving Implementation of Human Papillomavirus Vaccination, Cervical Cancer Screening, and Surveillance Worldwide.

PubMed

Senkomago, Virginia; Duran, Denise; Loharikar, Anagha; Hyde, Terri B; Markowitz, Lauri E; Unger, Elizabeth R; Saraiya, Mona

2017-12-01

Cervical cancer incidence and mortality rates are high, particularly in developing countries. Most cervical cancers can be prevented by human papillomavirus (HPV) vaccination, screening, and timely treatment. The US Centers for Disease Control and Prevention (CDC) provides global technical assistance for implementation and evaluation of HPV vaccination pilot projects and programs and laboratory-related HPV activities to assess HPV vaccines. CDC collaborates with global partners to develop global cervical cancer screening recommendations and manuals, implement screening, create standardized evaluation tools, and provide expertise to monitor outcomes. CDC also trains epidemiologists in cancer prevention through its Field Epidemiology Training Program and is working to improve cancer surveillance by supporting efforts of the World Health Organization in developing cancer registry hubs and assisting countries in estimating costs for developing population-based cancer registries. These activities contribute to the Global Health Security Agenda action packages to improve immunization, surveillance, and the public health workforce globally.

Implementation Strategy

NASA Technical Reports Server (NTRS)

1983-01-01

Meeting the identified needs of Earth science requires approaching EOS as an information system and not simply as one or more satellites with instruments. Six elements of strategy are outlined as follows: implementation of the individual discipline missions as currently planned; use of sustained observational capabilities offered by operational satellites without waiting for the launch of new mission; put first priority on the data system; deploy an Advanced Data Collection and Location System; put a substantial new observing capability in a low Earth orbit in such a way as to provide for sustained measurements; and group instruments to exploit their capabilities for synergism; maximize the scientific utility of the mission; and minimize the costs of implementation where possible.

FPGA Implementation of Heart Rate Monitoring System.

PubMed

Panigrahy, D; Rakshit, M; Sahu, P K

2016-03-01

This paper describes a field programmable gate array (FPGA) implementation of a system that calculates the heart rate from Electrocardiogram (ECG) signal. After heart rate calculation, tachycardia, bradycardia or normal heart rate can easily be detected. ECG is a diagnosis tool routinely used to access the electrical activities and muscular function of the heart. Heart rate is calculated by detecting the R peaks from the ECG signal. To provide a portable and the continuous heart rate monitoring system for patients using ECG, needs a dedicated hardware. FPGA provides easy testability, allows faster implementation and verification option for implementing a new design. We have proposed a five-stage based methodology by using basic VHDL blocks like addition, multiplication and data conversion (real to the fixed point and vice-versa). Our proposed heart rate calculation (R-peak detection) method has been validated, using 48 first channel ECG records of the MIT-BIH arrhythmia database. It shows an accuracy of 99.84%, the sensitivity of 99.94% and the positive predictive value of 99.89%. Our proposed method outperforms other well-known methods in case of pathological ECG signals and successfully implemented in FPGA.

Implementation of Competency-Based Pharmacy Education (CBPE)

PubMed Central

Koster, Andries; Schalekamp, Tom; Meijerman, Irma

2017-01-01

Implementation of competency-based pharmacy education (CBPE) is a time-consuming, complicated process, which requires agreement on the tasks of a pharmacist, commitment, institutional stability, and a goal-directed developmental perspective of all stakeholders involved. In this article the main steps in the development of a fully-developed competency-based pharmacy curriculum (bachelor, master) are described and tips are given for a successful implementation. After the choice for entering into CBPE is made and a competency framework is adopted (step 1), intended learning outcomes are defined (step 2), followed by analyzing the required developmental trajectory (step 3) and the selection of appropriate assessment methods (step 4). Designing the teaching-learning environment involves the selection of learning activities, student experiences, and instructional methods (step 5). Finally, an iterative process of evaluation and adjustment of individual courses, and the curriculum as a whole, is entered (step 6). Successful implementation of CBPE requires a system of effective quality management and continuous professional development as a teacher. In this article suggestions for the organization of CBPE and references to more detailed literature are given, hoping to facilitate the implementation of CBPE. PMID:28970422

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

PubMed

1997-01-01

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

Bridging informatics and implementation science: evaluating a framework to assess electronic health record implementations in community settings.

PubMed

Richardson, Joshua E; Abramson, Erika L; Pfoh, Elizabeth R; Kaushal, Rainu

2012-01-01

Effective electronic health record (EHR) implementations in community settings are critical to promoting safe and reliable EHR use as well as mitigating provider dissatisfaction that often results. The implementation challenge is compounded given the scale and scope of EHR installations that are occurring and will continue to occur over the next five years. However, when compared to EHR evaluations relatively few biomedical informatics researchers have published on evaluating EHR implementations. Fewer still have evaluated EHR implementations in community settings. We report on the methods we used to achieve a novel application of an implementation science framework in informatics to qualitatively evaluate community-based EHR implementations. We briefly provide an overview of the implementation science framework, our methods for adapting it to informatics, the effects the framework had on our qualitative methods of inquiry and analysis, and discuss its potential value for informatics research.

The meaning and measurement of implementation climate

PubMed Central

2011-01-01

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

Transforming the Organic Chemistry Lab Experience: Design, Implementation, and Evaluation of Reformed Experimental Activities--REActivities

ERIC Educational Resources Information Center

Collison, Christina G.; Kim, Thomas; Cody, Jeremy; Anderson, Jason; Edelbach, Brian; Marmor, William; Kipsang, Rodgers; Ayotte, Charles; Saviola, Daniel; Niziol, Justin

2018-01-01

Reformed experimental activities (REActivities) are an innovative approach to the delivery of the traditional material in an undergraduate organic chemistry laboratory. A description of the design and implementation of REActivities at both a four- and two-year institution is discussed. The results obtained using a reformed teaching observational…

Implementation Planning and Progress on Physical Activity Goals: The Mediating Role of Life-Management Strategies

ERIC Educational Resources Information Center

Dugas, Michelle; Gaudreau, Patrick; Carraro, Natasha

2012-01-01

This 4-week prospective study examined whether the use of life-management strategies mediates the relationship between implementation planning and short-term progress on physical activity goals. In particular, the strategies of elective selection, compensation, and loss-based selection were disentangled to assess their specific mediating effects.…

Implementing Innovations in Global Women's, Children's, and Adolescents' Health: Realizing the Potential for Implementation Science.

PubMed

Peterson, Herbert B; Haidar, Joumana; Fixsen, Dean; Ramaswamy, Rohit; Weiner, Bryan J; Leatherman, Sheila

2018-03-01

The launch of the United Nations Sustainable Development Goals and the new Secretary General's Global Strategy for Women's, Children's, and Adolescents' Health are a window of opportunity for improving the health and well-being of women, children, and adolescents in the United States and around the world. Realizing the full potential of this historic moment will require that we improve our ability to successfully implement life-saving and life-enhancing innovations, particularly in low-resource settings. Implementation science, a new and rapidly evolving field that addresses the "how-to" component of providing sustainable quality services at scale, can make an important contribution on this front. A synthesis of the implementation science evidence indicates that three interrelated factors are required for successful, sustainable outcomes at scale: 1) effective innovations, 2) effective implementation, and 3) enabling contexts. Implementation science addresses the interaction among these factors to help make innovations more usable, to build ongoing capacity to assure the effective implementation of these innovations, and to ensure enabling contexts to sustain their full and effective use in practice. Improving access to quality services will require transforming health care systems and, therefore, much of the focus of implementation science in global health is on improving the ability of health systems to serve as enabling contexts. The field of implementation science is inherently interdisciplinary and academe will need to respond by facilitating collaboration among scientists from relevant disciplines, including evaluation, improvement, and systems sciences. Platforms and programs to facilitate collaborations among researchers, practitioners, policymakers, and funders are likewise essential.

The implementation of POSTGRES

NASA Technical Reports Server (NTRS)

Stonebraker, Michael; Rowe, Lawrence A.; Hirohama, Michael

1990-01-01

The design and implementation decisions made for the three-dimensional data manager POSTGRES are discussed. Attention is restricted to the DBMS backend functions. The POSTGRES data model and query language, the rules system, the storage system, the POSTGRES implementation, and the current status and performance are discussed.

Implementation of Metal Casting Best Practices

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

Eppich, Robert; Naranjo, Robert D.

2007-01-01

The project examined cases where metal casters had implemented ITP research results and the benefits they received due to that implementation. In cases where casters had not implemented those results, the project examined the factors responsible for that lack of implementation. The project also informed metal casters of the free tools and service offered by the ITP Technology Delivery subprogram.

Tank waste remediation system configuration management implementation plan

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

Vann, J.M.

1998-03-31

The Tank Waste Remediation System (TWRS) Configuration Management Implementation Plan describes the actions that will be taken by Project Hanford Management Contract Team to implement the TWRS Configuration Management program defined in HNF 1900, TWRS Configuration Management Plan. Over the next 25 years, the TWRS Project will transition from a safe storage mission to an aggressive retrieval, storage, and disposal mission in which substantial Engineering, Construction, and Operations activities must be performed. This mission, as defined, will require a consolidated configuration management approach to engineering, design, construction, as-building, and operating in accordance with the technical baselines that emerge from themore » life cycles. This Configuration Management Implementation Plan addresses the actions that will be taken to strengthen the TWRS Configuration Management program.« less

A Pragmatic Approach to Guide Implementation Evaluation Research: Strategy Mapping for Complex Interventions.

PubMed

Huynh, Alexis K; Hamilton, Alison B; Farmer, Melissa M; Bean-Mayberry, Bevanne; Stirman, Shannon Wiltsey; Moin, Tannaz; Finley, Erin P

2018-01-01

evaluation data, mapping implementation strategies has informed development of a pragmatic blueprint for implementation and longitudinal analyses and evaluation activities. We update recent recommendations on specification of implementation strategies by considering the implications for multi-strategy frameworks and propose an approach for mapping the use of implementation strategies within complex, multi-level interventions, in support of rigorous evaluation. Developing pragmatic tools to aid in operationalizing the conduct of implementation and evaluation activities is essential to enacting sound implementation research.

78 FR 34964 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

...] Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation Plan... Ambient Air Quality Standards for Ozone: State Implementation Plan Requirements'' which published in the... the 2008 ozone national ambient air quality standards (NAAQS) (the ``2008 ozone NAAQS'') that were...

Organization, management, implementation and value of ehr implementation in a solo pediatric practice.

PubMed

Cooper, Jeffrey D

2004-01-01

This case study-based on this practice's application for the 2003 HIMSS Davies Award for Primary Care-describes the processes, costs and benefits of the implementation of an EHR in a solo practice. The organization, management and value of an EHR implementation is described, as well as a description of the physician's 15 business objectives, which shows how each objective was met and to what degree and gives specific financial data. An EHR that is implemented in a small practice improves quality of patient care, office efficiency and patient safety. A small practice can realize significant ROI from an EHR.

Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact.

PubMed

Curran, Geoffrey M; Bauer, Mark; Mittman, Brian; Pyne, Jeffrey M; Stetler, Cheryl

2012-03-01

This study proposes methods for blending design components of clinical effectiveness and implementation research. Such blending can provide benefits over pursuing these lines of research independently; for example, more rapid translational gains, more effective implementation strategies, and more useful information for decision makers. This study proposes a "hybrid effectiveness-implementation" typology, describes a rationale for their use, outlines the design decisions that must be faced, and provides several real-world examples. An effectiveness-implementation hybrid design is one that takes a dual focus a priori in assessing clinical effectiveness and implementation. We propose 3 hybrid types: (1) testing effects of a clinical intervention on relevant outcomes while observing and gathering information on implementation; (2) dual testing of clinical and implementation interventions/strategies; and (3) testing of an implementation strategy while observing and gathering information on the clinical intervention's impact on relevant outcomes. The hybrid typology proposed herein must be considered a construct still in evolution. Although traditional clinical effectiveness and implementation trials are likely to remain the most common approach to moving a clinical intervention through from efficacy research to public health impact, judicious use of the proposed hybrid designs could speed the translation of research findings into routine practice.

BIOINFORMATICS IN THE K-8 CLASSROOM: DESIGNING INNOVATIVE ACTIVITIES FOR TEACHER IMPLEMENTATION

PubMed Central

Shuster, Michele; Claussen, Kira; Locke, Melly; Glazewski, Krista

2016-01-01

At the intersection of biology and computer science is the growing field of bioinformatics—the analysis of complex datasets of biological relevance. Despite the increasing importance of bioinformatics and associated practical applications, these are not standard topics in elementary and middle school classrooms. We report on a pilot project and its evolution to support implementation of bioinformatics-based activities in elementary and middle school classrooms. Specifically, we ultimately designed a multi-day summer teacher professional development workshop, in which teachers design innovative classroom activities. By focusing on teachers, our design leverages enhanced teacher knowledge and confidence to integrate innovative instructional materials into K-8 classrooms and contributes to capacity building in STEM instruction. PMID:27429860

14 CFR 1232.104 - Implementation procedures by non-NASA institutions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Implementation procedures by non-NASA... CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES § 1232.104 Implementation procedures by non-NASA institutions. (a) Proposal Information. No animal subjects may be utilized unless a proposal...

14 CFR 1232.104 - Implementation procedures by non-NASA institutions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Implementation procedures by non-NASA... CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES § 1232.104 Implementation procedures by non-NASA institutions. (a) Proposal Information. No animal subjects may be utilized unless a proposal...

14 CFR 1232.104 - Implementation procedures by non-NASA institutions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Implementation procedures by non-NASA... CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES § 1232.104 Implementation procedures by non-NASA institutions. (a) Proposal Information. No animal subjects may be utilized unless a proposal...

14 CFR 1232.104 - Implementation procedures by non-NASA institutions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Implementation procedures by non-NASA... CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES § 1232.104 Implementation procedures by non-NASA institutions. (a) Proposal Information. No animal subjects may be utilized unless a proposal...

Effective Implementation of a Comprehension-Improvement Approach in Secondary Schools.

ERIC Educational Resources Information Center

Levine, Daniel U.; Sherk, John K.

This report describes in depth the implementation and impact of instructional strategies to improve students' comprehension skills at three diverse urban secondary schools. While activities and characteristics varied, educators at all three locations were implementing local variations of a school-improvement approach based on the use of the…

78 FR 69397 - Agency Information Collection Activities; Comment Request; Implementation Study of the Ramp Up to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... DEPARTMENT OF EDUCATION [Docket No. ED-2013-ICCD-0142] Agency Information Collection Activities; Comment Request; Implementation Study of the Ramp Up to Readiness Program AGENCY: Institute of Education Sciences/National Center for Education Statistics (IES), Department of Education (ED). ACTION: Notice...

An Operational Implementation of a CBRN Sensor-Driven Modeling Paradigm for Stochastic Event Reconstruction

DTIC Science & Technology

2010-05-01

Eight (GS) and Twenty (G20) Summits , Francophonie Summit]. iv DRDC Suffield TR 2010-070 Somma ire An Operational Implementation of a CBRN Sensor...terrain Joint Urban 2003 effectuee a Oklahoma City, Okla- homa ), qui comprend le transport et la dispersion d’un agent a une echelle complexe urbaine

Policy at play: The implementation of Healthy Eating and Active Living Guidelines in municipal child care settings.

PubMed

McKay, Kelly; Nigro, Sherry

2017-03-01

In 2012, Ottawa Public Health (OPH) partnered with the City of Ottawa Municipal Child Care (MCC) Services to develop Healthy Eating and Active Living (HEAL) Guidelines. The Guidelines aim to promote consistent standards of practice in child care settings related to healthy environments and food, physical activity, physical literacy, decreased sedentary behaviours, and positive role modeling by staff. The Guidelines targeted 498 children aged 18 months to 5 years, attending MCC centres. Resources and training were provided to 10 supervisors, 63 child care educators and 9 cooks. Components of the Guidelines were piloted in 5 MCC sites prior to being launched in 10 MCC sites across Ottawa, Ontario. Two project Advisory Groups supported the development of the Guidelines. Staff training, resources, recipes and menus were provided. An evaluation was conducted and has informed the Guidelines' subsequent community implementation. In 2015, accompanying web-based resources and e-modules were developed. The evaluation demonstrated environmental and programming changes. Parent satisfaction was high and preliminary findings showed no real changes in food costs. Following implementation, the cooks reported high compliance to the 6-week menu plans provided, and the number of sites offering 120 minutes or more of daily physical activity increased. Through novel intersectoral partnerships, OPH was able to implement and evaluate HEAL Guidelines in tandem. The interdisciplinary project Advisory Groups, training of cooks, and engagement of the Ontario Coaches Association were all innovative elements of this project and may influence future public health activity in this area.

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...

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…

Active Residents in Care Homes (ARCH): study protocol to investigate the implementation and outcomes of a whole-systems activity programme in residential care homes for older people.

PubMed

Koskela, Sian A; Jones, Fiona; Clarke, Natasha; Anderson, Liezl; Kennedy, Bernadette; Grant, Robert; Gage, Heather; Hurley, Michael V

2017-03-01

To evaluate the effectiveness, acceptability and costs of Active Residents in Care Homes, ARCH - a programme aiming to increase opportunities for activity in older care home residents. Feasibility study. Residential care homes for older people. 10-15 residents, staff and family members will be recruited in each of the three participating care homes. ARCH is a 12-month 'whole-systems' programme implemented by occupational therapists and physiotherapists. They will conduct a comprehensive assessment of each care home, considering the physical environment, working practices and organisation structure as well as residents' individual needs, and recommend ways to address barriers and increase residents' activity levels. The therapists will then work with staff to improve understanding of the issues, instigate training, environmental, organisational and working practice changes as necessary. Residents' activity levels, health and quality of life will be tested using several measures to see which are practicable and appropriate for this population in this context. This includes: Assessment of Physical Activity in Frail Older People; Pool Activity Level Checklist; Dementia Care Mapping observations; and EQ-5D-5L. Residents will be assessed prior to programme implementation then 4- and 12-months post-implementation. Semi-structured interviews will explore the experiences of residents, staff, family members and therapists. Providing evidence of effectiveness and acceptability of ARCH, and documenting factors that impede/facilitate implementation will help us identify ways to enhance the care and quality of life of older people in residential care, and our understanding of how to implement them. ISRCTN24000891. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Implementation of a Magnetic Stimulator to Study the Human Stomach Activity

NASA Astrophysics Data System (ADS)

Córdova-Fraga, T.; Sosa-Aquino, M.; Vargas-Luna, M.; Gutiérrez-Juárez, G.; Bernal-Alvarado, J.

2004-09-01

Implementation of a magnetic stimulator, arranged in a Helmholtz configuration, to study the mechanical activity on human stomachs is presented. In this work, a biomagnetic modality was used, this include swallowed of an oral magnetic contrast made up with 2, 3, 4 or 5 g of ferromagnetic particles diluted in 250 mL of yogurt. After a volunteer had swallowed the oral contrast, a biomagnetic pulse around 15 mT was applied, and then the remanent field is relaxed by mechanical contractions produced on the stomach wall. These studies were performed in 11 health male volunteers, where peristaltic frequencies were measured and a average value of 3.18 cpm was obtained.

Implementation strategies: recommendations for specifying and reporting

PubMed Central

2013-01-01

Implementation strategies have unparalleled importance in implementation science, as they constitute the ‘how to’ component of changing healthcare practice. Yet, implementation researchers and other stakeholders are not able to fully utilize the findings of studies focusing on implementation strategies because they are often inconsistently labelled and poorly described, are rarely justified theoretically, lack operational definitions or manuals to guide their use, and are part of ‘packaged’ approaches whose specific elements are poorly understood. We address the challenges of specifying and reporting implementation strategies encountered by researchers who design, conduct, and report research on implementation strategies. Specifically, we propose guidelines for naming, defining, and operationalizing implementation strategies in terms of seven dimensions: actor, the action, action targets, temporality, dose, implementation outcomes addressed, and theoretical justification. Ultimately, implementation strategies cannot be used in practice or tested in research without a full description of their components and how they should be used. As with all intervention research, their descriptions must be precise enough to enable measurement and ‘reproducibility.’ We propose these recommendations to improve the reporting of implementation strategies in research studies and to stimulate further identification of elements pertinent to implementation strategies that should be included in reporting guidelines for implementation strategies. PMID:24289295

Implementation strategies: recommendations for specifying and reporting.

PubMed

Proctor, Enola K; Powell, Byron J; McMillen, J Curtis

2013-12-01

Implementation strategies have unparalleled importance in implementation science, as they constitute the 'how to' component of changing healthcare practice. Yet, implementation researchers and other stakeholders are not able to fully utilize the findings of studies focusing on implementation strategies because they are often inconsistently labelled and poorly described, are rarely justified theoretically, lack operational definitions or manuals to guide their use, and are part of 'packaged' approaches whose specific elements are poorly understood. We address the challenges of specifying and reporting implementation strategies encountered by researchers who design, conduct, and report research on implementation strategies. Specifically, we propose guidelines for naming, defining, and operationalizing implementation strategies in terms of seven dimensions: actor, the action, action targets, temporality, dose, implementation outcomes addressed, and theoretical justification. Ultimately, implementation strategies cannot be used in practice or tested in research without a full description of their components and how they should be used. As with all intervention research, their descriptions must be precise enough to enable measurement and 'reproducibility.' We propose these recommendations to improve the reporting of implementation strategies in research studies and to stimulate further identification of elements pertinent to implementation strategies that should be included in reporting guidelines for implementation strategies.

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...

78 FR 44485 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

...] Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation Plan... Rule Regarding ``Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State... ground-level ozone formation. B. What should I consider as I prepare my comments for the EPA? 1...

Assessing implementation mechanisms for an international agreement on research and development for health products

PubMed Central

Røttingen, John-Arne

2012-01-01

Abstract The Member States of the World Health Organization (WHO) are currently debating the substance and form of an international agreement to improve the financing and coordination of research and development (R&D) for health products that meet the needs of developing countries. In addition to considering the content of any possible legal or political agreement, Member States may find it helpful to reflect on the full range of implementation mechanisms available to bring any agreement into effect. These include mechanisms for states to make commitments, administer activities, manage financial contributions, make subsequent decisions, monitor each other’s performance and promote compliance. States can make binding or non-binding commitments through conventions, contracts, declarations or institutional reforms. States can administer activities to implement their agreements through international organizations, sub-agencies, joint ventures or self-organizing processes. Finances can be managed through specialized multilateral funds, financial institutions, membership organizations or coordinated self-management. Decisions can be made through unanimity, consensus, equal voting, modified voting or delegation. Oversight can be provided by peer review, expert review, self-reports or civil society. Together, states should select their preferred options across categories of implementation mechanisms, each of which has advantages and disadvantages. The challenge lies in choosing the most effective combinations of mechanisms for supporting an international agreement (or set of agreements) that achieves collective aspirations in a way and at a cost that are both sustainable and acceptable to those involved. In making these decisions, WHO’s Member States can benefit from years of experience with these different mechanisms in health and its related sectors. PMID:23226898

Predictive Engineering Implementation at KSC

NASA Technical Reports Server (NTRS)

Mosconi, Jane; Schafer, Loraine

1995-01-01

This paper provides an overview of what the primary contractors at Kennedy Space Center (KSC) are doing in the field of predictive engineering. The technologies employed by each of the contractors and the cost savings associated with the implementation of these predictive engineering methods are discussed. The sources include predictive engineering implementation plans, published by each of the contractors and interviews with the authors of these implementation plans.

A theoretical analysis of the barriers and facilitators to the implementation of school-based physical activity policies in Canada: a mixed methods scoping review.

PubMed

Weatherson, Katie A; Gainforth, Heather L; Jung, Mary E

2017-03-27

Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. This review descriptively summarizes the implementation status, approaches used to implement DPA, and the effectiveness of DPA at increasing the physical activity of children at school. In addition, the Theoretical Domains Framework (TDF) was used to explore the barriers and facilitators to DPA implementation. A scoping review of English articles using ERIC, CINAHL, and Google Scholar (2005 to 2016) was conducted. Only studies that evaluated the implementation and/or student-level effectiveness of DPA policies in Canadian elementary schools were included. Only articles that examined DPA implementation barriers and facilitators by teachers, principals, and/or administration were eligible for the TDF analysis. Data on study characteristics and major findings regarding implementation status, implementation approach used, and impact on student's physical activity were extracted and were summarized descriptively, including study quality indicators. Two coders extracted and categorized implementation barriers and facilitators into TDF domains. The search resulted in 66 articles being retrieved and 38 being excluded for not meeting the eligibility criteria, leaving 15 eligible for review (10 of which examined barriers and facilitators to implementation from DPA deliverers' perspective). Eleven of 15 studies examined the Ontario DPA policy, and 2 studies were from both Alberta and British Columbia. Thirteen studies examined implementation, and only two examined effectiveness. DPA implementation status, approaches to delivery, and effectiveness on student's PA levels are inconsistent across the

Implementation of evidence-based knowledge in general practice.

PubMed

Le, Jette Videbæk

2017-12-01

Background Keeping up with the evidence and implementing it into the daily care for patients are fundamental prerequisites for delivering a high quality of care in general practice. However, despite many years of research into dissemination and implementation of evidence-based recommendations, significant challenges remain. In recent years, organisational factors have become widely acknowledged as vitally important for ensuring successful implementation. Further knowledge is needed to understand more about which factors affect the seeking and implementation of evidence-based knowledge in general practice. Aim The overall aim was to investigate how evidence-based knowledge is sought and implemented in general practice and to analyse associations with GP characteristics and quality of care. Three separate studies, each covering a specific part of the overall aim, were undertaken: I. To examine how GPs implement clinical practice guidelines in everyday clinical practice, and how implementation approaches differ between practices. II. To assess GPs’ information seeking behaviour with regard to the use and perceived importance of scientific medical information sources and to investigate associations with GP characteristics. III. To investigate if there are associations between specific formalised implementation activities within general practice and quality of care – exemplified by the use of spirometry testing among first-time users of medication against obstructive lung diseases. Methods The study was designed as a mixed methods study combining qualitative interviews, questionnaire and register data. Study I was a qualitative interview study that involved purposefully selected GPs representing seven different practices. The interviews were analysed using systematic text condensation, and results were used to qualify the development of a national survey of general practitioners regarding their seeking and implementation of evidence-based knowledge. This survey was

Implementing an online pharmaceutical service using design science research.

PubMed

Lapão, Luís Velez; da Silva, Miguel Mira; Gregório, João

2017-03-27

The rising prevalence of chronic diseases is pressing health systems to introduce reforms. Primary healthcare and multidisciplinary models have been suggested as approaches to deal with this challenge, with new roles for nurses and pharmacists being advocated. More recently, implementing healthcare based on information systems and technologies (e.g. eHealth) has been proposed as a way to improve health services. However, implementing online pharmaceutical services, including their adoption by pharmacists and patients, is still an open research question. In this paper we present ePharmacare, a new online pharmaceutical service implemented using Design Science Research. The Design Science Research Methodology (DSRM) was chosen to implement this online service for chronic diseases management. In the paper, DSRM's different activities are explained, from the definition of the problem to the evaluation of the artifact. During the design and development activities, surveys, observations, focus groups, and eye-tracking glasses were used to validate pharmacists' and patients' requirements. During the demonstration and evaluation activities the new service was used with real-world pharmacists and patients. The results show the contribution of DSRM in the implementation of online services for pharmacies. We found that pharmacists spend only 50% of their time interacting with patients, uncovering a clear opportunity to implement online pharmaceutical care services. On the other hand, patients that regularly visit the same pharmacy recognize the value in patient follow-up demanding to use channels such as the Internet for their pharmacy interactions. Limitations were identified regarding the high workload of pharmacists, but particularly their lack of know-how and experience in dealing with information systems (IST) for the provision of pharmaceutical services. This paper summarizes a research project in which an online pharmaceutical service was proposed, designed, developed

NASA GRC MBSE Implementation Status

NASA Technical Reports Server (NTRS)

Parrott, Edith; Trase, Katie; Green, Randi; Varga, Denise; Powell, Joe

2016-01-01

This presentation gives a brief overview on GRCs Model Based System Engineering (MBSE) implementation status. This overview covers: history, project usage and implementation, challenges and future work.

Analog hardware implementation of neocognitron networks

NASA Astrophysics Data System (ADS)

Inigo, Rafael M.; Bonde, Allen, Jr.; Holcombe, Bradford

1990-08-01

This paper deals with the analog implementation of neocognitron based neural networks. All of Fukushima''s and related work on the neocognitron is based on digital computer simulations. To fully take advantage of the power of this network paradigm an analog electronic approach is proposed. We first implemented a 6-by-6 sensor network with discrete analog components and fixed weights. The network was given weight values to recognize the characters U L and F. These characters are recognized regardless of their location on the sensor and with various levels of distortion and noise. The network performance has also shown an excellent correlation with software simulation results. Next we implemented a variable weight network which can be trained to recognize simple patterns by means of self-organization. The adaptable weights were implemented with PETs configured as voltage-controlled resistors. To implement a variable weight there must be some type of " memory" to store the weight value and hold it while the value is reinforced or incremented. Two methods were evaluated: an analog sample-hold circuit and a digital storage scheme using binary counters. The latter is preferable for VLSI implementation because it uses standard components and does not require the use of capacitors. The analog design and implementation of these small-scale networks demonstrates the feasibility of implementing more complicated ANNs in electronic hardware. The circuits developed can also be designed for VLSI implementation. 1.

Now's the Time: Implementing Performance Management

ERIC Educational Resources Information Center

Legutko, Lee V.

2012-01-01

During the past several years, school systems have implemented a variety of organizational improvement initiatives, such as Six Sigma, Balanced Scorecards, Baldrige Criteria, activity-based costing, and managing for results. Unfortunately, evidence of sustained success is fleeting as school districts remain trapped in a time warp of command,…

Implementation Science: Buzzword or Game Changer?

PubMed

Douglas, Natalie F; Campbell, Wenonah N; Hinckley, Jacqueline J

2015-12-01

The purpose of this supplement article is to provide a resource of pertinent information concerning implementation science for immediate research application in communication sciences and disorders. Key terminology related to implementation science is reviewed. Practical suggestions for the application of implementation science theories and methodologies are provided, including an overview of hybrid research designs that simultaneously investigate clinical effectiveness and implementation as well as an introduction to approaches for engaging stakeholders in the research process. A detailed example from education is shared to show how implementation science was utilized to move an intervention program for autism into routine practice in the public school system. In particular, the example highlights the value of strong partnership among researchers, policy makers, and frontline practitioners in implementing and sustaining new evidence-based practices. Implementation science is not just a buzzword. This is a new field of study that can make a substantive contribution in communication sciences and disorders by informing research agendas, reducing health and education disparities, improving accountability and quality control, increasing clinician satisfaction and competence, and improving client outcomes.

Assessment of Egyptian Agricultural Technical School Instructors' Ability to Implement Experiential Learning Activities

ERIC Educational Resources Information Center

Barrick, R. Kirby; Samy, Mohamed M.; Roberts, T. Grady; Thoron, Andrew C.; Easterly, R. G., III

2011-01-01

The purpose of this study was to assess the perceptions of ATS instructors in Egypt related to implementing experiential learning in the form of internships. In July 2007, 90 ATS instructors attended workshops focused on conducting internship experiences. Self-perceived competency of ATS instructors to implement internships was assessed…

Implementing a C++ Version of the Joint Seismic-Geodetic Algorithm for Finite-Fault Detection and Slip Inversion for Earthquake Early Warning

NASA Astrophysics Data System (ADS)

Smith, D. E.; Felizardo, C.; Minson, S. E.; Boese, M.; Langbein, J. O.; Guillemot, C.; Murray, J. R.

2015-12-01

The earthquake early warning (EEW) systems in California and elsewhere can greatly benefit from algorithms that generate estimates of finite-fault parameters. These estimates could significantly improve real-time shaking calculations and yield important information for immediate disaster response. Minson et al. (2015) determined that combining FinDer's seismic-based algorithm (Böse et al., 2012) with BEFORES' geodetic-based algorithm (Minson et al., 2014) yields a more robust and informative joint solution than using either algorithm alone. FinDer examines the distribution of peak ground accelerations from seismic stations and determines the best finite-fault extent and strike from template matching. BEFORES employs a Bayesian framework to search for the best slip inversion over all possible fault geometries in terms of strike and dip. Using FinDer and BEFORES together generates estimates of finite-fault extent, strike, dip, preferred slip, and magnitude. To yield the quickest, most flexible, and open-source version of the joint algorithm, we translated BEFORES and FinDer from Matlab into C++. We are now developing a C++ Application Protocol Interface for these two algorithms to be connected to the seismic and geodetic data flowing from the EEW system. The interface that is being developed will also enable communication between the two algorithms to generate the joint solution of finite-fault parameters. Once this interface is developed and implemented, the next step will be to run test seismic and geodetic data through the system via the Earthworm module, Tank Player. This will allow us to examine algorithm performance on simulated data and past real events.

Counting to 20: Online Implementation of a Face-to-Face, Elementary Mathematics Methods Problem-Solving Activity

ERIC Educational Resources Information Center

Schwartz, Catherine Stein

2012-01-01

This study describes implementation of the same problem-solving activity in both online and face-to-face environments. The activity, done in the first class period or first module of a K-2 mathematics methods course, was initially used in a face-to-face class and then adapted later for use in an online class. While the task was originally designed…

HSE12 implementation in libxc

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

Moussa, Jonathan E.

2013-05-13

This piece of software is a new feature implemented inside an existing open-source library. Specifically, it is a new implementation of a density functional (HSE, short for Heyd-Scuseria-Ernzerhof) for a repository of density functionals, the libxc library. It fixes some numerical problems with existing implementations, as outlined in a scientific paper recently submitted for publication. Density functionals are components of electronic structure simulations, which model properties of electrons inside molecules and crystals.

Implementing a wound care resource nurse program.

PubMed

Tully, Sandra; Ganson, Claudia; Savage, Pamela; Banez, Carol; Zarins, Baiba

2007-08-01

Nurses are leaders in implementing innovations that can create positive outcomes in the prevention and management of pressure ulcers in patients admitted to acute care hospitals. Believing that nurses knowledgeable in best practices could impact prevalence, incidence, and care of pressure ulcers, an educational program was developed in a Canadian healthcare system to inform and empower nurses providing skin and wound care. The program afforded participants the opportunity to acquire the knowledge and skill to recognize patients at risk for developing pressure ulcers and to independently treat Stage I and Stage II pressure ulcers and skin breakdown related to moisture, friction, and shear. The program includes evidence-based practice recommendations and highlights the Best Practice Guidelines developed by the Registered Nurses Association of Ontario, a provincial body taking an active role in the development, implementation, and evaluation of published guidelines derived from global research literature synthesis. Pre- and post participation assessment of 65 nurse participants from three hospitals deemed the program successful in terms of knowledge and fulfillment of their educational expectations. Organizational support to implement the skin and wound care resource nurse role was encouraging and medical directives for Stage I and Stage II pressure ulcers by nurses were implemented. Evaluation and monitoring of program outcomes, including pressure ulcer incidence rates, continue.

A randomised controlled trial of an intervention to facilitate the implementation of healthy eating and physical activity policies and practices in childcare services

PubMed Central

Jones, Jannah; Wolfenden, Luke; Wyse, Rebecca; Finch, Meghan; Yoong, Sze Lin; Dodds, Pennie; Pond, Nicole; Gillham, Karen; Freund, Megan; McElduff, Patrick; Wye, Paula; Wiggers, John

2014-01-01

Introduction Childhood overweight and obesity tracks into adulthood, increasing the risk of developing future chronic disease. Implementing initiatives promoting healthy eating and physical activity in childcare settings has been identified as a priority to prevent excessive child weight gain. Despite this, few trials have been conducted to assess the effectiveness of interventions to support population-wide implementation of such initiatives. The aim of this study is to assess the effectiveness of a multicomponent intervention in increasing the implementation of healthy eating and physical activity policies and practices by centre-based childcare services. Methods and analysis The study will employ a parallel group randomised controlled trial design. A sample of 128 childcare services in the Hunter region of New South Wales, Australia, will be recruited to participate in the trial. 64 services will be randomly allocated to a 12-month implementation intervention. The remaining 64 services will be allocated to a usual care control group. The intervention will consist of a number of strategies to facilitate childcare service implementation of healthy eating and physical activity policies and practices. Intervention strategies will include implementation support staff, securing executive support, consensus processes, staff training, academic detailing visits, performance monitoring and feedback, tools and resources, and a communications strategy. The primary outcome of the trial will be the prevalence of services implementing all healthy eating and physical activity policies and practices targeted by the intervention. To assess the effectiveness of the intervention, telephone surveys with nominated supervisors and room leaders of childcare services will be conducted at baseline and immediately postintervention. Ethics and dissemination The study was approved by the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics

Organizational theory for dissemination and implementation research.

PubMed

Birken, Sarah A; Bunger, Alicia C; Powell, Byron J; Turner, Kea; Clary, Alecia S; Klaman, Stacey L; Yu, Yan; Whitaker, Daniel J; Self, Shannon R; Rostad, Whitney L; Chatham, Jenelle R Shanley; Kirk, M Alexis; Shea, Christopher M; Haines, Emily; Weiner, Bryan J

2017-05-12

Even under optimal internal organizational conditions, implementation can be undermined by changes in organizations' external environments, such as fluctuations in funding, adjustments in contracting practices, new technology, new legislation, changes in clinical practice guidelines and recommendations, or other environmental shifts. Internal organizational conditions are increasingly reflected in implementation frameworks, but nuanced explanations of how organizations' external environments influence implementation success are lacking in implementation research. Organizational theories offer implementation researchers a host of existing, highly relevant, and heretofore largely untapped explanations of the complex interaction between organizations and their environment. In this paper, we demonstrate the utility of organizational theories for implementation research. We applied four well-known organizational theories (institutional theory, transaction cost economics, contingency theories, and resource dependency theory) to published descriptions of efforts to implement SafeCare, an evidence-based practice for preventing child abuse and neglect. Transaction cost economics theory explained how frequent, uncertain processes for contracting for SafeCare may have generated inefficiencies and thus compromised implementation among private child welfare organizations. Institutional theory explained how child welfare systems may have been motivated to implement SafeCare because doing so aligned with expectations of key stakeholders within child welfare systems' professional communities. Contingency theories explained how efforts such as interagency collaborative teams promoted SafeCare implementation by facilitating adaptation to child welfare agencies' internal and external contexts. Resource dependency theory (RDT) explained how interagency relationships, supported by contracts, memoranda of understanding, and negotiations, facilitated SafeCare implementation by balancing

Active-learning implementation in an advanced elective course on infectious diseases.

PubMed

Hidayat, Levita; Patel, Shreya; Veltri, Keith

2012-06-18

To describe the development, implementation, and assessment of an advanced elective course on infectious diseases using active-learning strategies. Pedagogy for active learning was incorporated by means of mini-lecture, journal club, and debate with follow-up discussion. Forty-eight students were enrolled in this 4-week elective course, in which 30% of course time was allocated for active-learning exercises. All activities were fundamentally designed as a stepwise approach in complementing each active-learning exercise. Achievement of the course learning objectives was assessed using a 5-point Likert scale survey instrument. Students' awareness of the significance of antimicrobial resistance was improved (p ≤ 0.05). Students' ability to critically evaluate the infectious-disease literature and its application in informed clinical judgments was also enhanced through these active-learning exercises (p ≤ 0.05). Students agreed that active learning should be part of the pharmacy curriculum and that active-learning exercises improved their critical-thinking, literature-evaluation, and self-learning skills. An elective course using active-learning strategies allowed students to combine information gained from the evaluation of infectious-disease literature, critical thinking, and informed clinical judgment. This blended approach ultimately resulted in an increased knowledge and awareness of infectious diseases.

Active-Learning Implementation in an Advanced Elective Course on Infectious Diseases

PubMed Central

Patel, Shreya; Veltri, Keith

2012-01-01

Objectives. To describe the development, implementation, and assessment of an advanced elective course on infectious diseases using active-learning strategies. Design. Pedagogy for active learning was incorporated by means of mini-lecture, journal club, and debate with follow-up discussion. Forty-eight students were enrolled in this 4-week elective course, in which 30% of course time was allocated for active-learning exercises. All activities were fundamentally designed as a stepwise approach in complementing each active-learning exercise. Assessment. Achievement of the course learning objectives was assessed using a 5-point Likert scale survey instrument. Students’ awareness of the significance of antimicrobial resistance was improved (p ≤ 0.05). Students’ ability to critically evaluate the infectious-disease literature and its application in informed clinical judgments was also enhanced through these active-learning exercises (p ≤ 0.05). Students agreed that active learning should be part of the pharmacy curriculum and that active-learning exercises improved their critical-thinking, literature-evaluation, and self-learning skills. Conclusion. An elective course using active-learning strategies allowed students to combine information gained from the evaluation of infectious-disease literature, critical thinking, and informed clinical judgment. This blended approach ultimately resulted in an increased knowledge and awareness of infectious diseases. PMID:22761528

Implementation of Kane's Method for a Spacecraft Composed of Multiple Rigid Bodies

NASA Technical Reports Server (NTRS)

Stoneking, Eric T.

2013-01-01

Equations of motion are derived for a general spacecraft composed of rigid bodies connected via rotary (spherical or gimballed) joints in a tree topology. Several supporting concepts are developed in depth. Basis dyads aid in the transition from basis-free vector equations to component-wise equations. Joint partials allow abstraction of 1-DOF, 2-DOF, 3-DOF gimballed and spherical rotational joints to a common notation. The basic building block consisting of an "inner" body and an "outer" body connected by a joint enables efficient organization of arbitrary tree structures. Kane's equation is recast in a form which facilitates systematic assembly of large systems of equations, and exposes a relationship of Kane's equation to Newton and Euler's equations which is obscured by the usual presentation. The resulting system of dynamic equations is of minimum dimension, and is suitable for numerical solution by computer. Implementation is ·discussed, and illustrative simulation results are presented.

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy.

PubMed

Egeland, Karina Myhren; Ruud, Torleif; Ogden, Terje; Färdig, Rickard; Lindstrøm, Jonas Christoffer; Heiervang, Kristin Sverdvik

2017-01-01

The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014.

Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.

PubMed

Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

2014-01-01

To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. Research methodology - Evaluation using theory-based realist methods for policy implementation. An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. © 2013

14 CFR 1232.105 - Implementation procedures by NASA field installations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Implementation procedures by NASA field... CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES § 1232.105 Implementation procedures by NASA... of animal subjects is identical to that described in § 1232.104(a). (b) Proposal Approval by the NASA...

14 CFR 1232.105 - Implementation procedures by NASA field installations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Implementation procedures by NASA field... CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES § 1232.105 Implementation procedures by NASA... of animal subjects is identical to that described in § 1232.104(a). (b) Proposal Approval by the NASA...

14 CFR 1232.105 - Implementation procedures by NASA field installations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Implementation procedures by NASA field... CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES § 1232.105 Implementation procedures by NASA... of animal subjects is identical to that described in § 1232.104(a). (b) Proposal Approval by the NASA...

14 CFR 1232.105 - Implementation procedures by NASA field installations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Implementation procedures by NASA field... CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES § 1232.105 Implementation procedures by NASA... of animal subjects is identical to that described in § 1232.104(a). (b) Proposal Approval by the NASA...

Activating multi-ethnic youth for smoking prevention: design, baseline findings, and implementation of project SPLASH.

PubMed

Glanz, Karen; Lunde, Kevin B; Leakey, Tricia; Maddock, Jay; Koga, Karin; Yamauchi, Jessica; Maskarinec, Gertraud; Shigaki, Dorothy

2007-01-01

Achieving significant reductions in tobacco use by youth is an important challenge. There is a pressing need to develop and evaluate innovative strategies that stimulate youth involvement and are effective in multi-ethnic populations. This article describes an innovative tobacco prevention trial, and reports baseline characteristics of participants and findings about implementation of the curriculum. The aim of Project SPLASH is to evaluate the impact of a school-based smoking prevention intervention that emphasizes active involvement of middle school students, on rates of smoking initiation and regular smoking in a multi-ethnic cohort of youth in Hawaii. Project SPLASH is a group randomized trial that compares a 2-year innovative intervention with a social influence prevention program, in 20 public schools in Hawaii. The main outcome is mean 30-day smoking prevalence rates. The response rate was 78.4%. Approximately 1 in 4 students had tried smoking and 30-day smoking prevalence at baseline was 8%. Intervention and control groups were comparable in terms of tobacco use, gender, ethnicity, behavioral, environmental, and psychosocial characteristics. Differences in ethnic identification, socio-economic status, acculturation, and involvement in prevention activities may be due to chance. The intervention was well implemented by teachers across both the intervention and control school classes. For this study, 20 schools in Hawaii with close to 4000 participating students were recruited. Student smoking behavior and curriculum implementation were comparable by group status. The intervention study has the potential to elucidate how youth respond to an intervention with student involvement that incorporates cognitive and social action components.

Implementation of Discovery Projects in Statistics

ERIC Educational Resources Information Center

Bailey, Brad; Spence, Dianna J.; Sinn, Robb

2013-01-01

Researchers and statistics educators consistently suggest that students will learn statistics more effectively by conducting projects through which they actively engage in a broad spectrum of tasks integral to statistical inquiry, in the authentic context of a real-world application. In keeping with these findings, we share an implementation of…

Dissemination and implementation: INQRI's potential impact.

PubMed

Titler, Marita G; Wilson, Deleise S; Resnick, Barbara; Shever, Leah L

2013-04-01

Application of research evidence in care delivery improves patient outcomes. Large gaps still exist, however, between recommended care and that used in practice. To increase the understanding of implementation studies, and dissemination of research findings, we present the perspective of investigators from seven Interdisciplinary Nursing Quality Research Initiative (INQRI)-funded studies. To describe implementation strategies, challenges, and lessons learned from conducting 5 INQRI-funded implementation studies, and present 2 case examples of other INQRI studies to illustrate dissemination strategies. Potential impact of study findings are set forth. Qualitative descriptive methods were used for the implementation studies. Case examples were set forth by investigators using reflection questions. Four of the 5 implementation studies focused on clinical topics and 1 on professional development of nurse managers, 4 were multisite studies. Common implementation strategies used across studies addressed education, ongoing interaction with sites, use of implementation tools, and visibility of the projects on the study units. Major challenges were the Institutional Review Board approval process and the short length of time allocated for implementation. Successes and lessons learned included creating excitement about research, packaging of study tools and resources for use by other organizations, and understanding the importance of context when conducting this type of research. Case examples revealed that study findings have been disseminated to study sites and to the health care community through publications and presentations. The potential impact of all 7 studies is far reaching. This study captures several nuanced perspectives from 5 Principal Investigators, who were completing INQRI-funded implementation studies. These nuanced perspectives are important lessons for other scientists embarking on implementation studies. The INQRI case examples illustrate important

HMA Longitudinal Joint Evaluation and Construction

DOT National Transportation Integrated Search

2011-02-01

Longitudinal joint quality is essential to the successful performance of asphalt pavements. A number of states have begun to implement longitudinal joint specifications, and most are based on determinations of density. However, distress at the joint ...

Review of policy and status of implementation of collaborative HIV-TB activities in 23 high-burden countries.

PubMed

Gupta, S; Granich, R; Date, A; Lepere, P; Hersh, B; Gouws, E; Samb, B

2014-10-01

Issuance of national policy guidance is a critical step to ensure quality HIV-TB (human immunodeficiency virus-tuberculosis) coordination and programme implementation. From the database of the Joint United Nations Programme on HIV/AIDS (UNAIDS), we reviewed 62 national HIV and TB guidelines from 23 high-burden countries for recommendations on HIV testing for TB patients, criteria for initiating antiretroviral therapy (ART) and the Three I's for HIV/TB (isoniazid preventive treatment [IPT], intensified TB case finding and TB infection control). We used UNAIDS country-level programme data to determine the status of implementation of existing guidance. Of the 23 countries representing 89% of the global HIV-TB burden, Brazil recommends ART irrespective of CD4 count for all people living with HIV, and four (17%) countries recommend ART at the World Health Organization (WHO) 2013 guidelines level of CD4 count ⩿500 cells/mm(3) for asymptomatic persons. Nineteen (83%) countries are consistent with WHO 2013 guidelines and recommend ART for HIV-positive TB patients irrespective of CD4 count. IPT is recommended by 16 (70%) countries, representing 67% of the HIV-TB burden; 12 recommend symptom-based screening alone for IPT initiation. Guidelines from 15 (65%) countries with 79% of the world's HIV-TB burden include recommendations on HIV testing and counselling for TB patients. Although uptake of ART, HIV testing for TB patients, TB screening for people living with HIV and IPT have increased significantly, progress is still limited in many countries. There is considerable variance in the timing and content of national policies compared with WHO guidelines. Missed opportunities to implement new scientific evidence and delayed adaptation of existing WHO guidance remains a key challenge for many countries.

Companion of choice at birth: factors affecting implementation.

PubMed

Kabakian-Khasholian, Tamar; Portela, Anayda

2017-08-31

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

Supporting Implementation of the Next Generation Science Standards: A Needs Assessment Outline

NASA Astrophysics Data System (ADS)

Sullivan, S. M.; Robeck, E.; Awad, A. A.

2015-12-01

The Next Generation Science Standards (NGSS) explicitly treat Earth and Space Science (ESS) content with the same level of priority as Physical Science, Life Science, and Engineering & Technology. Therefore, the geoscience community has a vested interest in the use of NGSS as it is being implemented in K-12 classrooms. Individuals and groups from all facets of the geosciences can take action to support the implementation of the NGSS. That action will be most effective if it is guided by a thorough understanding of the needs of teachers and other stakeholders who have a role to play in NGSS implementation. This session will describe qualitative and quantitative needs assessment data that was gathered in advance of the Summit Meeting on the Implementation of the NGSS at the State Level, which was jointly organized in April 2015 by the American Geosciences Institute (AGI) and the National Association of Geoscience Teachers (NAGT). The data to be discussed are from interviews and quantitative survey data, as well as data based on responses by the 50+ Summit attendees who represented a variety of perspectives in geoscience education. Particular attention will be given to areas where responses suggested points of tension, such as the fact that many survey respondents feel that they understand dimensions of the NGSS that their colleagues do not understand as well, making for a potentially difficult context in which to work to implement the NGSS. Actions suggested by the Summit attendees that are related to the different need areas will also be described, with the intent being to open discussion among session participants about additional actions that they can take individually and/or collectively. The overarching goal of this presentation will be to work in coordination with the other presentations in the session to expand the network of member of the geoscience community who are informed and committed to supporting NGSS implementation.

Implementation of smoke-free homes in Poland.

PubMed

Kaleta, Dorota; Fronczak, Adam; Usidame, Bukola; Dziankowska-Zaborszczyk, Elżbieta; Makowiec-Dąbrowska, Teresa; Wojtysiak, Piotr

2016-01-01

Exposure to environmental tobacco smoke (ETS) constitutes a threat to the health of many people. In order to diminish ETS exposure, countries (including Poland) implemented legal restrictions of smoking in public places and worksites. Currently more attention is also paid to reduce overall and residential ETS exposure by voluntary smoke-free home policy adoption. The aim of current analysis was to evaluate the prevalence and determinants of implementing smoking bans at place of residence among economically active males and females in Poland. Data from cross-sectional, household study - Global Adult Tobacco Survey (GATS 2009-2010) were analyzed. The logistic regression model was applied for appropriate calculations. Out of 3696 studied subjects only 37.1% adopted total smoking ban within the home. Decreased likelihood of adopting total smoking bans was associated with current smoker status, low education attainment, lack of awareness on adverse health consequences of ETS, low level of support for tobacco control policies, and cohabitation with a smoker in both genders. Having smoke-free homes was also linked with age in women, place of residence and work smoking policy in indoor areas in men. Targeted activities to encourage adopting voluntary smoke-free rules among groups least likely to implement 100% smoking bans in the home and activities to decrease social acceptance of smoking in the presence of nonsmokers, children, pregnant woman are urgently needed. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

In-field implementation of impedance-based structural health monitoring for insulated rail joints

NASA Astrophysics Data System (ADS)

Albakri, Mohammad I.; Malladi, V. V. N. Sriram; Woolard, Americo G.; Tarazaga, Pablo A.

2017-04-01

Track defects are a major safety concern for the railroad industry. Among different track components, insulated rail joints, which are widely used for signaling purposes, are considered a weak link in the railroad track. Several joint-related defects have been identified by the railroad community, including rail wear, torque loss, and joint bar breakage. Current track inspection techniques rely on manual and visual inspection or on specially equipped testing carts, which are costly, timeconsuming, traffic disturbing, and prone to human error. To overcome the aforementioned limitations, the feasibility of utilizing impedance-based structural health monitoring for insulated rail joints is investigated in this work. For this purpose, an insulated joint, provided by Koppers Inc., is instrumented with piezoelectric transducers and assembled with 136 AREA rail plugs. The instrumented joint is then installed and tested at the Facility for Accelerated Service Testing, Transportation Technology Center Inc. The effects of environmental and operating conditions on the measured impedance signatures are investigated through a set of experiments conducted at different temperatures and loading conditions. The capabilities of impedance-based SHM to detect several joint-related damage types are also studied by introducing reversible mechanical defects to different joint components.

A Review of Activity Implementation in Out-of-School Time Programs. Out-of-School Time Evaluation Snapshot.

ERIC Educational Resources Information Center

Bouffard, Suzanne; Little, Priscilla M. D.

Noting that most evaluations of out-of-school (OST) programs have examined the programs as a whole without taking into account the specific activities offered, this issue of "Out-of-School Time Evaluation Snapshots" surveys the range of activities being implemented in OST settings across the country to better understand and promote…

Implementation of Knowledge Management in Organizations

ERIC Educational Resources Information Center

Winkler, Katrin; Mandl, Heinz

2007-01-01

In the context of learning implementation of new ideas e.g. knowledge management in organizations often is neglected. Concerning knowledge management measures we demonstrate its implementation in organizations. A theoretical framework was developed showing the necessary basic conditions for implementing knowledge management. Subsequently we…

Implementation Science: Buzzword or Game Changer?

ERIC Educational Resources Information Center

Douglas, Natalie F.; Campbell, Wenonah N.; Hinckley, Jacqueline J.

2015-01-01

Purpose: The purpose of this supplement article is to provide a resource of pertinent information concerning implementation science for immediate research application in communication sciences and disorders. Method: Key terminology related to implementation science is reviewed. Practical suggestions for the application of implementation science…

How was the UNAIDS drug access initiative implemented in Chile?

PubMed Central

Brousselle, Astrid; Champagne, François

2012-01-01

In 1997, UNAIDS decided to implement Drug Access Initiatives (DAI) in four different pilot-countries. We studied the implementation of the DAI in Chile as part of the evaluation program conducted by the ‘Agence Nationale de Recherche sur le SIDA’ (ANRS/France). The objective was to understand how the politico-organizational dynamic influenced the implementation process of the DAI. Approximately 50 semi-directed interviews and observation activities were conducted with the actors who participated in the implementation of the DAI or who played a role in the HIV/AIDS context. The program theory models were established and their evolution analyzed. This article offers an original analysis of an international HIV/AIDS drug access program that was put in place at a time when such programs were seen as a priority by international and governmental institutions. It also offers some insights for the creation of international projects that will be locally implemented. PMID:23230344

Semi-active tuned liquid column damper implementation with real-time hybrid simulations

NASA Astrophysics Data System (ADS)

Riascos, Carlos; Marulanda Casas, Johannio; Thomson, Peter

2016-04-01

Real-time hybrid simulation (RTHS) is a modern cyber-physical technique used for the experimental evaluation of complex systems, that treats the system components with predictable behavior as a numerical substructure and the components that are difficult to model as an experimental substructure. Therefore it is an attractive method for evaluation of the response of civil structures under earthquake, wind and anthropic loads. In this paper, the response of three-story shear frame controlled by a tuned liquid column damper (TLCD) and subject to base excitation is considered. Both passive and semi-active control strategies were implemented and are compared. While the passive TLCD achieved a reduction of 50% in the acceleration response of the main structure in comparison with the structure without control, the semi-active TLCD achieved a reduction of 70%, and was robust to variations in the dynamic properties of the main structure. In addition, a RTHS was implemented with the main structure modeled as a linear, time-invariant (LTI) system through a state space representation and the TLCD, with both control strategies, was evaluated on a shake table that reproduced the displacement of the virtual structure. Current assessment measures for RTHS were used to quantify the performance with parameters such as generalized amplitude, equivalent time delay between the target and measured displacement of the shake table, and energy error using the measured force, and prove that the RTHS described in this paper is an accurate method for the experimental evaluation of structural control systems.

[The two-year post graduate training program for nurses: implementation status and personal perspectives].

PubMed

Yin, Yu-Chun

2013-06-01

The Taiwan Joint Commission on Hospital Accreditation (TJCHA) authorized the Teaching Quality Improvement Program for Teaching Hospitals as a way for the Department of Health to plan and implement improvements. The program assists medical and paramedical professionals to establish a postgraduate clinical training system. The two-year postgraduate training program for nurses is one of the program's regular activities, divided into three phases that include location-based curriculum training (3 months), core curriculum training (9 months), and professional courses training (12 months). This paper describes the origin, current implementation status, and efficacy / key problems of this two-year post graduate training program, Information regarding the opinions of new nurses, preceptors, and nursing managers on the three aspects is drawn from the author's relevant professional experience, interactions with nurses, and a review of the literature. Findings include: (1) nursing departments should operate in accordance with TJCHA guidelines; (2) department training should be adequate to promote the ability and willingness of nurses to train a new generation of clinical preceptors; and (3) participant opinions on project execution progress and difficulties. Findings may be referenced to better achieve Teaching Quality Improvement Program for Teaching Hospital objectives.

Understanding ED performance after the implementation of activity-based funding.

PubMed

Toloo, Ghasem-Sam; Burke, John; Crilly, Julia; Williams, Ged; McCann, Bridie; FitzGerald, Gerry; Bell, Anthony

2017-11-29

The aim of this study was to describe emergency department (ED) activities and staffing after the introduction of activity-based funding (ABF) to highlight the challenges of new funding arrangements and their implementation. A retrospective study of public hospital EDs in Queensland, Australia, was undertaken for 2013-2014. The ED and hospital characteristics are described to evaluate the alignment between activity and resourcing levels and their impact on performance. Twenty EDs participated (74% response rate). Weighted activity units (WAUs) and nursing staff varied based on hospital type and size. Larger hospital EDs had on average 9076 WAUs and 13 full time equivalent (FTE) nursing staff per 1000 WAUs; smaller EDs had on average 4587 WAUs and 10.3 FTE nursing staff per 1000 WAUs. Medical staff was relatively consistent (8.1-8.7 FTE per 1000 WAUs). The proportion of patients admitted, discharged, or transferred within 4 hours ranged from 73% to 79%. The ED medical and nursing staffing numbers did not correlate with the 4-hour performance. Substantial variation exists across Queensland EDs when resourcing service delivery in an activity-based funding environment. Historical inequity persists in the staffing profiles for regional and outer metropolitan departments. The lack of association between resourcing and performance metrics provides opportunity for further investigation of efficient models of care. Copyright © 2017 John Wiley & Sons, 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...

10 CFR 960.3 - Implementation guidelines.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this subpart...

10 CFR 960.3 - Implementation guidelines.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this subpart...

10 CFR 960.3 - Implementation guidelines.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this subpart...

10 CFR 960.3 - Implementation guidelines.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this subpart...

10 CFR 960.3 - Implementation guidelines.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this subpart...

Design and Implementation of an Underlay Control Channel for Cognitive Radios

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

Daryl Wasden; Hussein Moradi; Behrouz Farhang-Boroujeny

Implementation of any cognitive radio network requires an effective control channel that can operate under various modes of activity from the primary users. This paper reports the design and implementation of a filter bank multicarrier spread spectrum (FBMC-SS) system for use as the control channel in cognitive radio networks. The proposed design is based on a filtered multitone (FMT) implementation. Carrier and timing acquisition and tracking methods as well as a blind channel estimation method are developed for the proposed control channel. We also report an implementation of the proposed FBMC-SS system on a hardware platform; a FlexRIO FPGA modulemore » from National Instruments.« less

Adapting the Consolidated Framework for Implementation Research to Create Organizational Readiness and Implementation Tools for Project ECHO.

PubMed

Serhal, Eva; Arena, Amanda; Sockalingam, Sanjeev; Mohri, Linda; Crawford, Allison

2018-03-01

The Project Extension for Community Healthcare Outcomes (ECHO) model expands primary care provider (PCP) capacity to manage complex diseases by sharing knowledge, disseminating best practices, and building a community of practice. The model has expanded rapidly, with over 140 ECHO projects currently established globally. We have used validated implementation frameworks, such as Damschroder's (2009) Consolidated Framework for Implementation Research (CFIR) and Proctor's (2011) taxonomy of implementation outcomes, combined with implementation experience to (1) create a set of questions to assess organizational readiness and suitability of the ECHO model and (2) provide those who have determined ECHO is the correct model with a checklist to support successful implementation. A set of considerations was created, which adapted and consolidated CFIR constructs to create ECHO-specific organizational readiness questions, as well as a process guide for implementation. Each consideration was mapped onto Proctor's (2011) implementation outcomes, and questions relating to the constructs were developed and reviewed for clarity. The Preimplementation list included 20 questions; most questions fall within Proctor's (2001) implementation outcome domains of "Appropriateness" and "Acceptability." The Process Checklist is a 26-item checklist to help launch an ECHO project; items map onto the constructs of Planning, Engaging, Executing, Reflecting, and Evaluating. Given that fidelity to the ECHO model is associated with robust outcomes, effective implementation is critical. These tools will enable programs to work through key considerations to implement a successful Project ECHO. Next steps will include validation with a diverse sample of ECHO projects.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version.

PubMed

Vlemmix, Floortje; Rosman, Ageeth N; Fleuren, Margot A H; Rijnders, Marlies E B; Beuckens, Antje; Haak, Monique C; Akerboom, Bettina M C; Bais, Joke M J; Kuppens, Simone M I; Papatsonis, Dimitri N; Opmeer, Brent C; van der Post, Joris A M; Mol, Ben Willem J; Kok, Marjolein

2010-05-10

Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less.We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV.The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Dutch Trial Register (NTR): 1878.

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

PubMed Central

2010-01-01

Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial Registration Dutch Trial Register

Understanding and Addressing Barriers to Implementation of Environmental and Policy Interventions to Support Physical Activity and Healthy Eating in Rural Communities

PubMed Central

Barnidge, Ellen K.; Radvanyi, Catherine; Duggan, Kathleen; Motton, Freda; Wiggs, Imogene; Baker, Elizabeth A.; Brownson, Ross C.

2016-01-01

PURPOSE Rural residents are at greater risk of obesity than urban and suburban residents. Failure to meet physical activity and healthy eating recommendations play a role. Emerging evidence shows the effectiveness of environmental and policy interventions to promote physical activity and healthy eating. Yet most of the evidence comes from urban and suburban communities. The objectives of this study were to 1) identify types of environmental and policy interventions being implemented in rural communities to promote physical activity or healthy eating, 2) identify barriers to the implementation of environmental or policy interventions, and 3) identify strategies rural communities have employed to overcome these barriers. METHODS Key informant interviews with public health professionals working in rural areas in the United States were conducted in 2010. A purposive sample included 15 practitioners engaged in planning, implementing, or evaluating environmental or policy interventions to promote physical activity or healthy eating. FINDINGS Our findings reveal that barriers in rural communities include cultural differences, population size, limited human capital, and difficulty demonstrating the connection between social and economic policy and health outcomes. Key informants identified a number of strategies to overcome these barriers such as developing broad-based partnerships and building on the existing infrastructure. CONCLUSON Recent evidence suggests that environmental and policy interventions have potential to promote physical activity and healthy eating at the population level. To realize positive outcomes, it is important to provide opportunities to implement these types of interventions and document their effectiveness in rural communities. PMID:23289660

From Implementation to Outcomes to Impacts: Designing a Comprehensive Program Evaluation

NASA Astrophysics Data System (ADS)

Shebby, S.

2015-12-01

Funders are often interested in learning about the impact of program activities, yet before the impacts are determined, educational evaluations should first examine program implementation and outcomes. Implementation evaluation examines how and the extent to which program activities are delivered as intended, including the extent to which activities reached the targeted participants. Outcome evaluation is comprised of a systematic examination of the effects that a program has on program participants, such as changes in knowledge, attitudes, beliefs, values, and behaviors. In this presentation, presenters will share insights on evaluating the implementation, outcomes, and impacts associated with an online science curriculum for K-2 students. The science curriculum was designed to provide students with access to science concepts and skills in an interactive and innovative environment, and teachers with embedded, aligned, and on-demand professional development. One of the most important—and challenging—steps in this evaluation was to select outcomes that were well-defined, measurable, and aligned to program activities, as well as relevant to program stakeholders. An additional challenge was to measure implementation given limited access to the classroom environment. This presentation will include a discussion of the process evaluators used to select appropriate implementation indicators and outcomes (teacher and student), design an evaluation approach, and craft data collection instruments. Although examples provided are specific to the K-2 science intervention, the best practices discussed are pertinent to all program and event evaluations. Impact evaluation goes beyond implementation and outcome evaluation to inform whether a program is working or not. It requires a comparison group to inform what outcomes would have been in the absence of the intervention. As such, this presentation will also include a discussion of impacts, including how impacts are defined

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...

Planned change or emergent change implementation approach and nurses' professional clinical autonomy.

PubMed

Luiking, Marie-Louise; Aarts, Leon; Bras, Leo; Grypdonck, Maria; van Linge, Roland

2017-11-01

Nurses' clinical autonomy is considered important for patients' outcome and influenced by the implementation approach of innovations. Emergent change approach with participation in the implementation process is thought to increase clinical autonomy. Planned change approach without this participation is thought not to increase clinical autonomy. Evidence of these effects on clinical autonomy is however limited. To examine the changes in clinical autonomy and in personal norms and values for a planned change and emergent change implementation of an innovation, e.g. intensive insulin therapy. Prospective comparative study with two geographically separated nurses' teams on one intensive care unit (ICU), randomly assigned to the experimental conditions. Data were collected from March 2008 to January 2009. Pre-existing differences in perception of team and innovation characteristics were excluded using instruments based on the innovation contingency model. The Nursing Activity Scale was used to measure clinical autonomy. The Personal Values and Norms instrument was used to assess orientation towards nursing activities and the Team Learning Processes instrument to assess learning as a team. Pre-implementation the measurements did not differ. Post-implementation, clinical autonomy was increased in the emergent change team and decreased in the planned change team. The Personal Values and Norms instrument showed in the emergent change team a decreased hierarchic score and increased developmental and rational scores. In the planned change team the hierarchical and group scores were increased. Learning as a team did not differ between the teams. In both teams there was a change in clinical autonomy and orientation towards nursing activities, in line with the experimental conditions. Emergent change implementation resulted in more clinical autonomy than planned change implementation. If an innovation requires the nurses to make their own clinical decisions, an emergent change

Active implementation strategy of CONSORT adherence by a dental specialty journal improved randomized clinical trial reporting.

PubMed

Pandis, Nikolaos; Shamseer, Larissa; Kokich, Vincent G; Fleming, Padhraig S; Moher, David

2014-09-01

To describe a novel CONsolidated Standards of Reporting Trials (CONSORT) adherence strategy implemented by the American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO) and to report its impact on the completeness of reporting of published trials. The AJO-DO CONSORT adherence strategy, initiated in June 2011, involves active assessment of randomized clinical trial (RCT) reporting during the editorial process. The completeness of reporting CONSORT items was compared between trials submitted and published during the implementation period (July 2011 to September 2013) and trials published between August 2007 and July 2009. Of the 42 RCTs submitted (July 2011 to September 2013), 23 were considered for publication and assessed for completeness of reporting, seven of which were eventually published. For all published RCTs between 2007 and 2009 (n = 20), completeness of reporting by CONSORT item ranged from 0% to 100% (Median = 40%, interquartile range = 60%). All published trials in 2011-2013, reported 33 of 37 CONSORT (sub) items. Four CONSORT 2010 checklist items remained problematic even after implementation of the adherence strategy: changes to methods (3b), changes to outcomes (6b) after the trial commenced, interim analysis (7b), and trial stopping (14b), which are typically only reported when applicable. Trials published following implementation of the AJO-DO CONSORT adherence strategy completely reported more CONSORT items than those published or submitted previously. Copyright © 2014 Elsevier Inc. All rights reserved.

Design and Implementation of a Mobile Exergaming Platform

NASA Astrophysics Data System (ADS)

Prévost, Laurent; Liechti, Olivier; Lyons, Michael J.

This paper describes the design, implementation, and initial testing of a reusable platform for the creation of pervasive games with geo-localization services. We concentrate on role-playing games built by combining several types of simpler mini-games having three major components: Quests; Collectables; and Non-player characters (NPC). Quests encourage players to be active in their physical environment and take part in collaborative play; Collectables provide motivation; and NPCs enable player-friendly interaction with the platform. Each of these elements poses different technical requirements, which were met by implementing the gaming platform using the inTrack pervasive middle-ware being developed by our group. Several sample games were implemented and tested within the urban environment of Kyoto, Japan, using gaming clients running on mobile phones from NTT DoCoMo, Japan’s largest mobile provider.

Guideline implementation strategies for specialist mental healthcare.

PubMed

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

2013-07-01

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

Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

PubMed

Sperber, Nina R; Carpenter, Janet S; Cavallari, Larisa H; J Damschroder, Laura; Cooper-DeHoff, Rhonda M; Denny, Joshua C; Ginsburg, Geoffrey S; Guan, Yue; Horowitz, Carol R; Levy, Kenneth D; Levy, Mia A; Madden, Ebony B; Matheny, Michael E; Pollin, Toni I; Pratt, Victoria M; Rosenman, Marc; Voils, Corrine I; W Weitzel, Kristen; Wilke, Russell A; Ryanne Wu, R; Orlando, Lori A

2017-05-22

To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies. We describe challenges and strategies in an implementation framework and typology to enable consistent definitions and cross-case comparisons. Strategies were linked to challenges based on expert review and shared themes. Three challenges were identified by all six projects, and strategies to address these challenges varied across the projects. One common challenge was to increase the relative priority of integrating genomics within the health system electronic health record (EHR). Four projects used data warehousing techniques to accomplish the integration. The second common challenge was to strengthen clinicians' knowledge and beliefs about genomic medicine. To overcome this challenge, all projects developed educational materials and conducted meetings and outreach focused on genomic education for clinicians. The third challenge was engaging patients in the genomic medicine projects. Strategies to overcome this challenge included use of mass media to spread the word, actively involving patients in implementation (e.g., a patient advisory board), and preparing patients to be active participants in their healthcare decisions. This is the first collaborative evaluation focusing on the description of genomic medicine innovations implemented in multiple real-world clinical settings. Findings suggest that strategies to facilitate integration of genomic

Implementation of Open and Closed Kinetic Chain Quadriceps Strengthening Exercises after Anterior Cruciate Ligament Reconstruction.

ERIC Educational Resources Information Center

Ross, Michael D.; Denegar, Craig R.; Winzenried, Jay A.

2001-01-01

Reviews the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) exercise on anterior cruciate ligament (ACL) strain and patellofemoral joint stress, suggesting a combination of the two for quadriceps strengthening after ACL reconstruction. Both OKC and CKC exercises may be modified and implemented for quadriceps strengthening after…

Implementation science in healthcare: Introduction and perspective.

PubMed

Wensing, Michel

2015-01-01

Implementation science is the scientific study of the methods to promote the uptake of research findings into routine healthcare in clinical, organisational, or policy contexts. The presence of gaps between knowledge and practice is well documented and a range of strategies is available to overcome these gaps. To optimize their impact, it is recommended that implementation strategies are tailored to the target population, setting and goals for improvement. Themes for future research in the field are: implementation of personalized medicine, the economics of implementation, knowledge implementation in various health professions, patient involvement in implementation, and a better understanding of the determinants of implementation. Addressing these challenges requires dedicated training programs, research funding, and networks for effective collaboration with stakeholders in healthcare. Copyright © 2015. Published by Elsevier GmbH.

25 CFR 275.4 - Implementing regulations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Implementing regulations. 275.4 Section 275.4 Indians... ACT PROGRAM STAFFING § 275.4 Implementing regulations. Regulations to implement section 105 of the Act will be issued by the Civil Service Commission. The regulations will cover the situations described in...

25 CFR 275.4 - Implementing regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Implementing regulations. 275.4 Section 275.4 Indians... ACT PROGRAM STAFFING § 275.4 Implementing regulations. Regulations to implement section 105 of the Act will be issued by the Civil Service Commission. The regulations will cover the situations described in...

Implementation-intention encoding in a prospective memory task enhances spontaneous retrieval of intentions.

PubMed

Rummel, Jan; Einstein, Gilles O; Rampey, Hilary

2012-01-01

Although forming implementation intentions (Gollwitzer, 1999) has been demonstrated to generally improve prospective memory, the underlying cognitive mechanisms are not completely understood. It has been proposed that implementation-intention encoding encourages spontaneous retrieval (McDaniel & Scullin, 2010). Alternatively one could assume the positive effect of implementation-intention encoding is caused by increased or more efficient monitoring for target cues. To test these alternative explanations and to further investigate the cognitive mechanisms underlying implementation-intention benefits, in two experiments participants formed the intention to respond to specific target cues in a lexical decision task with a special key, but then had to suspend this intention during an intervening word-categorisation task. Response times on trials directly following the occurrence of target cues in the intervening task were significantly slower with implementation-intention encoding than with standard encoding, indicating that spontaneous retrieval was increased (Experiment 1). However, when activation of the target cues was controlled for, similar slowing was found with both standard and implementation-intention encoding (Experiment 2). The results imply that implementation-intention encoding as well as increased target-cue activation foster spontaneous retrieval processes.

Evaluating the implementation process of a participatory organizational level occupational health intervention in schools.

PubMed

Schelvis, Roosmarijn M C; Wiezer, Noortje M; Blatter, Birgitte M; van Genabeek, Joost A G M; Oude Hengel, Karen M; Bohlmeijer, Ernst T; van der Beek, Allard J

2016-12-01

The importance of process evaluations in examining how and why interventions are (un) successful is increasingly recognized. Process evaluations mainly studied the implementation process and the quality of the implementation (fidelity). However, in adopting this approach for participatory organizational level occupational health interventions, important aspects such as context and participants perceptions are missing. Our objective was to systematically describe the implementation process of a participatory organizational level occupational health intervention aimed at reducing work stress and increasing vitality in two schools by applying a framework that covers aspects of the intervention and its implementation as well as the context and participants perceptions. A program theory was developed, describing the requirements for successful implementation. Each requirement was operationalized by making use of the framework, covering: initiation, communication, participation, fidelity, reach, communication, satisfaction, management support, targeting, delivery, exposure, culture, conditions, readiness for change and perceptions. The requirements were assessed by quantitative and qualitative data, collected at 12 and 24 months after baseline in both schools (questionnaire and interviews) or continuously (logbooks). The intervention consisted of a needs assessment phase and a phase of implementing intervention activities. The needs assessment phase was implemented successfully in school A, but not in school B where participation and readiness for change were insufficient. In the second phase, several intervention activities were implemented at school A, whereas this was only partly the case in school B (delivery). In both schools, however, participants felt not involved in the choice of intervention activities (targeting, participation, support), resulting in a negative perception of and only partial exposure to the intervention activities. Conditions, culture and

Clinical governance implementation in a selected teaching emergency department: a systems approach

PubMed Central

2012-01-01

Background Clinical governance (CG) is among the different frameworks proposed to improve the quality of healthcare. Iran, like many other countries, has put healthcare quality improvement in its top health policy priorities. In November 2009, implementation of CG became a task for all hospitals across the country. However, it has been a challenge to clarify the notion of CG and the way to implement it in Iran. The purpose of this action research study is to understand how CG can be defined and implemented in a selected teaching emergency department (ED). Methods/design We will use Soft Systems Methodology for both designing the study and inquiring into its content. As we considered a complex problem situation regarding the quality of care in the selected ED, we initially conceptualized CG as a cyclic set of purposeful activities designed to explore the situation and find relevant changes to improve the quality of care. Then, implementation of CG will conceptually be to carry out that set of purposeful activities. The activities will be about: understanding the situation and finding out relevant issues concerning the quality of care; exploring different stakeholders’ views and ideas about the situation and how it can be improved; and defining actions to improve the quality of care through structured debates and development of accommodations among stakeholders. We will flexibly use qualitative methods of data collection and analysis in the course of the study. To ensure the study rigor, we will use different strategies. Discussion Successful implementation of CG, like other quality improvement frameworks, requires special consideration of underlying complexities. We believe that addressing the complex situation and reflections on involvement in this action research will make it possible to understand the concept of CG and its implementation in the selected setting. By describing the context and executed flexible methods of implementation, the results of this study

Development and Validation of a Principal Implementation Practices Measure: The Principal Implementation Questionnaire

PubMed Central

Nettles, Stephen M.; Petscher, Yaacov

2015-01-01

Measurement of principal implementation behaviors has proved difficult to researchers in educational leadership due to a lack of consensus on the operational definitions of leadership constructs. The Principal Implementation Questionnaire (PIQ) was developed and validated with the intention of providing clarity in the assessment of principal leadership behaviors in the implementation of effective reading programs. Constructs were operationally defined within the context of the population of interest, with subsequent item writing centered around the constructs. A resulting calibration sample of principals from Florida Reading First schools was used to test the hypothesized measurement model to determine how well the items were described by the proposed factors. Results from LISREL analyses revealed a well-fitted model, based on numerous fit indices. PMID:26366043

Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study.

PubMed

Waltz, Thomas J; Powell, Byron J; Matthieu, Monica M; Damschroder, Laura J; Chinman, Matthew J; Smith, Jeffrey L; Proctor, Enola K; Kirchner, JoAnn E

2015-08-07

Poor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses. This inconsistency is also a barrier for those seeking guidance from the research literature when developing and planning implementation initiatives. The Expert Recommendations for Implementing Change (ERIC) study aims to address one area of terminological inconsistency: discrete implementation strategies involving one process or action used to support a practice change. The present report is on the second stage of the ERIC project that focuses on providing initial validation of the compilation of 73 implementation strategies that were identified in the first phase. Purposive sampling was used to recruit a panel of experts in implementation science and clinical practice (N = 35). These key stakeholders used concept mapping sorting and rating activities to place the 73 implementation strategies into similar groups and to rate each strategy's relative importance and feasibility. Multidimensional scaling analysis provided a quantitative representation of the relationships among the strategies, all but one of which were found to be conceptually distinct from the others. Hierarchical cluster analysis supported organizing the 73 strategies into 9 categories. The ratings data reflect those strategies identified as the most important and feasible. This study provides initial validation of the implementation strategies within the ERIC compilation as being conceptually distinct. The categorization and strategy ratings of importance and feasibility may facilitate the search for, and selection of, strategies that are best suited for implementation efforts in a particular setting.

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

PubMed

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

2016-08-25

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

Speed challenge: a case for hardware implementation in soft-computing

NASA Technical Reports Server (NTRS)

Daud, T.; Stoica, A.; Duong, T.; Keymeulen, D.; Zebulum, R.; Thomas, T.; Thakoor, A.

2000-01-01

For over a decade, JPL has been actively involved in soft computing research on theory, architecture, applications, and electronics hardware. The driving force in all our research activities, in addition to the potential enabling technology promise, has been creation of a niche that imparts orders of magnitude speed advantage by implementation in parallel processing hardware with algorithms made especially suitable for hardware implementation. We review our work on neural networks, fuzzy logic, and evolvable hardware with selected application examples requiring real time response capabilities.

From micro to macro: assessing implementation of integrated care in Australia.

PubMed

Angus, Lisa; Valentijn, Pim P

2018-03-01

Many countries and health systems are pursuing integrated care as a means of achieving better outcomes. However, no standard approaches exist for comparing integration approaches across models or settings, and for evaluating whether the key components of integrated care are present in different initiatives. This study sheds light on how integrated care is being implemented in Australia, using a new tool to characterise and compare integration strategies at micro, meso and macro levels. In total, 114 staff from a purposive sample of 38 integrated care projects completed a survey based on the Rainbow Model of Integrated Care. Ten key informants gave follow-up interviews. Participating projects reported using multiple strategies to implement integrated care, but descriptions of implementation were often inconsistent. Micro-level strategies, including clinical-professional service coordination and person-centred care, were most commonly reported. A common vision was often described as an essential foundation for joint work. However, performance feedback appeared under-utilised, as did strategies requiring macro-level action such as data linkages or payment reform. The results suggest that current integrated care efforts are unevenly weighted towards micro-level strategies. Increased attention to macro-level strategies may be warranted in order to accelerate progress and sustain integrated care in Australia.

Toward fidelity between specification and implementation

NASA Technical Reports Server (NTRS)

Callahan, John R.; Montgomery, Todd L.; Morrison, Jeff; Wu, Yunqing

1994-01-01

This paper describes the methods used to specify and implement a complex communications protocol that provides reliable delivery of data in multicast-capable, packet-switching telecommunication networks. The protocol, called the Reliable Multicasting Protocol (RMP), was developed incrementally by two complementary teams using a combination of formal and informal techniques in an attempt to ensure the correctness of the protocol implementation. The first team, called the Design team, initially specified protocol requirements using a variant of SCR requirements tables and implemented a prototype solution. The second team, called the V&V team, developed a state model based on the requirements tables and derived test cases from these tables to exercise the implementation. In a series of iterative steps, the Design team added new functionality to the implementation while the V&V team kept the state model in fidelity with the implementation through testing. Test cases derived from state transition paths in the formal model formed the dialogue between teams during development and served as the vehicles for keeping the model and implementation in fidelity with each other. This paper describes our experiences in developing our process model, details of our approach, and some example problems found during the development of RMP.

Some Key Factors in Policy Implementation.

ERIC Educational Resources Information Center

Rowen, Henry

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

Implementation, adoption, and utility of family health history risk assessment in diverse care settings: evaluating implementation processes and impact with an implementation framework.

PubMed

Wu, R Ryanne; Myers, Rachel A; Sperber, Nina; Voils, Corrine I; Neuner, Joan; McCarty, Catherine A; Haller, Irina V; Harry, Melissa; Fulda, Kimberly G; Cross, Deanna; Dimmock, David; Rakhra-Burris, Teji; Buchanan, Adam H; Ginsburg, Geoffrey S; Orlando, Lori A

2018-06-06

This paper describes the implementation outcomes associated with integrating a family health history-based risk assessment and clinical decision support platform within primary care clinics at four diverse healthcare systems. A type III hybrid implementation-effectiveness trial. Uptake and implementation processes were evaluated using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. One hundred (58%) primary care providers and 2514 (7.8%) adult patients enrolled. Enrolled patients were 69% female, 22% minority, and 32% Medicare/Medicaid. Compared with their respective clinic's population, patient-participants were more likely to be female (69 vs. 59%), older (mean age 57 vs. 49), and Caucasian (88 vs. 69%) (all p values <0.001). Female (81.3% of females vs. 78.5% of males, p value = 0.018) and Caucasian (Caucasians 90.4% vs. minority 84.1%, p value = 0.02) patient-participants were more likely to complete the study once enrolled. Patient-participant survey responses indicated MeTree was easy to use (95%), and patient-participants would recommend it to family/friends (91%). Minorities and those with less education reported greatest benefit. Enrolled providers reflected demographics of underlying provider population. Family health history-based risk assessment can be effectively implemented in diverse primary care settings and can effectively engage patients and providers. Future research should focus on finding better ways to engage young adults, males, and minorities in preventive healthcare.

Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS).

PubMed

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

2014-10-23

Although the importance of the organizational environment for implementing evidence-based practices (EBP) has been widely recognized, there are limited options for measuring implementation climate in public sector health settings. The goal of this research was to develop and test a measure of EBP implementation climate that would both capture a broad range of issues important for effective EBP implementation and be of practical use to researchers and managers seeking to understand and improve the implementation of EBPs. Participants were 630 clinicians working in 128 work groups in 32 US-based mental health agencies. Items to measure climate for EBP implementation were developed based on past literature on implementation climate and other strategic climates and in consultation with experts on the implementation of EBPs in mental health settings. The sample was randomly split at the work group level of analysis; half of the sample was used for exploratory factor analysis (EFA), and the other half was used for confirmatory factor analysis (CFA). The entire sample was utilized for additional analyses assessing the reliability, support for level of aggregation, and construct-based evidence of validity. The EFA resulted in a final factor structure of six dimensions for the Implementation Climate Scale (ICS): 1) focus on EBP, 2) educational support for EBP, 3) recognition for EBP, 4) rewards for EBP, 5) selection for EBP, and 6) selection for openness. This structure was supported in the other half of the sample using CFA. Additional analyses supported the reliability and construct-based evidence of validity for the ICS, as well as the aggregation of the measure to the work group level. The ICS is a very brief (18 item) and pragmatic measure of a strategic climate for EBP implementation. It captures six dimensions of the organizational context that indicate to employees the extent to which their organization prioritizes and values the successful implementation of EBPs

Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation.

PubMed

Padek, Margaret; Allen, Peg; Erwin, Paul C; Franco, Melissa; Hammond, Ross A; Heuberger, Benjamin; Kasman, Matt; Luke, Doug A; Mazzucca, Stephanie; Moreland-Russell, Sarah; Brownson, Ross C

2018-03-23

Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes. This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation. This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with

The Potential of Religion in the Promotion and Implementation of the Concept of Sustainable Development

NASA Astrophysics Data System (ADS)

Sadowski, Ryszard F.

2017-12-01

This article presents religion's potential where the promotion and implementation of the concept of sustainable development are concerned. First inspired by Lynn White in the 1960s, discussion on religion's role in the ecological crisis now allows for an honest assessment of the ecological potential of various religious traditions and their contribution to the building of a sustainable world. This article on the one hand points to the religious inspirations behind the concept of sustainable development, and on the other highlights the joint action of representatives of religion and science in the name of sustainable development, as well as the involvement of religions in the concept's implementation.

Implementation of electronic medical records

PubMed Central

Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

2011-01-01

Abstract Objective To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario’s pay-for-performance program. Design Prospective double-cohort study. Participants Twenty-seven community-based family physicians. Setting Toronto, Ont. Intervention Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records. Main outcome measure Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation. Results After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval −2.8 to 3.9). Conclusion When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied. PMID:21998246

Implementing multiple intervention strategies in Dutch public health-related policy networks.

PubMed

Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

2017-10-13

Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to implement an intervention mix. Data were collected (2009-14) from 29 Dutch public health policy networks. Surveys were used to identify the number of policy sectors, participation of actors, level of trust, networking by the project leader, and intervention strategies implemented. Conditions sufficient for an intervention mix (≥3 of 4 non-educational strategies present) were determined in a fuzzy-set qualitative comparative analysis. A multisectoral policy network (≥7 of 14 sectors present) was neither a necessary nor a sufficient condition. In multisectoral networks, additionally required was either the active participation of network actors (≥50% actively involved) or active networking by the project leader (≥monthly contacts with network actors). In policy networks that included few sectors, a high level of trust (positive perceptions of each other's intentions) was needed-in the absence though of any of the other conditions. If the network actors were also actively involved, an extra requirement was active networking by the project leader. We conclude that the multisectoral composition of policy networks can contribute to the implementation of a variety of intervention strategies, but not without additional efforts. However, policy networks that include only few sectors are also able to implement an intervention mix. Here, trust seems to be the most important condition. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A conceptual framework for implementation fidelity

PubMed Central

Carroll, Christopher; Patterson, Malcolm; Wood, Stephen; Booth, Andrew; Rick, Jo; Balain, Shashi

2007-01-01

Background Implementation fidelity refers to the degree to which an intervention or programme is delivered as intended. Only by understanding and measuring whether an intervention has been implemented with fidelity can researchers and practitioners gain a better understanding of how and why an intervention works, and the extent to which outcomes can be improved. Discussion The authors undertook a critical review of existing conceptualisations of implementation fidelity and developed a new conceptual framework for understanding and measuring the process. The resulting theoretical framework requires testing by empirical research. Summary Implementation fidelity is an important source of variation affecting the credibility and utility of research. The conceptual framework presented here offers a means for measuring this variable and understanding its place in the process of intervention implementation. PMID:18053122

Implementing the virtual reality learning environment: Second Life.

PubMed

Schmidt, Bonnie; Stewart, Stephanie

2009-01-01

Today, faculty members are challenged to find meaningful learning activities that enhance online nursing education. Second Life is an innovative Internet-based strategy that may be used to engage students in active learning. The authors discuss how this technology was implemented into an accelerated online nursing program.

Effective Implementation of a Comprehension-Improvement Approach in Secondary Schools. Summary.

ERIC Educational Resources Information Center

Levine, Daniel U.; Sherk, John K.

This document summarizes a report on the implementation and impact of instructional strategies to improve students' comprehension skills at three diverse urban secondary schools. While activities and characteristics varied, educators at all three locations were implementing local variations of a school-improvement approach based on the use of the…

Implementation research: a mentoring programme to improve laboratory quality in Cambodia

PubMed Central

Voeurng, Vireak; Sek, Sophat; Song, Sophanna; Vong, Nora; Tous, Chansamrach; Flandin, Jean-Frederic; Confer, Deborah; Costa, Alexandre; Martin, Robert

2016-01-01

Abstract Objective To implement a mentored laboratory quality stepwise implementation (LQSI) programme to strengthen the quality and capacity of Cambodian hospital laboratories. Methods We recruited four laboratory technicians to be mentors and trained them in mentoring skills, laboratory quality management practices and international standard organization (ISO) 15189 requirements for medical laboratories. Separately, we trained staff from 12 referral hospital laboratories in laboratory quality management systems followed by tri-weekly in-person mentoring on quality management systems implementation using the LQSI tool, which is aligned with the ISO 15189 standard. The tool was adapted from a web-based resource into a software-based spreadsheet checklist, which includes a detailed action plan and can be used to qualitatively monitor each laboratory’s progress. The tool – translated into Khmer – included a set of quality improvement activities grouped into four phases for implementation with increasing complexity. Project staff reviewed the laboratories’ progress and challenges in weekly conference calls and bi-monthly meetings with focal points of the health ministry, participating laboratories and local partners. We present the achievements in implementation from September 2014 to March 2016. Findings As of March 2016, the 12 laboratories have completed 74–90% of the 104 activities in phase 1, 53–78% of the 178 activities in phase 2, and 18–26% of the 129 activities in phase 3. Conclusion Regular on-site mentoring of laboratories using a detailed action plan in the local language allows staff to learn concepts of quality management system and learn on the job without disruption to laboratory service provision. PMID:27843164

Implementation-effectiveness trial of an ecological intervention for physical activity in ethnically diverse low income senior centers.

PubMed

Rich, Porchia; Aarons, Gregory A; Takemoto, Michelle; Cardenas, Veronica; Crist, Katie; Bolling, Khalisa; Lewars, Brittany; Sweet, Cynthia Castro; Natarajan, Loki; Shi, Yuyan; Full, Kelsie M; Johnson, Eileen; Rosenberg, Dori E; Whitt-Glover, Melicia; Marcus, Bess; Kerr, Jacqueline

2017-07-18

As the US population ages, there is an increasing need for evidence based, peer-led physical activity programs, particularly in ethnically diverse, low income senior centers where access is limited. The Peer Empowerment Program 4 Physical Activity' (PEP4PA) is a hybrid Type II implementation-effectiveness trial that is a peer-led physical activity (PA) intervention based on the ecological model of behavior change. The initial phase is a cluster randomized control trial randomized to either a peer-led PA intervention or usual center programming. After 18 months, the intervention sites are further randomized to continued support or no support for another 6 months. This study will be conducted at twelve senior centers in San Diego County in low income, diverse communities. In the intervention sites, 24 peer health coaches and 408 adults, aged 50 years and older, are invited to participate. Peer health coaches receive training and support and utilize a tablet computer for delivery and tracking. There are several levels of intervention. Individual components include pedometers, step goals, counseling, and feedback charts. Interpersonal components include group walks, group sharing and health tips, and monthly celebrations. Community components include review of PA resources, walkability audit, sustainability plan, and streetscape improvements. The primary outcome of interest is intensity and location of PA minutes per day, measured every 6 months by wrist and hip accelerometers and GPS devices. Secondary outcomes include blood pressure, physical, cognitive, and emotional functioning. Implementation measures include appropriateness & acceptability (perceived and actual fit), adoption & penetration (reach), fidelity (quantity & quality of intervention delivered), acceptability (satisfaction), costs, and sustainability. Using a peer led implementation strategy to deliver a multi-level community based PA program can enhance program adoption, implementation, and

Policy Implementation: Implications for Evaluation

ERIC Educational Resources Information Center

DeGroff, Amy; Cargo, Margaret

2009-01-01

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

Factors Influencing Implementation of a Preschool-Based Physical Activity Intervention

ERIC Educational Resources Information Center

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

2017-01-01

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

76 FR 2293 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota; Gopher Resource, LLC

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-13

... the Minnesota Pollution Control Agency (MPCA) on July 29, 2010, to revise the Minnesota State Implementation Plan (SIP) for lead (Pb) under the Clean Air Act (CAA). The State has submitted a joint Title I... that the conditions laid out with the citation ``Title I Condition: SIP for Lead NAAQS'' replace an...

Using Teacher-Implemented Playground Interventions to Increase Engagement, Social Behaviors, and Physical Activity for Young Children with Autism

ERIC Educational Resources Information Center

Ledford, Jennifer R.; Lane, Justin D.; Shepley, Collin; Kroll, Sarah M.

2016-01-01

Children with autism have deficits in social communication and may engage in less moderate-to-vigorous physical activity (MVPA) than children without disabilities. In this study, a classroom teacher implemented two interventions in the context of an alternating treatments design. Physical activity, engagement, and social behaviors were monitored…

Rethinking Curriculum Implementation: Paradigms, Models, and Teachers' Work.

ERIC Educational Resources Information Center

Cho, Jeasik

The paper looks at traditional curriculum implementation strategies, claiming that they have been divided into two polarized perspectives: fidelity implementation and adaptive implementation. These two implementation perspectives have dominated contemporary curriculum textbooks. The paper suggests that curriculum implementation as a field of study…

Student Characteristics as Predictors of Teachers’ Implementation of a Kindergarten Readiness Program

PubMed Central

Voegler-Lee, Mary Ellen; Kupersmidt, Janis B.; Field, Samuel; Willoughby, Michael T.

2017-01-01

Recent years have seen increasing numbers of classroom-based interventions designed to enhance the school readiness of at-risk preschoolers. Even the most comprehensive, well-designed programs can suffer from limited effectiveness due to low-frequency implementation by teachers. The current study presents findings from the Building Bridges project (BB), an integrated program targeting school readiness in Head Start and low-income child care centers. Previous studies have reported the role of teacher-level and program-level characteristics in predicting teacher implementation of an intervention. The present study examines the role of student characteristics—language and math ability, social skills, and behavioral functioning—in predicting implementation exposure. These associations were examined in the context of program type (Head Start, child care) and intervention condition (consultation, no consultation). 88 classrooms (41 Head Start, 47 child care) participated in the BB intervention. Implementation exposure was predicted by several distinct student characteristics. Teachers whose students exhibited poorer language skills implemented significantly more BB activities, a finding that was consistent across program types and intervention conditions. A marginally significant trend was identified for oppositional behavior when interacted with intervention group in that teachers whose students demonstrated higher rates of oppositional behavior implemented fewer intervention activities when they did not have a consultant. Teachers in child care centers with a BB consultant had higher rates of implementation than did teachers in all other groups. These findings provide important information regarding the student-level characteristics that should be evaluated in order to optimize implementation of an intervention. PMID:22615022

An abstract class loader for the SSP and its implementation in TL.

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

Wickstrom, Gregory Lloyd; Winter, Victor Lono; Fraij, Fares

2004-08-01

The SSP is a hardware implementation of a subset of the JVM for use in high consequence embedded applications. In this context, a majority of the activities belonging to class loading, as it is defined in the specification of the JVM, can be performed statically. Static class loading has the net result of dramatically simplifying the design of the SSP as well as increasing its performance. Due to the high consequence nature of its applications, strong evidence must be provided that all aspects of the SSP have been implemented correctly. This includes the class loader. This article explores the possibilitymore » of formally verifying a class loader for the SSP implemented in the strategic programming language TL. Specifically, an implementation of the core activities of an abstract class loader is presented and its verification in ACL2 is considered.« less

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.

Critical stakeholder determinants to the implementation of intersectoral community approaches targeting childhood obesity.

PubMed

van der Kleij, R M J J; Crone, M R; Reis, R; Paulussen, T G W M

2016-12-01

Several intersectoral community approaches targeting childhood obesity (IACOs) have been launched in the Netherlands. Translation of these approaches into practice is however arduous and implementation. We therefore studied the implementation of five IACOs in the Netherlands for one-and-a-half years. IACO implementation was evaluated via an adapted version of the MIDI questionnaire, consisting of 18 theory-based constructs. A response rate of 62% was obtained. A hierarchical multivariate linear regression model was used to analyse our data; the final regression model predicted 65% of the variance in adherence. Higher levels of self-efficacy, being an implementer embedded in community B, and having more than 1 year of experience with IACO implementation were associated with higher degrees of adherence. Formal ratification of implementation by management and being prescribed a higher number of activities were related to lower degrees of adherence. We advise that, when designing implementation strategies, emphasis should be placed on the enhancement of professionals' self-efficacy, limitation of the number of activities prescribed and allocation of sufficient time to get acquainted and experienced with IACO implementation. Longitudinal studies are needed to further evaluate interaction between and change within critical determinants while progressing through the innovation process. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

14 CFR § 1232.105 - Implementation procedures by NASA field installations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Implementation procedures by NASA field... ADMINISTRATION CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES (Eff. until 2-14-14) § 1232.105 Implementation procedures by NASA field installations. (a) Proposal Information. The information required for...

40 CFR 6.406 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS Assessing the Environmental Effects Abroad of EPA Actions § 6.406 Implementation. (a) Oversight. OFA is responsible for...

47 CFR 213.8 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Implementation. 213.8 Section 213.8 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL GOVERNMENT AND PUBLIC CORRESPONDENCE TELECOMMUNICATIONS PRECEDENCE SYSTEM § 213.8 Implementation. Federal departments and agencies are...

47 CFR 213.8 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Implementation. 213.8 Section 213.8 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL GOVERNMENT AND PUBLIC CORRESPONDENCE TELECOMMUNICATIONS PRECEDENCE SYSTEM § 213.8 Implementation. Federal departments and agencies are...

47 CFR 213.8 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Implementation. 213.8 Section 213.8 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL GOVERNMENT AND PUBLIC CORRESPONDENCE TELECOMMUNICATIONS PRECEDENCE SYSTEM § 213.8 Implementation. Federal departments and agencies are...

47 CFR 213.8 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Implementation. 213.8 Section 213.8 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL GOVERNMENT AND PUBLIC CORRESPONDENCE TELECOMMUNICATIONS PRECEDENCE SYSTEM § 213.8 Implementation. Federal departments and agencies are...

47 CFR 213.8 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Implementation. 213.8 Section 213.8 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL GOVERNMENT AND PUBLIC CORRESPONDENCE TELECOMMUNICATIONS PRECEDENCE SYSTEM § 213.8 Implementation. Federal departments and agencies are...

7 CFR 1580.601 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Implementation. 1580.601 Section 1580.601 Agriculture Regulations of the Department of Agriculture (Continued) FOREIGN AGRICULTURAL SERVICE, DEPARTMENT OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.601 Implementation. Trade adjustment assistance is...

5 CFR 731.102 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Implementation. 731.102 Section 731.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Scope § 731.102 Implementation. (a) An investigation conducted for the purpose of determining...

5 CFR 731.102 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Implementation. 731.102 Section 731.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Scope § 731.102 Implementation. (a) An investigation conducted for the purpose of determining...

5 CFR 731.102 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Implementation. 731.102 Section 731.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Scope § 731.102 Implementation. (a) An investigation conducted for the purpose of determining...

5 CFR 731.102 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Implementation. 731.102 Section 731.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Scope § 731.102 Implementation. (a) An investigation conducted for the purpose of determining...

5 CFR 731.102 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Implementation. 731.102 Section 731.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Scope § 731.102 Implementation. (a) An investigation conducted for the purpose of determining...

41 CFR 109-27.102-52 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... initial feasibility study for the implementation of systems contracting shall perform such a study for selected commodity groups. The study may be accomplished over a period of time, until all commodity groups have been considered. The study should address functional requirements, activity levels of commodity...

Retrospective evaluation of factors that influence the implementation of CATCH in southern Illinois schools.

PubMed

Bice, Matthew R; Brown, Stephen L; Parry, Thomas

2014-09-01

Coordinated Approach to Child Health (CATCH) is a school health program implemented in southern Illinois that focuses on physical activity and nutrition and consists of a classroom curriculum, physical education framework, and cafeteria guidelines. Though many schools agreed to implement CATCH, some schools implemented it better than others. This study examined implementation practices of classroom and physical education teachers and cafeteria supervisors. We surveyed 284 school employees at 36 elementary schools located in southern Illinois. Attention focused on organizational readiness, commitment to change, school leadership, implementation barriers, and innovation perceptions concerning degree of implementation of CATCH. Organizational readiness and implementation barriers were significant predictors of degree of implementation for school employees. Additionally, organizational readiness was reported a significant predictor of classroom teacher degree of implementation whereas leadership was a significant predictor of degree of implementation by physical education teachers. Data from this study can be used to enhance implementation of CATCH as well as other school health programs. This study provides educators evidence of why school employees have different implementation practices, evidence of what constructs influence degree of implementation most, and some explanation of school employee degree of implementation. © 2014 Society for Public Health Education.

Implementing newborn mock codes.

PubMed

Blakely, Teresa Gail

2007-01-01

This article describes the implementation of a newborn mock code program. Although the Neonatal Resuscitation Program (NRP) is one of the most widely used health education programs in the world and is required for most hospital providers who attend deliveries, research tells us that retention of NRP skills deteriorates rapidly after completion of the course. NRP requires coordination and cooperation among all providers; however, a lack of leadership and teamwork during resuscitation (often associated with a lack of confidence) has been noted. Implementation of newborn mock code scenarios can encourage teamwork, communication, skills building, and increased confidence levels of providers. Mock codes can help providers become strong team members and team leaders by helping them be better prepared for serious situations in the delivery room. Implementation of newborn mock codes can be effectively accomplished with appropriate planning and consideration for adult learning behaviors.

Development and Implementation of a Video-Based Physical Activity Preference Assessment for Children with Autism and Their Parents

ERIC Educational Resources Information Center

Sankovich, Lena

2013-01-01

Development and Implementation of a Video-Based Physical Activity Preference Assessment for Children with Autism and Their Parents Individuals with autism often lack the necessary motivation to engage in physical activity. In addition, due to the characteristics defining autism, such as deficits in social skills, motor coordination, and behavior,…

23 CFR 630.1014 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1014 Implementation. Each State shall work in partnership with the FHWA in the implementation of its policies and procedures to improve work zone safety and...

23 CFR 630.1014 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1014 Implementation. Each State shall work in partnership with the FHWA in the implementation of its policies and procedures to improve work zone safety and...

23 CFR 630.1014 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1014 Implementation. Each State shall work in partnership with the FHWA in the implementation of its policies and procedures to improve work zone safety and...

23 CFR 630.1014 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1014 Implementation. Each State shall work in partnership with the FHWA in the implementation of its policies and procedures to improve work zone safety and...

Implementation of an Automated System.

ERIC Educational Resources Information Center

Epstein, Susan Baerg

1983-01-01

Discussion of care and planning given to the implementation of an automated library system highlights informing the staff in the early stages, project management, involvement of the entire staff, the control log, time and money, where and when to go online, and implementation consultants. (EJS)

Secret Key Crypto Implementations

NASA Astrophysics Data System (ADS)

Bertoni, Guido Marco; Melzani, Filippo

This chapter presents the algorithm selected in 2001 as the Advanced Encryption Standard. This algorithm is the base for implementing security and privacy based on symmetric key solutions in almost all new applications. Secret key algorithms are used in combination with modes of operation to provide different security properties. The most used modes of operation are presented in this chapter. Finally an overview of the different techniques of software and hardware implementations is given.

Evaluating the implementation of "managing the risk of suicide: a suicide prevention strategy for the ACT 2009-2014".

PubMed

Sheehan, Johann; Griffiths, Kathleen; Rickwood, Debra; Carron-Arthur, Bradley

2015-01-01

Over the past two decades, governments have invested significantly in policies and strategies to prevent the tragic loss of life to suicide. However, there has been little focus on evaluating the implementation of such policies. This paper reports on the evaluation of the implementation of "Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009-2014," the Australian Capital Territory's (ACT) suicide prevention strategy. We sought to answer two questions: (1) Could agencies provide data reporting on their progress in implementing the activities for which they were responsible?; and (2) Could a judgment about implementation progress be made and, if so, to what extent was the activity implemented? Individually tailored electronic surveys were sent to 18 ACT agencies annually over 4 years to measure their progress in implementing activities for which they had responsibility. By year four, full data were provided for 64% of activities, maximal partial data for 9%, and minimal partial data for 27%. Forty-two per cent of activities were fully implemented, 20% were partially implemented, and 38% were not implemented or could not be measured. It is possible to measure implementation of suicide prevention strategies, but appropriate processes and dedicated resources must be in place at the outset.

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...

Development and implementation of a writing program to improve resident authorship rates.

PubMed

Clemmons, Amber Bradley; Hoge, Stephanie C; Cribb, Ashley; Manasco, Kalen B

2015-09-01

The development, implementation, and evaluation of a writing program with a formalized writing project as a component of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residencies are described. The writing program at Georgia Regents Medical Center/University of Georgia College of Pharmacy, a collaborative and jointly funded program, was initiated in the 2010-11 residency year. The goals of the program are to teach residents to communicate effectively, apply leadership skills, employ project management skills, and provide medication- and practice- related education and training. The program combines both writing experiences and mentorship. At the beginning of the residency year, trainees are presented with opportunities to participate in both research projects and writing projects. Specifically, opportunities within the writing program include involvement in review articles, case reports, drug information rounds, book chapters, letters to the editor, and high-quality medication-use evaluations for potential publication. The writing project is highly encouraged, and completion of a manuscript to be submitted for publication is expected by graduation. Nine papers were published by 8 of 18 PGY1 and PGY2 residents in the four years before program implementation. A total of 23 publications were published by 18 (72%) of the 25 PGY1 and PGY2 residents in the four years after implementation of the writing program. Implementation of a formal writing program increased the overall publication rate of residents. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

14 CFR § 1232.104 - Implementation procedures by non-NASA institutions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Implementation procedures by non-NASA... ADMINISTRATION CARE AND USE OF ANIMALS IN THE CONDUCT OF NASA ACTIVITIES (Eff. until 2-14-14) § 1232.104 Implementation procedures by non-NASA institutions. (a) Proposal Information. No animal subjects may be utilized...

Control designs for low-loss active magnetic bearings: Theory and implementation

NASA Astrophysics Data System (ADS)

Wilson, Brian Christopher David

Active Magnetic Bearings (AMB) have been proposed for use in Electromechanical Flywheel Batteries. In these devices, kinetic energy is stored in a magnetically levitated flywheel which spins in a vacuum. The AMB eliminates all mechanical losses, however, electrical loss, which is proportional to the square of the magnetic flux, is still significant. For efficient operation, the flux bias, which is typically introduced into the electromagnets to improve the AMB stiffness, must be reduced, preferably to zero. This zero-bias (ZB) mode of operation cripples the classical control techniques which are customarily used and nonlinear control is required. As a compromise between AMB stiffness and efficiency, a new flux bias scheme is proposed called the generalized complementary flux condition (gcfc). A flux-bias dependent trade-off exists between AMB stiffness, power consumption, and power loss. This work theoretically develops and experimentally verifies new low-loss AMB control designs which employ the gcfc condition. Particular attention is paid to the removal of the singularity present in the standard nonlinear control techniques when operating in ZB. Experimental verification is conduced on a 6-DOF AMB reaction wheel. Practical aspects of the gcfc implementation such as flux measurement and flux-bias implementation with voltage mode amplifiers using IR compensation are investigated. Comparisons are made between the gcfc bias technique and the standard constant-flux-sum (cfs) bias method. Under typical operating circumstances, theoretical analysis and experimental data show that the new gcfc bias scheme is more efficient in producing the control flux required for rotor stabilization than the ordinary cfs bias strategy.

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

PubMed

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

2018-05-10

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

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

Implementation of Health Insurance Support Tools in Community Health Centers.

PubMed

Huguet, Nathalie; Hatch, Brigit; Sumic, Aleksandra; Tillotson, Carrie; Hicks, Elizabeth; Nelson, Joan; DeVoe, Jennifer E

2018-01-01

Health information technology (HIT) provides new opportunities for primary care clinics to support patients with health insurance enrollment and maintenance. We present strategies, early findings, and clinic reflections on the development and implementation of HIT tools designed to streamline and improve health insurance tracking at community health centers. We are conducting a hybrid implementation-effectiveness trial to assess novel health insurance enrollment and support tools in primary care clinics. Twenty-three clinics in 7 health centers from the OCHIN practice-based research network are participating in the implementation component of the trial. Participating health centers were randomized to 1 of 2 levels of implementation support, including arm 1 (n = 4 health centers, 11 clinic sites) that received HIT tools and educational materials and arm 2 (n = 3 health centers, 12 clinic sites) that received HIT tools, educational materials, and individualized implementation support with a practice coach. We used mixed-methods (qualitative and quantitative) to assess tool use rates and facilitators and barriers to implementation in the first 6 months. Clinics reported favorable attitudes toward the HIT tools, which replace less efficient and more cumbersome processes, and reflect on the importance of clinic engagement in tool development and refinement. Five of 7 health centers are now regularly using the tools and are actively working to increase tool use. Six months after formal implementation, arm 2 clinics demonstrated higher rates of tool use, compared with arm 1. These results highlight the value of early clinic input in tool development, the potential benefit of practice coaching during HIT tool development and implementation, and a novel method for coupling a hybrid implementation-effectiveness design with principles of improvement science in primary care research. © Copyright 2018 by the American Board of Family Medicine.

Homework in Physical Education: Benefits and Implementation

ERIC Educational Resources Information Center

Novak, Benjamin Edward; Lynott, Francis John, III.

2015-01-01

This article identifies homework as an underutilized strategy in physical education. It reviews the benefits associated with the use of homework in the physical education setting, and provides guidelines for the effective implementation of this strategy. The guidelines include practical application examples and define structured active homework…

10 CFR 35.10 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Implementation. 35.10 Section 35.10 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL General Information § 35.10 Implementation. (a) A Government agency or a Federally recognized Indian Tribe that possesses and uses accelerator-produced...

Active Control of Mixing and Combustion, from Mechanisms to Implementation

NASA Astrophysics Data System (ADS)

Ghoniem, Ahmed F.

2001-11-01

Implementation of active control in complex processes, of the type encountered in high Reynolds number mixing and combustion, is predicated upon the identification of the underlying mechanisms and the construction of reduced order models that capture their essential characteristics. The mechanisms of interest must be shown to be amenable to external actuations, allowing optimal control strategies to exploit the delicate interactions that lead to the desired outcome. Reduced order models are utilized in defining the form and requisite attributes of actuation, its relationship to the monitoring system and the relevant control algorithms embedded in a feedforward or a feedback loop. The talk will review recent work on active control of mixing in combustion devices in which strong shear zones concur with mixing, combustion stabilization and flame anchoring. The underlying mechanisms, e.g., stability of shear flows, formation/evolution of large vortical structures in separating and swirling flows, their mutual interactions with acoustic fields, flame fronts and chemical kinetics, etc., are discussed in light of their key roles in mixing, burning enhancement/suppression, and combustion instability. Subtle attributes of combustion mechanisms are used to suggest the requisite control strategies.

28 CFR 19.6 - Responsibility of DOJ organizational units for program implementation and implementation procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... consent to use the photograph and biographical information. See 28 CFR 0.1, Organizational Structure of... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Responsibility of DOJ organizational... Responsibility of DOJ organizational units for program implementation and implementation procedures. (a) The...

Internet Protocol Implementation Guide.

DTIC Science & Technology

1982-08-01

RD-R153 624 INTERNET PROTOCOL IMPLEMENTATION GIDE(U) SRI 1/2 INTERNATIONAL MENLO PARK CA NETWORK INFORMATION CENTER AUG 82 DCA2e-83-C-8e25 N... INTERNET PROTOCOL S IMPLEMENTATION GUIDE August 1982 DTICFL. !.ECTE .-" MAY 1 31985 ;z B Q.. Network Information Center SRI International Menlo Park...this is more information than the receiving Internet * module needs. The specified procedure is to take the return route recorded in the first

14. Implementation, execution, and completion of projects.

PubMed

2014-05-01

Once an intervention has been selected for implementation, it becomes a project. Implementation of a project is a complex process and requires completion of a host of tasks. The implementation process has been deconstructed into its components so that it can be analysed and evaluated. A prerequisite for implementation is an operational plan. The tasks that require completion include: (1) reassessing current status and verifying the needs; (2) activating the operational plan; (3) setting-up and operating an administrative structure; (4) identifying, acquiring, and organising resources (including human resources); (5) assigning roles and responsibilities; (6) educating and training personnel (including mission-specific); (7) briefing staff; (8) preparing/readying resources for transport; (9) assuring project self-sufficiency; (10) arranging for personal necessities; (11) ensuring the safety of personnel and the security of equipment and supplies; (12) insuring personnel; (13) coordinating with other projects/actors; (14) coordinating with other BSF systems (role of the coordination and control centre); (15) communicating with community leaders; (16) initiating the use of standardised progress reports; (17) deploying personnel, equipment, and supplies; (18) initiating the intervention(s); (19) executing the intervention(s); (20) reporting start of interventions; (21) completing the project; and (22) completing and submitting a formal report. This deconstruction is essential in order to study the process and identify critical points of success and failure. It also is recognised that many interventions consist of many components (subfunctions), each of which may be considered a production process.

Modeling of enterprise information systems implementation: a preliminary investigation

NASA Astrophysics Data System (ADS)

Yusuf, Yahaya Y.; Abthorpe, M. S.; Gunasekaran, Angappa; Al-Dabass, D.; Onuh, Spencer

2001-10-01

The business enterprise has never been in greater need of Agility and the current trend will continue unabated well into the future. It is now recognized that information system is both the foundation and a necessary condition for increased responsiveness. A successful implementation of Enterprise Resource Planning (ERP) can help a company to move towards delivering on its competitive objectives as it enables suppliers to reach out to customers beyond the borders of traditional market defined by geography. The cost of implementation, even when it is successful, could be significant. Bearing in mind the potential strategic benefits, it is important that the implementation project is managed effectively. To this end a project cost model against which to benchmark ongoing project expenditure versus activities completed has been proposed in this paper.

The implementation of quality management systems in hospitals: a comparison between three countries

PubMed Central

Wagner, C; Gulácsi, L; Takacs, E; Outinen, M

2006-01-01

Background Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient progress is being made and how this can be stimulated. The objective of the study was to investigate agreement and disparities in the implementation of QMS between The Netherlands, Hungary and Finland with respect to the evaluation model used and the national policy strategy of the three countries. Methods The study has a cross sectional design, based on measurements in 2000. Empirical data about QM-activities in hospitals were gathered by a self-administered questionnaire. The questionnaires were answered by the directors of the hospitals or the quality coordinators. The analyses are based on data from 101 hospitals in the Netherlands, 116 hospitals in Hungary and 59 hospitals in Finland. Outcome measures are the developmental stage of the Quality Management System (QMS), the development within five focal areas, and distinct QM-activities which were listed in the questionnaire. Results A mean of 22 QM-activities per hospital was found in the Netherlands and Finland versus 20 QM-activities in Hungarian hospitals. Only a small number of hospitals has already implemented a QMS (4% in The Netherlands,0% in Hungary and 3% in Finland). More hospitals in the Netherlands are concentrating on quality documents, whereas Finnish hospitals are concentrating on training in QM and guidelines. Cyclic quality improvement activities have been developed in the three countries, but in most hospitals the results were not used for improvements. All three countries pay hardly any attention to patient participation. Conclusion The study demonstrates that the implementation of QM-activities can be measured at national level and that differences between countries can be