NASA Astrophysics Data System (ADS)
Wee, B.; Car, N.; Percivall, G.; Allen, D.; Fitch, P. G.; Baumann, P.; Waldmann, H. C.
2014-12-01
The Belmont Forum E-Infrastructure and Data Management Cooperative Research Agreement (CRA) is designed to foster a global community to collaborate on e-infrastructure challenges. One of the deliverables is an implementation plan to address global data infrastructure interoperability challenges and align existing domestic and international capabilities. Work package three (WP3) of the CRA focuses on the harmonization of global data infrastructure for sharing environmental data. One of the subtasks under WP3 is the development of user scenarios that guide the development of applicable deliverables. This paper describes the proposed protocol for user scenario development. It enables the solicitation of user scenarios from a broad constituency, and exposes the mechanisms by which those solicitations are evaluated against requirements that map to the Belmont Challenge. The underlying principle of traceability forms the basis for a structured, requirements-driven approach resulting in work products amenable to trade-off analyses and objective prioritization. The protocol adopts the ISO Reference Model for Open Distributed Processing (RM-ODP) as a top level framework. User scenarios are developed within RM-ODP's "Enterprise Viewpoint". To harmonize with existing frameworks, the protocol utilizes the conceptual constructs of "scenarios", "use cases", "use case categories", and use case templates as adopted by recent GEOSS Architecture Implementation Project (AIP) deliverables and CSIRO's eReefs project. These constructs are encapsulated under the larger construct of "user scenarios". Once user scenarios are ranked by goodness-of-fit to the Belmont Challenge, secondary scoring metrics may be generated, like goodness-of-fit to FutureEarth science themes. The protocol also facilitates an assessment of the ease of implementing given user scenario using existing GEOSS AIP deliverables. In summary, the protocol results in a traceability graph that can be extended to coordinate across research programmes. If implemented using appropriate technologies and harmonized with existing ontologies, this approach enables queries, sensitivity analyses, and visualization of complex relationships.
Blumenstein, I; Tacke, W; Filmann, N; Zosel, C; Bock, H; Heuzeroth, V; Zeuzem, S; Schröder, O
2013-07-01
In our previous studies investigating the drug therapy in patients suffering from inflammatory bowel disease (IBD) in the Rhein-Main region, Germany, we detected serious discrepancies between treatment reality and treatment guidelines. Consecutively, patient outcome in this cohort was compromised. Following this pilot project a network between primary deliverers of care for IBD patients and one large health-care insurance company [BKK Taunus (Gesundheit), the second largest insurance company in Hessen, Germany] was established. An analysis of treatment and socioeconomic data from 220 IBD patients (Crohn's disease - CD = 96, ulcerative colitis - UC = 124) entering the integrative health-care programme between 1.1.-30.9.2009 was performed. Remission rates for CD and UC in the integrated health-care programme could be improved from 60 - 73 % (CD) and from 61 - 79 % (UC). Guideline-conform treatment was observed in 81 % of patients with CD and 85 % with UC, respectively. Although medication costs increased, total costs could be cut by 162 304.- €, as secondary costs for hospitalisation and days off work could be reduced. The study shows that networking of deliverers of care for IBD patients with health insurances provides an excellent possibility to optimise medical treatment and can cut down costs significantly. © Georg Thieme Verlag KG Stuttgart · New York.
20 CFR 638.300 - Eligibility for funds and eligible deliverers.
Code of Federal Regulations, 2010 CFR
2010-04-01
..., and Facilities Management § 638.300 Eligibility for funds and eligible deliverers. (a) Funds shall be... provision of Job Corps operational support services. (b) Eligible deliverers for the operation of centers and for the operational support services necessary to center operation shall be units of Federal...
Engineering and management experience at Texas A&M Transportation Institute
NASA Astrophysics Data System (ADS)
Chowdhury, Arif Tahjibul
This manuscript presents the author's engineering and management experience during his internship in the Materials and Pavements (M&P) Division at the Texas A&M Transportation Institute (TTI), and is a record of study for the Doctor of Engineering at Texas A&M University. Through this internship, he met his established internship objectives of gaining technical knowledge as well as knowledge and skills in project management, organizational communication, and quality management of pavement condition data, and of attaining professional development. In meeting these objectives, the author describes the history, mission, and organizational structure of his workplace. He also presents his experience of developing and delivering a two-week training course on pavement design and construction in Kosovo. Participating in a number of professional development training courses and other activities prepared him for working as an engineering manager. These activities include Delta-T leadership training, an instructor development course, a time management and organizational skills course, and the M&P Division lecture series. Leadership and skills learned through the Delta-T program were beneficial for the employee as well as the employer. For the class project, the author and his teammates performed a study dealing with improving TTI's deliverables. The Delta-T team composed a report summarizing their efforts of examining the current state of TTI's project deliverables, the deliverables' shortcomings, and potential enhancements to expand the deliverables' appeal to additional types of potential users outside the traditional research community. The team also developed a prototype web-based model of deliverables and presented some implementation recommendations. Participating in the Texas Department of Transportation's (TxDOT's) pavement surface distress data collection program enabled the author to become familiar with pavement distress data quality management and thus attain the technical and nontechnical skills required for project management. He noticed some areas for improvement in TxDOT's rater's manual, rater's training class, and acceptance criteria for visual distress data.
Effective Partnership Working in Music Education: Principles and Practice
ERIC Educational Resources Information Center
Hallam, Richard
2011-01-01
Successful partnerships between policy makers and deliverers, providers and recipients can be both strategic and operational. Partnerships can operate in several different ways at the same time. Joint programmes achieve more than each organization or individual can achieve separately. The impact on children and young people can be profound if the…
ERIC Educational Resources Information Center
Saigal, Anju
2012-01-01
Recent educational policy in India has repositioned elementary school teachers as active, reflective practitioners, not just "deliverers" of syllabus material. This article examines innovations in teacher support in Rajasthan's government schools through the "Quality Education Program." Drawing on qualitative research of…
ERIC Educational Resources Information Center
Yu, Wei
2013-01-01
This dissertation applied the quantitative approach to the data gathered from online survey questionnaires regarding the three objects: Information Technology (IT) Portfolio Management, IT-Business Alignment, and IT Project Deliverables. By studying this data, this dissertation uncovered the underlying relationships that exist between the…
Global engineering teams - a programme promoting teamwork in engineering design and manufacturing
NASA Astrophysics Data System (ADS)
Oladiran, M. T.; Uziak, J.; Eisenberg, M.; Scheffer, C.
2011-05-01
Engineering graduates are expected to possess various competencies categorised into hard and soft skills. The hard skills are acquired through specific coursework, but the soft skills are often treated perfunctorily. Global Engineering Teams (GET) is a programme that promotes project-oriented tasks in virtual student teams working in collaboration with industry partners. Teamwork is a major success factor for GET as students always work in groups of varying sizes. A questionnaire-based survey of the 2008 cohort of GET students was conducted to assess teamwork, communication and conflict resolution among group members. The results confirmed that deliverables are readily achieved in teams and communication was open. A challenge of using virtual teams is the availability of high-speed Internet access. The GET programme shows that it is possible to deliver engineering design and manufacturing via industry/university collaboration. The programme also facilitates multidisciplinary teamwork at an international level.
Using Education Technology as a Proactive Approach to Healthy Ageing.
Rodger, Daragh; Spencer, Anne; Hussey, Pamela
2016-01-01
Bone Health in the Park was created in Ireland and is an online health promotion education resource focussing on bone health, healthy ageing and falls prevention. The programme was designed by an Advanced Nurse Practitioner in collaboration with an Education Technologist and primarily uses storytelling to promote education specifically on bone health and falls risk prevention for health care professionals, clients, families and informal carers. This paper reports on core deliverables from this programme from 2010 to 2015, and provides insight into their development, in addition to details on its clinical effectiveness by using technology enhanced learning to underpin health promotion initiatives.
NASA Astrophysics Data System (ADS)
Johan, Kartina; Mohd Turan, Faiz
2016-11-01
Malaysian Engineering Accreditation (Engineering Programme Accreditation Manual, 2007) requires all bachelor degree in engineering programmes to incorporate a minimum of two months industrial training in order for the programme to be accredited by the council. The industrial training has the objective to provide students on the insights of being an engineer at the workplace hence increasing their knowledge in employability skills prior to graduation. However the current structure of industrial training is not able to inculcate good leadership ability and prepare students with sustainability competencies needed in the era of Sustainable Development (SD). This paper aims to study project management methodology as a framework to create a training pathway in industrial training for students in engineering programs using Green Project Management (GPM) P5 standard for sustainability in project management. The framework involves students as interns, supervisors from both university and industry and also participation from NonProfit Organisation (NPO). The framework focus on the development of the student's competency in employability skills, lean leadership and sustainability competencies using experiential learning approach. Deliverables of the framework include internship report, professional sustainability report using GPM P5 standard and competency assessment. The post-industrial phase of the framework is constructed for students to be assessed collaboratively by the university, industry and the sustainability practitioner in the country. The ability for the interns to act as a change agent in sustainability practices is measured by the competency assessment and the quality of the sustainability report. The framework support the call for developing holistic students based on Malaysian Education Blueprint (Higher Education) 2015-2025 and address the gap between the statuses of engineering qualification to the sustainability competencies in the 21st century in particular by achieving the Sustainability Graduates (SG) attributes outlined in the framework.
Managing Research in a Risk World
NASA Technical Reports Server (NTRS)
Anton, W.; Havenhill, M.
2014-01-01
The Office of Chief Medical Officer (OCHMO) owns all human health and performance risks managed by the Human System Risk Board (HSRB). While the HSRB manages the risks, the Human Research Program (HRP) manages the research portion of the overall risk mitigation strategy for these risks. The HSRB manages risks according to a process that identifies and analyzes risks, plans risk mitigation and tracks and reviews the implementation of these strategies according to its decisions pertaining to the OCHMO risk posture. HRP manages risk research work using an architecture that describes evidence-based risks, gaps in our knowledge about characterizing or mitigating the risk, and the tasks needed to produce deliverables to fill the gaps and reduce the risk. A planning schedule reflecting expected research milestones is developed, and as deliverables and new evidence are generated, research progress is tracked via the Path to Risk Reduction (PRR) that reflects a risk's research plan for a design reference mission. HRP's risk research process closely interfaces with the HSRB risk management process. As research progresses, new deliverables and evidence are used by the HSRB in conjunction with other operational and non-research evidence to inform decisions pertaining to the likelihood and consequence of the risk and risk posture. Those decisions in turn guide forward work for research as it contributes to overall risk mitigation strategies. As HRP tracks its research work, it aligns its priorities by assessing the effectiveness of its contributions and maintaining specific core competencies that would be invaluable for future work for exploration missions.
Managers Handbook for Software Development
NASA Technical Reports Server (NTRS)
Agresti, W.; Mcgarry, F.; Card, D.; Page, J.; Church, V.; Werking, R.
1984-01-01
Methods and aids for the management of software development projects are presented. The recommendations are based on analyses and experiences with flight dynamics software development. The management aspects of organizing the project, producing a development plan, estimation costs, scheduling, staffing, preparing deliverable documents, using management tools, monitoring the project, conducting reviews, auditing, testing, and certifying are described.
Preparing project managers for faster-better-cheaper robotic planetary missions
NASA Technical Reports Server (NTRS)
Gowler, P.; Atkins, K.
2003-01-01
The authors have developed and implemented a week-long workshop for Jet Propulsion Laboratory Project Managers, designed around the development phases of the JPL Project Life Cycle. The workshop emphasizes the specific activities and deliverables that pertain to JPL managers of NASA robotic space exploration and instrument development projects.
Computational discovery of metal-organic frameworks with high gas deliverable capacity
NASA Astrophysics Data System (ADS)
Bao, Yi
Metal-organic frameworks (MOFs) are a rapidly emerging class of nanoporous materials with largely tunable chemistry and diverse applications in gas storage, gas purification, catalysis, sensing and drug delivery. Efforts have been made to develop new MOFs with desirable properties both experimentally and computationally for decades. To guide experimental synthesis, we here develop a computational methodology to explore MOFs with high gas deliverable capacity. This de novo design procedure applies known chemical reactions, considers synthesizability and geometric requirements of organic linkers, and efficiently evolves a population of MOFs to optimize a desirable property. We identify 48 MOFs with higher methane deliverable capacity at 65-5.8 bar condition than the MOF-5 reference in nine networks. In a more comprehensive work, we predict two sets of MOFs with high methane deliverable capacity at a 65-5.8 bar loading-delivery condition or a 35-5.8 bar loading-delivery condition. We also optimize a set of MOFs with high methane accessible internal surface area to investigate the relationship between deliverable capacities and internal surface area. This methodology can be extended to MOFs with multiple types of linkers and multiple SBUs. Flexibile MOFs may allow for sophisticated heat management strategies and also provide higher gas deliverable capacity than rigid frameworks. We investigate flexible MOFs, such as MIL-53 families, and Fe(bdp) and Co(bdp) analogs, to understand the structural phase transition of frameworks and the resulting influence on heat of adsorption. Challenges of simulating a system with a flexible host structure and incoming guest molecules are discussed. Preliminary results from isotherm simulation using the hybrid MC/MD simulation scheme on MIL-53(Cr) are presented. Suggestions for proceeding to understand the free energy profile of flexible MOFs are provided.
Repository-Based Software Engineering (RBSE) program
NASA Technical Reports Server (NTRS)
1992-01-01
Support of a software engineering program was provided in the following areas: client/customer liaison; research representation/outreach; and program support management. Additionally, a list of deliverables is presented.
Highway project cost estimating and management.
DOT National Transportation Integrated Search
2009-02-01
"This report provides detailed information about the project objectives, deliverables, and findings. The project team : thoroughly reviewed the Montana Department of Transportation (MDT) structure, operations, and current procedures as : related to M...
Designing equitable workplace dietary interventions: perceptions of intervention deliverers.
Smith, Sarah A; Visram, Shelina; O'Malley, Claire; Summerbell, Carolyn; Araujo-Soares, Vera; Hillier-Brown, Frances; Lake, Amelia A
2017-10-16
Workplaces are a good setting for interventions that aim to support workers in achieving a healthier diet and body weight. However, little is known about the factors that impact on the feasibility and implementation of these interventions, and how these might vary by type of workplace and type of worker. The aim of this study was to explore the views of those involved in commissioning and delivering the Better Health at Work Award, an established and evidence-based workplace health improvement programme. One-to-one semi-structured interviews were conducted with 11 individuals in North East England who had some level of responsibility for delivering workplace dietary interventions. Interviews were transcribed verbatim and analysed using thematic framework analysis. A number of factors were felt to promote the feasibility and implementation of interventions. These included interventions that were cost-neutral (to employee and employer), unstructured, involved colleagues for support, took place at lunchtimes, and were well-advertised and communicated via a variety of media. Offering incentives, not necessarily monetary, was perceived to increase recruitment rates. Factors that militate against feasibility and implementation of interventions included worksites that were large in size and remote, working patterns including shifts and working outside of normal working hours that were not conducive to workers being able to access intervention sessions, workplaces without appropriate provision for healthy food on site, and a lack of support from management. Intervention deliverers perceived that workplace dietary interventions should be equally and easily accessible (in terms of cost and timing of sessions) for all staff, regardless of their job role. Additional effort should be taken to ensure those staff working outside normal working hours, and those working off-site, can easily engage with any intervention, to avoid the risk of intervention-generated inequalities (IGIs).
DOT National Transportation Integrated Search
1996-01-01
FAST-TRAC : SELECTING THE MOST APPROPRIATE TRAFFIC CONTROL STRATEGY FOR INCIDENT CONGESTION MANAGEMENT CAN HAVE A MAJOR IMPACT ON THE EXTENT AND DURATION OF THE RESULTING CONGESTION. THIS RESEARCH INVESTIGATED THE EFFECTIVENESSES OF SEVERAL CONTRO...
Manager's handbook for software development, revision 1
NASA Technical Reports Server (NTRS)
1990-01-01
Methods and aids for the management of software development projects are presented. The recommendations are based on analyses and experiences of the Software Engineering Laboratory (SEL) with flight dynamics software development. The management aspects of the following subjects are described: organizing the project, producing a development plan, estimating costs, scheduling, staffing, preparing deliverable documents, using management tools, monitoring the project, conducting reviews, auditing, testing, and certifying.
Vluggen, Tom P M M; van Haastregt, Jolanda C M; Verbunt, Jeanine A; Keijsers, Elly J M; Schols, Jos M G A
2012-12-31
Stroke is one of the major causes of loss of independence, decreased quality of life and mortality among elderly people. About half of the elderly stroke patients discharged after rehabilitation in a nursing home still experience serious impairments in daily functioning one year post stroke, which can lead to difficulties in picking up and managing their social life. The aim of this study is to evaluate the effectiveness and feasibility of a new multidisciplinary transmural rehabilitation programme for older stroke patients. A two group multicentre randomised controlled trial is used to evaluate the effects of the rehabilitation programme. The programme consists of three care modules: 1) neurorehabilitation treatment for elderly stroke patients; 2) empowerment training for patient and informal caregiver; and 3) stroke education for patient and informal caregiver. The total programme has a duration of between two and six months, depending on the individual problems of the patient and informal caregiver. The control group receives usual care in the nursing home and after discharge. Patients aged 65 years and over are eligible for study participation when they are admitted to a geriatric rehabilitation unit in a nursing home due to a recent stroke and are expected to be able to return to their original home environment after discharge. Data are gathered by face-to-face interviews, self-administered questionnaires, focus groups and registration forms. Primary outcomes for patients are activity level after stroke, functional dependence, perceived quality of life and social participation. Outcomes for informal caregivers are perceived care burden, objective care burden, quality of life and perceived health. Outcome measures of the process evaluation are implementation fidelity, programme deliverance and the opinion of the stroke professionals, patients and informal caregivers about the programme. Outcome measures of the economic evaluation are the healthcare utilisation and associated costs. Data are collected at baseline, and after six and 12 months. The first results of the study will be expected in 2014. International Standard Randomised Controlled Trial Register Number ISRCTN62286281, The Dutch Trial Register NTR2412.
A New Tool for Effective and Efficient Project Management
DOE Office of Scientific and Technical Information (OSTI.GOV)
Willett, Jesse A
2011-12-01
Organizations routinely handle thousands of projects per year, and it is difficult to manage all these projects concurrently. Too often, projects do not get the attention they need when they need it. Management inattention can lead to late projects or projects with less than desirable content and/or deliverables. This paper discusses the application of Visual Project Management (VPM) as a method to track and manage projects. The VPM approach proved to be a powerful management tool without the overhead and restrictions of traditional management methods.
Atkins, Salla; Marsden, Sophie; Diwan, Vishal; Zwarenstein, Merrick
2016-01-01
Background Research capacity enhancement is needed in low- and middle-income countries (LMICs) for improved health, wellbeing, and health systems’ development. In this article, we discuss two capacity-building projects, the African/Asian Regional Capacity Development (ARCADE) in Health Systems and Services Research (HSSR) and Research on Social Determinants of Health (RSDH), implemented from 2011 to 2015. The two projects focussed on providing courses in HSSR and social determinants of health research, and on developing collaborations between universities, along with capacity in LMIC universities to manage research grant submissions, financing, and reporting. Both face-to-face and sustainable online teaching and learning resources were used in training at higher postgraduate levels (Masters and Doctoral level). Design We collated project meeting and discussion minutes along with project periodic reports and deliverables. We extracted key outcomes from these, reflected on these in discussions, and summarised them for this paper. Results Nearly 55 courses and modules were developed that were delivered to over 920 postgraduate students in Africa, Asia, and Europe. Junior researchers were mentored in presenting, developing, and delivering courses, and in preparing research proposals. In total, 60 collaborative funding proposals were prepared. The consortia also developed institutional capacity in research dissemination and grants management through webinars and workshops. Discussion ARCADE HSSR and ARCADE RSDH were comprehensive programmes, focussing on developing the research skills, knowledge, and capabilities of junior researchers. One of the main strengths of these programmes was the focus on network building amongst the partner institutions, where each partner brought skills, expertise, and diverse work cultures into the consortium. Through these efforts, the projects improved both the capacity of junior researchers and the research environment in Africa, Asia, and Europe. PMID:27725081
Atkins, Salla; Marsden, Sophie; Diwan, Vishal; Zwarenstein, Merrick
2016-01-01
Research capacity enhancement is needed in low- and middle-income countries (LMICs) for improved health, wellbeing, and health systems' development. In this article, we discuss two capacity-building projects, the African/Asian Regional Capacity Development (ARCADE) in Health Systems and Services Research (HSSR) and Research on Social Determinants of Health (RSDH), implemented from 2011 to 2015. The two projects focussed on providing courses in HSSR and social determinants of health research, and on developing collaborations between universities, along with capacity in LMIC universities to manage research grant submissions, financing, and reporting. Both face-to-face and sustainable online teaching and learning resources were used in training at higher postgraduate levels (Masters and Doctoral level). We collated project meeting and discussion minutes along with project periodic reports and deliverables. We extracted key outcomes from these, reflected on these in discussions, and summarised them for this paper. Nearly 55 courses and modules were developed that were delivered to over 920 postgraduate students in Africa, Asia, and Europe. Junior researchers were mentored in presenting, developing, and delivering courses, and in preparing research proposals. In total, 60 collaborative funding proposals were prepared. The consortia also developed institutional capacity in research dissemination and grants management through webinars and workshops. ARCADE HSSR and ARCADE RSDH were comprehensive programmes, focussing on developing the research skills, knowledge, and capabilities of junior researchers. One of the main strengths of these programmes was the focus on network building amongst the partner institutions, where each partner brought skills, expertise, and diverse work cultures into the consortium. Through these efforts, the projects improved both the capacity of junior researchers and the research environment in Africa, Asia, and Europe.
O'Brien, James; Young, Warren; Finch, Caroline F
2017-01-01
Injury prevention exercise programmes for amateur soccer have gained considerable attention, but little is known about their relevance and adaptability to professional soccer settings. The first aim of this study was to evaluate the delivery and content of injury prevention exercise programmes used by professional youth soccer teams, compared to the industry standard injury prevention exercise programme for soccer, the Fédération Internationale de Football Association's FIFA 11+. The second aim was to document specific challenges to implementing injury prevention exercise programmes in this context. Prospective observational study. The participants were soccer coaches, fitness coaches and physiotherapists (n=18) from four teams in a professional youth soccer academy. Each team's chosen injury prevention exercise programmes were observed weekly across an entire soccer season (160 sessions). The delivery and content of the programmes were documented on a standardised worksheet and compared to the FIFA 11+. Specific implementation challenges were recorded. Fitness coaches were the primary deliverers of injury prevention exercise programmes, with support from physiotherapists. Multiple delivery formats and locations were employed, along with the extensive use of equipment. Across all injury prevention exercise programme sessions, a median of one FIFA 11+ exercise was performed in its original form and a further four in a modified form. Implementation challenges included poor staff communication, competing training priorities and heavy game schedules. Although the basic components of the FIFA 11+ hold relevance for professional youth male teams, the delivery and content of injury prevention exercise programmes require considerable tailoring for this context. Recognising this will inform the development of improved, context-specific injury prevention exercise programmes, along with corresponding strategies to enhance their implementation. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
DOT National Transportation Integrated Search
1998-04-01
The report documents the results of a study designed to test the effectiveness of ATMS and ATIS strategies to reduce delay resulting from an incident. The study had two main sections: a simulation study to test the effectiveness of several control st...
Developers and Deliverers: The Potential Dichotomy.
ERIC Educational Resources Information Center
Luoma-Overstreet, Kristine
1993-01-01
Examines the relationship between course developers and instructors in large corporations. Highlights include hiring practices for training department personnel; qualifications sought by the organization; self-report of competencies; separation of responsibilities; job frustrations; role of technology; and management's role in facilitating…
DOT National Transportation Integrated Search
1999-02-12
This report focuses on the system integration aspect of the Transportation Information Management System (TIMS), a component of the FAST-TRAC project. The TIMS functions as the center of a communications network which integrates advanced traffic cont...
Mytton, Julie A; Towner, Elizabeth Ml; Kendrick, Denise; Stewart-Brown, Sarah; Emond, Alan; Ingram, Jenny; Blair, Peter S; Powell, Jane; Mulvaney, Caroline; Thomas, James; Deave, Toity; Potter, Barbara
2014-02-01
Unintentional injury is the leading cause of preventable death in children in the UK, and 0-4-year-olds frequently attend emergency departments following injuries in the home. Parenting programmes designed to support parents, promote behaviour change and enhance parent-child relationships have been shown to improve health outcomes in children. It is not known whether group-based parenting programmes have the potential to prevent unintentional injuries in preschool children. A study to develop a group-based parenting programme to prevent unintentional home injuries in preschool children, and assess the feasibility of evaluation through a cluster-randomised controlled trial. The intervention, designed for parents of children who have sustained a medically attended injury, will be developed with two voluntary sector organisations. The feasibility study will assess ability to recruit parents, deliver the programme and follow-up participants. Participants will complete questionnaires at baseline, 3 months and 6 months, and report injuries in their preschool children using a tool designed and validated for this study. Qualitative methods will assess user and deliverer perceptions of the programme. This study will develop the first group-based parenting programme to prevent injuries in preschool children, and design tools for parent-reported injury outcomes. A key challenge will be to recruit parents to participate in a manner that is non-stigmatising, and does not result in feelings of guilt or belief that they are perceived to be a bad parent. The findings will be used to prepare a trial to assess the effectiveness and cost-effectiveness of the intervention.
DOT National Transportation Integrated Search
2005-09-30
The Altarum Institute, under contract to the Michigan Department of Transportation (MDOT), currently is engaged in a project called the Altarum Restricted Use Technology Study. This study, an 18-month effort, seeks to apply restricted use techn...
NASA Technical Reports Server (NTRS)
New, S. R.
1981-01-01
The multiplexer-demultiplexer (MDM) project included the design, documentation, manufacture, and testing of three MDM Data Systems. The equipment is contained in 59 racks, and includes more than 3,000 circuit boards and 600 microprocessors. Spares, circuit card testers, a master set of programmable integrated circuits, and a program development system were included as deliverables. All three MDM's were installed, and were operationally tested. The systems performed well with no major problems. The progress and problems analysis, addresses schedule conformance, new technology, items awaiting government approval, and project conclusions are summarized. All contract modifications are described.
NASA Astrophysics Data System (ADS)
New, S. R.
1981-06-01
The multiplexer-demultiplexer (MDM) project included the design, documentation, manufacture, and testing of three MDM Data Systems. The equipment is contained in 59 racks, and includes more than 3,000 circuit boards and 600 microprocessors. Spares, circuit card testers, a master set of programmable integrated circuits, and a program development system were included as deliverables. All three MDM's were installed, and were operationally tested. The systems performed well with no major problems. The progress and problems analysis, addresses schedule conformance, new technology, items awaiting government approval, and project conclusions are summarized. All contract modifications are described.
Benchmarking Peer Production Mechanisms, Processes & Practices
ERIC Educational Resources Information Center
Fischer, Thomas; Kretschmer, Thomas
2008-01-01
This deliverable identifies key approaches for quality management in peer production by benchmarking peer production practices and processes in other areas. (Contains 29 footnotes, 13 figures and 2 tables.)[This report has been authored with contributions of: Kaisa Honkonen-Ratinen, Matti Auvinen, David Riley, Jose Pinzon, Thomas Fischer, Thomas…
Automated Procurement System (APS) revised project management plan (DS-03)
NASA Technical Reports Server (NTRS)
Murphy, Diane R.
1995-01-01
The Project Plan is the governing document for the implementation of the Automated Procurement System (APS). It includes a description of the proposed system, describes the work to be done, establishes a schedule of deliverables, and discusses the major standards and procedures to be followed.
Project deliverables - a waste of time or a chance for knowledge transfer and dissemination?
NASA Astrophysics Data System (ADS)
Walter, Sylvia
2016-04-01
Deliverables are a common tool to measure a distinct output of a project. They should be meaningful in terms of the project's objectives and are normally constituted by e.g. a written report or document, a developed tool or software, an organized training or conference. They can be scientific or technical. The number of deliverables must be reasonable and commensurate to the project and its content. Deliverables as contractual obligations are often time consuming and often seen as a waste of "research" time, as one more administrative task without any use. However, deliverables are needed to verify the progress of a project and to convince the sponsor that the project is going in the right direction and the money well-invested. The presentation will deal with the question on how to use a deliverable in a profitable way for the project and what are the possibilities of use.
Definition, aims, and implementation of GA(2) LEN Urticaria Centers of Reference and Excellence.
Maurer, M; Metz, M; Bindslev-Jensen, C; Bousquet, J; Canonica, G W; Church, M K; Godse, K V; Grattan, C E; Hide, M; Kocatürk, E; Magerl, M; Makris, M; Meshkova, R; Saini, S S; Sussman, G; Toubi, E; Zhao, Z; Zuberbier, T; Gimenez-Arnau, A
2016-08-01
GA²LEN, the Global Allergy and Asthma European Network, has recently launched a program for the development, interaction, and accreditation of centers of reference and excellence in special areas of allergy embedded in its overall quality management of allergy centers of excellence. The first area chosen is urticaria. Urticaria is a common and debilitating condition and can be a challenge for both patients and treating physicians, especially when chronic. Centers of reference and excellence in urticaria (UCAREs) can help to improve the management of hard-to-treat conditions such as urticaria. Here, we describe the aims, the requirements and deliverables, the application process, and the audit and accreditation protocol for GA²LEN UCAREs. The main aims of GA²LEN UCAREs are to provide excellence in urticaria management, to increase the knowledge of urticaria by research and education, and to promote the awareness of urticaria by advocacy activities. To become a certified GA²LEN UCARE, urticaria centers have to apply and fulfill 32 requirements, defined by specific deliverables that are assessed during an audit visit. The GA²LEN UCARE program will result in a strong network of urticaria specialists, promote urticaria research, and harmonize and improve urticaria management globally. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
UAS Integration in the NAS Project Test Site Kick-off Meeting
NASA Technical Reports Server (NTRS)
Kopardekar, Parimal; Witzberger, Kevin; Hackenberg, Davis L.; Murphy, Jim
2015-01-01
This briefing was presented during the Test Site Kick Off Meeting to discuss the contract awards for Task 1 and Task 2. This briefing covered a high level overview for contract deliverables, Task 1 - UAS Traffic Management and Task 2, Live Virtual Constructive Distributed Environment.
77 FR 427 - EPAAR Clause for Compliance With EPA Policies for Information Resources Management
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-05
... the IRM policies, standards, and procedures set forth on the Office of Environmental Information..., standards, and procedures. (c) Section 508 requirements. Contract deliverables are required to be compliant... contracts. This revision incorporates to the EPAAR, administrative changes to update terminology and Web...
Autonomous Systems, Robotics, and Computing Systems Capability Roadmap: NRC Dialogue
NASA Technical Reports Server (NTRS)
Zornetzer, Steve; Gage, Douglas
2005-01-01
Contents include the following: Introduction. Process, Mission Drivers, Deliverables, and Interfaces. Autonomy. Crew-Centered and Remote Operations. Integrated Systems Health Management. Autonomous Vehicle Control. Autonomous Process Control. Robotics. Robotics for Solar System Exploration. Robotics for Lunar and Planetary Habitation. Robotics for In-Space Operations. Computing Systems. Conclusion.
TH-AB-202-03: A Novel Tool for Computing Deliverable Doses in Dynamic MLC Tracking Treatments
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fast, M; Kamerling, C; Menten, M
2016-06-15
Purpose: In tracked dynamic multi-leaf collimator (MLC) treatments, segments are continuously adapted to the target centroid motion in beams-eye-view. On-the-fly segment adaptation, however, potentially induces dosimetric errors due to the finite MLC leaf width and non-rigid target motion. In this study, we outline a novel tool for computing the 4d dose of lung SBRT plans delivered with MLC tracking. Methods: The following automated workflow was developed: A) centroid tracking, where the initial segments are morphed to each 4dCT phase based on the beams-eye-view GTV shift (followed by a dose calculation on each phase); B) re-optimized tracking, in which all morphedmore » initial plans from (A) are further optimised (“warm-started”) in each 4dCT phase using the initial optimisation parameters but phase-specific volume definitions. Finally, both dose sets are accumulated to the reference phase using deformable image registration. Initial plans were generated according to the RTOG-1021 guideline (54Gy, 3-Fx, equidistant 9-beam IMRT) on the peak-exhale (reference) phase of a phase-binned 4dCT. Treatment planning and delivery simulations were performed in RayStation (research v4.6) using our in-house segment-morphing algorithm, which directly links to RayStation through a native C++ interface. Results: Computing the tracking plans and 4d dose distributions via the in-house interface takes 5 and 8 minutes respectively for centroid and re-optimized tracking. For a sample lung SBRT patient with 14mm peak-to-peak motion in sup-inf direction, mainly perpendicular leaf motion (0-collimator) resulted in small dose changes for PTV-D95 (−13cGy) and GTV-D98 (+18cGy) for the centroid tracking case compared to the initial plan. Modest reductions of OAR doses (e.g. spinal cord D2: −11cGy) were achieved in the idealized tracking case. Conclusion: This study presents an automated “1-click” workflow for computing deliverable MLC tracking doses in RayStation. Adding a non-deliverable re-optimized tracking scenario is expected to help quantify plan robustness for more challenging patients with anatomy deformations. We acknowledge support of the MLC tracking research from Elekta AB. MFF is supported by Cancer Research UK under Programme C33589/A19908. Research at ICR is also supported by Cancer Research UK under Programme C33589/A19727 and NHS funding to the NIHR Biomedical Research Centre at RMH and ICR.« less
Integrated Advanced Sounding Unit-A (AMSU-A). Configuration Management Plan
NASA Technical Reports Server (NTRS)
Cavanaugh, J.
1996-01-01
The purpose of this plan is to identify the baseline to be established during the development life cycle of the integrated AMSU-A, and define the methods and procedures which Aerojet will follow in the implementation of configuration control for each established baseline. Also this plan establishes the Configuration Management process to be used for the deliverable hardware, software, and firmware of the Integrated AMSU-A during development, design, fabrication, test, and delivery.
49 CFR 22.25 - Lender deliverables and delivery schedule.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 1 2010-10-01 2010-10-01 false Lender deliverables and delivery schedule. 22.25 Section 22.25 Transportation Office of the Secretary of Transportation SHORT-TERM LENDING PROGRAM (STLP) Participating Lenders § 22.25 Lender deliverables and delivery schedule. All Participating Lenders must adhere...
76 FR 63916 - Transcontinental Gas Pipe Line Company, LLC; Notice of Application
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-14
... associated storage deliverability and capacity at the Eminence Storage Field (Eminence) in Covington County... Caverns 1, 2, 3, and 4, and reduce deliverability and capacity from 20.5 Bcf to 15.025 Bcf in Caverns 5, 6, and 7. Transco also seeks to partially abandon the total storage capacity and deliverability...
20 CFR 638.812 - State and local taxation of Job Corps deliverers.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false State and local taxation of Job Corps deliverers. 638.812 Section 638.812 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF... § 638.812 State and local taxation of Job Corps deliverers. The Act provides that transactions conducted...
20 CFR 638.812 - State and local taxation of Job Corps deliverers.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false State and local taxation of Job Corps deliverers. 638.812 Section 638.812 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF... § 638.812 State and local taxation of Job Corps deliverers. The Act provides that transactions conducted...
MO-FG-CAMPUS-TeP3-04: Deliverable Robust Optimization in IMPT Using Quadratic Objective Function
DOE Office of Scientific and Technical Information (OSTI.GOV)
Shan, J; Liu, W; Bues, M
Purpose: To find and evaluate the way of applying deliverable MU constraints into robust spot intensity optimization in Intensity-Modulated- Proton-Therapy (IMPT) to prevent plan quality and robustness from degrading due to machine deliverable MU-constraints. Methods: Currently, the influence of the deliverable MU-constraints is retrospectively evaluated by post-processing immediately following optimization. In this study, we propose a new method based on the quasi-Newton-like L-BFGS-B algorithm with which we turn deliverable MU-constraints on and off alternatively during optimization. Seven patients with two different machine settings (small and large spot size) were planned with both conventional and new methods. For each patient, threemore » kinds of plans were generated — conventional non-deliverable plan (plan A), conventional deliverable plan with post-processing (plan B), and new deliverable plan (plan C). We performed this study with both realistic (small) and artificial (large) deliverable MU-constraints. Results: With small minimum MU-constraints considered, new method achieved a slightly better plan quality than conventional method (D95% CTV normalized to the prescription dose: 0.994[0.992∼0.996] (Plan C) vs 0.992[0.986∼0.996] (Plan B)). With large minimum MU constraints considered, results show that the new method maintains plan quality while plan quality from the conventional method is degraded greatly (D95% CTV normalized to the prescription dose: 0.987[0.978∼0.994] (Plan C) vs 0.797[0.641∼1.000] (Plan B)). Meanwhile, plan robustness of these two method’s results is comparable. (For all 7 patients, CTV DVH band gap at D95% normalized to the prescription dose: 0.015[0.005∼0.043] (Plan C) vs 0.012[0.006∼0.038] (Plan B) with small MU-constraints and 0.019[0.009∼0.039] (Plan C) vs 0.030[0.015∼0.041] (Plan B) with large MU-constraints) Conclusion: Positive correlation has been found between plan quality degeneration and magnitude of deliverable minimal MU. Compared to conventional post-processing method, our new method of incorporating deliverable minimal MU-constraints directly into plan optimization, can produce machine-deliverable plans with better plan qualities and non-compromised plan robustness. This research was supported by the National Cancer Institute Career Developmental Award K25CA168984, by the Fraternal Order of Eagles Cancer Research Fund Career Development Award, by The Lawrence W. and Marilyn W. Matteson Fund for Cancer Research, by Mayo Arizona State University Seed Grant and by The Kemper Marley Foundation.« less
Jeffrey S. Evans; Andrew T. Hudak; Russ Faux; Alistair M. S. Smith
2009-01-01
Recent years have seen the progression of light detection and ranging (lidar) from the realm of research to operational use in natural resource management. Numerous government agencies, private industries, and public/private stakeholder consortiums are planning or have recently acquired large-scale acquisitions, and a national U.S. lidar acquisition is likely before...
Implementation plan for HANDI 2000 TWRS master equipment list
DOE Office of Scientific and Technical Information (OSTI.GOV)
BENNION, S.I.
This document presents the implementation plan for an additional deliverable of the HANDI 2000 Project. The PassPort Equipment Data module processes include those portions of the COTS PassPort system required to support tracking and management of the Master Equipment List for Lockheed Martin Hanford Company (LMHC) and custom software created to work with the COTS products.
reflect it. There are commercially available manual and powered suction devices on the market , and several are specifically advertised for use in...combine to suggest that no device on the market meets even the most basic requirements of being small, lightweight, rugged, and demonstrating adequate
Final Design Report for the RH LLW Disposal Facility (RDF) Project
DOE Office of Scientific and Technical Information (OSTI.GOV)
Austad, Stephanie Lee
2015-09-01
The RH LLW Disposal Facility (RDF) Project was designed by AREVA Federal Services (AFS) and the design process was managed by Battelle Energy Alliance (BEA) for the Department of Energy (DOE). The final design report for the RH LLW Disposal Facility Project is a compilation of the documents and deliverables included in the facility final design.
Final Design Report for the RH LLW Disposal Facility (RDF) Project
DOE Office of Scientific and Technical Information (OSTI.GOV)
Austad, S. L.
2015-05-01
The RH LLW Disposal Facility (RDF) Project was designed by AREVA Federal Services (AFS) and the design process was managed by Battelle Energy Alliance (BEA) for the Department of Energy (DOE). The final design report for the RH LLW Disposal Facility Project is a compilation of the documents and deliverables included in the facility final design.
Project Turnover Deliverables for the SY Farm Enraf Annulus Leak Detectors
DOE Office of Scientific and Technical Information (OSTI.GOV)
SCAIEF, C.C.
2000-09-19
This document identifies the deliverables that ensure the end user of the SY Farm Enraf Annulus Leak Detectors (ALD) has all the documentation and training required for operating and maintaining the new system. All deliverable items checked on the Acceptance For Beneficial Use (ABU) form have been completed and are available to the end user. This document was written as required by HNF-IP-0842, Volume IV section 3.12 Acceptance of Structures, Systems, and Components for Beneficial Use. This document applies to the deliverable documentation required to operate and maintain the SY Farm Enraf ALD System. Appendix A provides a copy ofmore » the ABU form as listed in the appendix of TWR-4092, Engineering Task Plan for the New SY Farm Annulus Leak Detectors. This document attests that all required deliverable items checked on the ABU have been completed and are available to the end user.« less
Technical support plan for HANDI 2000 business management system
DOE Office of Scientific and Technical Information (OSTI.GOV)
Adams, D.E.
The Hanford Data Integration 2000 (HANDI 2000) Project will result in an integrated and comprehensive set of functional applications containing core information necessary to support the Project Hanford Management Contract. It is based on the Commercial-Off-The-Shelf (COTS) product solution with commercially proven business processes. The PassPort (PP) software is an integrated application for Accounts Payable, Contract Management, Inventory Management, and Purchasing. The PeopleSoft (PS) software is an integrated application for General Ledger, Project Costing, Human Resources, Payroll, Benefits, and Training. The implementation of this set of products, as the first deliverable of the HAND1 2000 Project, is referred to asmore » Business Management System (BMS) and Chemical Management.« less
NPS TINYSCOPE Program Management
2010-09-01
SMDC - Space and Missile Defense Command SOW - Statement of Work STEM - Science, Technology, Engineering and Mathematics STP - Space Test Program...the project. A statement of work ( SOW ) is typically used to document broad responsibilities, deliverables, and the work activities required in a...given project. The SOW acts as a guideline Summary of TINYSCOPE and Argus Requirements Requirement Threshold Objective Mission IOC Sep 2011 ASAP
Research, development and demonstration of lead-acid batteries for electric vehicle propulsion
NASA Astrophysics Data System (ADS)
Bowman, D. E.
1983-08-01
Research programs on lead-acid batteries are reported that cover active materials utilization, active material integrity, and some technical support projects. Processing problems were encountered and corrected. Components and materials, a lead-plastic composite grid, cell designs, and deliverables are described. Cell testing is discussed, as well as battery subsystems, including fuel gage, thermal management, and electrolyte circulation.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Piscotty, M A; Nazario, O L
2007-06-20
The objective of this project is the delivery of an application that will provide a unified, web-based system for collecting, verifying and analyzing the achievements for Laboratory employees. The application will enable individual Directorates to manage and report achievement record data for their employees using an LLNL standard web browser. In addition, cross directorate data reporting and analysis will be available for such organizations as LSTO and programmatic directorates. This system is intended to store reference data and metadata for employee achievements. Abstracts and entire publications will not be stored in this system.Directorates are expected to use this system atmore » all levels of management in preparing for Annual Self-Assessments, peer reviews, LDRD reviews, work force reviews, performance appraisals, and requests from sponsors. This document represents the primary deliverable for the Requirements Definition stage of system development. As part of a successful Requirements Definition, this document provides the development staff, the project sponsor, and the user community with a clear understanding of the product's operational, data, and other requirements. With this understanding, the development staff will take the opportunity to refine estimates regarding the cost, schedule, and deliverables reflected in it.« less
Rockwell, Barnaby W.; Knepper, Daniel H.; Horton, John D.
2015-01-01
The image products derived from Landsat TM and ASTER data enable the delineation of mineral groups across wide areas based on color response. Guides are provided that allow users to interpret these colors as to mineral group occurrence over lithologic units and known deposits. This information can be extrapolated to other geologically permissive tracts for various deposit types in the search for similar mineralogic responses that may be indicative of concealed deposits.
2009-04-09
detecting proliferative diabetic retinopathy . Telemedicine and e-Health. 2005;11: 641-651. MILESTONES AND DELIVERABLES: Completion of data...telemedicine system for comprehensive diabetes management and assessment of diabetic retinopathy that provides increased access for diabetic patients to...CDMP developed under this collaborative effort. 15. SUBJECT TERMS Joslin Vision Network, telemedicine, diabetes mellitus, diabetic retinopathy
1996--1997 TEMA/DOE oversight annual report
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1998-06-01
The Tennessee Emergency Management Agency (TEMA) has entered into a five-year agreement with the Department of Energy (DOE) to provide emergency response activities associated with the Oak Ridge Reservation (ORR). The Agreement in Principle (AIP) delineates the duties and responsibilities of the parties. The agreement tasked TEMA with the following responsibilities: develop offsite emergency plans; conduct emergency management training; develop offsite emergency organizations; develop emergency communications; develop emergency facilities; conduct exercises and drills; provide detection and protection equipment; and develop an emergency staff. This report describes progress on the 14 deliverables connected with this contract.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Grant, C W; Lenderman, J S; Gansemer, J D
This document is an update to the 'ADIS Algorithm Evaluation Project Plan' specified in the Statement of Work for the US-VISIT Identity Matching Algorithm Evaluation Program, as deliverable II.D.1. The original plan was delivered in August 2010. This document modifies the plan to reflect modified deliverables reflecting delays in obtaining a database refresh. This document describes the revised schedule of the program deliverables. The detailed description of the processes used, the statistical analysis processes and the results of the statistical analysis will be described fully in the program deliverables. The US-VISIT Identity Matching Algorithm Evaluation Program is work performed bymore » Lawrence Livermore National Laboratory (LLNL) under IAA HSHQVT-07-X-00002 P00004 from the Department of Homeland Security (DHS).« less
2013-04-26
and 6-8 books annually. Some deliverables are due “as required.” This is because the mission of the IATF is dependent upon real-world events and...six lines of investigation (4.1.18). Some deliverables do not have specific due dates or schedules because the mission of the IATF is dependent upon...34 This is because the mission of the IATF is dependent upon real-world events and deliverables are linked to dynamic findings from the SOCOM GSC
1999-10-01
to prove that we can operate as efficiently as other nations where worker safety and health are emphasized as highly. With the support of government...N8-96-3 Application of Industrial Engineering Techniques to Reduce Workers ’ Compensation and Environmental Costs - Deliverable G U.S. DEPARTMENT OF THE...Techniques to Reduce Workers ’ Compensation and Environmental Costs - Deliverable G 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6
Cao, Wenhua; Lim, Gino; Li, Xiaoqiang; Li, Yupeng; Zhu, X. Ronald; Zhang, Xiaodong
2014-01-01
The purpose of this study is to investigate the feasibility and impact of incorporating deliverable monitor unit (MU) constraints into spot intensity optimization in intensity modulated proton therapy (IMPT) treatment planning. The current treatment planning system (TPS) for IMPT disregards deliverable MU constraints in the spot intensity optimization (SIO) routine. It performs a post-processing procedure on an optimized plan to enforce deliverable MU values that are required by the spot scanning proton delivery system. This procedure can create a significant dose distribution deviation between the optimized and post-processed deliverable plans, especially when small spot spacings are used. In this study, we introduce a two-stage linear programming (LP) approach to optimize spot intensities and constrain deliverable MU values simultaneously, i.e., a deliverable spot intensity optimization (DSIO) model. Thus, the post-processing procedure is eliminated and the associated optimized plan deterioration can be avoided. Four prostate cancer cases at our institution were selected for study and two parallel opposed beam angles were planned for all cases. A quadratic programming (QP) based model without MU constraints, i.e., a conventional spot intensity optimization (CSIO) model, was also implemented to emulate the commercial TPS. Plans optimized by both the DSIO and CSIO models were evaluated for five different settings of spot spacing from 3 mm to 7 mm. For all spot spacings, the DSIO-optimized plans yielded better uniformity for the target dose coverage and critical structure sparing than did the CSIO-optimized plans. With reduced spot spacings, more significant improvements in target dose uniformity and critical structure sparing were observed in the DSIO- than in the CSIO-optimized plans. Additionally, better sparing of the rectum and bladder was achieved when reduced spacings were used for the DSIO-optimized plans. The proposed DSIO approach ensures the deliverability of optimized IMPT plans that take into account MU constraints. This eliminates the post-processing procedure required by the TPS as well as the resultant deteriorating effect on ultimate dose distributions. This approach therefore allows IMPT plans to adopt all possible spot spacings optimally. Moreover, dosimetric benefits can be achieved using smaller spot spacings. PMID:23835656
DOE Office of Scientific and Technical Information (OSTI.GOV)
McGarry, Conor K., E-mail: conor.mcgarry@belfasttrust.hscni.net; Bokrantz, Rasmus; RaySearch Laboratories, Stockholm
2014-10-01
Efficacy of inverse planning is becoming increasingly important for advanced radiotherapy techniques. This study’s aims were to validate multicriteria optimization (MCO) in RayStation (v2.4, RaySearch Laboratories, Sweden) against standard intensity-modulated radiation therapy (IMRT) optimization in Oncentra (v4.1, Nucletron BV, the Netherlands) and characterize dose differences due to conversion of navigated MCO plans into deliverable multileaf collimator apertures. Step-and-shoot IMRT plans were created for 10 patients with localized prostate cancer using both standard optimization and MCO. Acceptable standard IMRT plans with minimal average rectal dose were chosen for comparison with deliverable MCO plans. The trade-off was, for the MCO plans, managedmore » through a user interface that permits continuous navigation between fluence-based plans. Navigated MCO plans were made deliverable at incremental steps along a trajectory between maximal target homogeneity and maximal rectal sparing. Dosimetric differences between navigated and deliverable MCO plans were also quantified. MCO plans, chosen as acceptable under navigated and deliverable conditions resulted in similar rectal sparing compared with standard optimization (33.7 ± 1.8 Gy vs 35.5 ± 4.2 Gy, p = 0.117). The dose differences between navigated and deliverable MCO plans increased as higher priority was placed on rectal avoidance. If the best possible deliverable MCO was chosen, a significant reduction in rectal dose was observed in comparison with standard optimization (30.6 ± 1.4 Gy vs 35.5 ± 4.2 Gy, p = 0.047). Improvements were, however, to some extent, at the expense of less conformal dose distributions, which resulted in significantly higher doses to the bladder for 2 of the 3 tolerance levels. In conclusion, similar IMRT plans can be created for patients with prostate cancer using MCO compared with standard optimization. Limitations exist within MCO regarding conversion of navigated plans to deliverable apertures, particularly for plans that emphasize avoidance of critical structures. Minimizing these differences would result in better quality treatments for patients with prostate cancer who were treated with radiotherapy using MCO plans.« less
Competitiveness Improvement Project Informational Workshop
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sinclair, Karin C; Preus, Robert W; Dana, Scott
This presentation was given at the Competitiveness Improvement Project (CIP) Informational Workshop on December 6, 2017. Topics covered during the workshop include an overview of the CIP, past projects, scoring criteria, technical support opportunities, certification body requirements, standards applicable to distributed wind generators, information on the National Electric Code, certification testing requirements, test site requirements, National Environmental Policy Act, design review, levelized cost of energy, procurement/contracting, project management/deliverables, and outreach materials.
Hackley, Donna M; Mumena, Chrispinus H; Gatarayiha, Agnes; Cancedda, Corrado; Barrow, Jane R
2018-06-01
Harvard School of Dental Medicine, University of Maryland School of Dentistry, and the University of Rwanda (UR) are collaborating to create Rwanda's first School of Dentistry as part of the Human Resources for Health (HRH) Rwanda initiative that aims to strengthen the health care system of Rwanda. The HRH oral health team developed three management tools to measure progress in systems-strengthening efforts: 1) the road map is an operations plan for the entire dental school and facilitates delivery of the curriculum and management of human and material resources; 2) each HRH U.S. faculty member develops a work plan with targeted deliverables for his or her rotation, which is facilitated with biweekly flash reports that measure progress and keep the faculty member focused on his or her specific deliverables; and 3) the redesigned HRH twinning model, changed from twinning of an HRH faculty member with a single Rwandan faculty member to twinning with multiple Rwandan faculty members based on shared academic interests and goals, has improved efficiency, heightened engagement of the UR dental faculty, and increased the impact of HRH U.S. faculty members. These new tools enable the team to measure its progress toward the collaborative's goals and understand the successes and challenges in moving toward the planned targets. The tools have been valuable instruments in fostering discussion around priorities and deployment of resources as well as in developing strong relationships, enabling two-way exchange of knowledge, and promoting sustainability.
NASA Technical Reports Server (NTRS)
Upchurch, Christopher
2011-01-01
The project, being the development of resource management applications, consisted entirely of my own effort. From deliverable requirements provided by my mentor, and some functional requirement additions generated through design reviews, It was my responsibility to implement the requested features as well as possible, given the resources available. For the most part development work consisted of database programming and functional testing using real resource data. Additional projects I worked on included some firing room console training, configuring the new NE-A microcontroller development lab network, mentoring high school CubeSat students, and managing the NE interns' component of the mentor appreciation ceremony.
2010-11-30
testing and analysis in ONR laboratories. Task 1.2 Contributors: Sunny Kedia, Shinzo Onishi , Scott Samson, Drew Hanser Task 1.2 Deliverable...Priscila Spagnol, Shinzo Onishi , Drew Hanser, Weidong Wang, Sunny Kedia, John Bumgarner Deliverable: Prototype device fabricated on a thin-film diamond
2010-12-31
laboratories. Task 1.2 Contributors: Sunny Kedia, Shinzo Onishi , Scott Samson, Drew Hanser Task 1.2 Deliverable: Functional MEMS-based DC-DC...Shinzo Onishi , Drew Hanser, Weidong Wang, Sunny Kedia, John Bumgarner Deliverable: Prototype device fabricated on a thin-film diamond heat spreader
DOE Office of Scientific and Technical Information (OSTI.GOV)
Temple, Brian Allen; Armstrong, Jerawan Chudoung
This document is a mid-year report on a deliverable for the PYTHON Radiography Analysis Tool (PyRAT) for project LANL12-RS-107J in FY15. The deliverable is deliverable number 2 in the work package and is titled “Add the ability to read in more types of image file formats in PyRAT”. Right now PyRAT can only read in uncompressed TIF files (tiff files). It is planned to expand the file formats that can be read by PyRAT, making it easier to use in more situations. A summary of the file formats added include jpeg, jpg, png and formatted ASCII files.
Transuranic Waste Program Framework Agreement - December Deliverable July 2012
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jones, Patricia
Framework agreement deliverables are: (1) 'DOE/NNSA commits to complete removal of all non-cemented above-ground EM Legacy TRU and newly generated TRU currently-stored at Area G as of October 1, 2011, by no later than June 30, 2014. This inventory of above-ground TRU is defined as 3706 cubic meters of material.' (2) 'DOE commits to the complete removal of all newly generated TRU received in Area G during FY 2012 and 2013 by no later than December 31, 2014.' (3) 'Based on projected funding profiles, DOE/NNSA will develop by December 31, 2012, a schedule, including pacing milestones, for disposition of themore » below-ground TRU requiring retrieval at Area G.' Objectives are to: (1) restore the 'Core Team' to develop the December, 2012 deliverable; (2) obtain agreement on the strategy for below ground water disposition; and (3) establish timeline for completion of the deliverable. Below Grade Waste Strategy is to: (1) Perform an evaluation on below grade waste currently considered retrievable TRU; (2) Only commit to retrieve waste that must be retrieved; (3) Develop the Deliverable including Pacing Milestones based on planned commitments; (4) Align all Regulatory Documents for Consistency; and (5) answer these 3 primary questions, is the waste TRU; is the waste retrievable, can retrieval cause more harm than benefit?« less
Operations system administration plan for HANDI 2000 business management system
DOE Office of Scientific and Technical Information (OSTI.GOV)
Adams, D.E.
The Hanford Data Integration 2000 (HANDI 2000) Project will result in an integrated and comprehensive set of functional applications containing core information necessary to support the Project Hanford Management Contract (PHMC). It is based on the Commercial-Off-The-Shelf (COTS) product solution with commercially proven business processes. This includes systems that support finance, supply, chemical management, human resources and payroll activities on the Hanford Site. The Passport (PP) software is an integrated application for Accounts Payable, Contract Management, Inventory Management, Purchasing, and Material Safety Data Sheets (MSDS). The PeopleSoft (PS) software is an integrated application for General Ledger, Project Costing, Human Resources,more » Payroll, Benefits, and Training. The implementation of this set of products, as the first deliverable of the HANDI 2000 Project, is referred to as Business Management System (BMS) and MSDS.« less
Teevale, Tasileta; Taufa, Seini; Percival, Teuila
2015-10-01
To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children. Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme. New Zealand. Forty-two parents/primary caregivers of obese children who were randomised in the intervention weight-management programme. Programmatic factors that enhanced retention included: simultaneous delivery to both children and parents as participants; delivery of the programme in small group settings at local community venues; enabling trustworthy and accountable relationships; providing resources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals; and day and time scheduling. Suggested programme improvements included having ethnic-specific Island-language delivery and practical sessions like cooking classes and shopping expeditions at local food stores. The research found that unpredictable external life crises like extended family deaths, a change in job shift, family illnesses (both acute and those requiring chronic management) and long-term family visitations affected participation and momentum. A loss of momentum through managing life crises was often difficult to overcome for participants, leading them to drop out of the weight-management programme. Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time. In order for weight-management programmes to be effective, participants must be able to complete them. Identifying factors that predict participation and attrition may serve as a basis for programme improvement.
[Relevance of medical rehabilitation in disease management programmes].
Lüngen, M; Lauterbach, K W
2003-10-01
Disease management programmes will increasingly be introduced in Germany due to the new risk adjustment scheme. The first disease management programmes started in 2003 for breast cancer and diabetes mellitus type II. German rehabilitation will have to face several challenges. Disease management programmes are strongly based on the notion of Evidence so that proof of the efficacy of a care giving task should be present. Verification of the evidence of the specifically German rehabilitation treatments must therefore be given. However, integration of rehabilitation in disease management programmes could lead to changes in the alignment of German rehabilitation. The essence of German rehabilitation, notably its holistic approach, could get lost with integration in disease management programmes.
Auditing emergency management programmes: Measuring leading indicators of programme performance.
Tomsic, Heather
Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.
Guidance for improving foundation layers to increase pavement performance on local roads.
DOT National Transportation Integrated Search
2014-11-01
This document is the second of two deliverables for the project Optimizing Pavement Base, Subbase, and Subgrade Layers : for Cost and Performance on Local Roads (TR-640). The first deliverable is the 454-page Final Field Data Report. The field : data...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jin, X; Yi, J; Xie, C
Purpose: To evaluate the impact of complexity indices on the plan quality and deliverability of volumetric modulated arc therapy (VMAT), and to determine the most significant parameters in the generation of an ideal VMAT plan. Methods: A multi-dimensional exploratory statistical method, canonical correlation analysis (CCA) was adopted to study the correlations between VMAT parameters of complexity, quality and deliverability, as well as their contribution weights with 32 two-arc VMAT nasopharyngeal cancer (NPC) patients and 31 one-arc VMAT prostate cancer patients. Results: The MU per arc (MU/Arc) and MU per control point (MU/CP) of NPC were 337.8±25.2 and 3.7±0.3, respectively, whichmore » were significantly lower than those of prostate cancer patients (MU/Arc : 506.9±95.4, MU/CP : 5.6±1.1). The plan complexity indices indicated that two-arc VMAT plans were more complex than one-arc VMAT plans. Plan quality comparison confirmed that one-arc VMAT plans had a high quality than two-arc VMAT plans. CCA results implied that plan complexity parameters were highly correlated with plan quality with the first two canonical correlations of 0.96, 0.88 (both p<0.001) and significantly correlated with deliverability with the first canonical correlation of 0.79 (p<0.001), plan quality and deliverability was also correlated with the first canonical correlation of 0.71 (p=0.02). Complexity parameters of MU/CP, segment area (SA) per CP, percent of MU/CP less 3 and planning target volume (PTV) were weighted heavily in correlation with plan quality and deliveability . Similar results obtained from individual NPC and prostate CCA analysis. Conclusion: Relationship between complexity, quality, and deliverability parameters were investigated with CCA. MU, SA related parameters and PTV volume were found to have strong effect on the plan quality and deliverability. The presented correlation among different quantified parameters could be used to improve the plan quality and the efficiency of the radiotherapy process when creating a complex VMAT plan.« less
Fawole, Olufunmilayo I; Ajumobi, Olufemi; Poggensee, Gabriele; Nguku, Patrick
2014-01-01
Although several research groups within institutions in Nigeria have been involved in extensive malaria research, the link between the research community and policy formulation has not been optimal. The workshop aimed to assist post graduate students to identify knowledge gaps and to develop relevant Malaria-related research proposals in line with identified research priorities. A training needs assessment questionnaire was completed by 22 students two week prior to the workshop. Also, a one page concept letter was received from 40 residents. Thirty students were selected based the following six criteria: - answerability and ethics; efficacy and impact; deliverability, affordability; scalability, sustainability; health systems, partnership and community involvement; and equity in achieved disease burden reduction. The workshop was over a three day period. The participants at the workshop were 30 Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) residents from cohorts 4 and 5. Ten technical papers were presented by the experts from the academia, National Malaria Elimination (NMEP) Programme, NFELTP Faculty and Implementing partners including CDC/PMI. Draft proposals were developed and presented by the residents. The "strongest need" for training was on malaria prevention, followed by malaria diagnosis. Forty seven new research questions were generated, while the 19 developed by the NMEP were shared. Evaluation revealed that all (100%) students either "agreed" that the workshop objectives were met. Full proposals were developed by some of the residents. A debriefing meeting was held with the NMEP coordinator to discuss funding of the projects. Future collaborative partnership has developed as the residents have supported NMEP to develop a research protocol for a national evaluation. Research prioritization workshops are required in most training programmes to ensure that students embark on studies that address the research needs of their country and foster collaborative linkages.
Development of a Carbon Management Geographic Information System (GIS) for the United States
DOE Office of Scientific and Technical Information (OSTI.GOV)
Howard Herzog; Holly Javedan
In this project a Carbon Management Geographical Information System (GIS) for the US was developed. The GIS stored, integrated, and manipulated information relating to the components of carbon management systems. Additionally, the GIS was used to interpret and analyze the effect of developing these systems. This report documents the key deliverables from the project: (1) Carbon Management Geographical Information System (GIS) Documentation; (2) Stationary CO{sub 2} Source Database; (3) Regulatory Data for CCS in United States; (4) CO{sub 2} Capture Cost Estimation; (5) CO{sub 2} Storage Capacity Tools; (6) CO{sub 2} Injection Cost Modeling; (7) CO{sub 2} Pipeline Transport Costmore » Estimation; (8) CO{sub 2} Source-Sink Matching Algorithm; and (9) CO{sub 2} Pipeline Transport and Cost Model.« less
The Creative Deliverable: A Short Communication
ERIC Educational Resources Information Center
Hartel, Jenna; Noone, Rebecca; Oh, Christie
2017-01-01
This paper encourages educators in library and information science (LIS) to adopt the "creative deliverable," that is, an assignment that gives students the freedom to display their understanding of course material in an almost unrestricted range of alternative formats and genres, while retaining some key features of traditional…
DOT National Transportation Integrated Search
2005-09-30
Under Deliverable 1.1 of the Work Plan governing the Altarum Restricted Use Technology Study, the Altarum project team is required to produce an unclassified summary and comprehensive written report of RADAR systems that can potentially address trans...
DOT National Transportation Integrated Search
2005-09-30
Under Deliverable 2.1 of the Work Plan governing the Altarum Restricted Use Technology Study, the Altarum project team is required to produce an unclassified summary and comprehensive written report of Electro-Optical (EO) systems that can potentiall...
A database management capability for Ada
NASA Technical Reports Server (NTRS)
Chan, Arvola; Danberg, SY; Fox, Stephen; Landers, Terry; Nori, Anil; Smith, John M.
1986-01-01
The data requirements of mission critical defense systems have been increasing dramatically. Command and control, intelligence, logistics, and even weapons systems are being required to integrate, process, and share ever increasing volumes of information. To meet this need, systems are now being specified that incorporate data base management subsystems for handling storage and retrieval of information. It is expected that a large number of the next generation of mission critical systems will contain embedded data base management systems. Since the use of Ada has been mandated for most of these systems, it is important to address the issues of providing data base management capabilities that can be closely coupled with Ada. A comprehensive distributed data base management project has been investigated. The key deliverables of this project are three closely related prototype systems implemented in Ada. These three systems are discussed.
Groundwater Data Package for Hanford Assessments
DOE Office of Scientific and Technical Information (OSTI.GOV)
Thorne, Paul D.; Bergeron, Marcel P.; Williams, Mark D.
2006-01-31
This report presents data and interpreted information that supports the groundwater module of the System Assessment Capability (SAC) used in Hanford Assessments. The objective of the groundwater module is to predict movement of radioactive and chemical contaminants through the aquifer to the Columbia River or other potential discharge locations. This data package is being revised as part of the deliverables under the Characterization of Systems Project (#49139) aimed at providing documentation for assessments being conducted under the Hanford Assessments Project (#47042). Both of these projects are components of the Groundwater Remediation and Closure Assessments Projects, managed by the Management andmore » Integration Project (#47043).« less
NASA Technical Reports Server (NTRS)
Cavanaugh, J.
1994-01-01
This plan describes methods and procedures Aerojet will follow in the implementation of configuration control for each established baseline. The plan is written in response to the GSFC EOS CM Plan 420-02-02, dated January 1990, and also meets he requirements specified in DOD-STD-480, DOD-D 1000B, MIL-STD-483A, and MIL-STD-490B. The plan establishes the configuration management process to be used for the deliverable hardware, software, and firmware of the EOS/AMSU-A during development, design, fabrication, test, and delivery. This revision includes minor updates to reflect Aerojet's CM policies.
Developing Researching Managers and Relevant Research--The "Executive Research Programme"
ERIC Educational Resources Information Center
Werr, Andreas; Strannegård, Lars
2014-01-01
The current paper argues for bridging the "relevance gap" in management research and education by creating educational programmes that bring together experienced managers and management researchers. In the "Executive Research Programme" discussed in this paper, managers were paired up with researchers to conduct a collaborative…
Effect of an experiential learning-based programme to foster competence among nurse managers.
Kuraoka, Yumiko
2018-03-30
The present study aimed to examine the effect of providing an experiential learning-based programme to foster competence among nurse managers in the early years of their supervisory roles. Nurse managers take supervisory positions without being sufficiently prepared for the task and therefore often experience difficultly in the early years of managerial roles. They need support from their supervisor and require opportunities for development. We developed an experiential learning-based programme for nurse managers in the first 3 years of a supervisory role. Sixty-three nurse managers and their supervisors were enrolled. The programme was evaluated using a one-group pretest-posttest design. The outcome measures were experiential learning, knowledge, social support, competency as a nurse manager, and sense of coherence. Outcomes were compared using paired t tests. Nurse managers showed significantly improved experiential learning (p = .001), knowledge (p < .001) and competence as a nurse manager (p = .002) after participating in this programme. This programme increased knowledge, promoted experiential learning, and improved competence among nurse managers. This experiential learning-based programme for nurse managers in the early years of a supervisory role fostered competence among nurse managers. © 2018 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.
C2 Domain Ontology within Our Lifetime
2009-06-01
25] Masolo, C., et al: The WonderWeb Library of Foundational Ontologies Prelimary Report, WonderWeb Deliverable D17, ISTC -CNR, May 2003. [26...www.ifomis.org/bfo/BFO [25] Masolo, C., et al: The WonderWeb Library of Foundational Ontologies Prelimary Report, WonderWeb Deliverable D17, ISTC -CNR
17 CFR 36.2 - Exempt boards of trade.
Code of Federal Regulations, 2011 CFR
2011-04-01
... Section 36.2 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION EXEMPT MARKETS § 36.2... deliverable supply; (ii) A deliverable supply that is sufficiently large, and a cash market sufficiently... manipulation; or (iii)No cash market. (2) The commodities that meet the criteria of paragraph (a)(1) of this...
17 CFR 36.2 - Exempt boards of trade.
Code of Federal Regulations, 2010 CFR
2010-04-01
... Section 36.2 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION EXEMPT MARKETS § 36.2... deliverable supply; (ii) A deliverable supply that is sufficiently large, and a cash market sufficiently... manipulation; or (iii)No cash market. (2) The commodities that meet the criteria of paragraph (a)(1) of this...
17 CFR 36.2 - Exempt boards of trade.
Code of Federal Regulations, 2012 CFR
2012-04-01
... Section 36.2 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION EXEMPT MARKETS § 36.2... deliverable supply; (ii) A deliverable supply that is sufficiently large, and a cash market sufficiently... manipulation; or (iii)No cash market. (2) The commodities that meet the criteria of paragraph (a)(1) of this...
DOT National Transportation Integrated Search
2005-09-01
This study, an 18-month effort, seeks to apply restricted use technology to the mandates of MDOT. For Deliverable 3.1 described in the Work Plan governing the Altarum Restricted Use Technology Study, the Altarum project team is required to provide a ...
The management of cardiovascular disease in the Netherlands: analysis of different programmes
Cramm, Jane M.; Tsiachristas, Apostolos; Walters, Bethany H.; Adams, Samantha A.; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P.M.H.; Nieboer, Anna P.
2013-01-01
Background Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery. But, disease management programme development and implementation is a complex undertaking that requires effective decision-making. Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. Methods To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Results Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Conclusions Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in routine care. As care pathways become more complex, they also become more expensive. Better preparedness and training can prevent unnecessary delays during the implementation period and are crucial to reducing costs. PMID:24167456
The management of cardiovascular disease in the Netherlands: analysis of different programmes.
Cramm, Jane M; Tsiachristas, Apostolos; Walters, Bethany H; Adams, Samantha A; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P M H; Nieboer, Anna P
2013-01-01
Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery. But, disease management programme development and implementation is a complex undertaking that requires effective decision-making. Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in routine care. As care pathways become more complex, they also become more expensive. Better preparedness and training can prevent unnecessary delays during the implementation period and are crucial to reducing costs.
Rapid tests for sexually transmitted infections (STIs): the way forward
Peeling, R W; Holmes, K K; Mabey, D
2006-01-01
In the developing world, laboratory services for sexually transmitted infections (STIs) are either not available, or where limited services are available, patients may not be able to pay for or physically access those services. Despite the existence of national policy for antenatal screening to prevent congenital syphilis and substantial evidence that antenatal screening is cost‐effective, implementation of syphilis screening programmes remains unacceptably low because of lack of screening tools that can be used in primary health care settings. The World Health Organization Sexually Transmitted Diseases Diagnostics Initiative (SDI) has developed the ASSURED criteria as a benchmark to decide if tests address disease control needs: Affordable, Sensitive, Specific, User‐friendly, Rapid and robust, Equipment‐free and Deliverable to end‐users. Rapid syphilis tests that can be used with whole blood approach the ASSURED criteria and can now be deployed in areas where no previous screening has been possible. Although rapid tests for chlamydia and gonorrhoea lack sensitivity, more tests are in development. The way forward for STI diagnostics requires a continuing quest for ASSURED tests, the development of a road map for test introduction, sustainable programmes for quality assurance, and the creation of a robust infrastructure linked to HIV prevention that ensures sustainability of STI control efforts that includes viral STIs. PMID:17151023
Rapid tests for sexually transmitted infections (STIs): the way forward.
Peeling, R W; Holmes, K K; Mabey, D; Ronald, A
2006-12-01
In the developing world, laboratory services for sexually transmitted infections (STIs) are either not available, or where limited services are available, patients may not be able to pay for or physically access those services. Despite the existence of national policy for antenatal screening to prevent congenital syphilis and substantial evidence that antenatal screening is cost-effective, implementation of syphilis screening programmes remains unacceptably low because of lack of screening tools that can be used in primary health care settings. The World Health Organization Sexually Transmitted Diseases Diagnostics Initiative (SDI) has developed the ASSURED criteria as a benchmark to decide if tests address disease control needs: Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free and Deliverable to end-users. Rapid syphilis tests that can be used with whole blood approach the ASSURED criteria and can now be deployed in areas where no previous screening has been possible. Although rapid tests for chlamydia and gonorrhoea lack sensitivity, more tests are in development. The way forward for STI diagnostics requires a continuing quest for ASSURED tests, the development of a road map for test introduction, sustainable programmes for quality assurance, and the creation of a robust infrastructure linked to HIV prevention that ensures sustainability of STI control efforts that includes viral STIs.
Bhat, Sarita; Baker, Paul; Eyres, Renata
2008-01-01
Postgraduate medical training is undergoing major change, shortening and disrupting traditional practices. Scholarship remains highly valued, but increasingly difficult to fit in. Workplace-based Masters study offers a solution. We want consultants who are driven by enquiry, good teachers and team workers. Academic qualifications demonstrate trainees' commitment and expertise in competitive employment markets. Most Deaneries allow two sessions weekly for research/personal development, so this resource demands effective use. The good will, talent and commitment of colleagues are vital. A credible structured curriculum combines real-life consultant-level generic practice, with technical medical skills. Academic writing and practical assignments are assessed. Linking with a far-sighted academic institution brings vast expertise in education administration and delivery of accredited learning. The course is more cost-effective than traditional study leave activities. Running part-time over 4 years fits with Higher Specialist Training. Structured programmes, over 9 month 'terms', fit with clinical rotations. Module leaders run yearly clinical modules alongside continuous generic modules. Clinical units are signed up to releasing trainees to attend. Evaluation is external to faculty, with highly favourable feedback. We believe training in academic disciplines underpins practice. With strong partnership working, planning and especially hard work, such a course is deliverable.
de Korte, J; Van Onselen, J; Kownacki, S; Sprangers, M A G; Bos, J D
2005-01-01
Patients with psoriasis have to cope with their disease for many years or even throughout their entire life. To provide optimal care, a disease management programme was developed. This programme consisted of disease education, disease management training, and psychological support, together with topical treatment. To test a disease management programme in dermatological practice, to assess patients' satisfaction with this programme, and adherence to topical treatment. Additionally, disease severity and quality of life were assessed. An initial clinical investigation was conducted in 10 European treatment centres. A total of 330 patients were included. Patient satisfaction, adherence, disease severity and quality of life were measured with study-specific and standardized self-report questionnaires. Patients reported a high degree of satisfaction with the programme, and a high degree of adherence to topical treatment. Disease severity and quality of life significantly improved. The programme was well received by the participating professionals. The disease management programme was found to be a useful tool in the management of psoriasis, providing patients with relief from the burden of psoriasis in everyday life. A full-scale evaluation is recommended.
Preliminary Airspace Operations Simulations Findings Report
NASA Technical Reports Server (NTRS)
2005-01-01
Provides preliminary findings of the initial series (normal operations and contingency management) of airspace operations simulations. The key elements of this report discuss feedback from controller subjects for UAS flight above FL430. Findings provide initial evaluation of routine UAS operations above dense ARTCC airspace (ZOB), and identify areas of further research, policy direction and procedural development. This document further serves as an addendum to the detailed AOS simulation plan (Deliverable SIM001), incorporating feedback from FAA air traffic personnel and Access 5 IPTs.
Using EnviroAtlas Data to Identify Cost-Effective Locations for ...
Manure Management Use Case A use case walks through an example application of how EnviroAtlas data, in conjunction with other available data or resources, may be used to address real-world questions. Use cases may be hypothetical or based on actual cases where EnviroAtlas has been used in decision making at the local, regional or national scale. The use case is a deliverable for the EnviroAtlas project under the SHC 1.62 and will be incorporated on the EnviroAtlas website.
A Survey On Management Of Software Engineering In Japan
NASA Astrophysics Data System (ADS)
Kadono, Yasuo; Tsubaki, Hiroe; Tsuruho, Seishiro
2008-05-01
The purpose of this study is to clarity the mechanism of how software engineering capabilities relate to the business performance of IT vendors in Japan. To do this, we developed a structural model using factors related to software engineering, business performance and competitive environment. By analyzing the data collected from 78 major IT vendors in Japan, we found that superior deliverables and business performance were correlated with the effort expended particularly on human resource development, quality assurance, research and development and process improvement.
Feasibility Study for Low Drag Acoustic Liners Final Report
NASA Technical Reports Server (NTRS)
Riedel, Brian; Wu, Jackie
2017-01-01
This report documents the design and structural analysis as a final deliverable for the Phase 1 contract activity. Also included is a community noise test plan, which is a key deliverable for Phase 2. Finally, a high-level estimate (Phase 3 deliverable) is provided for the work statement of Phases 2-4, which covers the build of two inlet test articles, planning and execution of a flight test with the test inlets, as well as data analysis and final documentation. The two test inlets will be compared to the production baseline inlet configuration. There is also a plan to test one of the inlets "hardwalled" using speed tape or some other similar tape to block the acoustic perforations.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-12
... trading option contracts overlying 1,000 SPDR[supreg] S&P 500[supreg] exchange-traded fund shares (``SPY''),\\3\\ or (``Jumbo SPY Options'').\\4\\ Whereas standard options contracts represent a deliverable of 100... the number of deliverable shares, Jumbo SPY Options have the same terms and contract characteristics...
Synthetic Report of Research and Development of Professional Knowledge Practices
ERIC Educational Resources Information Center
Toiviainen, Hanna; Hoynalanmaa, Mikko; Lallimo, Jiri; Moen, Anne; Smordal, Ole; Morch, Anders; Toikka, Seppo
2006-01-01
This deliverable has been produced in the context of the Knowledge-Practice Laboratory (KP-Lab) project, which is aimed at facilitating innovative practices of working with knowledge in higher education, teacher training, and professional networks. This deliverable is a synopsis of the first experiences encountered during the first 6 months of the…
Heart failure management programmes in Europe.
Jaarsma, T; Strömberg, A; De Geest, S; Fridlund, B; Heikkila, J; Mårtensson, J; Moons, P; Scholte op Reimer, W; Smith, K; Stewart, S; Thompson, D R
2006-09-01
The ESC guidelines recommend that an organised system of specialist heart failure (HF) care should be established to improve outcomes of HF patients. The aim of this study was therefore to identify the number and the content of HF management programmes in Europe. A two-phase descriptive study was conducted: an initial screening to identify the existence of HF management programmes; and a survey to describe the content in countries where at least 30% of the hospitals had a programme. Of the 43 European countries approached, 26 (60%) estimated the percentage of HF management programmes. Seven countries reported that they had such programmes in more than 30% of their hospitals. Of the 673 hospitals responding to the questionnaire, 426 (63%) had a HF management programme. Half of the programmes (n = 205) were located in an outpatient clinic. In the UK a combination of hospital and home-based programmes was common (75%). The most programmes included physical examination, telephone consultation, patient education, drug titration and diagnostic testing. Most (89%) programmes involved nurses and physicians. Multi-disciplinary teams were active in 56% of the HF programmes. The most prominent differences between the 7 countries were the degree of collaboration with home care and GP's, the role in palliative care and the funding. Only a few European countries have a large number of organised programmes for HF care and follow up. To improve outcomes of HF patients throughout Europe more effort should be taken to increase the number of these programmes in all countries.
Solberg, Hilde Strøm; Steinsbekk, Aslak; Solbjør, Marit; Granbo, Randi; Garåsen, Helge
2014-11-08
Development of more self-management support programmes in primary health care has been one option used to enhance positive outcomes in chronic disease management. At present, research results provide no consensus on what would be the best way to develop support programmes into new settings. The aim of the present study was therefore to explore users' and health professionals' perceptions of what would be the vital elements in a self - management support programme applicable in primary health care, how to account for them, and why. Four qualitative, semi-structured focus group interviews were conducted in Central Norway. The informants possessed experience in development, provision, or participation in a self-management support programme. Data was analysed by the Systematic Text Condensation method. The results showed an overall positive expectation to the potential benefits of development of a self-management support programme in primary health care. Despite somewhat different arguments and perspectives, the users and the health professionals had a joint agreement on core characteristics; a self-management support programme in primary health care should therefore be generic, not disease specific, and delivered in a group- based format. A special focus should be on the everyday- life of the participants. The most challenging aspect was a present lack of competence and experience among health professionals to moderate self-management support programmes. The development and design of a relevant and applicable self-management support programme in primary health care should balance the interests of the users with the possibilities and constraints within each municipality. It would be vital to benefit from the closeness of the patients' every-day life situations. The user informants' perception of a self-management support programme as a supplement to regular medical treatment represented an expanded understanding of the self-management support concept. An exploring approach should be applied in the development of the health professionals' competence in practice. The effect of a self-management support programme based on the core characteristics found in this study needs to be evaluated.
Management of organisational changes in a case of de-institutionalisation.
Parlalis, Stavros K
2011-01-01
This paper seeks to explore the development of a discharge programme in one learning disability hospital in Scotland. The study aims to concentrate on organisational developmental changes in that institution. The model of the management during the discharge programme was investigated. The aim of the study is to explore how the discharge programme developed, as seen under the lens of organisational change, in order to find out what kind of model of management is more suitable in similar programmes. A case study was employed. Data were collected by means of interviews. The interviews followed a structured format. The sample of the study had to be a purposive sample and the method of snowball sampling was used; finally, 28 interviews were conducted. A grounded approach was adopted for the data analysis. The software program QSR "NUD*IST" (version "N6") was used as a technical tool, in order to facilitate the data analysis. The findings of this study show that various management models were adopted in the four phases of the discharge programme. These different models represent a "quest" by the institution's management regarding the most appropriate model for managing the discharge programme. This study shows that this goes on continuously in organisations under transition until they settle down to a more permanent state. It was concluded that management models, which are composed of characteristics from the organic theory of organisational management, could apply in discharge programmes. The data gathered enabled the researcher to arrive at a model of management which is suitable for managing organisational changes in discharge programmes, the named "stakeholder management model".
The integration of studio cycling into a worksite stress management programme.
Clark, Matthew M; Soyring, Jason E; Jenkins, Sarah M; Daniels, Denise C; Berkland, Bridget E; Werneburg, Brooke L; Hagen, Philip T; Lopez-Jimenez, Francisco; Warren, Beth A; Olsen, Kerry D
2014-04-01
High stress is a prevalent problem in the worksite. To reduce stress, improve productivity, reduce absenteeism, and lower healthcare costs, many companies offer exercise classes or stress management programmes. Although physical activity is an important component of stress management, few worksites have integrated physical activity into their comprehensive stress reduction programmes. The purpose of this single-arm pilot project was to examine the potential effectiveness of an integrated exercise (studio cycling) and cognitive-behavioural stress management programme. Eighty-four adults, 75% female, mostly aged 40+ years, participated in an integrated 12-week cycling studio and cognitive-behavioural stress management programme. Participants experienced a significant and clinically meaningful reduction on the Perceived Stress Scale (p < 0.01), rating of current stress level and confidence to manage stress at the programme's end and at a 1-month follow-up. Participants also reported having significantly improved overall health, improved nutritional habits, higher physical activity level, greater confidence in their ability to follow a healthy diet, higher spiritual well-being, improved sleep, receiving more support for maintaining healthy living and improved quality of life at the completion of the 12-week programme and 1-month follow-up. These findings provide further support for an integrated exercise and stress management programme. © 2013 John Wiley & Sons, Ltd.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Appel, Gordon John
Sandia National Laboratories (SNL) Fuel Cycle Technologies (FCT) program activities are conducted in accordance with FCT Quality Assurance Program Document (FCT-QAPD) requirements. The FCT-QAPD interfaces with SNL approved Quality Assurance Program Description (SNL-QAPD) as explained in the Sandia National Laboratories QA Program Interface Document for FCT Activities (Interface Document). This plan describes SNL's FY16 assessment of SNL's FY15 FCT M2 milestone deliverable's compliance with program QA requirements, including SNL R&A requirements. The assessment is intended to confirm that SNL's FY15 milestone deliverables contain the appropriate authenticated review documentation and that there is a copy marked with SNL R&A numbers.
Jonsdottir, Helga
2013-03-01
To synthesise findings from previously published studies on the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease. Self-management is a widely valued concept to address contemporary issues of chronic health problems. Yet, findings of self-management programmes for people with chronic obstructive pulmonary disease are indecisive. Literature review of (1) previously published systematic reviews and (2) an integrative literature review. Synthesis of findings from previously published systematic reviews (n = 4) of the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease and an integrated review that was performed on papers published between January 2007-June 2012 (n = 9). Findings demonstrate that there are few studies on the effectiveness of self-management programmes on people with chronic obstructive pulmonary disease despite more than a decade of research activities. Outcomes of the studies reveal some increase in health-related quality of life and reduction in use of healthcare resources. The methodological approaches vary, and the sample size is primarily small. Families are not acknowledged. Features of patient-centredness exist in self-management programmes, particularly in the more recent articles. The effectiveness of self-management programmes for people with chronic obstructive pulmonary disease remains indecisive. A reconceptualisation of self-management programmes is called for with attention to a family-centred, holistic and relational care focusing on living with and minimising the handicapping consequences of the health problems in their entirety. © 2013 Blackwell Publishing Ltd.
ERIC Educational Resources Information Center
Caperchione, Cristina M.; Reid, R. Colin; Sharp, Paul G.; Stehmeier, Joshua
2016-01-01
Objectives: The value of workplace wellness programmes (WWPs) has been established in the literature. Such programmes, however, have an increased likelihood for success when both management and non-management employees' perspectives and needs are incorporated into development and implementation. This study aimed to identify the perspectives of…
Lwembe, Saumu; Green, Stuart A; Tanna, Nuttan; Connor, Jane; Valler, Colin; Barnes, Ruth
2016-07-30
Childhood vaccination remains a primary mechanism for reducing the burden of infectious disease. In the United Kingdom, as in many countries, a sustained effort is required to ensure that vaccination targets are met to afford protection to the whole population from vaccine preventable disease. The Celebrate and Protect programme is a collaborative partnership developed to improve the uptake of childhood vaccination across a number of boroughs within London through the use of a celebration card to encourage attendance for vaccination and enhance relationships between general practices and the parents/carers of children. This study was undertaken to assess the suitability, feasibility and acceptability of the Celebrate and Protect programme across nine boroughs in London. Data were collected either from telephone interviews (n = 24) or from focus groups (n = 31). A total of 55 key informants were included in the study, representing strategic, commissioning or policy leads, healthcare professionals and primary care teams delivering vaccinations and parents/carers of children under five. The analysis of data identified that whilst parents/carers saw the celebration card positively this raised the issue of 'vaccine hesitancy' and the lack of information that parents/carers have to make informed decisions about vaccination. Similarly, healthcare professionals viewed the programme positively and felt that it was deliverable within existing resources although they raised wider questions about on-going sustainability and about quantitative data collection. In relation to the collaboration between primary care and a pharmaceutical company in developing the Celebrate and Protect programme, it was generally felt that, provided appropriate governance is in place, it was a pragmatic approach in which the benefits outweighed any perceived disadvantages. The Celebrate and Protect programme was seen as an innovative collaborative programme to engage with parents and carers of children in order to improve relationships between service users and providers and subsequently increase vaccination uptake. The analysis demonstrates that that the celebration card is suitable for its purpose, acceptable to both healthcare professionals and to parents/carers of children and the Celebrate and Protect programme has been able to deliver its aims. Whilst the delivery of the 'celebration card' intervention in primary met its objectives there are some outstanding issues in terms of the sustainability of the initiative and the ability to demonstrate quantitative improvements in vaccination uptake rates.
NASA Astrophysics Data System (ADS)
Bazin, S.
2012-04-01
Landslide monitoring means the comparison of landslide characteristics like areal extent, speed of movement, surface topography and soil humidity from different periods in order to assess landslide activity. An ultimate "universal" methodology for this purpose does not exist; every technology has its own advantages and disadvantages. End-users should carefully consider each one to select the methodologies that represent the best compromise between pros and cons, and are best suited for their needs. Besides monitoring technology, there are many factors governing the choice of an Early Warning System (EWS). A people-centred EWS necessarily comprises five key elements: (1) knowledge of the risks; (2) identification, monitoring, analysis and forecasting of the hazards; (3) operational centre; (4) communication or dissemination of alerts and warnings; and (5) local capabilities to respond to the warnings received. The expression "end-to-end warning system" is also used to emphasize that EWSs need to span all steps from hazard detection through to community response. The aim of the present work is to provide guidelines for establishing the different components for landslide EWSs. One of the main deliverables of the EC-FP7 SafeLand project addresses the technical and practical issues related to monitoring and early warning for landslides, and identifies the best technologies available in the context of both hazard assessment and design of EWSs. This deliverable targets the end-users and aims to facilitate the decision process by providing guidelines. For the purpose of sharing the globally accumulated expertise, a screening study was done on 14 EWSs from 8 different countries. On these bases, the report presents a synoptic view of existing monitoring methodologies and early-warning strategies and their applicability for different landslide types, scales and risk management steps. Several comprehensive checklists and toolboxes are also included to support informed decisions. The deliverable was compiled with contributions from experts on landslides, monitoring technologies, remote sensing, and social researchers from 16 European institutions. The deliverable addresses one of the main objectives of the SafeLand project, namely to merge experience and expert judgment and create synergies on European level towards guidelines for early warning and to make these results available to end-users and local stakeholders.
Integrating software architectures for distributed simulations and simulation analysis communities.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Goldsby, Michael E.; Fellig, Daniel; Linebarger, John Michael
2005-10-01
The one-year Software Architecture LDRD (No.79819) was a cross-site effort between Sandia California and Sandia New Mexico. The purpose of this research was to further develop and demonstrate integrating software architecture frameworks for distributed simulation and distributed collaboration in the homeland security domain. The integrated frameworks were initially developed through the Weapons of Mass Destruction Decision Analysis Center (WMD-DAC), sited at SNL/CA, and the National Infrastructure Simulation & Analysis Center (NISAC), sited at SNL/NM. The primary deliverable was a demonstration of both a federation of distributed simulations and a federation of distributed collaborative simulation analysis communities in the context ofmore » the same integrated scenario, which was the release of smallpox in San Diego, California. To our knowledge this was the first time such a combination of federations under a single scenario has ever been demonstrated. A secondary deliverable was the creation of the standalone GroupMeld{trademark} collaboration client, which uses the GroupMeld{trademark} synchronous collaboration framework. In addition, a small pilot experiment that used both integrating frameworks allowed a greater range of crisis management options to be performed and evaluated than would have been possible without the use of the frameworks.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
The multi-agent system (MAS) approach has been applied with promising results for enhancing an electric power distribution circuit, such as the Circuit of the Future as developed by Southern California Edison. These next generation power system results include better ability to reconfigure the circuit as well as the increased capability to improve the protection and enhance the reliability of the circuit. There were four main tasks in this project. The specific results for each of these four tasks and their related topics are presented in main sections of this report. Also, there were seven deliverables for this project. The mainmore » conclusions for these deliverables are summarized in the identified subtask section of this report. The specific details for each of these deliverables are included in the “Project Deliverables” section at the end of this Final Report.« less
Observations, Ideas, and Opinions: Systems Engineering and Integration for Return to Flight
NASA Technical Reports Server (NTRS)
Gafka, George K.
2006-01-01
This presentation addresses project management and systems engineering and integration challenges for return to flight, focusing on the Thermal Protection System Tile Repair Project (TRP). The program documentation philosophy, communication with program requirements flow and philosophy and planned deliverables and documentation are outlined. The development of TRP 'use-as-is' analytical tools is also highlighted and emphasis is placed on the use flight history to assess pre-flight and real-time risk. Additionally, an overview is provided of the repair procedure, including an outline of the logistics deployment chart.
NASA Technical Reports Server (NTRS)
Englander, Jacob; Vavrina, Matthew
2015-01-01
The customer (scientist or project manager) most often does not want just one point solution to the mission design problem Instead, an exploration of a multi-objective trade space is required. For a typical main-belt asteroid mission the customer might wish to see the trade-space of: Launch date vs. Flight time vs. Deliverable mass, while varying the destination asteroid, planetary flybys, launch year, etcetera. To address this question we use a multi-objective discrete outer-loop which defines many single objective real-valued inner-loop problems.
Stakeholder Perspectives: CLIL Programme Management in Estonia
ERIC Educational Resources Information Center
Mehisto, Peeter; Asser, Hiie
2007-01-01
In 2000, Estonia launched a voluntary Estonian language CLIL programme for seven year-olds in four Russian-medium schools. The programme has expanded rapidly to a total of 48 kindergartens and schools. This paper reports on research into stakeholder perspectives on programme management. In addition to surveying parents, teachers, vice-principals…
School Security Assessment Programme in Australia
ERIC Educational Resources Information Center
Marrapodi, John
2007-01-01
This article describes a successful security risk management programme in Australia. The state-wide programme follows a structured risk management approach focusing on the safety and security of people, information, provision, and assets in the school environment. To assist school principals, a Security Risk Assessment Programme was developed on a…
Odhiambo, Jackline; Amoroso, Cheryl L.; Barebwanuwe, Peter; Warugaba, Christine; Hedt-Gauthier, Bethany L.
2017-01-01
ABSTRACT Background: Promoting national health research agendas in low- and middle-income countries (LMICs) requires adequate numbers of individuals with skills to initiate and conduct research. Recently, non-governmental organizations (NGOs) have joined research capacity building efforts to increase research leadership by LMIC nationals. Partners In Health, an international NGO operating in Rwanda, implemented its first Intermediate Operational Research Training (IORT) course to cultivate Rwandan research talent and generate evidence to improve health care delivery. Objective: This paper describes the implementation of IORT to share experiences with other organizations interested in developing similar training programmes. Methods: The Intermediate Operational Research Training utilized a deliverable-driven training model, using learning-by-doing pedagogy with intensive hands-on mentorship to build research skills from protocol development to scientific publication. The course had short (two-day) but frequent training sessions (seven sessions over eight months). Trainees were clinical and programme staff working at the district level who were paired to jointly lead a research project. Results: Of 10 trainees admitted to the course from a pool of 24 applicants, nine trainees completed the course with five research projects published in peer-reviewed journals. Strengths of the course included supportive national and institutional research capacity guidelines, building from a successful training model, and trainee commitment. Challenges included delays in ethical review, high mentorship workload of up to 250 hours of practicum mentorship, lack of access to literature in subscription journals and high costs of open access publication. Conclusions: The IORT course was an effective way to support the district-based government and NGO staff in gaining research skills, as well as answering research questions relevant to health service delivery at district hospitals. Other NGOs should build on successful programmes while adapting course elements to address context-specific challenges. Mentorship for LMIC trainees is critical for effectiveness of research capacity building initiatives. PMID:29119872
Odhiambo, Jackline; Amoroso, Cheryl L; Barebwanuwe, Peter; Warugaba, Christine; Hedt-Gauthier, Bethany L
2017-01-01
Promoting national health research agendas in low- and middle-income countries (LMICs) requires adequate numbers of individuals with skills to initiate and conduct research. Recently, non-governmental organizations (NGOs) have joined research capacity building efforts to increase research leadership by LMIC nationals. Partners In Health, an international NGO operating in Rwanda, implemented its first Intermediate Operational Research Training (IORT) course to cultivate Rwandan research talent and generate evidence to improve health care delivery. This paper describes the implementation of IORT to share experiences with other organizations interested in developing similar training programmes. The Intermediate Operational Research Training utilized a deliverable-driven training model, using learning-by-doing pedagogy with intensive hands-on mentorship to build research skills from protocol development to scientific publication. The course had short (two-day) but frequent training sessions (seven sessions over eight months). Trainees were clinical and programme staff working at the district level who were paired to jointly lead a research project. Of 10 trainees admitted to the course from a pool of 24 applicants, nine trainees completed the course with five research projects published in peer-reviewed journals. Strengths of the course included supportive national and institutional research capacity guidelines, building from a successful training model, and trainee commitment. Challenges included delays in ethical review, high mentorship workload of up to 250 hours of practicum mentorship, lack of access to literature in subscription journals and high costs of open access publication. The IORT course was an effective way to support the district-based government and NGO staff in gaining research skills, as well as answering research questions relevant to health service delivery at district hospitals. Other NGOs should build on successful programmes while adapting course elements to address context-specific challenges. Mentorship for LMIC trainees is critical for effectiveness of research capacity building initiatives.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-04
... at $145 per share would carry a total deliverable value of $145,000, and the strike price would be... Jumbo option strike price of $145 was trading at $146 per share, the intrinsic $1 per share value would... Shares Deliverable Upon Exercise 100 shares........ 1,000 shares Strike Price if underlying is 45 45 $45...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Appel, Gordon John
This report is the milestone deliverable M4FT-17SN111102091 “Summary of Assessments Performed FY17 by SNL QA POC” for work package FT-17SN11110209 titled “Quality Assurance – SNL”. This report summarizes the FY17 assessment performed on Fuel Cycle Technologies / Spent Fuel and Waste Disposition efforts.
Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz; Hassounah, Sondus
2016-01-01
To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programmes in Pakistan. 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB strategy over others due to external influences and 3. Limitations in the overall health system. To improve the tuberculosis control programme in the country political commitment needs to be enhanced and public -private partnerships increased. This can be done through government prioritisation of TB control at both national and provincial levels; donor-funded components should not receive undue attention; and partnerships with the private health sector, health institutions not yet covered by DOTS services, non-governmental organisations and patient coalitions should be increased.
ERIC Educational Resources Information Center
Aldowaisan, Tariq; Allahverdi, Ali
2016-01-01
This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and…
A Masters Programme in Telecommunications Management--Demand-Based Curriculum Design
ERIC Educational Resources Information Center
Gharaibeh, Khaled M.; Kaylani, Hazem; Murphy, Noel; Brennan, Conor; Itradat, Awni; Al-Bataineh, Mohammed; Aloqlah, Mohammed; Salhieh, Loay; Altarazi, Safwan; Rawashdeh, Nathir; del Carmen Bas Cerdá, María; Conchado Peiró, Andrea; Al-Zoubi, Asem; Harb, Bassam; Bany Salameh, Haythem
2015-01-01
This paper presents a curriculum design approach for a Masters Programme in Telecommunications Management based on demand data obtained from surveying the needs of potential students of the proposed programme. Through online surveys disseminated at telecom companies in Jordan, it was possible to measure the demand for such a programme and to…
The milk delivery chain and presence of Brucella spp. antibodies in bulk milk in Uganda.
Rock, Kim Toeroek; Mugizi, Denis Rwabiita; Ståhl, Karl; Magnusson, Ulf; Boqvist, Sofia
2016-06-01
This study examined the influence of informal milk delivery chains on the risk of human exposure to Brucella spp. through milk consumption in two regions of Uganda (Gulu and Soroti Districts). The work involved describing milk delivery chains, investigating brucellosis awareness amongst milk deliverers and determining the presence of Brucella spp. antibodies in cattle milk on delivery to primary collection points (boiling points and dairies). Milk samples (n = 331) were collected from deliverers at primary collection points and from street vendors at point of sale and analysed using indirect enzyme-linked immunosorbent assay (I-ELISA). A written questionnaire was used to collect data from deliverers (n = 279) on their milk delivery chains and their brucellosis awareness. The most common delivery points in Gulu District were small dairies and in Soroti District boiling points. The presence of Brucella spp. antibodies in milk samples was higher in Soroti (40 %) than in Gulu (11 %) (P < 0.0001). There are possible public health risk consequences of this finding as 42 % of deliverers in Soroti District reported drinking raw milk, compared with 15 % in Gulu District (P < 0.0001). Awareness of brucellosis was low, with 70 % of all milk deliverers reporting not having heard of the disease or the bacterium. Application of quality controls for milk (colour and odour) along the delivery chain varied depending upon supply and demand. This study provides evidence of the diversity of informal milk markets in low-income countries and of the potential public health risks of consuming unpasteurised milk. These results can be useful to those planning interventions to reduce brucellosis.
Implementation of Task-Tracking Software for Clinical IT Management.
Purohit, Anne-Maria; Brutscheck, Clemens; Prokosch, Hans-Ulrich; Ganslandt, Thomas; Schneider, Martin
2017-01-01
Often in clinical IT departments, many different methods and IT systems are used for task-tracking and project organization. Based on managers' personal preferences and knowledge about project management methods, tools differ from team to team and even from employee to employee. This causes communication problems, especially when tasks need to be done in cooperation with different teams. Monitoring tasks and resources becomes impossible: there are no defined deliverables, which prevents reliable deadlines. Because of these problems, we implemented task-tracking software which is now in use across all seven teams at the University Hospital Erlangen. Over a period of seven months, a working group defined types of tasks (project, routine task, etc.), workflows, and views to monitor the tasks of the 7 divisions, 20 teams and 340 different IT services. The software has been in use since December 2016.
Brownlie, Tom S; Morton, John M; Heuer, Cord; McDougall, Scott
2015-02-01
A group-based reproductive management extension programme has been designed to help managers of dairy herds improve herd reproductive performance. The aims of this study were, firstly, to assess effects of participation by key decision makers (KDMs) in a farmer action group programme in 2009 and 2010 on six key management outcomes (KMOs) that affect reproductive performance over 2 years (2009-2010 and 2010-2011), and secondly, to describe KDM intentions to change management behaviour(s) affecting each management outcome after participation in the programme. Seasonal calving dairy herds from four regions of New Zealand were enrolled in the study. Intentions to modify management behaviour were recorded using the formal written action plans developed during the extension programme. KMOs assessed were calving pattern of the herd, pre-calving heifer liveweight, pre-calving and premating body condition score (BCS), oestrus detection, anoestrus cow management and bull management. Participation was associated with improvements in heifer liveweight, more heifers calving in the first 6 weeks of the seasonal calving period, premating BCS and oestrus detection. No significant effects were observed on anoestrus cow management or bull management. KDMs with greater numbers of proposed actions had lower 6 week in-calf rates in the second study year than KDMs who proposed fewer actions. A more effective strategy to ensure more appropriate objectives is proposed. Strategies to help KDMs to implement proposed actions more successfully should be investigated to improve the programme further. Copyright © 2014 Elsevier Ltd. All rights reserved.
Mukumbang, Ferdinand C; van Belle, Sara; Marchal, Bruno; van Wyk, Brian
2016-01-01
The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theory-the assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. The perspectives of the programme designers and managers provided an important step towards developing an initial programme theory, which will guide our realist evaluation of the adherence club programme in South Africa.
Employees' perceptions of the Aid-for-AIDS disease-management programme, South Africa.
Rothberg, Alan; Van Huyssteen, Karen
2008-11-01
It is estimated that 18-20% of South Africa's more than 5 million HIV-positive individuals are formally employed. Disease management programmes for these employees vary in scope and sophistication, with services provided by the employer, or third-party specialist disease managers, or through medical aid schemes. This study surveyed 215 HIV-positive employees in two organisations contracted to the Aid for AIDS (AfA) disease management programme through their in-house medical aid schemes. The two organisations differed in their overall approach to HIV and AIDS: one mainly relies on on-site access to voluntary counselling and testing (VCT) and AfA's management of registered HIV-positive employees, while the other has invested in and actively developed a comprehensive programme that also extends to families and the community as well as links employees to the AfA programme. Responses received from 28 of the 215 employees surveyed indicate that fear of disclosure of one's HIV status and of stigmatisation are reasons for late registration with the AfA programme or non-utilisation of other available support programmes. Respondents mentioned that confidence in the employer's ability to maintain confidentiality was also an issue. Respondents' important suggestions for change included: a) on-site educational and awareness programmes for management personnel and staff in order to reduce HIV discrimination and stigmatisation; b) information directed at HIV-positive employees publicising the benefits and effectiveness of medical treatment; c) support groups for HIV-positive employees; and d) management personnel to engage with HIV-infected employees who are willing to take an active role in staff education and the development of workplace policies and programmes.
Tay, Kay Chai Peter; Drury, Vicki Blair; Mackey, Sandra
2014-02-01
Self-management programmes have previously been found to decrease health problems, enhance quality of life and increase independence. However, there is no literature that examines the influence of the participants' intrinsic motivation on the outcomes of such programmes. This study examined the role of intrinsic motivation in a pilot low vision self-management programme to enhance self-efficacy and quality of life of the programme participants. A positive association was observed between the female participants' perceived choice and perceived competence, two underlying dimensions of the Intrinsic Motivation Inventory. In addition, a positive correlation was observed between the younger participants' perceived competence and the change in their quality of life. The findings provide some support for consideration of participants' intrinsic motivation in the development of effective self-management programmes. © 2013 Wiley Publishing Asia Pty Ltd.
Woodford Guegan, Eleanor; Cook, Andrew
2014-06-01
The European network for Health Technology Assessment Joint Action (EUnetHTA JA) project's overarching objective was to 'establish an effective and sustainable HTA [Health technology assessment] collaboration in Europe that brings added value at the regional, national and European level'. Specific objectives were to develop a strategy and business model for sustainable European collaboration on HTA, develop HTA tools and methods and promote good practice in HTA methods and processes. We describe activities performed on behalf of the National Institute for Health Research HTA programme; evaluating the project processes and developing a data set for a registry of planned clinical studies of relevance to public funders. Annual self-completion online questionnaires were sent to project participants and external stakeholders to identify their views about the project processes. Documentary review was undertaken at the project end on the final technical reports from the work packages to examine whether or not their deliverables had been achieved. The project's impact was assessed by whether or not the deliverables were produced, the objectives met and additional 'added value' generated. The project's effectiveness was evaluated by its processes, communication, administration, workings of individual work packages and involvement of external stakeholders. A two-stage Delphi exercise was undertaken to identify the data elements that should be included in a registry of planned clinical studies of relevance to public funders. The data set was validated by an efficacy testing exercise. High response rates were achieved for the questionnaires sent to project participants and this was attributed to the evidence-based strategy implemented. Response rates to questionnaires sent to external stakeholders were disappointingly lower. Most of the high-level objectives were achieved, although applying the developed tools in practice will be implemented in the European network for Health Technology Assessment Joint Action 2 (EUnetHTA JA2). Most work packages produced their planned deliverables. Networking emerged as one of the main benefits of the project and face-to-face meetings were important. However, the overarching objective did not appear to have been met because there will be a follow-up EUnetHTA JA2 project (reliant on project funding) before the establishment of any permanent network. Twelve organisations from three continents participated in the Delphi exercise to develop the data set. It was demonstrated that a registry for matching pragmatic clinical studies under consideration by funders could be built on a very small data set. This would include 10 unique items, of which five are required to describe a study and the rest are metadata. In the test sample the data set with an appropriate matching rule was able to deliver a sensitivity of between 50% and 100% and a specificity of between 43% and 86% for matching different elements. A number of recommendations have been made for the next EUnetHTA JA2 project and its evaluation. This included that the evaluation of the EUnetHTA JA2 project should extend beyond the end of the project to allow assessment of its impact; that the quality, usability and cost-effectiveness of tools in 'real-world HTA practice' should be assessed and tangible benefits of international networking should be evaluated. It is worth proceeding to develop a database registry aimed at identifying trials in development based on the data set developed. The study was funded by the National Institute for Health Research Health Technology Assessment programme (50%) and the European Union Commission (50%).
Woodford Guegan, Eleanor; Cook, Andrew
2014-01-01
BACKGROUND The European network for Health Technology Assessment Joint Action (EUnetHTA JA) project's overarching objective was to 'establish an effective and sustainable HTA [Health technology assessment] collaboration in Europe that brings added value at the regional, national and European level'. Specific objectives were to develop a strategy and business model for sustainable European collaboration on HTA, develop HTA tools and methods and promote good practice in HTA methods and processes. We describe activities performed on behalf of the National Institute for Health Research HTA programme; evaluating the project processes and developing a data set for a registry of planned clinical studies of relevance to public funders. METHODS Annual self-completion online questionnaires were sent to project participants and external stakeholders to identify their views about the project processes. Documentary review was undertaken at the project end on the final technical reports from the work packages to examine whether or not their deliverables had been achieved. The project's impact was assessed by whether or not the deliverables were produced, the objectives met and additional 'added value' generated. The project's effectiveness was evaluated by its processes, communication, administration, workings of individual work packages and involvement of external stakeholders. A two-stage Delphi exercise was undertaken to identify the data elements that should be included in a registry of planned clinical studies of relevance to public funders. The data set was validated by an efficacy testing exercise. RESULTS AND DISCUSSION High response rates were achieved for the questionnaires sent to project participants and this was attributed to the evidence-based strategy implemented. Response rates to questionnaires sent to external stakeholders were disappointingly lower. Most of the high-level objectives were achieved, although applying the developed tools in practice will be implemented in the European network for Health Technology Assessment Joint Action 2 (EUnetHTA JA2). Most work packages produced their planned deliverables. Networking emerged as one of the main benefits of the project and face-to-face meetings were important. However, the overarching objective did not appear to have been met because there will be a follow-up EUnetHTA JA2 project (reliant on project funding) before the establishment of any permanent network. Twelve organisations from three continents participated in the Delphi exercise to develop the data set. It was demonstrated that a registry for matching pragmatic clinical studies under consideration by funders could be built on a very small data set. This would include 10 unique items, of which five are required to describe a study and the rest are metadata. In the test sample the data set with an appropriate matching rule was able to deliver a sensitivity of between 50% and 100% and a specificity of between 43% and 86% for matching different elements. CONCLUSIONS A number of recommendations have been made for the next EUnetHTA JA2 project and its evaluation. This included that the evaluation of the EUnetHTA JA2 project should extend beyond the end of the project to allow assessment of its impact; that the quality, usability and cost-effectiveness of tools in 'real-world HTA practice' should be assessed and tangible benefits of international networking should be evaluated. It is worth proceeding to develop a database registry aimed at identifying trials in development based on the data set developed. FUNDING The study was funded by the National Institute for Health Research Health Technology Assessment programme (50%) and the European Union Commission (50%). PMID:24913263
2014-01-01
Background Acquired brain injury (ABI), often arising from stroke or trauma, is a common cause of long-term disability, physical inactivity and poor health outcomes globally. Individuals with ABI face many barriers to increasing physical activity, such as impaired mobility, access to services and knowledge regarding management of physical activity. Self-management programmes aim to build skills to enable an individual to manage their condition, including their physical activity levels, over a long period of time. Programme delivery modes can include traditional face-to-face methods, or remote delivery, such as via the Internet. However, it is unknown how effective these programmes are at specifically improving physical activity in community-dwelling adults with ABI, or how effective and acceptable remote delivery of self-management programmes is for this population. Methods/Design We will conduct a comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro and Science Citation Index Expanded (SCI-EXPANDED) databases that assess the efficacy of a self-management intervention, which aims to enhance levels of physical activity in adults living in the community with ABI. Two independent reviewers will screen studies for eligibility, assess risk of bias, and extract relevant data. Where possible, a meta-analysis will be performed to calculate the overall effect size of self-management interventions on physical activity levels and on outcomes associated with physical activity. A comparison will also be made between face-to-face and remote delivery modes of self-management programmes, in order to examine efficacy and acceptability. A content analysis of self-management programmes will also be conducted to compare aspects of the intervention that are associated with more favourable outcomes. Discussion This systematic review aims to review the efficacy of self-management programmes aimed at increasing physical activity levels in adults living in the community with ABI, and the efficacy and acceptability of remote delivery of these programmes. If effective, remote delivery of self-management programmes may offer an alternative way to overcome barriers and empower individuals with ABI to increase their levels of physical activity, improving health and general wellbeing. Trial registration Our protocol has been registered on PROSPERO 2013: CRD42013006748. PMID:24745356
Jones, Taryn M; Hush, Julia M; Dear, Blake F; Titov, Nickolai; Dean, Catherine M
2014-04-21
Acquired brain injury (ABI), often arising from stroke or trauma, is a common cause of long-term disability, physical inactivity and poor health outcomes globally. Individuals with ABI face many barriers to increasing physical activity, such as impaired mobility, access to services and knowledge regarding management of physical activity. Self-management programmes aim to build skills to enable an individual to manage their condition, including their physical activity levels, over a long period of time. Programme delivery modes can include traditional face-to-face methods, or remote delivery, such as via the Internet. However, it is unknown how effective these programmes are at specifically improving physical activity in community-dwelling adults with ABI, or how effective and acceptable remote delivery of self-management programmes is for this population. We will conduct a comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro and Science Citation Index Expanded (SCI-EXPANDED) databases that assess the efficacy of a self-management intervention, which aims to enhance levels of physical activity in adults living in the community with ABI. Two independent reviewers will screen studies for eligibility, assess risk of bias, and extract relevant data. Where possible, a meta-analysis will be performed to calculate the overall effect size of self-management interventions on physical activity levels and on outcomes associated with physical activity. A comparison will also be made between face-to-face and remote delivery modes of self-management programmes, in order to examine efficacy and acceptability. A content analysis of self-management programmes will also be conducted to compare aspects of the intervention that are associated with more favourable outcomes. This systematic review aims to review the efficacy of self-management programmes aimed at increasing physical activity levels in adults living in the community with ABI, and the efficacy and acceptability of remote delivery of these programmes. If effective, remote delivery of self-management programmes may offer an alternative way to overcome barriers and empower individuals with ABI to increase their levels of physical activity, improving health and general wellbeing. Our protocol has been registered on PROSPERO 2013: CRD42013006748.
ERIC Educational Resources Information Center
de Jager, M.; Ntlokwana, N.
2011-01-01
A survey was sent to 33 managers at units and centres involved in Higher Education student-to-student support services in the form of peer help programmes. The survey focused on managers' perspectives on peer help programme demographics, management, planning and resourcing, on intra-institutional and other linkages, as well as on institutional…
Cost Analysis of Chronic Disease Self-Management Programmes Being Delivered in South Florida
ERIC Educational Resources Information Center
Page, Timothy F.; Palmer, Richard C.
2014-01-01
Background: Chronic disease accounts for the majority of healthcare costs. The Chronic Disease Self-Management Programme (CDSMP) has been shown to be effective in reducing the burden of chronic disease. Objectives: The objective of this study was to measure the cost of delivering the Chronic Disease Self-Management Programme (CDSMP) in order to…
Tourism and Management Study Programme through Blended Learning: Development and Results
ERIC Educational Resources Information Center
Simonova, Ivana
2018-01-01
This paper introduces and discusses a tourism and management study programme at the Faculty of Informatics and Management (FIM), University of Hradec Králové. It begins with description of the programme, along with a summary of its history and is considered in the light of changes in accreditation requirements. Students' interest in the programme…
ERIC Educational Resources Information Center
Russell, Jack; Russell, Barbara
2015-01-01
The goal is to provide a robust and challenging problem statement for a capstone, advanced systems analysis and design course for CIS/MIS/CS majors. In addition to the problem narrative, a representative solution for much of the business modeling deliverables is presented using the UML paradigm. A structured analysis deliverable will be the topic…
ERIC Educational Resources Information Center
Ludwig, Timothy D.; Geller, E. Scott; Clarke, Steven W.
2010-01-01
Additive effects of publicly posting individual feedback following group goal-setting and feedback were evaluated. The turn-signal use of pizza deliverers was studied in a multiple baseline design across two pizza stores. After baseline observations, pizza deliverers voted on a group turn-signal goal and then received 4 weeks of group feedback on…
Transfer of Learning from Management Development Programmes: Testing the Holton Model
ERIC Educational Resources Information Center
Kirwan, Cyril; Birchall, David
2006-01-01
Transfer of learning from management development programmes has been described as the effective and continuing application back at work of the knowledge and skills gained on those programmes. It is a very important issue for organizations today, given the large amounts of investment in these programmes and the small amounts of that investment that…
NASA Technical Reports Server (NTRS)
Meyer, Michael L.; Doherty, Michael P.; Moder, Jeffrey P.
2014-01-01
In support of its goal to find an innovative path for human space exploration, NASA embarked on the Cryogenic Propellant Storage and Transfer (CPST) Project, a Technology Demonstration Mission (TDM) to test and validate key cryogenic capabilities and technologies required for future exploration elements, opening up the architecture for large in-space cryogenic propulsion stages and propellant depots. Recognizing that key Cryogenic Fluid Management (CFM) technologies anticipated for on-orbit (flight) demonstration would benefit from additional maturation to a readiness level appropriate for infusion into the design of the flight demonstration, the NASA Headquarters Space Technology Mission Directorate (STMD) authorized funding for a one-year technology maturation phase of the CPST project. The strategy, proposed by the CPST Project Manager, focused on maturation through modeling, concept studies, and ground tests of the storage and fluid transfer of CFM technology sub-elements and components that were lower than a Technology Readiness Level (TRL) of 5. A technology maturation plan (TMP) was subsequently approved which described: the CFM technologies selected for maturation, the ground testing approach to be used, quantified success criteria of the technologies, hardware and data deliverables, and a deliverable to provide an assessment of the technology readiness after completion of the test, study or modeling activity. The specific technologies selected were grouped into five major categories: thick multilayer insulation, tank applied active thermal control, cryogenic fluid transfer, propellant gauging, and analytical tool development. Based on the success of the technology maturation efforts, the CPST project was approved to proceed to flight system development.
NASA Astrophysics Data System (ADS)
Carr, Gemma; Bloeschl, Guenter; Loucks, Daniel Pete
2013-04-01
Evaluation of participation programmes, projects and activities is essential to identify whether stakeholder involvement has been successful in achieving its aims. Aims may include an improvement in water resource management such as enhanced ecological functioning, an improvement in human wellbeing and economic conditions, or overcoming a conflict between interest groups. Evaluating against "interest-based" resource management criteria requires that a desirable outcome can be identified, agreed upon and be measured at the time of evaluation. In many water management situations where collaborative approaches are applied, multiple interests and objectives are present, or stakeholders have not yet identified their own positions and priorities. Even if a resource management objective has been identified and strategy agreed upon, resource management changes tend to emerge over longer timescales and evaluation frequently takes place before they can be recognised. Evaluating against resource management criteria may lead evaluators to conclude that a programme has failed because it has not achieved a resource management objective at the time of evaluation. This presents a critical challenge to researchers assessing the effectiveness of stakeholder participation programmes. One strategy to overcome this is to conduct "goal-free" evaluation to identify what the programme is actually achieving. An evaluation framework that includes intermediary outcomes that are both tangible achievements such as innovation, creation of new organisations, and shared information and knowledge, as well as intangible achievements such as trust and network development can be applied to more broadly assess a programme's success. Analysis of case-studies in the published literature for which a resource management outcome has been achieved shows that intermediary outcomes frequently precede resource management outcomes. They seem to emerge over shorter timescales than resource management outcomes. Furthermore, failure to achieve intermediary outcomes correlates to failure to achieve resource management outcomes. Evaluating intermediary outcomes leads to both a broader assessment of a programme's achievements at the time of evaluation, and can indicate whether a programme will go on to achieve resource management objectives in the future.
Developments in veterinary herd health programmes on dairy farms: a review.
Noordhuizen, J P; Wentink, G H
2001-11-01
This review article addresses some major developments in herd health programmes for dairy farms over the last decades. It focuses particularly on herd health and production management programmes that use protocols and monitoring activities. The article further emphasizes the need for merging herd health programmes with quantitative epidemiological principles and methods. Subsequently, this article points to the latest developments regarding quality assurance in the dairy sector and some quality management methods. Quality should be regarded in its broadest sense. The importance of integrating veterinary herd health programmes and quality (risk) management support at a dairy farm level is stressed. Examples are provided.
Bottom-up implementation of disease-management programmes: results of a multisite comparison.
Lemmens, K M M; Nieboer, A P; Rutten-Van Mölken, M P M H; van Schayck, C P; Spreeuwenberg, C; Asin, J D; Huijsman, R
2011-01-01
To evaluate the implementation of three regional disease-management programmes on chronic obstructive pulmonary disease (COPD) based on bottlenecks experienced in professional practice. The authors performed a multisite comparison of three Dutch regional disease-management programmes combining patient-related, professional-directed and organisational interventions. Process (Assessing Chronic Illness Care survey) and outcome (disease specific quality of life (clinical COPD questionnaire (CCQ); chronic respiratory questionnaire (CRQ)), Medical Research Council dyspnoea and patients' experiences) data were collected for 370 COPD patients and their care providers. Bottlenecks in region A were mostly related to patient involvement, in region B to organisational issues and in region C to both. Selected interventions related to identified bottlenecks were implemented in all programmes, except for patient-related interventions in programme A. Within programmes, significant improvements were found on dyspnoea and patients' experiences with practice nurses. Outcomes on quality of life differed between programmes: programme A did not show any significant improvements; programme B did show any significant improvements on CCQ total (p<0.001), functional (p=0.011) and symptom (p<0.001), CRQ fatigue (p<0.001) and emotional scales (p<0.001); in programme C, CCQ symptom (p<0.001) improved significantly, whereas CCQ mental score (p<0.001) deteriorated significantly. Regression analyses showed that programmes with better implementation of selected interventions resulted in relatively larger improvements in quality of life (CCQ). Bottom-up implementation of COPD disease-management programmes is a feasible approach, which in multiple settings leads to significant improvements in outcomes of care. Programmes with a better fit between implemented interventions and bottlenecks showed more positive changes in outcomes.
LBNL report of the vetting review of the GRETINA project
DOE Office of Scientific and Technical Information (OSTI.GOV)
Robinson, K.E.; Bercovitz, J.H.; Bieser, F.S.
GRETINA is a gamma-ray detector array capable of reconstructing the energy and spatial positions of gamma-ray interactions within the germanium crystals. It will be used to study the structure and stability of nuclei under various conditions. The new capabilities provided by gamma-ray tracking will give large gains in sensitivity for a large number of experiments, particularly those aimed at nuclei far from beta stability. A proposal for GRETINA was submitted to DOE in June 2003. It presented the scientific case, the readiness of technical development, the design, the suggested management organizations, and a proposed cost and schedule. The GRETINA proposalmore » received its CD0 approval in August 2003. The CD-1 review will be held on December 3 and 4, 2003, and will be handled by the DOE-N. This report presents the charge to the GRETINA vetting review committee, and the findings, comments and recommendations of this committee. The purpose of this project vetting review was to assure that the GRETINA project is on track to provide DOE and the nuclear physics community with the agreed upon deliverables within the agreed upon budget and schedule. The vetting review committee was asked to cover both technical and management aspects of the GRETINA Project. Reviewers offer expert knowledge in relevant areas and provide recommendations and findings to the project's management team. Upon successful completion, the Laboratory's Integrated Project Management Office (IPMO) will recommend signoff of the project to the Laboratory Directorate. The GRETINA vetting review committee was asked to consider all relevant aspects of the project's management, project execution plan (PEP), technical approach and status, cost estimate, resources, schedule and risk and, in doing so, to advise as to whether the GRETINA Project was likely to successfully provide the agreed upon deliverables within the agreed upon budget and schedule. The review committee was asked to identify any project areas that may be incomplete for the current phase in the project and any area of significant risk for the project reaching its objectives. The committee was also asked to review and evaluate the technical status of the project and advise on any concerns or significant technical risks.« less
Delivering a quality-assured fracture liaison service in a UK teaching hospital-is it achievable?
Shipman, K E; Stammers, J; Doyle, A; Gittoes, N
2016-10-01
To determine whether new national guidance on the specifications of a fracture liaison service are realistically deliverable, 1 year of data on the performance of such a service were audited. Audit targets were mostly met. This audit demonstrates that these standards are deliverable in a real world setting. UK service specifications for a fracture liaison service (FLS) have been produced (National Osteoporosis Society, NOS) to promote effective commissioning and delivery of the highest quality care to patients with fragility fractures. How deliverable these standards are has not as yet been methodically reported. Our FLS was modelled on the ten NOS standards; performance was audited after 1 year to determine whether these standards could be delivered and to describe the lessons learnt. Performance was audited against the NOS FLS Service Standards, with management based on the Fracture Risk Assessment Tool (FRAX®), the four-item Falls Risk Assessment Tool (FRAT), National Institute for Health and Care Excellence (NICE) and the National Osteoporosis Guideline Groups (NOGG) guidance. Data were recorded prospectively on a database. The FLS commenced in May 2014, was fully operational in August 2014 and data were captured from 1 September 2014 to 1 September 2015. The FLS detected 1773 patients and standards were largely achieved. Most, 94 %, patients were seen within 6 weeks, 533 DXA requests were generated, 804 outpatient FRAT assessments were recorded (134 required falls intervention) and 773 patients had bone treatments started. On follow-up at 3 months, between 78-79 % were still taking medication. Preliminary evaluation of a FLS implemented according to UK NOS standards demonstrates that the model is practical to apply to a large teaching hospital population. Collection and review of outcome and cost effectiveness data is required to determine the performance of this model in comparison with existing models.
Pinxsterhuis, Irma; Hellum, Live Lange; Aannestad, Hilde Hassum; Sveen, Unni
2015-03-01
The aim of the study was to develop a group-based self-management programme for individuals with chronic fatigue syndrome (CFS) by using the participants' experiences with the initial version of the programme, which intends to promote coping with the illness in a primary healthcare setting. An initial programme was developed, based on self-efficacy theory and the concepts of client-centred practice and empowerment. Subsequently, the programme was tested and further developed by drawing on the participants' experiences with the programme. Focus-group interviews were applied. The interviews were analysed using thematic analysis. The initial programme was found to be feasible, although several modifications regarding the content and practical organization of the programme were proposed. In line with the participants' experiences, the final self-management programme was developed, which includes short presentations of eight topics, exchange of experiences among participants, goal-setting, construction of action plans, and relaxation exercises, in addition to a meeting for relatives. The programme will be provided in eight biweekly sessions and be led by juxtaposed peer counsellors and occupational therapists. The effects of the final programme will be evaluated in a randomized controlled trial.
Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz
2016-01-01
Objective To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. Design A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). Participants National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). Setting National and provincial tuberculosis programmes in Pakistan Main outcome measures 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. Results The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. Conclusion This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB strategy over others due to external influences and 3. Limitations in the overall health system. To improve the tuberculosis control programme in the country political commitment needs to be enhanced and public -private partnerships increased. This can be done through government prioritisation of TB control at both national and provincial levels; donor-funded components should not receive undue attention; and partnerships with the private health sector, health institutions not yet covered by DOTS services, non-governmental organisations and patient coalitions should be increased. PMID:28203383
Lee, Gregory K.
2015-01-01
A digital elevation model (DEM) of the entire country of the Islamic Republic of Mauritania was produced using Shuttle Radar Topography Mission (SRTM) data as required for deliverable 65 of the contract. In addition, because of significant recent advancements of availability, seamlessness, and validity of Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) global elevation data, the U.S. Geological Survey (USGS) extended its efforts to include a higher resolution countrywide ASTER DEM as value added to the required Deliverable 63, which was limited to five areas within the country. Both SRTM and ASTER countrywide DEMs have been provided in ERDAS Imagine (.img) format that is also directly compatible with ESRI ArcMap, ArcGIS Explorer, and other GIS applications.
A model to evaluate quality and effectiveness of disease management.
Lemmens, K M M; Nieboer, A P; van Schayck, C P; Asin, J D; Huijsman, R
2008-12-01
Disease management has emerged as a new strategy to enhance quality of care for patients suffering from chronic conditions, and to control healthcare costs. So far, however, the effects of this strategy remain unclear. Although current models define the concept of disease management, they do not provide a systematic development or an explanatory theory of how disease management affects the outcomes of care. The objective of this paper is to present a framework for valid evaluation of disease-management initiatives. The evaluation model is built on two pillars of disease management: patient-related and professional-directed interventions. The effectiveness of these interventions is thought to be affected by the organisational design of the healthcare system. Disease management requires a multifaceted approach; hence disease-management programme evaluations should focus on the effects of multiple interventions, namely patient-related, professional-directed and organisational interventions. The framework has been built upon the conceptualisation of these disease-management interventions. Analysis of the underlying mechanisms of these interventions revealed that learning and behavioural theories support the core assumptions of disease management. The evaluation model can be used to identify the components of disease-management programmes and the mechanisms behind them, making valid comparison feasible. In addition, this model links the programme interventions to indicators that can be used to evaluate the disease-management programme. Consistent use of this framework will enable comparisons among disease-management programmes and outcomes in evaluation research.
Introducing innovation in a management development programme for a UK primary care organisation.
Smith, Paul; Hampson, Libby; Scott, Jonathan; Bower, Karen
2011-01-01
The aim of this paper is to examine the introduction of innovation as part of a management development programme at a primary care organisation, a legal form known as a Primary Care Trust (PCT), in the UK. The paper draws on experience of managing a successful management development programme for a PCT. The report of the case study analyses the key events that took place between 2008 and 2010, from direct observation, surveys, discussion and documentary evidence. The Northern PCT has partnerships with a number of educational providers to deliver their leadership and management development programmes. A close working relationship had developed and the programme is bespoke - hence it is current and of practical use to the UK's National Health Service (NHS). In addition, there are regular meetings, with module leaders gaining a firsthand understanding of the organisation's needs and aspirations. This has resulted in a very focused and personalised offering and a genuine involvement in the programme and individuals concerned. The research was conducted among a relatively small sample, and there is a lack of previous literature evidence to make significant comparisons. The paper identifies key implications for practitioners and educators in this area. This paper is one of few to investigate innovation and improvement in the NHS, and is unique in that it uses the lenses of a management development programme to explore this important, and under-researched, topic.
Quality of Service for Real-Time Applications Over Next Generation Data Networks
NASA Technical Reports Server (NTRS)
Atiquzzaman, Mohammed; Jain, Raj
2001-01-01
This project, which started on January 1, 2000, was funded by the NASA Glenn Research Center for duration of one year. The deliverables of the project included the following tasks: (1) Study of QoS mapping between the edge and core networks envisioned in the Next Generation networks will provide us with the QoS guarantees that can be obtained from next generation networks; (2) Buffer management techniques to provide strict guarantees to real-time end-to-end applications through preferential treatment to packets belonging to real-time applications. In particular, use of ECN to help reduce the loss on high bandwidth-delay product satellite networks needs to be studied; (3) Effect of Prioritized Packet Discard to increase goodput of the network and reduce the buffering requirements in the ATM switches; (4) Provision of new IP circuit emulation services over Satellite IP backbones using MPLS will be studied; and (5) Determine the architecture and requirements for internetworking ATN and the Next Generation Internet for real-time applications. The project has been completed on time. All the objectives and deliverables of the project have been completed. Research results obtained from this project have been published in a number of papers in journals, conferences, and technical reports, included in this document.
Application of a theoretical framework to foster a cardiac-diabetes self-management programme.
Wu, C-J Jo; Chang, A M
2014-09-01
This paper analyses and illustrates the application of Bandura's self-efficacy construct to an innovative self-management programme for patients with both type 2 diabetes and coronary heart disease. Using theory as a framework for any health intervention provides a solid and valid foundation for aspects of planning and delivering such an intervention; however, it is reported that many health behaviour intervention programmes are not based upon theory and are consequently limited in their applicability to different populations. The cardiac-diabetes self-management programme has been specifically developed for patients with dual conditions with the strategies for delivering the programme based upon Bandura's self-efficacy theory. This patient group is at greater risk of negative health outcomes than that with a single chronic condition and therefore requires appropriate intervention programmes with solid theoretical foundations that can address the complexity of care required. The cardiac-diabetes self-management programme has been developed incorporating theory, evidence and practical strategies. This paper provides explicit knowledge of the theoretical basis and components of a cardiac-diabetes self-management programme. Such detail enhances the ability to replicate or adopt the intervention in similar or differing populations and/or cultural contexts as it provides in-depth understanding of each element within the intervention. Knowledge of the concepts alone is not sufficient to deliver a successful health programme. Supporting patients to master skills of self-care is essential in order for patients to successfully manage two complex, chronic illnesses. Valuable information has been provided to close the theory-practice gap for more consistent health outcomes, engaging with patients for promoting holistic care within organizational and cultural contexts. © 2014 International Council of Nurses.
Enhancing frontline clinical leadership in an acute hospital trust.
Phillips, Natasha; Byrne, Geraldine
2013-09-01
To report on a leadership programme for ward managers in one National Health Service Trust that aimed to enhance their contribution to the delivery of the organisation's key objectives to support excellent patient experience. Effective ward leadership has been recognised as vital to the quality of care, resource management and interprofessional working. However, there is evidence that, at present, front-line nurse leaders are ill equipped to lead effectively and lack confidence in their ability to do so. The project aimed to provide a tailored programme for ward managers to develop their portfolio of skills to perform this pivotal role. The course contained two key elements: an integrated teaching programme to enhance leadership knowledge and skills and action learning to facilitate application to individual's own leadership practice. Both were underpinned by a change project where each individual identified, undertook and evaluated an innovation in practice. Twenty-two ward managers completed the leadership programme. Participants completed semi-structured questionnaires after each taught module. Action learning was evaluated through a combined structured and semi-structured questionnaire. All participants evaluated the programme as increasing their repertoire of leadership skills. Following completion of the programme, ward managers continue to work together as an evolving community of practice. Ward managers' development is enhanced by a programme integrating theory, action learning and completion of a ward-based project. Ward managers cannot be effectively developed in isolation. Leadership development is best supported where the organisation is also committed to developing. A leadership development programme that incorporates knowledge from within the organisation with external expertise can be an effective method to enhance front-line clinical leadership. © 2013 Blackwell Publishing Ltd.
ERIC Educational Resources Information Center
Molsted, Stig; Tribler, Jane; Poulsen, Peter B.; Snorgaard, Ole
2012-01-01
The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type 2 diabetes. Seven hundred and two patients…
Mukumbang, Ferdinand C.; van Belle, Sara; Marchal, Bruno; van Wyk, Brian
2016-01-01
Background The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theory—the assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). Methods We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. Results We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. Conclusion The perspectives of the programme designers and managers provided an important step towards developing an initial programme theory, which will guide our realist evaluation of the adherence club programme in South Africa. PMID:27560352
B-Lajoie, Marie-Renée; Hulme, Jennifer; Johnson, Kirsten
2014-12-05
Community health workers (CHWs) have been central to broadening the access and coverage of preventative and curative health services worldwide. Much has been debated about how to best remunerate and incentivize this workforce, varying from volunteers to full time workers. Policy bodies, including the WHO and USAID, now advocate for regular stipends. This qualitative study examines the perspective of health programme managers from 16 international non-governmental organizations (NGOs) who directly oversee programmes in resource-limited settings. It aimed to explore institutional guidelines and approaches to designing CHW incentives, and inquire about how NGO managers are adapting their approaches to working with CHWs in this shifting political and funding climate. Second, it meant to understand the position of stakeholders who design and manage non-governmental organization-run CHW programmes on what they consider priorities to boost CHW motivation. Individuals were recruited using typical case sampling through chain referral at the semi-annual CORE Group meeting in the spring of 2012. Semi-structured interviews were guided by a peer reviewed tool. Two reviewers analyzed the transcripts for thematic saturation. Six key factors influenced programme manager decision-making: National-level government policy, donor practice, implicit organizational approaches, programmatic, cultural, and community contexts, experiences and values of managers, and the nature of the work asked of CHWs. Programme managers strongly relied on national government to provide clear guidance on CHW incentives schemes. Perspectives on remuneration varied greatly, from fears that it is unsustainable, to the view that it is a basic human right, and a mechanism to achieve greater gender equity. Programme managers were interested in exploring career paths and innovative financing schemes for CHWs, such as endowment funds or material sales, to heighten local ownership and sustainability of programmes. Participants also supported the creation of both national-level and global interfaces for sharing practical experience and best practices with other CHW programmes. Prescriptive recommendations for monetary remuneration, aside from those coming from national governments, will likely continue to meet resistance by NGOs, as contexts are nuanced. There is growing consensus that incentives should reflect the nature of the work asked of CHWs, and the potential for motivation through sustainable financial schemes other than regular salaries. Programme managers advocate for greater transparency and information sharing among organizations.
Liddy, C; Johnston, S; Irving, H; Nash, K
2013-06-01
With chronic diseases becoming an increasing burden for healthcare systems worldwide, self-management support has gained traction in many health regions and organizations. However, the real-world application of the findings from clinical trials into actual community programming is not self-evident. The aim of this study was to present a model of programme implementation, namely the Community Connection Model. The process of implementing a chronic disease self-management programme has been documented in detail from its initial inception through to a sustainable programme. This account includes a description of the strategic activities undertaken (e.g. alignment with local policy and the formation of community partnerships) and the specific steps taken on the path to programme implementation (e.g. a scoping literature review, an environmental scan and a pilot programme with an evaluation component). Reflection on this case example suggests that a cognizance of the interactions between policy, partnership, planning and programme could act as a useful tool to guide programme implementation, evaluation and sustainability. Multiple types of self-management support have been implemented (as part of the Living Health Champlain programme), and are being evaluated and adapted in response to new evidence, shifting priorities and direction from more partners. The widespread access means that self-management support programmes are becoming part of the culture of care in the study region. Establishing a connection around an important health problem, ensuring active partnerships, adequate planning and early implementation of a programme grounded on the principles of applying best-available evidence can lead to successful solutions. The Community Connection Model is proposed as a way of conceptualizing these processes. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Translating childhood tuberculosis case management research into operational policies.
Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O
2011-08-01
The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.
Final Report Extreme Computing and U.S. Competitiveness DOE Award. DE-FG02-11ER26087/DE-SC0008764
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mustain, Christopher J.
The Council has acted on each of the grant deliverables during the funding period. The deliverables are: (1) convening the Council’s High Performance Computing Advisory Committee (HPCAC) on a bi-annual basis; (2) broadening public awareness of high performance computing (HPC) and exascale developments; (3) assessing the industrial applications of extreme computing; and (4) establishing a policy and business case for an exascale economy.
Mechanics Methodology for Textile Preform Composite Materials
NASA Technical Reports Server (NTRS)
Poe, Clarence C., Jr.
1996-01-01
NASA and its contractors have completed a program to develop a basic mechanics underpinning for textile composites. Three major deliverables were produced by the program: 1. A set of test methods for measuring material properties and design allowables; 2. Mechanics models to predict the effects of the fiber preform architecture and constituent properties on engineering moduli, strength, damage resistance, and fatigue life; and 3. An electronic data base of coupon type test data. This report describes these three deliverables.
Apps, Lindsay D; Harrison, Samantha L; Mitchell, Katy E; Williams, Johanna E A; Hudson, Nicky; Singh, Sally J
2017-10-01
The aim of this study was to understand experiences of participation in a supported self-management programme for chronic obstructive pulmonary disease (COPD). There is a wealth of clinical trials examining the outcomes of self-management interventions for individuals with COPD, but current understanding regarding patients' perspectives of such complex interventions is limited. Further insight may help to tailor self-management interventions and maximise patient engagement. Semi-structured interviews were conducted with individuals participating in a self-management programme, SPACE for COPD. Interviews took place at 6 weeks and 6 months following the programme. Data were analysed at each time point using inductive thematic analysis, and subsequently re-examined together. 40 interviews were undertaken and four themes emerged from the analysis: perceptions of the programme; lifestyle changes; social support; and disrupting factors and barriers to maintaining routines. SPACE for COPD was acceptable to participants in this study. The importance of education and social support was emphasised at both time points studied, but there were challenges such as comorbidities, ill health of family members and limited maintenance of exercise behaviours over the longer term. Further consideration of the role of carers and partners may help to improve adherence to self-management programmes once healthcare professional support has stopped.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stein, Joshua; Burnham, Laurie; Jones, Christian Birk
The U.S. DOE Regional Test Center for Solar Technologies program was established to validate photovoltaic (PV) technologies installed in a range of different climates. The program is funded by the Energy Department's SunShot Initiative. The initiative seeks to make solar energy cost competitive with other forms of electricity by the end of the decade. Sandia National Laboratory currently manages four different sites across the country. The National Renewable Energy Laboratory manages a fifth site in Colorado. The entire PV portfolio currently includes 20 industry partners and almost 500 kW of installed systems. The program follows a defined process that outlinesmore » tasks, milestones, agreements, and deliverables. The process is broken out into four main parts: 1) planning and design, 2) installation, 3) operations, and 4) decommissioning. This operations manual defines the various elements of each part.« less
Luhr, Kristina; Holmefur, Marie; Theander, Kersti; Eldh, Ann Catrine
2018-06-01
Patient participation is facilitated by patients' ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF); the aim was to describe if and how a self-management programme in primary healthcare influenced patient participation. Patients who had participated in a self-management programme were interviewed in nine focus groups (36 patients). Data was analysed using qualitative content analysis. Patients described equality in personal interactions, opportunities to share and discuss, and a willingness to share and learn to facilitate patient participation in a self-management programme. Consequently, patient participation was promoted by a match between the individuals' personal traits and the context. Features facilitating patient participation by means of sharing and assimilating knowledge and insights should be included in self-management programmes and in the care for patients with COPD and CHF. A self-management programme can complement regular primary care regarding enhanced understanding of one's disease and support patient participation and the patient's own resources in self-management. Copyright © 2018 Elsevier B.V. All rights reserved.
Stark, Reneé G; Schunk, Michaela V; Meisinger, Christine; Rathmann, Wolfgang; Leidl, Reiner; Holle, Rolf
2011-05-01
Type 2 diabetes disease management programmes (DDMPs) are offered by German social health insurance to promote healthcare consistent with evidence-based medical guidelines. The aim of this study was to compare healthcare quality and medical endpoints between diabetes management programme participants and patients receiving usual care designated as controls. All patients with type 2 diabetes (age range: 36-81) in a cross-sectional survey of a cohort study, performed by the Cooperative Health Research in the Region of Augsburg, received a self-administered questionnaire regarding their diabetes care. Physical examination and laboratory tests were also performed. The analysis only included patients with social health insurance and whose participation status in a diabetes disease management program was validated by the primary physician (n = 166). Regression analyses, adjusting for age, sex, education, diabetes duration, baseline waist circumference and clustering regarding primary physician were conducted. Evaluation of healthcare processes showed that those in diabetes disease management programmes (n = 89) reported medical examination of eyes and feet and medical advice regarding diet [odds ratio (OR): 2.39] and physical activity (OR: 2.87) more frequently, received anti-diabetic medications (OR: 3.77) and diabetes education more often (OR: 2.66) than controls. Both groups had satisfactory HbA(1c) control but poor low-density lipoprotein cholesterol control. Blood pressure goals (<140/90 mmHg) were achieved more frequently by patients in diabetes disease management programmes (OR: 2.21). German diabetes disease management programmes are associated with improved healthcare processes and blood pressure control. Low-density lipoprotein cholesterol control must be improved for all patients with diabetes. Further research will be required to assess the long-term effects of this diabetes disease management programme. Copyright © 2011 John Wiley & Sons, Ltd.
ERIC Educational Resources Information Center
Aldowaisan, Tariq; Allahverdi, Ali
2016-01-01
This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been…
Experiences of Action Leaning in Two SME Business Support Programmes
ERIC Educational Resources Information Center
Smith, Laurie
2009-01-01
Action learning sets are used by Lancaster University Management School's Institute for Entrepreneurship and Enterprise Development to provide business support to owner managers of small to medium sized enterprises (SMEs). This paper compares the experiences of participants and facilitator of two programmes: one part of a wider programme of…
Nurse manager succession planning: A cost-benefit analysis.
Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R
2018-03-01
This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.
Emerging models for mobilizing family support for chronic disease management: a structured review.
Rosland, Ann-Marie; Piette, John D
2010-03-01
We identify recent models for programmes aiming to increase effective family support for chronic illness management and self-care among adult patients without significant physical or cognitive disabilities. We then summarize evidence regarding the efficacy for each model identified. Structured review of studies published in medical and psychology databases from 1990 to the present, reference review, general Web searches and conversations with family intervention experts. Review was limited to studies on conditions that require ongoing self-management, such as diabetes, chronic heart disease and rheumatologic disease. Programmes with three separate foci were identified: (1) Programmes that guide family members in setting goals for supporting patient self-care behaviours have led to improved implementation of family support roles, but have mixed success improving patient outcomes. (2) Programmes that train family in supportive communication techniques, such as prompting patient coping techniques or use of autonomy supportive statements, have successfully improved patient symptom management and health behaviours. (3) Programmes that give families tools and infrastructure to assist in monitoring clinical symptoms and medications are being conducted, with no evidence to date on their impact on patient outcomes. The next generation of programmes to improve family support for chronic disease management incorporate a variety of strategies. Future research can define optimal clinical situations for family support programmes, the most effective combinations of support strategies, and how best to integrate family support programmes into comprehensive models of chronic disease care.
Hendy, Jane; Fulop, Naomi; Reeves, Barnaby C; Hutchings, Andrew; Collin, Simon
2007-06-30
To describe progress and perceived challenges in implementing the NHS information and technology (IT) programme in England. Case studies and in-depth interviews, with themes identified using a framework developed from grounded theory. We interviewed personnel who had been interviewed 18 months earlier, or new personnel in the same posts. Four NHS acute hospital trusts in England. Senior trust managers and clinicians, including chief executives, directors of IT, medical directors, and directors of nursing. Interviewees unreservedly supported the goals of the programme but had several serious concerns. As before, implementation is hampered by local financial deficits, delays in implementing patient administration systems that are compliant with the programme, and poor communication between Connecting for Health (the agency responsible for the programme) and local managers. New issues were raised. Local managers cannot prioritise implementing the programme because of competing financial priorities and uncertainties about the programme. They perceive a growing risk to patients' safety associated with delays and a loss of integration of components of the programme, and are discontented with Choose and Book (electronic booking for referrals from primary care). We recommend that the programme sets realistic timetables for individual trusts and advises managers about interim IT systems they have to purchase because of delays outside their control. Advice needs to be mindful of the need for trusts to ensure longer term compatibility with the programme and value for money. Trusts need assistance in prioritising modernisation of IT by, for example, including implementation of the programme in the performance management framework. Even with Connecting for Health adopting a different approach of setting central standards with local implementation, these issues will still need to be addressed. Lessons learnt in the NHS have wider relevance as healthcare systems, such as in France and Australia, look to realise the potential of large scale IT modernisation.
Cohen, Debbie; Allen, Joanna; Rhydderch, Melody; Aylward, Mansel
2012-07-01
To investigate the conversation between line manager and employee about return to work to inform the development of an online interactive educational programme for line managers to improve the effectiveness of their discussions. An inductive qualitative approach, using the principles of action research and motivational interviewing were adopted. The results informed the development of the educational programme for line managers. Middle grade line managers in a large public services employer in the UK. Four discussion groups were conducted over a period of 8 months. Line managers explored the challenges of the return to work interview, analysed their interactions with employees and constructed the content of an educational programme. Multiple methods were used to build engagement with participants, including video and role-play. Nine line managers were recruited across 3 business areas. Managers recognised that their conversations focused on the organisations' policies and procedures and the outcome, rather than the interaction. They recognised the strength of shifting style to shared decision-making and guidance rather than process and instruction. These communication strategies were depicted in the educational programme. The content and flow of the return to work discussion is of high importance and influences employee behaviour and return to work outcomes.
1999-10-01
N8-96-3 Application of Industrial Engineering Techniques to Reduce Workers ’ Compensation and Environmental Costs - Deliverable A U.S. DEPARTMENT OF...disclosed in the report. As used in the above, “Persons acting on behalf of the United States Navy” includes any employee , contractor, or subcontractor to...the contractor of the United States Navy to the extent that such employee , contractor, or subcontractor to the contractor prepares, handles, or
Talent Management Programmes at British, American and Canadian Universities: Comparative Study
ERIC Educational Resources Information Center
Boichenko, Maryna
2015-01-01
The article deals with the peculiarities of talent management programmes implementation at the top British, American and Canadian universities. The essence of the main concepts of research--talent and talent management--has been revealed. Talent management is referred to as the systematic attraction, identification, development, engagement,…
NASA Technical Reports Server (NTRS)
Norcross, Jason; Steinberg, Susan; Kundrot, Craig; Charles, John
2011-01-01
The Human Research Program (HRP) is formulated around the program architecture of Evidence-Risk-Gap-Task-Deliverable. Review of accumulated evidence forms the basis for identification of high priority risks to human health and performance in space exploration. Gaps in knowledge or disposition are identified for each risk, and a portfolio of research tasks is developed to fill them. Deliverables from the tasks inform the evidence base with the ultimate goal of defining the level of risk and reducing it to an acceptable level. A comprehensive framework for gap identification, focus, and metrics has been developed based on principles of continuous risk management and clinical care. Research towards knowledge gaps improves understanding of the likelihood, consequence or timeframe of the risk. Disposition gaps include development of standards or requirements for risk acceptance, development of countermeasures or technology to mitigate the risk, and yearly technology assessment related to watching developments related to the risk. Standard concepts from clinical care: prevention, diagnosis, treatment, monitoring, rehabilitation, and surveillance, can be used to focus gaps dealing with risk mitigation. The research plan for the new HRP Risk of Decompression Sickness (DCS) used the framework to identify one disposition gap related to establishment of a DCS standard for acceptable risk, two knowledge gaps related to DCS phenomenon and mission attributes, and three mitigation gaps focused on prediction, prevention, and new technology watch. These gaps were organized in this manner primarily based on target for closure and ease of organizing interim metrics so that gap status could be quantified. Additional considerations for the knowledge gaps were that one was highly design reference mission specific and the other gap was focused on DCS phenomenon.
Kawonga, Mary; Blaauw, Duane; Fonn, Sharon
2015-06-01
With increasing interest in maximising synergies between disease control programmes (DCP) and general health services (GHS), methods are needed to measure interactions between DCP and GHS actors. In South Africa, administrative integration reforms make GHS managers at decentralised level (district managers) responsible for the oversight of DCP operations within districts, with DCP managers (programme managers) providing specialist support. The reforms necessitate interdependence, but these actors work together ineffectively. Communication is crucial for joint working, but no research to assess communication between these actors has been done. This study explores the use of social network analysis (SNA) to measure the extent to which programme and district managers in South Africa communicate, using HIV monitoring and evaluation (M&E) as an exemplar. Data were collected from fifty one managers in two provinces during 2010-2011, to measure: a) one-on-one task-related communication - talking about the collation (verification, reporting) and use of HIV data for monitoring HIV interventions; and b) group communication through co-participating in management committees where HIV data are used for monitoring HIV interventions in districts. SNA measures were computed to describe actor centrality, network density (cohesion), and communication within and between respective manager groups. Block modelling was applied to identify management committees that connect respective manager groups. Results show HIV programme managers located at higher level communicated largely amongst themselves as a group (homophily), seldom talked to the district managers to whom they are supposed to provide specialist HIV M&E support, and rarely participated with them in management committees. This research demonstrates the utility of SNA as a tool for measuring the extent of communication between DCP and GHS actors at sub-national level. Actions are needed to bridge observed communication gaps in order to promote collaborative monitoring of HIV programme interventions within districts. Copyright © 2015 Elsevier Ltd. All rights reserved.
Risk management and lessons learned solutions for satellite product assurance
NASA Astrophysics Data System (ADS)
Larrère, Jean-Luc
2004-08-01
The historic trend of the space industry towards lower cost programmes and more generally a better economic efficiency raises a difficult question to the quality assurance community: how to achieve the same—or better—mission success rate while drastically reducing the cost of programmes, hence the cost and level of quality assurance activities. EADS Astrium Earth Observation and Science (France) Business Unit have experimented Risk Management and Lessons Learned on their satellite programmes to achieve this goal. Risk analysis and management are deployed from the programme proposal phase through the development and operations phases. Results of the analysis and the corresponding risk mitigation actions are used to tailor the product assurance programme and activities. Lessons learned have been deployed as a systematic process to collect positive and negative experience from past and on-going programmes and feed them into new programmes. Monitoring and justification of their implementation in programmes is done under supervision from the BU quality assurance function. Control of the system is ensured by the company internal review system. Deployment of these methods has shown that the quality assurance function becomes more integrated in the programme team and development process and that its tasks gain focus and efficiency while minimising the risks associated with new space programmes.
ERIC Educational Resources Information Center
Weinstein, Larry
2009-01-01
One of the greatest challenges music programme administrators face is that of recruiting students for their programmes. This article suggests that administrators should investigate the benefits of implementing a comprehensive total quality management programme in their institutions. The core values, techniques and tools embodied in the Total…
Navigating the Turbulent Waters of Academia: The Leadership Role of Programme Managers
ERIC Educational Resources Information Center
Vilkinas, Tricia; Cartan, Greg
2015-01-01
The focus of our paper is the leadership role of programme managers in the higher education sector. In particular, we highlight the complex and paradoxical nature of the programme leader's role, and provide an insight into leadership in this challenging and dynamic environment. We identify cognitive and behavioural complexity as necessary…
An Analysis of Whitewater Rafting Safety Data: Risk Management for Programme Organizers
ERIC Educational Resources Information Center
Hunter, I. Roy
2007-01-01
Many outdoor organizations integrate whitewater rafting into their programmes. Often this is accomplished by contracting with a whitewater outfitter. This paper analyses rafting accident data collected by the American Canoe Association in an effort to suggest ways in which programmes can better manage risk while contracting with outfitters for…
2010-01-01
Abstract Background The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. Methods The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. Results The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a “resource team”, supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. Conclusions For effective scaling up of PMR programmes, the provision of technical support and adequate resources are vital, but not sufficient on their own. An active strategy to manage relationships between implementing actors through effective communication mechanisms is essential. Successful outcomes may be realised if a strong and transparent management system, including management of financial resources, is put in place. This study provides evidence of the value of assessing implementation processes as part of impact evaluation for public health programmes. PMID:20594373
Abuya, Timothy; Amin, Abdinasir; Molyneux, Sassy; Akhwale, Willis; Marsh, Vicki; Gilson, Lucy
2010-07-02
The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a "resource team", supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. For effective scaling up of PMR programmes, the provision of technical support and adequate resources are vital, but not sufficient on their own. An active strategy to manage relationships between implementing actors through effective communication mechanisms is essential. Successful outcomes may be realised if a strong and transparent management system, including management of financial resources, is put in place. This study provides evidence of the value of assessing implementation processes as part of impact evaluation for public health programmes.
NASA Technical Reports Server (NTRS)
Doherty, Michael P.; Meyer, Michael L.; Motil, Susan M.; Ginty, Carol A.
2014-01-01
As part of U.S. National Space Policy, NASA is seeking an innovative path for human space exploration, which strengthens the capability to extend human and robotic presence throughout the solar system. NASA is laying the groundwork to enable humans to safely reach multiple potential destinations, including asteroids, Lagrange points, the Moon and Mars. In support of this, NASA is embarking on the Technology Demonstration Mission Cryogenic Propellant Storage and Transfer (TDM CPST) Project to test and validate key cryogenic capabilities and technologies required for future exploration elements, opening up the architecture for large cryogenic propulsion stages (CPS) and propellant depots. The TDM CPST project will provide an on-orbit demonstration of the capability to store, transfer, and measure cryogenic propellants for a duration which is relevant to enable long term human space exploration missions beyond low Earth orbit (LEO). Recognizing that key cryogenic fluid management technologies anticipated for on-orbit (flight) demonstration needed to be matured to a readiness level appropriate for infusion into the design of the flight demonstration, the NASA Headquarters Space Technology Mission Directorate authorized funding for a one-year (FY12) ground based technology maturation program. The strategy, proposed by the CPST Project Manager, focused on maturation through modeling, studies, and ground tests of the storage and fluid transfer Cryogenic Fluid Management (CFM) technology sub-elements and components that were not already at a Technology Readiness Level (TRL) of 5. A technology maturation plan (TMP) was subsequently approved which described: the CFM technologies selected for maturation, the ground testing approach to be used, quantified success criteria of the technologies, hardware and data deliverables, and a deliverable to provide an assessment of the technology readiness after completion of the test, study or modeling activity. This paper will present the testing, studies, and modeling that occurred in FY12 to mature cryogenic fluid management technologies for propellant storage, transfer, and supply, to examine extensibility to full scale, long duration missions, and to develop and validate analytical models. Finally, the paper will briefly describe an upcoming test to demonstrate Liquid Oxygen (LO2) Zero Boil-Off (ZBO).
NASA Technical Reports Server (NTRS)
Doherty, Michael P.; Meyer, Michael L.; Motil, Susan M.; Ginty, Carol A.
2013-01-01
As part of U.S. National Space Policy, NASA is seeking an innovative path for human space exploration, which strengthens the capability to extend human and robotic presence throughout the solar system. NASA is laying the groundwork to enable humans to safely reach multiple potential destinations, including asteroids, Lagrange points, the Moon and Mars. In support of this, NASA is embarking on the Technology Demonstration Mission Cryogenic Propellant Storage and Transfer (TDM CPST) Project to test and validate key cryogenic capabilities and technologies required for future exploration elements, opening up the architecture for large cryogenic propulsion stages (CPS) and propellant depots. The TDM CPST project will provide an on-orbit demonstration of the capability to store, transfer, and measure cryogenic propellants for a duration which is relevant to enable long term human space exploration missions beyond low Earth orbit (LEO). Recognizing that key cryogenic fluid management technologies anticipated for on-orbit (flight) demonstration needed to be matured to a readiness level appropriate for infusion into the design of the flight demonstration, the NASA Headquarters Space Technology Mission Directorate authorized funding for a one-year (FY12) ground based technology maturation program. The strategy, proposed by the CPST Project Manager, focused on maturation through modeling, studies, and ground tests of the storage and fluid transfer Cryogenic Fluid Management (CFM) technology sub-elements and components that were not already at a Technology Readiness Level (TRL) of 5. A technology maturation plan (TMP) was subsequently approved which described: the CFM technologies selected for maturation, the ground testing approach to be used, quantified success criteria of the technologies, hardware and data deliverables, and a deliverable to provide an assessment of the technology readiness after completion of the test, study or modeling activity. This paper will present the testing, studies, and modeling that occurred in FY12 to mature cryogenic fluid management technologies for propellant storage, transfer, and supply, to examine extensibility to full scale, long duration missions, and to develop and validate analytical models. Finally, the paper will briefly describe an upcoming test to demonstrate Liquid Oxygen (LO2) Zero Boil- Off (ZBO).
Programmes for tobacco and alcohol users in Australian work-places.
Richmond, R; Heather, N; Holt, P
1996-12-01
This article presents findings from a survey of programmes available for tobacco and alcohol users working in 455 of Australia's top 600 companies. Companies were twice as likely to have programmes for smokers (43%) as for problem drinkers (24%) and these programmes were more apparent in large companies. The majority of programmes for smoking were delivered within a health promotion context which included other life-style issues, such as nutrition, exercise, weight management and stress management. Although Employee Assistance Programs (EAPs) were the most commonly available type of work-place programme for excessive drinkers and other drug users, followed by Alcoholics Anonymous and local hospital clinics, only 6% had an EAP for alcohol. Only 21% of programmes for smokers and 12% for excessive alcohol users were evaluated. Around one-quarter of companies knew the costs of smoking programmes, and 9% reported costs of conducting programmes for excessive alcohol consumers.
The SLMTA programme: Transforming the laboratory landscape in developing countries
Maruta, Talkmore; Luman, Elizabeth T.; Nkengasong, John N.
2014-01-01
Background Efficient and reliable laboratory services are essential to effective and well-functioning health systems. Laboratory managers play a critical role in ensuring the quality and timeliness of these services. However, few laboratory management programmes focus on the competencies required for the daily operations of a laboratory in resource-limited settings. This report provides a detailed description of an innovative laboratory management training tool called Strengthening Laboratory Management Toward Accreditation (SLMTA) and highlights some challenges, achievements and lessons learned during the first five years of implementation (2009–2013) in developing countries. Programme SLMTA is a competency-based programme that uses a series of short courses and work-based learning projects to effect immediate and measurable laboratory improvement, while empowering laboratory managers to implement practical quality management systems to ensure better patient care. A SLMTA training programme spans from 12 to 18 months; after each workshop, participants implement improvement projects supported by regular supervisory visits or on-site mentoring. In order to assess strengths, weaknesses and progress made by the laboratory, audits are conducted using the World Health Organization’s Regional Office for Africa (WHO AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist, which is based on International Organization for Standardization (ISO) 15189 requirements. These internal audits are conducted at the beginning and end of the SLMTA training programme. Conclusion Within five years, SLMTA had been implemented in 617 laboratories in 47 countries, transforming the laboratory landscape in developing countries. To our knowledge, SLMTA is the first programme that makes an explicit connection between the performance of specific management behaviours and routines and ISO 15189 requirements. Because of this close relationship, SLMTA is uniquely positioned to help laboratories seek accreditation to ISO 15189. PMID:26752335
Van Grootven, Bastiaan; McNicoll, Lynn; Mendelson, Daniel A; Friedman, Susan M; Fagard, Katleen; Milisen, Koen; Flamaing, Johan; Deschodt, Mieke
2018-01-01
Objective To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. Design An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). Setting Western Europe and the USA. Participants Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate). Measures Participants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method. Results In the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications. Conclusion The indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes. PMID:29549210
Structured patient education: the X-PERT Programme.
Deakin, Trudi; Whitham, Claire
2009-09-01
The X-PERT Programme seeks to develop the knowledge, skills and confidence in diabetes treatment for health-care professionals and diabetes self-management. The programme trains health-care professionals to deliver the six-week structured patient education programme to people with diabetes. Over 850 health-care professionals have attended the X-PERT 'Train the Trainer' course and audit results document improved job satisfaction and competence in diabetes treatment and management. National audit statistics for X-PERT implementation to people with diabetes illustrate excellent attendance rates, improved diabetes control, reduced weight, blood pressure, cholesterol and waist circumference and more confidence in self-managing diabetes that has impacted positively on quality of life.
Load Composition Model Workflow (BPA TIP-371 Deliverable 1A)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chassin, David P.; Cezar, Gustavo V.
This project is funded under Bonneville Power Administration (BPA) Strategic Partnership Project (SPP) 17-005 between BPA and SLAC National Accelerator Laboratory. The project in a BPA Technology Improvement Project (TIP) that builds on and validates the Composite Load Model developed by the Western Electric Coordinating Council's (WECC) Load Modeling Task Force (LMTF). The composite load model is used by the WECC Modeling and Validation Work Group to study the stability and security of the western electricity interconnection. The work includes development of load composition data sets, collection of load disturbance data, and model development and validation. This work supports reliablemore » and economic operation of the power system. This report was produced for Deliverable 1A of the BPA TIP-371 Project entitled \\TIP 371: Advancing the Load Composition Model". The deliverable documents the proposed work ow for the Composite Load Model, which provides the basis for the instrumentation, data acquisition, analysis and data dissemination activities addressed by later phases of the project.« less
A Masters Programme in telecommunications management - demand-based curriculum design
NASA Astrophysics Data System (ADS)
Gharaibeh, Khaled M.; Kaylani, Hazem; Murphy, Noel; Brennan, Conor; Itradat, Awni; Al-Bataineh, Mohammed; Aloqlah, Mohammed; Salhieh, Loay; Altarazi, Safwan; Rawashdeh, Nathir; Bas Cerdá, María del Carmen; Conchado Peiró, Andrea; Al-Zoubi, Asem; Harb, Bassam; Bany Salameh, Haythem
2015-05-01
This paper presents a curriculum design approach for a Masters Programme in Telecommunications Management based on demand data obtained from surveying the needs of potential students of the proposed programme. Through online surveys disseminated at telecom companies in Jordan, it was possible to measure the demand for such a programme and to determine the required programme contents and specifications. The curriculum design is based on definition of programme outcomes and on using a house of quality approach (HOQ) to determine the list of courses required in the programme. Surveyed competencies are mapped to a long list of proposed courses in a HOQ in order to determine the importance of each of these courses. A final list of core and elective courses is then developed considering the contribution to programme outcomes and the academic standards.
Hospital management training and improvement in managerial skills: Serbian experience.
Supic, Zorica Terzic; Bjegovic, Vesna; Marinkovic, Jelena; Milicevic, Milena Santric; Vasic, Vladimir
2010-06-01
The purpose of this study was to analyze the improvement of managerial skills of hospitals' top managers after a specific management training programme, and to explore possible predictors and relations. The study was conducted during the years 2006 and 2007 with cohort of 107 managers from 20 Serbian general hospitals. The managers self-assessed the improvement in their managerial skills before and after the training programme. After the training programme, all managers' skills had improved. The biggest improvement was in the following skills: organizing daily activities, motivating and guiding others, supervising the work of others, group discussion, and situation analysis. The least improved were: applying creative techniques, working well with peers, professional self-development, written communication, and operational planning. Identified predictors of improvement were: shorter years of managerial experience, type of manager, type of profession, and recognizing the importance of the managerial skills in oral communication, evidence-based decision making, and supervising the work of others. Specific training programme related to strategic management can increase managerial competencies, which are an important source of competitive advantage for organizations. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
[Disease management programs from a health insurer's point of view].
Szymkowiak, Christof; Walkenhorst, Karen; Straub, Christoph
2003-06-01
Disease Management Programmes represent a great challenge to the German statutory health insurance system. According to politicians, disease management programmes are an appropriate tool for increasing the level of care for chronically ill patients significantly, while at the same time they can slow down the cost explosion in health care. The statutory health insurers' point of view yields a more refined picture of the chances and risks involved. The chances are that a medical guideline-based, evidence-based, co-operative care of the chronically ill could be established. But also, there are the risks of misuse of disease management programmes and of misallocation of funds due to the ill-advised linkage with the so-called risk compensation scheme (RSA) balancing the sickness funds' structural deficits through redistribution. The nation-wide introduction of disease management programmes appears to be a gigantic experiment whose aim is to change the care of chronically ill patients and whose outcome is unpredictable.
Smith Gueye, Cara; Newby, Gretchen; Tulloch, Jim; Slutsker, Laurence; Tanner, Marcel; Gosling, Roland D
2016-09-22
A malaria eradication goal has been proposed, at the same time as a new global strategy and implementation framework. Countries are considering the strategies and tools that will enable progress towards malaria goals. The eliminating malaria case-study series reports were reviewed to identify successful programme management components using a cross-case study analytic approach. Nine out of ten case-study reports were included in the analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for malaria elimination programme management was developed and data were extracted and synthesized. Findings were reviewed at a consultative workshop, which led to a revision of the framework and further data extraction and synthesis. Success factors of implementation, programme choices and changes, and enabling factors were distilled. Decentralized programmes enhanced engagement in malaria elimination by sub-national units and communities. Integration of the malaria programme into other health services was also common. Decentralization and integration were often challenging due to the skill and experience levels of newly tasked staff. Accountability for programme impact was not clarified for most programmes. Motivation of work force was a key factor in maintaining programme quality but there were few clear, detailed strategies provided. Different incentive schemes targeted various stakeholders. Training and supervision, although not well described, were prioritized by most programmes. Multi-sectoral collaboration helped some programmes share information, build strategies and interventions and achieve a higher quality of implementation. In most cases programme action was spurred by malaria outbreaks or a new elimination goal with strong leadership. Some programmes showed high capacity for flexibility through introduction of new strategies and tools. Several case-studies described methods for monitoring implementation quality and coverage; however analysis and feedback to those implementing malaria elimination in the periphery was not well described. Political commitment and sustained financing contributed to malaria programme success. Consistency of malaria programmes depends on political commitment, human and financial resources, and leadership. Operational capacity of the programme and the overall health system structure and strength are also important aspects. Malaria eradication will require adaptive, well-managed malaria programmes that are able to tailor implementation of evidence-based strategies, founded upon strong sub-national surveillance and response, with adequate funding and human resources.
Use of herd management programmes to improve the reproductive performance of dairy cattle.
McDougall, S; Heuer, C; Morton, J; Brownlie, T
2014-05-01
There has been a long history of herd health and production management programmes in many dairy industries around the world, but evidence for the efficacy of such programmes is limited. In response to a perceived decline in fertility of dairy cows, a herd reproductive management programme (InCalf) was introduced in New Zealand in 2007. This programme uses a management cycle approach that includes an assessment of the current herd status, identification of areas for improvement, development of a plan, implementation of this plan and finally a review process. The programme uses facilitators who work with farmers either in a one-to-one manner or in a formalised group setting that involves a series of meetings over a 12-month period (the farmer action group). The hypothesis that involvement in a reproductive management programme would improve herd reproductive performance was tested using a herd-level controlled randomised study (the National Herd Fertility Study) involving herds in four geographic regions of New Zealand over 2 years. Within each region, herds were ranked on the basis of the 6-week in-calf rate (i.e. the proportion of the herd pregnant in the first 6 weeks of the seasonal breeding programme) in the year preceding commencement of the study and then randomly assigned to be involved in a farmer action group or left as untreated controls. The key outcome variable of the study was the 6-week in-calf rate. Pregnancy diagnosis was undertaken at 12 weeks after the start of the seasonal breeding programme, which allowed determination of conception dates and hence calculation of the 6-week in-calf rate. Additional measurements including heifer live weight and body condition score (pre-calving and pre-mating) were undertaken to test whether treatment resulted in measurable changes in some of the key determinants of herd reproductive performance. Involvement in the farmer action group of InCalf resulted in a 2 percentage point increase in the 6-week in-calf rate (P=0.05). The following additional observations were made in herds involved in the farmer action group relative to control herds: heifers had live weight closer to target; the pre-mating body condition score of cows was higher; and oestrous detection rates were higher. It was concluded that involvement in this herd reproductive management programme improved reproductive outcomes in this New Zealand study. However, to achieve substantial improvements in herd reproductive performance at the regional or national level a greater response to the programme and a high uptake of such programmes is required, as well as use of other industry-level tools such as genetic management programmes.
ERIC Educational Resources Information Center
Kitawi, Alfred Kirigha
2014-01-01
This research examined the issue of community capacity development in a university. The main way communities were empowered was through the education management programmes offered at Strathmore University in Nairobi, Kenya. The research is among the first to examine the issue of community capacity development through university programmes. The…
ERIC Educational Resources Information Center
Wang, Chengbo; Chen, Xuezhong; Edgar, David; Zhao, Yang
2013-01-01
In higher education institutes (HEIs), Operations Management programmes (OMPs) are among those programmes attracting a substantial amount of international student enrollment. With the current situation that the government is reducing its funding input, the UK HEIs' financial balance relies more than before on the international students who pay…
Patient level cost of diabetes self-management education programmes: an international evaluation
Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan
2017-01-01
Objectives The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Setting Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Participants Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary and secondary measures Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. Results We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. Conclusions This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. PMID:28583913
Patient level cost of diabetes self-management education programmes: an international evaluation.
Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan
2017-06-04
The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Lloyd, J; McHugh, C; Minton, J; Eke, H; Wyatt, K
2017-08-14
Recruitment and retention of participants is crucial for statistical power and internal and external validity and participant engagement is essential for behaviour change. However, many school-based interventions focus on programme content rather than the building of supportive relationships with all participants and tend to employ specific standalone strategies, such as incentives, to improve retention. We believe that actively involving stakeholders in both intervention and trial design improves recruitment and retention and increases the chances of creating an effective intervention. The Healthy Lifestyles Programme, HeLP (an obesity prevention programme for children 9-10 years old) was developed using intervention mapping and involved extensive stakeholder involvement in both the design of the trial and the intervention to ensure that: (i) delivery methods were suitably engaging, (ii) deliverers had the necessary skills and qualities to build relationships and (iii) the intervention dovetailed with the National Curriculum. HeLP was a year-long intervention consisting of 4 multi-component phases using a range of delivery methods. We recruited 1324 children from 32 schools from the South West of England to a cluster-randomised controlled trial to determine the effectiveness of HeLP in preventing obesity. The primary outcome was change in body mass index standard deviation score (BMI SDS) at 24 months post randomisation. Secondary outcomes included additional anthropometric and behavioural (physical activity and diet) measures at 18 and 24 months. Anthropometric and behavioural measures were taken in 99%, 96% and 94% of children at baseline, 18 and 24 months, respectively, with no differential follow up between the control and intervention groups at each time point. All children participated in the programme and 92% of children and 77% of parents across the socio-economic spectrum were considered to have actively engaged with HeLP. We attribute our excellent retention and engagement results to the high level of stakeholder involvement in both trial and intervention design, the building of relationships using appropriate personnel and creative delivery methods that are accessible to children and their families across the social spectrum. International Standard Randomised Controlled Trials Register, ISRCTN15811706 . Registered on 1 May 2012.
[Clinical trial data management and quality metrics system].
Chen, Zhao-hua; Huang, Qin; Deng, Ya-zhong; Zhang, Yue; Xu, Yu; Yu, Hao; Liu, Zong-fan
2015-11-01
Data quality management system is essential to ensure accurate, complete, consistent, and reliable data collection in clinical research. This paper is devoted to various choices of data quality metrics. They are categorized by study status, e.g. study start up, conduct, and close-out. In each category, metrics for different purposes are listed according to ALCOA+ principles such us completeness, accuracy, timeliness, traceability, etc. Some general quality metrics frequently used are also introduced. This paper contains detail information as much as possible to each metric by providing definition, purpose, evaluation, referenced benchmark, and recommended targets in favor of real practice. It is important that sponsors and data management service providers establish a robust integrated clinical trial data quality management system to ensure sustainable high quality of clinical trial deliverables. It will also support enterprise level of data evaluation and bench marking the quality of data across projects, sponsors, data management service providers by using objective metrics from the real clinical trials. We hope this will be a significant input to accelerate the improvement of clinical trial data quality in the industry.
System and method for acquisition management of subject position information
Carrender, Curt
2005-12-13
A system and method for acquisition management of subject position information that utilizes radio frequency identification (RF ID) to store position information in position tags. Tag programmers receive position information from external positioning systems, such as the Global Positioning System (GPS), from manual inputs, such as keypads, or other tag programmers. The tag programmers program each position tag with the received position information. Both the tag programmers and the position tags can be portable or fixed. Implementations include portable tag programmers and fixed position tags for subject position guidance, and portable tag programmers for collection sample labeling. Other implementations include fixed tag programmers and portable position tags for subject route recordation. Position tags can contain other associated information such as destination address of an affixed subject for subject routing.
System and method for acquisition management of subject position information
Carrender, Curt [Morgan Hill, CA
2007-01-23
A system and method for acquisition management of subject position information that utilizes radio frequency identification (RF ID) to store position information in position tags. Tag programmers receive position information from external positioning systems, such as the Global Positioning System (GPS), from manual inputs, such as keypads, or other tag programmers. The tag programmers program each position tag with the received position information. Both the tag programmers and the position tags can be portable or fixed. Implementations include portable tag programmers and fixed position tags for subject position guidance, and portable tag programmers for collection sample labeling. Other implementations include fixed tag programmers and portable position tags for subject route recordation. Position tags can contain other associated information such as destination address of an affixed subject for subject routing.
Development of a self-managed loaded exercise programme for rotator cuff tendinopathy.
Littlewood, Chris; Malliaras, Peter; Mawson, Sue; May, Stephen; Walters, Stephen
2013-12-01
This paper describes a self-managed loaded exercise programme which has been designed to address the pain and disability associated with rotator cuff tendinopathy. The intervention has been developed with reference to current self-management theory and with reference to the emerging benefit of loaded exercise for tendinopathy. This self-managed loaded exercise programme is being evaluated within the mixed methods SELF study (ISRCTN 84709751) which includes a pragmatic randomised controlled trial conducted within the UK National Health Service. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
The TMIS life-cycle process document, revision A
NASA Technical Reports Server (NTRS)
1991-01-01
The Technical and Management Information System (TMIS) Life-Cycle Process Document describes the processes that shall be followed in the definition, design, development, test, deployment, and operation of all TMIS products and data base applications. This document is a roll out of TMIS Standards Document (SSP 30546). The purpose of this document is to define the life cycle methodology that the developers of all products and data base applications and any subsequent modifications shall follow. Included in this methodology are descriptions of the tasks, deliverables, reviews, and approvals that are required before a product or data base application is accepted in the TMIS environment.
Energy Systems Test Area (ESTA) Pyrotechnic Operations: User Test Planning Guide
NASA Technical Reports Server (NTRS)
Hacker, Scott
2012-01-01
The Johnson Space Center (JSC) has created and refined innovative analysis, design, development, and testing techniques that have been demonstrated in all phases of spaceflight. JSC is uniquely positioned to apply this expertise to components, systems, and vehicles that operate in remote or harsh environments. We offer a highly skilled workforce, unique facilities, flexible project management, and a proven management system. The purpose of this guide is to acquaint Test Requesters with the requirements for test, analysis, or simulation services at JSC. The guide includes facility services and capabilities, inputs required by the facility, major milestones, a roadmap of the facility s process, and roles and responsibilities of the facility and the requester. Samples of deliverables, facility interfaces, and inputs necessary to define the cost and schedule are included as appendices to the guide.
Assessment of a Targeted Trap-Neuter-Return Pilot Study in Auckland, New Zealand
Zito, Sarah; Vigeant, Shalsee; Dale, Arnja
2018-01-01
Simple Summary It is generally accepted that stray cats need to be managed to minimise the associated negative impacts and there is a need for effective and humane management tools. One such potential tool is trap-neuter-return (TNR), which anecdotally has been used in New Zealand to manage stray cats, but no concerted and targeted implementation of this technique has been reported, nor any formal assessments conducted. A targeted TNR (TTNR) programme for urban stray cats was implemented and assessed in one Auckland suburb. Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray feline, underage euthanasia, and unsocialised stray cat euthanasia numbers all reduced for the targeted suburb when these outcome measures were compared for the years before and after the programme. These outcome measures had a greater reduction in the targeted suburb compared to the other Auckland suburbs not targeted by the TTNR programme, although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable humane cat management tool in urban New Zealand, and further assessment is warranted. Abstract There is a need for effective and humane management tools to manage urban stray cats and minimise negative impacts associated with stray cats. One such tool is targeted trap-neuter-return (TTNR), but no concerted implementation of this technique or formal assessments have been reported. To address this deficit, a TTNR programme was implemented and assessed in one Auckland suburb from May 2015 to June 2016; the programme sterilised and returned 348 cats (4.2 cats/1000 residents). Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray felines, underage euthanasias, and unsocialised stray cat euthanasias were all reduced for the targeted suburb when compared for the years before and after the programme (the percentage reduction in these parameters was −39, −17, −34, −7, and −47, respectively). These outcome measures had a greater reduction in the targeted suburb compared to the Auckland suburbs not targeted by the TTNR programme (p < 0.01), although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable, humane cat management tool in urban New Zealand, and further assessment is warranted. PMID:29757255
An Integrated Approach to Environmental Education: A Case Study
ERIC Educational Resources Information Center
du Preez, Nicolaas P.; Mohr-Swart, Maryna
2004-01-01
In 1994, the Executive Management Committee (EMC) of Technikon Pretoria took a strategic decision to develop educational programmes in environmental management and sustainable development. The EMC also decided to integrate these programmes with the development and implementation of an environmental management policy for Technikon Pretoria. This…
Planning, Designing and Managing Higher Education Institutions
ERIC Educational Resources Information Center
Daigneau, William A.; Valenti, Mark S.; Ricciarini, Sylvana; Bender, Stephen O.; Alleyne, Nicole; Di Grappa, Michael; Duart, Josep M.; Lupianez, Francisco; Sanchez, Miguel Angel Ehrenzweig
2005-01-01
The OECD Programme on Educational Building, together with the Association of Higher Education Facilities Officers (APPA) and the OECD Programme on Institutional Management in Higher Education, organised an international conference on the planning, design and management of facilities for higher education institutions on April 24-27, 2005. The…
IEC 61511 and the capital project process--a protective management system approach.
Summers, Angela E
2006-03-17
This year, the process industry has reached an important milestone in process safety-the acceptance of an internationally recognized standard for safety instrumented systems (SIS). This standard, IEC 61511, documents good engineering practice for the assessment, design, operation, maintenance, and management of SISs. The foundation of the standard is established by several requirements in Part 1, Clauses 5-7, which cover the development of a management system aimed at ensuring that functional safety is achieved. The management system includes a quality assurance process for the entire SIS lifecycle, requiring the development of procedures, identification of resources and acquisition of tools. For maximum benefit, the deliverables and quality control checks required by the standard should be integrated into the capital project process, addressing safety, environmental, plant productivity, and asset protection. Industry has become inundated with a multitude of programs focusing on safety, quality, and cost performance. This paper introduces a protective management system, which builds upon the work process identified in IEC 61511. Typical capital project phases are integrated with the management system to yield one comprehensive program to efficiently manage process risk. Finally, the paper highlights areas where internal practices or guidelines should be developed to improve program performance and cost effectiveness.
ERIC Educational Resources Information Center
Wedawatta, Gayan
2018-01-01
Undergraduate programmes on construction management and other closely related built environment disciplines are currently taught and assessed on a modular basis. This is the case in the UK and in many other countries globally. However, it can be argued that professionally oriented programmes like these are better assessed on a non-modular basis,…
Steuten, L M G; Vrijhoef, H J M; Landewé-Cleuren, S; Schaper, N; Van Merode, G G; Spreeuwenberg, C
2007-10-01
To assess the impact of a disease management programme for patients with diabetes mellitus (Type 1 and Type 2) on cost-effectiveness, quality of life and patient self-management. By organizing care in accordance with the principles of disease management, it is aimed to increase quality of care within existing budgets. Single-group, pre-post design with 2-year follow-up in 473 patients. Substantial significant improvements in glycaemic control, health-related quality of life (HRQL) and patient self-management were found. No significant changes were detected in total costs of care. The probability that the disease management programme is cost-effective compared with usual care amounts to 74%, expressed in an average saving of 117 per additional life year at 5% improved HRQL. Introduction of a disease management programme for patients with diabetes is associated with improved intermediate outcomes within existing budgets. Further research should focus on long-term cost-effectiveness, including diabetic complications and mortality, in a controlled setting or by using decision-analytic modelling techniques.
The effectiveness of a multidisciplinary pain management programme managing chronic pain.
Dysvik, Elin; Vinsnes, Anne Guttormsen; Eikeland, Ole-Johan
2004-10-01
The aim of this study was to develop and evaluate the effects of a multidisciplinary pain management programme on coping, health-related quality of life and pain intensity. Seventy-six outpatients suffering from chronic pain completed this eight-week programme with the primary aims to increase coping, as measured by the Ways of Coping Checklist, and health-related quality of life, as measured by the Short Form-36 Health Survey. Therapeutic dialogues and education, combined with physical activity, were given in order to increase understanding of and attention to non-medical factors that might affect pain perception. The programme was active, time-limited and structured on the basis of multidisciplinary pain management programmes based on a cognitive-behavioural approach. The findings suggest that this programme has the potential to improve coping skills and health-related quality of life. Additionally, pain intensity, as measured by the Visual Analogue Scale, was reduced. Age and disability were revealed as the prominent predictors of change after treatment. The differences in this sample indicated that the drop-outs tended to be older and reported more health problems, although these findings were non-significant. Clinical and research implications are discussed.
Process development for automated solar cell and module production. Task 4: Automated array assembly
NASA Technical Reports Server (NTRS)
Hagerty, J. J.
1981-01-01
The Unimate robot was programmed for the final 35 cell pattern to be used in the fabrication of the deliverable modules. Mechanical construction of the Automated Lamination Station and Final Assembly Station were completed on schedule. All final wiring and interconnect cables were also completed and the first operational testing began. The final controlling program was written. A local fabricator was contracted to produce the glass reinforced concrete panels to be used for testing and deliverables. A video tape showing all three stations in operation was produced.
NASA Technical Reports Server (NTRS)
Maronde, R. G.
1980-01-01
The Ku-band test equipment, known as the Deliverable System Test equipment (DSTE), is reviewed and evaluated. The DSTE is semiautomated and computer programs were generated for 14 communication mode tests and 17 radar mode tests. The 31 test modules provide a good cross section of tests with which to exercise the Ku-band system; however, it is very limited when being used to verify Ku-band system performance. More detailed test descriptions are needed, and a major area of concern is the DSTE sell-off procedure which is inadequate.
Wu, Shu-Fang Vivienne; Liang, Shu-Yuan; Lee, Mei-Chen; Yu, Neng-Chun; Kao, Mu-Jung
2014-09-01
To analyse the efficacy of improving disease management after implementing a self-management programme for people with type 2 diabetes administered by healthcare workers who have received special training. The needs for diabetic care include increased training for healthcare providers to enhance their confidence and skills in managing patients, both physically and mentally. Quasi-experimental design. This study recruited participants from outpatient clinics in 10 hospitals in Taiwan. In 2010, purposive sampling was used to recruit 228 participants from two medical centres, five regional hospitals and three district hospitals. Participants were enrolled in a 'diabetes self-management programme' (watching patient videos, reading a diabetes self-care handbook, participating in four consultation courses of diabetes self-efficacy improvement, telephone follow-up and positive reinforcement). Efficacy analysis of post-test diabetes outcome variables of the experimental group was carried out. Sex, age and pretest score were used as the control variables for ancova test. Patients in the experimental group had significant improvement in body mass index (p < 0·01), waistline circumference (p < 0·001), haemoglobin A1C levels (p < 0·001), degrees of anxiety and depression (p < 0·001), self-efficacy (p < 0·001) and levels of self-care (p < 0·001). Self-efficacy of people with diabetes can be effectively improved by planned implementation of a 'diabetes self-management programme' by trained healthcare workers. The diabetes care professionals are provided the self-management programme to strengthen the awareness and importance of self-management in diabetes care. © 2013 John Wiley & Sons Ltd.
Chaki, Prosper P; Kannady, Khadija; Mtasiwa, Deo; Tanner, Marcel; Mshinda, Hassan; Kelly, Ann H; Killeen, Gerry F
2014-06-25
Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam's City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes.
The cost-effectiveness of weight management programmes in a postnatal population.
Rawdin, A C; Duenas, A; Chilcott, J B
2014-09-01
The aim of the study was to estimate the cost-effectiveness of a weight management programme including elements of physical exercise and dietary restriction which are designed to help women lose excess weight gained during pregnancy in the vulnerable postnatal period and inhibit the development of behaviours which could lead to future excess weight gain and obesity. A mathematical model based on a regression equation predicting change in weight over a fifteen year postnatal period was developed. The model included programme effectiveness and resource data based on a randomized controlled trial of a weight management programme implemented in a postnatal population in the United States. Utility and mortality data based on body mass index categories were also included. The model adopted a National Health Service (NHS) and personal social services (PSS) perspective, a lifetime time horizon and estimated the cost effectiveness of a weight management programme against a no change comparator in terms of an incremental cost-effectiveness ratio (ICER). The baseline results show that the difference in weight between women who received the weight management programme and women who received the control intervention was 3.02 kg at six months and 3.53 kg at fifteen years following childbirth. This results in an ICER of £7355 per quality adjusted life year (QALY) for women who were married at childbirth. The estimated ICER would suggest that such a weight management programme is cost-effective at a NICE threshold of £20,000 per QALY. However significant structural and evidence based uncertainty is present in the analysis. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
2014-01-01
Background Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. Case description The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. Discussion and evaluation The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. Conclusions The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes. PMID:24964790
ERIC Educational Resources Information Center
Latinopoulos, Pericles; Angelidis, Panagiotis
2014-01-01
The management of complex water problems is nowadays being practised through new ways and approaches. Therefore, water engineers, planners and managers should be appropriately educated through modern undergraduate curricula and by well-designed postgraduate specialisation programmes. Within this framework, a study of the specific characteristics…
Hughes, Stephen; Lewis, Sophie; Willis, Karen; Rogers, Anne; Wyke, Sally; Smith, Lorraine
2017-12-01
Our aim was to systematically review the qualitative literature about the experiences of both facilitators and participants in a range of group-based programmes to support the self-management of long-term conditions. We searched 7 databases using the terms 'self-management', 'group' and 'qualitative'. Full text articles meeting the inclusion criteria were retrieved for review. A thematic synthesis approach was used to analyse the studies. 2126 articles were identified and 24 were included for review. Group participants valued being with similar others and perceived peer support benefits. Facilitators (HCP and lay) had limited group specific training, were uncertain of purpose and prioritised education and medical conformity over supportive group processes and the promotion of self-management agency and engagement. Overall, studies prioritised positive descriptions. Group programmes' medical self-management focus may reduce their ability to contribute to patient-valued outcomes. Further research is needed to explore this disconnect. This review supports broadening the scope of group-based programmes to foreground shared learning, social support and development of agency. It is of relevance to developers and facilitators of group self-management programmes and their ability to address the burden of long-term conditions. Copyright © 2017 Elsevier B.V. All rights reserved.
Van Olmen, Josefien; Marie, Ku Grace; Christian, Darras; Clovis, Kalobu Jean; Emery, Bewa; Maurits, Van Pelt; Heang, Hen; Kristien, Van Acker; Natalie, Eggermont; François, Schellevis; Guy, Kegels
2015-06-01
To improve access and quality of diabetes care for people in low-income countries, it is important to understand which elements of diabetes care are effective. This paper analyses three diabetes care programmes in the DR Congo, Cambodia and the Philippines. Three programmes offering diabetes care and self-management were selected. Programme information was collected through document review and interviews. Data about participants' characteristics, health outcomes, care utilisation, expenditures, care perception and self-management were extracted from a study database. Comparative univariate analyses were performed. Kin-réseau (DR Congo) is an urban primary care network with 8000 patients. MoPoTsyo (Cambodia) is a community-based peer educator network, covering 7000 patients. FiLDCare (Philippines) is a programme in which 1000 patients receive care in a health facility and self-management support from a community health worker. Content of care of the programmes is comparable, the focus on self-management largest in MoPoTsyo. On average, Kin-réseau patients have a higher age, longer diabetes history and more overweight. MoPoTsyo includes most female, most illiterate and most lean patients. Health outcomes (HbA1C level, systolic blood pressure, diabetes foot lesions) were most favourable for MoPoTsyo patients. Diabetes-related health care expenditure was highest for FiLDCare patients. This study shows it possible to maintain a diabetes programme with minimal external resources, offering care and self-management support. It also illustrates that health outcomes of persons with diabetes are determined by their bio-psycho-social characteristics and behaviour, which are each subject to the content of care and the approach to chronic illness and self-management of the programme, in turn influenced by the larger context. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Jones, Fiona; Kilbride, Cherry; Victor, Christina
2014-01-01
Purpose: The utility of self-management with people from minority ethnic backgrounds has been questioned, resulting in the development of culturally specific tools. Yet, the use of stroke specific self-management programmes is underexplored in these high risk groups. This article presents the experience of stroke therapists in using a stroke specific self-management programme with stroke survivors from minority ethnic backgrounds. Methods: 26 stroke therapists with experience of using the self-management programme with stroke survivors from minority ethnic backgrounds participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Results: Three themes were identified. One questioned perceived differences in stroke survivors interaction with self-management based on ethnicity. The other themes contrasted with this view demonstrating two areas in which ethnic and cultural attributes were deemed to influence the self-management process both positively and negatively. Aspects of knowledge of health, illness and recovery, religion, family and the professionals themselves are highlighted. Conclusions: This study indicates that ethnicity should not be considered a limitation to the use of an individualized stroke specific self-management programme. However, it highlights potential facilitators and barriers, many of which relate to the capacity of the professional to effectively navigate cultural and ethnic differences. Implications for Rehabilitation Stroke therapists suggest that ethnicity should not be considered a barrier to successful engagement with a stroke specific self-management programme. Health, illness and recovery beliefs along with religion and the specific role of the family do however need to be considered to maximize the effectiveness of the programme. A number of the facilitators and barriers identified are not unique to stroke survivors from ethnic minority communities, nor shared by all. The therapists skills at negotiating identified barriers to self-management are highlighted as an area for further development. PMID:24670190
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-05
... Operations Management Tricon Programmable Logic Controller (PLC), Version 10, and the CS Innovations, LLC... process protection system that is based on the Invensys Operations Management Tricon Programmable Logic...
Edwards, Helen; Walsh, Anne; Courtney, Mary; Monaghan, Sarah; Wilson, Jenny; Young, Jeanine
2007-10-01
This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management. Paediatric nurses' inconsistent, ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests. Determinants of antipyretic administration, identified by the theory of planned behaviour, were belief-based attitudes and subjective norms. A quasi-experiment explored group effects of a peer education programme, based on the theory of planned behaviour, on factors influencing paediatric nurses' antipyretic administration. Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months postpeer education programme. All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited. The peer education programme consisted of four one-hour sessions targeting evidence-based knowledge, myths and misconceptions, normative, attitudinal and control influences over and rehearsal of evidence-based fever management. All nurses in experimental hospital targeted wards were eligible to attend. Peer education and support facilitated session information reaching those unable to attend sessions. Two-way univariate anovas explored between subject, experimental and control group and within subject factors, pre, post and latency data. Significant interactions in normative influence (p = 0.01) and intentions (p = 0.01), a significant main group effect in control influence (p = 0.01) and a significant main effect between audit data across time points (p = 0.03) highlight peer education programme effectiveness in behaviour change. Normative, control and intention changes postpeer education programme were maintained in latency data; mean temperature was not. The peer education programme, based on a behaviour change theory, initiated and maintained evidence-based intentions for antipyretics use in fever management. The promotion of evidence-based change in organizational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes.
1981-06-01
TI - 59 programmable calculator to aid...training. The Texas Instruments TI - 59 Programmable Calculator has only ten lettered registers that would be simple for clerical personnel to use (A...SASSY Management Units. Appendix C is a set of user instructions written for the Texas Instrument TI - 59 Programmable Calculator . The TI-59 was
Beck, Peter; Truskaller, Thomas; Rakovac, Ivo; Bruner, Fritz; Zanettin, Dominik; Pieber, Thomas R
2009-01-01
5.9% of the Austrian population is affected by diabetes mellitus. Disease Management is a structured treatment approach that is suitable for application to the diabetes mellitus area and often is supported by information technology. This article describes the information systems developed and implemented in the Austrian disease management programme for type 2 diabetes. Several workflows for administration as well as for clinical documentation have been implemented utilizing the Austrian e-Health infrastructure. De-identified clinical data is available for creating feedback reports for providers and programme evaluation.
Shen, Huixia; Edwards, Helen; Courtney, Mary; McDowell, Jan; Wu, Ming
2012-12-01
A protocol for a new peer-led self-management programme for community-dwelling older people with diabetes in Shanghai, China. The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self-management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising. Quasi-experimental. This study is a non-equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self-efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self-efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self-efficacy, social support, self-management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks. This theory-based programme tailored to Chinese patients has potential for improving diabetes self-management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks, is especially promising considering healthcare resource shortage in China. © 2012 Blackwell Publishing Ltd.
Using a formal requirements management tool for system engineering: first results at ESO
NASA Astrophysics Data System (ADS)
Zamparelli, Michele
2006-06-01
The attention to proper requirement analysis and maintenance is growing in modern astronomical undertakings. The increasing degree of complexity that current and future generations of projects have reached requires substantial system engineering efforts and the usage of all available technology to keep project development under control. One such technology is a tool which helps managing relationships between deliverables at various development stages, and across functional subsystems and disciplines as different as software, mechanics, optics and electronics. The immediate benefits are traceability and the possibility to do impact analysis. An industrially proven tool for requirements management is presented together with the first results across some projects at ESO and a cost/benefit analysis of its usage. Experience gathered so far shows that the extensibility and configurability of the tool from one hand, and integration with common documentation formats and standards on the other, make it appear as a promising solution for even small scale system development.
Environmental Hazards Assessment Program. Quarterly report, January 1994--March 1994
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1994-05-04
The objectives of the EHAP program are to: Develop a holistic, national basis for risk assessment, risk management and risk communication; Develop a pool of talented scientists and experts in cleanup activities, especially in human health aspects, and; Identify needs and develop programs addressing the critical shortage of well-educated, highly-skilled technical and scientific personnel to address the health oriented aspects of environmental restoration and waste management. This report describes activities and reports on progress for the third quarter of year two (January-March, 1994) of the grant. To better accomplish objectives, grant efforts are organized into three major elements: The Crossroadsmore » of Humanity Series; Research, Science and Education Programs; and Program Management. The Crossroads of Humanity Series charted a new course, incorporating lessons learned during previous quarters into a series of programs designed to address environmental issues in a real world setting. Reports are included on the various research programs with milestones and deliverables from the third quarter.« less
Van Grootven, Bastiaan; McNicoll, Lynn; Mendelson, Daniel A; Friedman, Susan M; Fagard, Katleen; Milisen, Koen; Flamaing, Johan; Deschodt, Mieke
2018-03-16
To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). Western Europe and the USA. Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate). Participants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method. In the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications. The indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Jonsdottir, Helga; Amundadottir, Olof R; Gudmundsson, Gunnar; Halldorsdottir, Bryndis S; Hrafnkelsson, Birgir; Ingadottir, Thorbjorg Soley; Jonsdottir, Rosa; Jonsson, Jon Steinar; Sigurjonsdottir, Ellen D; Stefansdottir, Ingibjorg K
2015-11-01
To evaluate the effectiveness of a 6-month, partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease. Self-management is a widely valued concept used to address contemporary issues of chronic health problems. Findings of self-management programmes for people with chronic obstructive pulmonary disease are inconclusive. Pragmatic randomized control trial. Patients, 45-65 years old, with mild and moderate chronic obstructive pulmonary disease were invited with a family member. Experimental group (n = 48) participated in a 6-month, partnership-based self-management programme consisting of: (a) three to four conversations between nurse and patient-family member; (b) 6 months of smoking cessation; and (c) interdisciplinary team-patient-family member group meeting. Control group (n = 52) received usual care. Data were collected at months zero, six and 12. The trial lasted from June 2009-March 2013. Patients with mild and moderate chronic obstructive pulmonary disease who participated in the partnership-based self-management programme perceived less intrusiveness of the disease and its treatment than patients in the control group. Patients in the experimental group did not have better health-related quality of life, less anxiety or depression, increased physical activity, fewer exacerbations or better smoking status than patients in the control group. Patients in both groups found participation in the research useful and important. The partnership-based self-management programme had benefits concerning perception of the intrusiveness of chronic obstructive pulmonary disease and its treatment on lifestyles, activities and interests for young patients with the disease in its early stages. High satisfaction in control group, low family attendance and the relatively short treatment period may explain the less than expected benefits of the programme. © 2015 John Wiley & Sons Ltd.
IMHE-Info. OECD Programme on Institutional Management in Higher Education, December 2006
ERIC Educational Resources Information Center
OECD Publishing (NJ1), 2006
2006-01-01
IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: Governance on the Agenda. IMHE News, publications of interest and upcoming events are included.
Steuten, Lotte; Vrijhoef, Bert; Van Merode, Frits; Wesseling, Geert-Jan; Spreeuwenberg, Cor
2006-12-01
To assess the impact of a population-based disease management programme for adult patients with asthma or chronic obstructive pulmonary disease (COPD) on process measures, intermediate outcomes, and endpoints of care. Quasi-experimental design with 12-month follow-up. Region of Maastricht (the Netherlands) including university hospital and 16 general practices. Nine hundred and seventy-five patients of whom 658 have asthma and 317 COPD. Disease management programme. Endpoints of care are respiratory health, health utility, patient satisfaction, and total health care costs related to asthma or COPD. Quality aspects of care, disease control, self-care behaviour, smoking status, disease-specific knowledge, and patients' satisfaction improved after implementation of the programme. Lung function was not affected by implementation of the programme. For COPD patients, a significant improvement in health utility was found. For patients with asthma, significant cost savings were measured. Organizing health care according to principles of disease management for adults with asthma or COPD is associated with significant improvements in several processes and outcomes of care, while costs of care do not exceed the existing budget.
ERIC Educational Resources Information Center
Cameron, Craig; Klopper, Christopher
2015-01-01
Work integrated learning (WIL) is in growing demand by multiple stakeholders within the higher education sector in Australia. There are significant and distinct legal risks to universities associated with WIL programmes. University lawyers, along with WIL administrators and university management, are responsible for managing legal risk. This…
Jasper, Melanie A; Grundy, Lynne; Curry, Esther; Jones, Lynne
2010-09-01
To discuss the challenges of designing a professional development programme for ward managers working in in-patient facilities in Wales. In 2008, the Minister of Health launched the Free to Lead, Free to Care initiative to empower ward managers. One work-stream involved the creation of a universal professional development programme to ensure they had the skills and knowledge to function effectively in their roles in the newly restructured NHS in Wales. A collaborative, staged approach, involving multiple stakeholders, resulted in the design of a programme founded in principles of action and work-based learning tailored to the needs of the individual in attaining accredited competencies. Achieving buy-in and ownership from stakeholders are essential to ensure standardization and consistency of implementation of a universal programme. Shared responsibility and acceptance of key principles underpinning an individualized, work-based programme are fundamental to ensuring equity of outcome achievement. IMPLICATIONS FOR MANAGEMENT: Managerially facilitated cultural change is needed to embed individual work-based professional development programmes in the clinical environment, with practitioners supported through a variety of learning strategies appropriate to their learning needs. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
Halsne, Julia
2015-01-01
The East Bay Municipal Utility District provides potable water to approximately 1.3 million customers and treats wastewater for approximately 680,000 customers on the eastern side of San Francisco Bay in Northern California. Corporate policy requires the District to create and maintain an active emergency preparedness programme to manage its critical functions during an emergency and protect people, property and the environment. The policy also requires the District to create and maintain a business continuity programme to minimise disruptions of critical business functions and enhance its capability to recover operations. For these programmes to work effectively they must be coordinated. As the programmes at the District have evolved, the natural interrelationship, overlaps and integration have become inherent in their success. To ensure integration and coordination of these programmes, the District has developed management systems to effectively drive towards a seamless overarching programme.
Programmable multi-node quantum network design and simulation
NASA Astrophysics Data System (ADS)
Dasari, Venkat R.; Sadlier, Ronald J.; Prout, Ryan; Williams, Brian P.; Humble, Travis S.
2016-05-01
Software-defined networking offers a device-agnostic programmable framework to encode new network functions. Externally centralized control plane intelligence allows programmers to write network applications and to build functional network designs. OpenFlow is a key protocol widely adopted to build programmable networks because of its programmability, flexibility and ability to interconnect heterogeneous network devices. We simulate the functional topology of a multi-node quantum network that uses programmable network principles to manage quantum metadata for protocols such as teleportation, superdense coding, and quantum key distribution. We first show how the OpenFlow protocol can manage the quantum metadata needed to control the quantum channel. We then use numerical simulation to demonstrate robust programmability of a quantum switch via the OpenFlow network controller while executing an application of superdense coding. We describe the software framework implemented to carry out these simulations and we discuss near-term efforts to realize these applications.
Clinical case management for patients with schizophrenia with high care needs.
Mas-Expósito, Laia; Amador-Campos, Juan Antonio; Gómez-Benito, Juana; Mauri-Mas, Lluís; Lalucat-Jo, Lluís
2015-02-01
The aim of this study is to establish the effectiveness of a clinical case management (CM) programme compared to a standard treatment programme (STP) in patients with schizophrenia. Patients for the CM programme were consecutively selected among patients in the STP with schizophrenia who had poor functioning. Seventy-five patients were admitted to the CM programme and were matched to 75 patients in the STP. Patients were evaluated at baseline and at 1 year follow-up. At baseline, patients in the CM programme showed lower levels of clinical and psychosocial functioning and more care needs than patients in the STP. Both treatment programmes were effective in maintaining contact with services but the CM programme did not show advantages over the STP on outcomes. Differences between groups at baseline may be masking the effects of CM at one year follow-up. A longer follow-up may be required to evaluate the real CM practices effects.
Serlachius, A; Northam, E; Frydenberg, E; Cameron, F
2012-04-01
Few qualitative studies have examined the views of adolescents with type 1 diabetes mellitus (T1DM) regarding psychosocial programme development and content. We conducted focus groups with 13 adolescents with T1DM to explore stressors and gain feedback on adapting a generic coping skills programme. The following prevalent stressors were identified: parental/adolescent conflict, balancing self-management and daily life, and health concerns. Prevalent views on programme adaptation included enhancing social support and adding diabetes-specific information and skills. Based on these data, the programme was adapted to address stressors and support self-management, thus better meeting the needs of, and appeal to, adolescents with T1DM.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mackintosh, Angela
For over five decades the Sellafield Site has been central to the UK's nuclear programme. Now operated by Sellafield Ltd, under the management of Parent Body Organisation Nuclear Management Partners (NMP), a consortium of URS Washington Division, AMEC and AREVA is focussed on the decommissioning of historical facilities. When Decommissioning commenced in the late 1980's the site focus at that time was on commercial reprocessing and waste management. Now through the implementation of a company change programme, emphasis has shifted towards accelerated risk and hazard reduction of degraded legacy plants with nuclear inventory whilst ensuring value for money for themore » customer, the Nuclear Decommissioning Authority. This paper will describe the management success by the Site owners in delivering a successful change programme. The paper will explain how the site has transitioned to the INPO Standard Nuclear Performance Model (SNPM) and how through the use of a change maturity matrix has contributed to the accelerated reduction in high risk high hazard nuclear facilities. The paper will explain in detail how the Decommissioning Programme Office has facilitated and coordinated the Governance and assured delivery of the change plan and how successful application of visual management has aided the communication of its progress. Finally, the paper will discuss how the Delivery Schedules have proved critical for presenting the change plan to Key Stakeholders, Government Owners and Powerful Regulators. Overall, this paper provides an insight into how a massive change programme is being managed within one of the world's highest regulated industries. (authors)« less
Turner, D A; Paul, S; Stone, M A; Juarez-Garcia, A; Squire, I; Khunti, K
2008-12-01
To determine if a disease management programme for patients with coronary heart disease and heart failure represents an efficient use of health services resources. We carried out an economic evaluation alongside a cluster randomised control trial of 1163 patients with coronary heart disease and chronic heart failure in 20 primary care practices in the United Kingdom. Practices were randomised to either a control group, where patients received standard general practice care, or an intervention group where patients had access to a specialist nurse-led disease management programme. We estimated costs in both groups for coronary heart disease-related resource use. The main outcome measure used in the economic evaluation was quality adjusted life years (QALY) measured using the EuroQol. The disease management programme was associated with an increase in the QALY measured of 0.03 per year and an increase in the total NHS costs of 425 pounds (540 euros), of this only 83 pounds was directly associated with the provision of the nurse clinics. The clinics generated additional QALY at an incremental cost of 13 pounds 158 per QALY compared to the control group. The use of a nurse-led disease management programme is associated with increased costs in other coronary heart disease-related services as well as for the costs of the clinics. They are also associated with improvements in health. Even in the short term these disease management programmes may represent a cost-effective service, as additional QALY are generated at an acceptable extra cost.
[Indication guidelines for medical rehabilitation in the context of disease management programmes].
Raspe, Heiner
2005-02-01
In current and upcoming disease management programmes in Germany, the provision of medical services is strongly oriented on ICD diagnoses and on services traditionally provided by the statutory health insurance. Multidisciplinary services, such as medical rehabilitation, mostly covered by other payers (e.g. pension funds) are not taken into account. On the other hand, many chronically-ill patients have complex and multifocal health complaints that are best addressed by multidisciplinary interventions. Considering this inherent deficit, in 2002 the German Society of Rehabilitation Sciences has initiated the research project "Indication Guidelines" aimed at developing indication criteria for rehabilitation in the context of disease management programmes. The concept presented in this paper relies on three basic requirements: 1. Impaired participation (according to ICF) caused by multifocal deficits leads to the definition of goals for rehabilitation, taking into account clinical and legal aspects as well as the patients preferences. 2. Multifocal health problems are best addressed by a multidisciplinary rehabilitation programme as it is currently provided by the German pension funds. 3. Scientific evidence has to demonstrate that these programmes are very likely to be effective (positive rehabilitation prognosis, evidence-based rehabilitation). Further requirements include adequate instruction of patients, as well as intensive and prolonged after-care. Both could be very well integrated into comprehensive disease management programmes.
Lara-Cabrera, M L; Gjerden, M; Gråwe, R W; Linaker, O M; Steinsbekk, A
2016-07-01
To investigate the 1-month effects of an educational programme co-led by peers delivered before treatment on treatment preferences, self-management knowledge and motivation in comparison to usual care. Adults referred to a community mental health centre were randomised to either a control group (n=48) or a peer co-led educational programme (intervention group, n=45). The programme consisted of an 8-hour group education session followed by an individual pretreatment planning session. The main topics of the educational programme were treatment options, patients' rights, self-management, the importance of patient activation and participation. At 1-month follow-up, a significantly larger proportion of the patients in the intervention group knew which type of treatment they preferred (76.7% vs. 32.5%, p<0.001). The intervention group had significantly higher self-management knowledge (p<0.001). There was no effect on treatment motivation (p=0.543). At 1-month following the delivery of a pretreatment educational programme, we found that participants' knowledge of treatment preferences and self-management had improved. Educational interventions co-led by peers can optimise the process of informing and educating outpatients, thereby helping patients to clarify their treatment preferences. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Huggare, J; Derringer, K A; Eliades, T; Filleul, M P; Kiliaridis, S; Kuijpers-Jagtman, A; Martina, R; Pirttiniemi, P; Ruf, S; Schwestka-Polly, R
2014-06-01
In 1989, the ERASMUS Bureau of the European Cultural Foundation of the Commission of the European Communities funded the development of a new 3-year curriculum for postgraduate education in orthodontics. The new curriculum was created by directors for orthodontic education representing 15 European countries. The curriculum entitled 'Three years Postgraduate Programme in Orthodontics: the Final Report of the Erasmus Project' was published 1992. In 2012, the 'Network of Erasmus Based European Orthodontic Programmes' developed and approved an updated version of the guidelines. The core programme consists of eight sections: general biological and medical subjects; basic orthodontic subjects; general orthodontic subjects; orthodontic techniques; interdisciplinary subjects; management of health and safety; practice management, administration, and ethics; extramural educational activities. The programme goals and objectives are described and the competencies to be reached are outlined. These guidelines may serve as a baseline for programme development and quality assessment for postgraduate programme directors, national associations, and governmental bodies and could assist future residents when selecting a postgraduate programme.
IMHE-Info. OECD Programme on Institutional Management in Higher Education, July 2006
ERIC Educational Resources Information Center
Lafon, Valerie, Ed.
2006-01-01
IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: Higher Education: Quality, Equity and Efficiency. IMHE News, publications of interest and upcoming events are included.
Radiation Hardened Telerobotic Dismantling System Development Final Report CRADA No. TC-1340-96
DOE Office of Scientific and Technical Information (OSTI.GOV)
Smith, C.; Lightman, A.
This project was a collaborative effort between the University of California, LLNL and RedZone Robotics, Inc. for the development of radiation-hardened telerobotic dismantling systems for use in applications such as nuclear facility remediation, nuclear accident response, and Chemobyltype remediation. The project supported the design, development, fabrication and testing of a Ukrainian robotic systems. The project was completed on time and within budget. All deliverables were completed. The final project deliverables were consistent with the plans developed in the original project with the exception that the fabricated systems remained in Ukraine.
Process development for automated solar cell and module production. Task 4: Automated array assembly
NASA Technical Reports Server (NTRS)
Hagerty, J. J.
1981-01-01
Progress in the development of automated solar cell and module production is reported. The unimate robot is programmed for the final 35 cell pattern to be used in the fabrication of the deliverable modules. The mechanical construction of the automated lamination station and final assembly station phases are completed and the first operational testing is underway. The final controlling program is written and optimized. The glass reinforced concrete (GRC) panels to be used for testing and deliverables are in production. Test routines are grouped together and defined to produce the final control program.
Operational competency development in E and F grade nursing staff: preparation for management.
Porter, S; Anderson, L; Chetty, A; Dyker, S; Murphy, F; Cheyne, H; Latto, D; Grant, A; McLachlan, M; Wild, P; McDonald, A; Kettles, A M
2006-07-01
There is limited literature for operational management competency development in E and F grade nursing staff. These grades of nursing staff have to take over from G grade nurses ward managers on a regular basis. With human resources doing less of the operational management and taking more of an advisory role, nursing staff are now required to deal with disciplinary procedures and other management issues in a more consistent manner. Therefore, this development programme in a Scottish primary care NHS psychiatric service was designed to enable E and F grade nurses to take over from ward managers and to enable ward managers to 'succession plan' for times when they will be absent. The literature is reviewed, the background to the development programme described and the design of the development programme is explained. The results from both the pilot study (n=13) and first group (n=8) through the course are presented, evaluated discussed.
[Work schedule management in the health institutions of Abomey-Calavi (Benin)].
Makoutodé, M; Kassanga, N N; Ouendo, E M; Agueh, V D; Diallo, P M
1999-12-01
Work time management of the health personnel of the health institutions in the sub-prefecture of Abomey-Calavi (Benin) This study was carried out with a sample size of 130, comprising health personnel, patients, members of management committees and twelve health institutions of the subprefecture of Abomey-Calavi. The survey was carried out through observation, one-on-one interviews and consultation of documents. The results reveal that work time is poorly managed in almost all of the programmes surveyed. There exist long waiting lines in almost all the health programmes. On average, the traffic report per service is 82 and 10 out of 12 of the programmes investigated do not have an agenda of activities.
Noble, Bram F
2004-03-01
Strategic environmental assessment (SEA) is gaining widespread recognition as a tool for integrating environmental considerations in policy, plan, and program development and decision-making. Notwithstanding the potential of SEA to improve higher-order decision processes, there has been very little attention given to integrating SEA with industry planning practices. As a result, the benefits of SEA have yet to be fully realized among industrial proponents. That said, SEA practice is ongoing, albeit informally and often under a different label, and is proving to be a valuable tool for industry planning and decision-making. Based on a case study of the Pasquai-Porcupine forest management plan in Saskatchewan, Canada, this paper illustrates how an integrated approach to SEA can contribute to industry environmental decision-making and can enhance the quality and deliverability of industry plans.
NASA Astrophysics Data System (ADS)
Flügel, W.-A.
2011-04-01
The EC-project BRAHMATWINN was carrying out a harmonised integrated water resources management (IWRM) approach as addressed by the European Water Initiative (EWI) in headwater river systems of alpine mountain massifs of the twinning Upper Danube River Basin (UDRB) and the Upper Brahmaputra River Basins (UBRB) in Europe and Southeast Asia respectively. Social and natural scientists in cooperation with water law experts and local stakeholders produced the project outcomes presented in Chapter 2 till Chapter 10 of this publication. BRAHMATWINN applied a holistic approach towards IWRM comprising climate modelling, socio-economic and governance analysis and concepts together with methods and integrated tools of applied Geoinformatics. A detailed description of the deliverables produced by the BRAHMATWINN project is published on the project homepage http://www.brahmatwinn.uni-jena.de.
Barriers to community case management of malaria in Saraya, Senegal: training, and supply-chains.
Blanas, Demetri A; Ndiaye, Youssoupha; Nichols, Kim; Jensen, Andrew; Siddiqui, Ammar; Hennig, Nils
2013-03-14
Health workers in sub-Saharan Africa can now diagnose and treat malaria in the field, using rapid diagnostic tests and artemisinin-based combination therapy in areas without microscopy and widespread resistance to previously effective drugs. This study evaluates communities' perceptions of a new community case management of malaria programme in the district of Saraya, south-eastern Senegal, the effectiveness of lay health worker trainings, and the availability of rapid diagnostic tests and artemisinin-based combination therapy in the field. The study employed qualitative and quantitative methods including focus groups with villagers, and pre- and post-training questionnaires with lay health workers. Communities approved of the community case management programme, but expressed concern about other general barriers to care, particularly transportation challenges. Most lay health workers acquired important skills, but a sizeable minority did not understand the rapid diagnostic test algorithm and were not able to correctly prescribe arteminisin-based combination therapy soon after the training. Further, few women lay health workers participated in the programme. Finally, the study identified stock-outs of rapid tests and anti-malaria medication products in over half of the programme sites two months after the start of the programme, thought due to a regional shortage. This study identified barriers to implementation of the community case management of malaria programme in Saraya that include lay health worker training, low numbers of women participants, and generalized stock-outs. These barriers warrant investigation into possible solutions of relevance to community case management generally.
ERIC Educational Resources Information Center
Zhong, Connie S.; Melendez-Torres, G. J.
2017-01-01
Background: Adolescents with asthma face unique challenges due to hormonal changes, psychosocial development and healthcare transition. Peer-led self-management programmes may increase treatment adherence and social adjustment by addressing these challenges. The purpose of this study was to assess whether peer-led self-management programmes…
ERIC Educational Resources Information Center
Health Education Journal, 2011
2011-01-01
Objective: The purpose of this study was to develop guidelines and recommendations on patient education programmes of any type, targeted specially to individuals with OA and which were designed to improve the clinical effectiveness of managing OA. Methods: The Ottawa Methods Group contacted specialized organizations that focus on management for…
A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities
Yao, Katy; Nkengasong, John N.
2014-01-01
Background Since its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented widely throughout Africa, as well as in the Caribbean, Central and South America, and Southeast Asia. Objective We compiled results from local, national and global studies to provide a broad view of the programme and identify directions for the future. The review consists of two companion papers; this paper focuses on content analysis, examining various thematic components of the SLMTA programme and future priorities. Methods A systematic literature search identified 28 published articles about implementing the SLMTA programme. Results for various components of the SLMTA programme were reviewed and summarised. Results Local and national studies provide substantial information on previous experiences with quality management systems; variations on SLMTA implementation; building human resource capacity for trainers, mentors and auditors; the benefits and effectiveness of various types of mentorship; the importance of management buy-in to ensure country ownership; the need to instill a culture of quality in the laboratory; success factors and challenges; and future directions for the programme. Conclusions Local, national and global results suggest that the SLMTA programme has been overwhelmingly successful in transforming laboratory quality management. There is an urgent need to move forward in four strategic directions: progression (continued improvement in SLMTA laboratories), saturation (additional laboratories within countries that have implemented SLMTA), expansion (implementation in additional countries), and extension (adapting SLMTA for implementation beyond the laboratory), to lead to transformation of overall health systems and patient care. PMID:29043200
Compilation of Abstracts of Theses Submitted by Candidates for Degrees.
1984-06-01
Management System for the TI - 59 Programmable Calculator Kersh, T. B. Signal Processor Interface 65 CPT, USA Simulation of the AN/SPY-lA Radar...DESIGN AND IMPLEMENTATION OF A BASIC CROSS-COMPILER AND VIRTUAL MEMORY MANAGEMENT SYSTEM FOR THE TI - 59 PROGRAMMABLE CALCULATOR Mark R. Kindl Captain...Academy, 1974 The instruction set of the TI - 59 Programmable Calculator bears a close similarity to that of an assembler. Though most of the calculator
Quality Assessment and Development in the Course of the EFMD CEL Programme Accreditation
ERIC Educational Resources Information Center
Meier, C.; Seufert, S.; Euler, D.
2012-01-01
This paper reviews the experiences and learnings derived from the European Foundation for Management Development's programme accreditation teChnology-Enhanced Learning (EFMD CEL) programme accreditation. The EFMD CEL quality framework is briefly described, and an overview of the programmes that have pursued accreditation is presented.…
Bourbeau, Jean; Lavoie, Kim L; Sedeno, Maria; De Sousa, Dorothy; Erzen, Damijan; Hamilton, Alan; Maltais, François; Troosters, Thierry; Leidy, Nancy
2016-04-04
Chronic obstructive pulmonary disease is generally progressive and associated with reduced physical activity. Both pharmacological therapy and exercise training can improve exercise capacity; however, these are often not sufficient to change the amount of daily physical activity a patient undertakes. Behaviour-change self-management programmes are designed to address this, including setting motivational goals and providing social support. We present and discuss the necessary methodological considerations when integrating behaviour-change interventions into a multicentre study. PHYSACTO is a 12-week phase IIIb study assessing the effects on exercise capacity and physical activity of once-daily tiotropium+olodaterol 5/5 µg with exercise training, tiotropium+olodaterol 5/5 µg without exercise training, tiotropium 5 µg or placebo, with all pharmacological interventions administered via the Respimat inhaler. Patients in all intervention arms receive a behaviour-change self-management programme to provide an optimal environment for translating improvements in exercise capacity into increases in daily physical activity. To maximise the likelihood of success, special attention is given in the programme to: (1) the Site Case Manager, with careful monitoring of programme delivery; (2) the patient, incorporating patient-evaluation/programme-evaluation measures to guide the Site Case Manager in the self-management intervention; and (3) quality assurance, to help identify and correct any problems or shortcomings in programme delivery and ensure the effectiveness of any corrective steps. This paper documents the comprehensive methods used to optimise and standardise the behaviour-change self-management programme used in the study to facilitate dialogue on the inclusion of this type of programme in multicentre studies. The study has been approved by the relevant Institutional Review Boards, Independent Ethics Committee and Competent Authority according to national and international regulations. The results of this study will be disseminated through relevant, peer-reviewed journals and international conference presentations. NCT02085161. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Lee, Lester; King, Nicolas K K; Kumar, Dinesh; Ng, Yew Poh; Rao, Jai; Ng, Huiyu; Lee, Kah Keow; Wang, Ernest; Ng, Ivan
2014-10-01
The choice of programmable or nonprogrammable shunts for the management of hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH) remains undefined. Variable intracranial pressures make optimal management difficult. Programmable shunts have been shown to reduce problems with drainage, but at 3 times the cost of nonprogrammable shunts. All patients who underwent insertion of a ventriculoperitoneal shunt for hydrocephalus after aneurysmal SAH between 2006 and 2012 were included. Patients were divided into those in whom nonprogrammable shunts and those in whom programmable shunts were inserted. The rates of shunt revisions, the reasons for adjustments of shunt settings in patients with programmable devices, and the effectiveness of the adjustments were analyzed. A cost-benefit analysis was also conducted to determine if the overall cost for programmable shunts was more than for nonprogrammable shunts. Ninety-four patients underwent insertion of shunts for hydrocephalus secondary to SAH. In 37 of these patients, nonprogrammable shunts were inserted, whereas in 57 programmable shunts were inserted. Four (7%) of 57 patients with programmable devices underwent shunt revision, whereas 8 (21.6%) of 37 patients with nonprogrammable shunts underwent shunt revision (p = 0.0413), and 4 of these patients had programmable shunts inserted during shunt revision. In 33 of 57 patients with programmable shunts, adjustments were made. The adjustments were for a trial of functional improvement (n = 21), overdrainage (n = 5), underdrainage (n = 6), or overly sunken skull defect (n = 1). Of these 33 patients, 24 showed neurological improvements (p = 0.012). Cost-benefit analysis showed $646.60 savings (US dollars) per patient if programmable shunts were used, because the cost of shunt revision is a lot higher than the cost of the shunt. The rate of shunt revision is lower in patients with programmable devices, and these are therefore more cost-effective. In addition, the shunt adjustments made for patients with programmable devices also resulted in better neurological outcomes.
Karlsen, Bjørg; Rasmussen Bruun, Bettina; Oftedal, Bjørg
2018-01-01
Research suggests that guided self-determination programmes can support self-management of diabetes by empowering self-determined goal setting and competence building. As most research in this area has focused on people with type 1 diabetes, knowledge is lacking on how adults with type 2 diabetes mellitus experience participation in such programmes. This study reports the modelling phase of a complex intervention design that explored the experiences of adults with type 2 diabetes who participated in a nurse-led guided self-determination programme in general practice and examines how the programme affected patients' motivation to self-manage diabetes. The qualitative design with semistructured interviews included 9 adults with type 2 diabetes who participated in the programme. Qualitative content analysis was used to analyse the data. The findings indicate that the participants experienced new life possibilities after participating in the programme, which seemed to have a positive influence on their motivation for self-management. Through reflections about how to live with diabetes, the participants reinterpreted their life with diabetes by gradually developing a closer relationship with the disease, moving towards acceptance. The fact that dialogue with the nurses was seen to be on an equal footing helped support the participants to become more self-determined.
Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management.
Zwerink, Marlies; Effing, Tanja; Kerstjens, Huib A M; van der Valk, Paul; Brusse-Keizer, Marjolein; Zielhuis, Gerhard; van der Palen, Job
2016-01-01
Information regarding cost-effectiveness of community-based exercise programmes in COPD is scarce. Therefore, we have investigated whether a community-based exercise programme is a cost-effective component of self-management for patients with COPD after 2 years of follow-up. All included COPD patients participated in four self-management sessions. Additionally, patients in the COPE-active group participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained 3 times/week for 6 months and two times/week during the subsequent 5 months. In both periods, one of these weekly training sessions was home-based (unsupervised). No formal physiotherapy sessions were offered to COPE-active patients in the second year. A decision analytical model with a 24-month perspective was used to evaluate cost-effectiveness. Incremental cost-effectiveness ratios (ICER) were calculated and cost-effectiveness planes were created. Data of 77 patients participating in the exercise programme and 76 patients in the control group were analysed. The ICER for an additional patient prevented from deteriorating at least 47.5 meters on the ISWT was €6257. The ICER for an additional patient with a clinically relevant improvement (≥ 500 steps/day) in physical activity was €1564, and the ICER for an additional quality-adjusted life year (QALY) was €10 950. Due to a lack of maintenance of beneficial effects on our primary outcome exercise capacity after 2 years of follow-up and higher costs of the programme, the community-based exercise programme cannot be considered cost-effective compared to self-management programmes only. Nevertheless, the ICERs for the secondary outcomes physical activity and QALY are generally considered acceptable.
Greb, Stefan; Focke, Axel; Hessel, Franz; Wasem, Jürgen
2006-10-01
As a result of recent health care reforms sickness funds and health care providers in German social health insurance face increased financial incentives for implementing disease management and integrated care. Sickness funds receive higher payments form the risk adjustment system if they set up certified disease management programmes and induce patients to enrol. If health care providers establish integrated care projects they are able to receive extra-budgetary funding. As a consequence, the number of certified disease management programmes and the number of integrated care contracts is increasing rapidly. However, contracts about disease management programmes between sickness funds and health care providers are highly standardized. The overall share of health care expenses spent on integrated care still is very low. Existing integrated care is mostly initiated by hospitals, is based on only one indication and is not fully integrated. However, opportunity to invest in integrated care may open up innovative processes, which generate considerable productivity gains. What is more, integrated care may serve as gateway for the introduction of more widespread selective contracting.
Application of a theoretical model to evaluate COPD disease management.
Lemmens, Karin M M; Nieboer, Anna P; Rutten-Van Mölken, Maureen P M H; van Schayck, Constant P; Asin, Javier D; Dirven, Jos A M; Huijsman, Robbert
2010-03-26
Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care.
Application of a theoretical model to evaluate COPD disease management
2010-01-01
Background Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. Methods A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Results Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. Conclusions The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care. PMID:20346135
Monninkhof, Evelyn; van der Aa, Maaike; van der Valk, Paul; van der Palen, Job; Zielhuis, Gerhard; Koning, Karen; Pieterse, Marcel
2004-11-01
The COPE self-management programme, including a self-management education course, self-treatment of exacerbations and a fitness programme, appeared to have no significant effect on health related quality of life (HRQoL) as measured by the St. George's Respiratory Questionnaire (SGRQ). This is in contrast to our hypothesis and despite expressions of satisfaction of patients to healthcare workers. To understand this discrepancy, a qualitative study was performed. A purposive sample of 20 participants of the COPE self-management programme were interviewed at home using in-depth, semi-structured interviews. Interviews were audio taped and transcribed verbatim and analysed according grounded theory. The fitness programme was most positively evaluated by patients due to the perceived increase of exercise capacity and the social aspect of the group training. Major effects gained by the self-management education course reported by patients were the skills to evenly distribute their energy and to listen to their body signals. Most patients thought favourable about self-treatment of exacerbations. The possibility to start early, not having to call a doctor and autonomy were raised as important advantages. Furthermore, several patients reported increased self-confidence and coping behaviour as important effects of the COPE programme. Finally, many patients reported feeling safe due to the frequent follow-up visits and 24h access to the hospital, and this aspect elicited to be very important. In this study, the qualitative interviews suggest that the SGRQ and possibly other existing HRQoL instruments might fail to capture the full experience of patients in self-management studies. The need for more elaborate qualitative research on this subject is indicated.
2011-01-01
Background There has been a growing concern in designing physical activity (PA) programmes for elderly people, since evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Complete programme evaluations are a necessary prerequisite to continuous quality improvements. Being able to refine, adapt and create tools that are suited to the realities and contexts of PA programmes for the elderly in order to support its continuous improvement is, therefore, crucial. Thus, the aim of this study was to develop a self-assessment tool for PA programmes for the elderly. Methods A 3-round Delphi process was conducted via the Internet with 43 national experts in PA for the elderly, management and delivery of PA programmes for the elderly, sports management, quality management and gerontology, asking experts to identify the propositions that they considered relevant for inclusion in the self-assessment tool. Experts reviewed a list of proposed statements, based on the criteria and sub-criteria from the European Foundation for Quality Management Excellence Model (EFQM) and PA guidelines for older adults and rated each proposition from 1 to 8 (disagree to agree) and modified and/or added propositions. Propositions receiving either bottom or top scores of greater than 70% were considered to have achieved consensus to drop or retain, respectively. Results In round 1, of the 196 originally-proposed statements (best practice principles), the experts modified 41, added 1 and achieved consensus on 93. In round 2, a total of 104 propositions were presented, of which experts modified 39 and achieved consensus on 53. In the last round, of 51 proposed statements, the experts achieved consensus on 19. After 3 rounds of rating, experts had not achieved consensus on 32 propositions. The resulting tool consisted of 165 statements that assess nine management areas involved in the development of PA programmes for the elderly. Conclusion Based on experts' opinions, a self-assessment tool was found in order to access quality of PA programmes for the elderly. Information obtained with evaluations would be useful to organizations seeking to improve their services, customer satisfaction and, consequently, adherence to PA programmes, targeting the ageing population. PMID:21958203
Thomas, S; Kersten, P; Thomas, P W; Slingsby, V; Nock, A; Jones, R; Davies Smith, A; Galvin, K T; Baker, R; Hillier, C
2015-10-20
To explore cross-sectional patterns of use of fatigue management strategies in people with multiple sclerosis (MS) who had attended a group-based fatigue management programme, Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle ('FACETS'). In a multicentre randomised controlled trial (RCT) the FACETS programme was shown to reduce fatigue severity and improve self-efficacy and quality of life. A questionnaire substudy within a RCT involving the self-completed Fatigue Management Strategies Questionnaire (FMSQ). The FMSQ includes: (1) closed questions about the use and helpfulness of fatigue management strategies taught in FACETS and (2) open items about changes to lifestyle, attitudes or expectations, barriers or difficulties encountered and helpful strategies not covered in FACETS. All had a clinical diagnosis of MS, significant fatigue, were ambulatory and had attended at least 4 of 6 scheduled FACETS sessions. Participants (n=72) were posted the FMSQ with a prepaid return envelope 4 months after the end of the FACETS programme. 82% (59/72) of participants returned the FMSQ. The fatigue management strategies most frequently used since attending FACETS were prioritisation (80%), pacing (78%), saying no to others (78%), grading tasks (75%) and challenging unhelpful thoughts (71%). Adding in those participants who were already using the respective strategies prior to FACETS, the three most used strategies at 4 months were prioritisation (55/59), grading (54/59) and pacing (53/58). Free-text comments illustrated the complex interplay between attitudes/expectations, behaviours, emotions and the environment. Issues related to expectations featured strongly in participants' comments. Expectations (from self and others) were both facilitators and barriers to effective fatigue management. Individuals' comments highlighted the complex, multifaceted nature of fatigue management. Revising expectations and a greater acceptance of fatigue were important shifts following the programme. Findings support the relevance of a cognitive behavioural approach for fatigue management. Booster sessions might be a useful addition to the FACETS programme. Current controlled trials ISRCTN76517470; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
[Disease management for chronic heart failure patient].
Bläuer, Cornelia; Pfister, Otmar; Bächtold, Christa; Junker, Therese; Spirig, Rebecca
2011-02-01
Patients with chronic heart failure (HF) are limited in their quality of life, have a poor prognosis and face frequent hospitalisations. Patient self-management was shown to improve quality of life, reduce rehospitalisations and costs in patients with chronic HF. Comprehensive disease management programmes are critical to foster patient self-management. The chronic care model developed by the WHO serves as the basis of such programmes. In order to develop self-management skills a needs orientated training concept is mandatory, as patients need both knowledge of the illness and the ability to use the information to make appropriate decisions according to their individual situation. Switzerland has no established system for the care of patients with chronic diseases in particular those with HF. For this reason a group of Swiss experts for HF designed a model for disease management for HF patients in Switzerland. Since 2009 the Swiss Heart Foundation offers an education programme based on this model. The aim of this programme is to offer education and support for practitioners, patients and families. An initial pilot evaluation of the program showed mixed acceptance by practitioners, whereas patient assessed the program as supportive and in line with their requirements.
IMHE-Info. OECD Programme on Institutional Management in Higher Education, April 2007
ERIC Educational Resources Information Center
Lafon, Valerie, Ed.
2007-01-01
IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) Regional Engagement: The Future for Higher Education?; and (2) Notes from Australia. IMHE News, publications of interest and upcoming events are included.
Developing a Virtual Engineering Management Community
ERIC Educational Resources Information Center
Hewitt, Bill; Kidd, Moray; Smith, Robin; Wearne, Stephen
2016-01-01
The paper reviews the lessons of planning and running an "Engineering Management" practitioner development programme in a partnership between BP and the University of Manchester. This distance-learning programme is for professional engineers in mid-career experienced in the engineering and support activities for delivering safe,…
Kumari, A. Krishna; J, Yuvaraj; Das, L. K
2012-01-01
Lymphatic filariasis is a vector borne parasitic disease causing long term disability. The Global Programme to Eliminate Lymphatic Filariasis aims to achieve its objective through two strategies; Mass Drug Administration (MDA) to interrupt transmission and Morbidity Management (MM) to manage disability for those already affected. MDA is going on in full swing in endemic areas; but MM is lagging behind. An exploratory study was conducted in Pondicherry through focus group discussions to find out whether there are delivery issues if any, in the MM programme and get suggestions from end users. The study results show that MM has not received the same attention as MDA and there are shortcomings in the delivery mechanism of the programme. The importance of these findings are discussed and suggestions given for improving the programme. PMID:22654597
What is the appropriate business continuity management staff size?
Walch, Damian; Merante, Jason
2008-04-01
This paper explores the question 'how many professionals does it take to build a resilient enterprise?' The paper describes the various segments of a comprehensive business continuity, disaster recovery and crisis management programme and then delves into the variables that determine the appropriate number of professionals required for the company. It is a thought-provoking examination that can help anybody in the `c-suite' examine their particular requirements, characteristics and culture to determine appropriate staffing levels. The reader will have a quantitative approach for determining the size and structure of a resilient enterprise which can provide a solid foundation for a programme that adapts and adjusts quickly and cost-effectively to disasters and events. It can also help build executive support for a programme management office which could ultimately increase the overall success of the programme.
Disability management in a sample of Australian self-insured companies.
Westmorland, M; Buys, N; Clements, N
2002-09-20
Disability management (DM) is a term developed in North America and refers to the prevention and management of injury and illness in the workplace. The purpose of this paper is to report findings of an Australian study that examined whether self-insured employers in that country have implemented integrated DM programmes. Key principles underpinning such programmes are explored to identify the extent to which Australian employers have adopted them. Data was collected from 29 self-insured Australian companies in three Australian States using a structured interview format with additional open-ended questions. It was found that companies have in place, to varying degrees, some of the key elements of disability management programmes. However, these elements were often not well integrated in a comprehensive disability management approach. The focus on workplace-based, early intervention in the area of return to work for injured employees was particularly strong, but there was little evidence of formal labour-management committee structures responsible for implementing DM programmes. If the concept of DM is relevant to the Australian environment then this study would suggest that self-insured companies need to undertake further work to develop integrated approaches to preventing and managing disability in the workplace. Several limitations of this study are highlighted and it is concluded that further work in this area is needed.
Brown, Adrian; Gouldstone, Amy; Fox, Emily; Field, Annmarie; Todd, Wendy; Shakher, Jayadave; Bellary, Srikanth; Teh, Ming Ming; Azam, Muhammad; John, Reggie; Jagielski, Alison; Arora, Teresa; Thomas, G Neil; Taheri, Shahrad
2015-01-01
Background Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was −4.1 kg (95% CI −3.6 to −4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving −5.5 kg (95% CI −4.2 to −6.2 kg, p=0.0001) and non-completers achieving −2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. Conclusions The SLiM programme is an effective group intervention for the management of severe and complex obesity. PMID:25854970
The Incredible Years Therapeutic Social and Emotional Skills Programme: A Pilot Study
ERIC Educational Resources Information Center
Hutchings, Judy; Bywater, Tracey; Gridley, Nicole; Whitaker, Christopher J.; Martin-Forbes, Pam; Gruffydd, Stella
2012-01-01
The Incredible Years (IY) universal child Classroom Dinosaur and Teacher Classroom Management programmes are delivered in all 102 primary schools in Gwynedd County, Wales. This article describes a pilot study of the IY Therapeutic (small group) Dinosaur School social and emotional coaching programme, developed as a treatment programme, in one such…
Exploring weight loss services in primary care and staff views on using a web-based programme.
Ware, Lisa J; Williams, Sarah; Bradbury, Katherine; Brant, Catherine; Little, Paul; Hobbs, F D Richard; Yardley, Lucy
2012-01-01
Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of e-health into primary care may face challenges. To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery. Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36) involved in delivering weight loss services. Data were analysed using inductive thematic analysis. Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation. Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and 'ad hoc' services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.
Guenthner, Daniel H
2012-01-01
A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.
Tabash, M I; Hussein, R A; Mahmoud, A H; El-Borgy, M D; Abu-Hamad, B A
2016-09-01
To assess knowledge, attitude and practice (KAP) of healthcare staff regarding pharmaceutical waste management; and to determine the impact of an educational programme on the KAP survey items. Pre-post-test intervention study. The pre-intervention phase was performed using a sample of 530 out of 1500 healthcare workers. A predesigned interview questionnaire was used to assess KAP. Next, an educational programme was designed and offered to a subsample of 69 healthcare workers. KAP were re-assessed for the programme attendees using the same interview questionnaire, both immediately (post-test) and six months after the end of the programme (follow-up test). The parametric paired sample t-test was used to assess the difference between pre-test and follow-up test results. Poor knowledge and poor practice levels (scores 50%) detected in the pre-intervention phase were found to improve to satisfactory levels (scores ≥75%) in the follow-up phase. Attitude was found to be positive (score ≥75%) in all phases of the study. The educational programme led to a significant improvement in KAP of healthcare staff regarding pharmaceutical waste management (P<0.001). Copyright © 2016. Published by Elsevier Ltd.
Ndou, Tshipfuralo; van Zyl, Greer; Hlahane, Salamina; Goudge, Jane
2013-01-24
Non-communicable diseases (NCD) and infectious chronic illnesses are recognised as significant contributing factors to the burden of disease globally, specifically in South Africa, yet clinical management is often poor. The involvement of community health workers (CHWs) in TB and HIV care in South Africa, and other low- and middle-income settings, suggests that they could make an important contribution in the management of NCDs. Using a rapid assessment, this study examines the outcomes of a pilot CHW programme to improve the management of hypertension and diabetes in Gauteng province, South Africa. A record review compared outcomes of patients receiving home visits (n56) with a control group (n168) attending the clinic, matched, as far as possible, on age, gender, and condition. Focus group discussions and semi-structured interviews with CHWs, patients, district, clinic, and NGO staff were used to obtain descriptions of the functioning of the programme and patient experiences. Despite the greater age and co-morbidity among those in the pilot programme, the findings suggest that control of hypertension was improved by CHW home visits in comparison to usual clinic care. However, too few doctor visits, insufficient monitoring of patient outcomes by clinic staff, and a poor procurement process for supplies required by the CHWs hampered the programme's activities. The role of CHWs in the management of hypertension should be given greater consideration, with larger studies being conducted to provide more robust evidence. Adequate training, supervision, and operational support will be required to ensure success of any CHW programme.
Consideration of stakeholder interests in the planning of sustainable waste management programmes.
López-Toro, Alberto A; Rubio-Romero, Juan Carlos; Suárez-Cebador, Manuel; Arjona-Jiménez, Rafael
2016-10-01
Those responsible for developing sustainable solid waste management programmes must consider the impacts of programme elements on everyone involved. This paper focuses on identifying the effects of waste management activities and assessing their overall impact on stakeholders. Collaborating with four focus groups and 36 experts, 19 effects were identified and nine questionnaires were designed to evaluate them, one for each stakeholder group. All told, 1805 people took part in the survey. The results show that the effects most important to the survey participants are: (a) recycling solid urban waste, (b) pollution and (c) corporate social responsibility. © The Author(s) 2016.
Implications of online learning for nurse managers.
McCarthy, Jillian
2014-10-30
Online learning for nurses is growing in popularity, with programmes ranging from mandatory update training to part-time master's degrees. E-learning, as it is known, offers flexibility in access to learning, study time and learning styles. In busy clinical areas, where guidance is provided on minimum nurse staffing levels, e-learning provides solutions for managers who wish to encourage professional development while maintaining adequate nursing cover. Caution must be taken, however, when choosing e-learning programmes, as quality and efficacy differ across the range. This article highlights the properties of good e-learning pedagogy to prepare nurse managers for successful assessment of these programmes.
Evaluation of the district health management fellowship training programme: a case study in Iran
Gholipour, Kamal; Tabrizi, Jafar Sadegh; Farahbakhsh, Mostafa; Iezadi, Shabnam; Ghiasi, Akbar; Jahanbin, Hasan
2018-01-01
Objective To evaluate the district health management fellowship training programme in the north-west of Iran. Data sources/study setting The programme was introduced to build the managerial capacity of district health managers in Iran. Eighty-nine heads of units in the province’s health centre, district health managers and the health deputies of the district health centres in the north-west provinces of Iran had registered for the district health management fellowship training programme in Tabriz in 2015–2016. Study design This was an educational evaluation study to evaluate training courses to measure participants' reactions and learning and, to a lesser extent, application of training to their job and the organisational impact. Data collection/extraction methods Valid and reliable questionnaires were used to assess learning techniques and views towards the fellowship, and self-assessment of health managers’ knowledge and skills. Also, pretest and post-test examinations were conducted in each course and a portfolio was provided to the trainees to be completed in their work settings. Principal findings About 63% of the participants were medical doctors and 42.3% of them had over 20 years of experience. Learning by practice (scored 18.37 out of 20) and access to publications (17.27) were the most useful methods of training in health planning and management from the participants’ perspective. Moreover, meeting peers from other districts and the academic credibility of teachers were the most important features of the current programme. Based on the managers’ self-assessment, they were most skilful in quality improvement, managing, planning and evaluation of the district. The results of the post-test analysis on data collected from district health managers showed the highest scores in managing the district (77 out of 100) and planning and evaluation (69) of the courses. Conclusion The results of this study indicated that training courses, methods and improvement in managers' knowledge about the health system and the skills necessary to manage their organisation were acceptable. PMID:29525773
2014-01-01
Background Menstrual pain which is severe enough to impact on daily activities is very common amongst menstruating females. Research suggests that menstrual pain which impacts on daily functioning may be even more prevalent amongst those with intellectual disabilities. Despite this, little research attention has focused on pain management programmes for those with intellectual disabilities. The aims of this pilot study were to develop and evaluate a theory-based cognitive behavioural therapy (CBT) programme for menstrual pain management in young women with intellectual disabilities. Methods/Design The study utilised a mixed methods controlled clinical trial to evaluate elements from a CBT programme called Feeling Better (McGuire & McManus, 2010). The Feeling Better programme is a modular, manualised intervention designed for people with an intellectual disability and their carers. The programme was delivered to 36 young women aged 12 – 30 years who have a Mild - Moderate Intellectual Disability, split between two conditions. The treatment group received the Feeling Better intervention and the control group received treatment as usual. To evaluate the effectiveness of the programme, measures were taken of key pain variables including impact, knowledge, self-efficacy and coping. Process evaluation was conducted to examine which elements of the programme were most successful in promoting change. Discussion Participants in the intervention group were expected to report the use of a greater number of coping strategies and have greater knowledge of pain management strategies following participation in the intervention and at three month follow-up, when compared to control group participants. A significant advantage of the study was the use of mixed methods and inclusion of process evaluation to determine which elements of a cognitive behavioural therapy programme work best for individuals with intellectual disabilities. Trial registration Current Controlled Trials ISRCTN75567759 PMID:25201648
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zanner, F.J.; Moffatt, W.C.
1995-07-01
In July, 1994, a team of materials specialists from Sandia and US. Industry traveled to Russia and the Ukraine to select and fund projects in materials and process technology in support of the Newly Independent States/Industrial Partnering Program (NIS/IPP). All of the projects are collaborations with scientists and Engineers at NIS Institutes. Each project is scheduled to last one year, and the deliverables are formatted to supply US. Industry with information which will enable rational decisions to be made regarding the commercial value of these technologies. This work is an unedited interim compilation of the deliverables received to date.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wilmer, CE; Farha, OK; Yildirim, T
We have synthesized and characterized a new metal-organic framework (MOF) material, NU-125, that, in the single-crystal limit, achieves a methane storage density at 58 bar (840 psi) and 298 K corresponding to 86% of that obtained with compressed natural gas tanks (CNG) used in vehicles today, when the latter are pressurized to 248 bar (3600 psi). More importantly, the deliverable capacity (58 bar to 5.8 bar) for NU-125 is 67% of the deliverable capacity of a CNG tank that starts at 248 bar. (For crystalline granules or powders, particle packing inefficiencies will yield densities and deliverable capacities lower than 86%more » and 67% of high-pressure CNG.) This material was synthesized in high yield on a gram-scale in a single-batch synthesis. Methane adsorption isotherms were measured over a wide pressure range (0.1-58 bar) and repeated over twelve cycles on the same sample, which showed no detectable degradation. Adsorption of CO2 and H-2 over a broad range of pressures and temperatures are also reported and agree with our computational findings.« less
Panoramic imaging and virtual reality — filling the gaps between the lines
NASA Astrophysics Data System (ADS)
Chapman, David; Deacon, Andrew
Close range photogrammetry projects rely upon a clear and unambiguous specification of end-user requirements to inform decisions relating to the format, coverage, accuracy and complexity of the final deliverable. Invariably such deliverables will be a partial and incomplete abstraction of the real world where the benefits of higher accuracy and increased complexity must be traded against the cost of the project. As photogrammetric technologies move into the digital era, computerisation offers opportunities for the photogrammetrist to revisit established mapping traditions in order to explore new markets. One such market is that for three-dimensional Virtual Reality (VR) models for clients who have previously had little exposure to the capabilities, and limitations, of photogrammetry and may have radically different views on the cost/benefit trade-offs in producing geometric models. This paper will present some examples of the authors' recent experience of such markets, drawn from a number of research and commercial projects directed towards the modelling of complex man-made objects. This experience seems to indicate that suitably configured digital image archives may form an important deliverable for a wide range of photogrammetric projects and supplement, or even replace, more traditional CAD models.
Bradley, Dwight C.; O'Sullivan, Paul; Cosca, Michael A.; Motts, Holly; Horton, John D.; Taylor, Cliff D.; Beaudoin, Georges; Lee, Gregory K.; Ramezani, Jahan; Bradley, Daniel N.; Jones, James V.; Bowring, Samuel
2015-01-01
This report is a companion to the new Geologic Map of Mauritania (Bradley and others, 2015; referred to herein as “Deliverable 51”) and the new Structural Geologic Map of Mauritania (Bradley and others, 2015a; referred to herein as “Deliverable 52”). Section 1 contains explanatory information for these two digital maps. Section 2 covers the analytical methods used in obtaining new U-Pb ages from 9 igneous rock samples, new detrital zircon ages from 40 sedimentary or metasedimentary rock samples, and new 40Ar/39Ar ages from 12 samples of metamorphic rocks and veins. Sections 3 through 6 present the new geochronological results, organized by region. In Section 7, we discuss implications of the new ages for the regional geology and discuss problematic results. Finally, in Section 8, we summarize the geology and tectonic evolution of Mauritania in narrative form, drawing on new and published information, in the context of global tectonics. The report is being released in both English and French. In both versions, we use the French-language names for formal stratigraphic units.
Governance in community based health programmes in I.R of Iran.
Falahat, Katayoun; Eftekhari, Monir Baradaran; Malekafzali, Hossein; Forouzan, Ameneh Setareh; Dejman, Masoumeh
2013-02-01
To assess the nature of community-based health programme experience in Iran, and use the results in order to advocate more friendly policies in community, academy and funding organisations. The qualitative study was done in 2010-11 at various locations in Iran using semi structural in-depth interviews with the principals and managers of programmes, and focus group discussions with volunteers and service users of 13 Community Based Health Programmes which were active for at least five years. A total of 21 in-depth interviews and 20 focus group discussions were conducted. Data analysis was based on deductive-inductive content analysis approach considering the pre-determined structure in accordance with the study questions. The participants' views were analysed within the main category of governance, including the three sub-categories of leadership, monitoring and evaluation, and resource mobilisation. According to the participants, governmental programmes have centralised decision-making and management processes and local volunteers have no role in selecting managers at different levels of a programme. Such programmes are funded by the governmental core resources. In non-government organisations, resources available for such purposes mainly come through charitable individuals, service delivery fees and profitable economical activities, financial participation of volunteers and by using other organisations' facilities. In most programmes, there were no systematic process for monitoring and evaluation. Community-based Health programmes in Iran need to be revised in line with the positive input.There is a need to have community-based units within the Ministry of Health and Medical Education and other relevant organisations.
Shao, Jung-Hua; Chen, Su-Hui
2016-12-01
To develop a dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours for older adults with low literacy and heart disease and evaluate the feasibility and acceptability of the programme. Eating behaviours such as fluid, salt, fat and cholesterol intake are an important factor related to heart disease outcomes. People with low literacy have difficulty following recommended health behaviours, but limited research has investigated intervention programmes for this population. Programme development and pilot testing its feasibility and acceptability. Recommendations were also collected from participants and the research assistant for future large-scale interventions. The study had two phases. Phase I consisted of programme development based on previous qualitative findings, a systematic review of the literature, clinical practice experience and expert opinion. In Phase II, we pilot tested the programme from January - June 2014 in a convenience sample of 10 older adults with low literacy, heart disease and recruited from a medical centre in northern Taiwan. Pilot testing showed that our programme was feasible and acceptable to older adults with low literacy and heart disease. Moreover, the final version of the programme was revised based on participants' and the research assistant's recommendations. Our study results suggest that with guidance and assistance, older adults with low literacy and heart disease can be motivated to take action for their health and are empowered by learning how to self-manage their heart-healthy eating behaviours. © 2016 John Wiley & Sons Ltd.
Bakon, Shannon; Craft, Judy; Wirihana, Lisa; Christensen, Martin; Barr, Jennie; Tsai, Lily
2018-01-01
Graduate transition programmes have been developed to recruit new nursing staff and facilitate an effective transition from nursing student to Registered Nurse within the clinical environment. Therefore the aim of this paper was to explore the various elements included in nursing graduate transition programmes. An integrative review was undertaken incorporating a strict inclusion criterion, critical appraisal, and thematic analysis of 30 studies. There are numerous transition programmes available yet there remains a lack of transparency regarding their aims/objectives, course content, support timeframe and the type of support provided. This inconsistency has resulted in a lack of clarity regarding efficacy or superiority of any one programme over another. Innovative multifaceted programs may assist in supporting the graduate registered nurse to transition effectively into the clinical environment. Providing these support programmes may allow nurse managers to recruit new graduates and therefore decrease the staff budget expenditure. No graduate programme was shown to be superior to others yet graduate programmes appear to positively influence the experience of the graduate and increase staff recruitment. Comparative research is needed to ascertain the integral components of these programmes. Copyright © 2017. Published by Elsevier Ltd.
Taming the Wild World of Management, Performance and Communication - 13459
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ford, Laurie
2013-07-01
Management has evolved a long way from its original meaning of 'governing a horse'. The industrial revolution fostered 'scientific management'; 1930's Hawthorne studies discovered that people's social interactions could alter productivity; and the dawn of the computer age in the post-war 1950's brought general systems theory into management thinking. Today, mobile wireless connectivity aims to transform ever-changing networks of players, mandates, and markets into something that can be 'managed'. So why is there no clear and simple recipe for how to practice management? We talk about financial management, safety management, and operations management, but surely the 'management' part of thosemore » endeavors will share the same set of practices. Instead, we are still arguing for 'management' to include everything from developing people to negotiating contracts. A manager's job may include many things, but one of them, the job of management, needs to be nailed down. Three standard practices for managing in a network are developed: (a) support the dialogues that connect people vital to accomplishing a goal or objective; (b) develop and sustain the scoreboards that serve as a road-map to reach the goal; and (c) control the feedback to 'govern the horse'. These three practices are useful for more than reaching goals, as they also support coordinating across boundaries and running productive meetings. The dialogues for productive relationships, scoreboards for goals and deliverables, and feedback for performance together constitute a recipe for managing in a networked world. (authors)« less
MED-SUV final strategic issues
NASA Astrophysics Data System (ADS)
Spampinato, Letizia; Puglisi, Giuseppe; Sangianantoni, Agata
2016-04-01
Aside the scientific, technical and financial aspects managed by the "Project Management" Work Package (WP1), the great challenge and more time consuming task of this WP has surely been the definition and application of some strategic guidelines crucial to trace the project right path to its final success and for the project outcome sustainability after month 36. In particular, given that one of the main objectives of MED-SUV is that to be compliant with the GEO initiative, particularly concerning the data sharing, great efforts have been made by WP1 at first to define the MED-SUV Data Policy Guidelines, and currently to make it suitable for the EU Supersites. At present, WP1 is also dealing with the exploitation of the achieved foreground among the project's participant and to define a Memorandum of Understanding to sustain the monitoring systems and e-infrastructure developed in the project framework. Whilst the Data Policy guidelines document was implemented in the first year of MED-SUV, WP1 is now focused on the last deliverable 'Strategic and Legal deliverables', which includes the remaining issues. To the aim, WP1 has strategically separated the Exploitation of Foreground document preparation from the Memorandum of Understanding definition. The Exploitation of Foreground process has regarded the identification of Foreground, the exploitable results, the purpose of such Foreground, the collection of information from either the scientific community of MED-SUV or industrial participants; to this aim WP1 circulated an ad hoc questionnaire to put together information on (the) every kind of MED-SUV outcome, on their owners, on the kind of ownership (single/joint), on the outcome exploitation, and on proposals for its sustainability. While the first information will allow us to prepare the final Exploitation Agreement among the project's participant, the information on the exploitation of the outcome and likely sustainability proposals will contribute to the definition of the project Memorandum of Understanding for the maintenance of the developed instrumentation and of the MED-SUV e-infrastructure following the project end.
Distiller, L A; Brown, M A; Joffe, B I; Kramer, B D
2010-02-01
In 1994 the Centre for Diabetes and Endocrinology (CDE) based in Johannesburg, South Africa established a novel community-based capitation and risk-sharing model for diabetes management. We here describe the model and present a recent survey of the performance/outcomes of this unique diabetes care programme. Data on 17 043 patients managed by the CDE Diabetes Management Programme at its Centre and its 262 affiliated Centres were analysed from its national database. From this total cohort, 1520 Type 1 and 8026 Type 2 diabetes patients have been in the Programme for > 5 years. The 5-year outcome data on hospital admission rates, glycaemic control (HbA(1c)), and microvascular complication rates were assessed in this subgroup of patients. Major reductions in hospital admission rates for both acute metabolic emergencies and all causes (40% overall) were achieved in patients enrolled onto the Diabetes Management Programme. The mean HBA(1c) on enrolment was 9.2% for subjects with Type 1 and 8.8% for those with Type 2 diabetes. After 1 year, mean HbA(1c) fell to 7.6% and 7.3% for the Type 1 and Type 2 subjects, respectively. At 5 years the HbA(1c) remained similar at 7.7% for the Type 1 subjects and 7.4% for the Type 2 subjects, demonstrating sustained improvement. Progression of microvascular complications appears to have been delayed. This managed care model of diabetes care in the context of the South African Private Health Care System achieved long-term improvement in glycaemic control and all-cause hospital admission rates. This may be due to the cost-containment being in the hands of the treating doctor, supported by an annual training programme. This programme is based on an individualized and holistic approach encompassing intensive patient education to facilitate self-empowerment and including prompting for the management of risk factors.
Financial aspects of veterinary herd health management programmes.
Ifende, V I; Derks, M; Hooijer, G A; Hogeveen, H
2014-09-06
Veterinary herd health management (VHHM) programmes have been shown to be economically effective in the past. However, no current information is available on costs and benefits of these programmes. This study compared economics and farm performance between participants and non-participants in VHHM programmes in 1013 dairy farms with over 40 cows. Milk Production Registration (MPR) data and a questionnaire concerning VHHM were used. Based on the level of participation in VHHM (as indicated in the questionnaire), costs of the programmes were calculated using a normative model. The economic value of the production effects was similarly calculated using normative modelling based on MPR data. Participants in VHHM had a better performance with regard to production, but not with regard to reproduction. Over 90 per cent of the VHHM participants were visited at least once every six weeks and most participants discussed at least three topics. In most farms, the veterinarian did the pregnancy checks as part of the VHHM programmes. There was a benefit to cost ratio of about five per cow per year for VHHM participants, and a mean difference in net returns of €30 per cow per year after adjusting for the cost of the programme. This portrays that participation in a VHHM programme is cost-efficient. There is, however, much unexplained variation in the net returns, possibly due to diverse approaches by veterinarians towards VHHM or by other factors not included in this analysis, like nutritional quality or management abilities of the farmer. British Veterinary Association.
A conceptual framework for cost management training in the Limpopo Province of South Africa.
Jooste, Karien; Mothiba, Tebogo Maria
2014-10-01
This paper describes the perceptions of nurse managers about their dual role in nursing units as cost centres. The tertiary hospital in the Limpopo province is the first institution to appoint nurse managers with a dual role in cost centres. The development of a conceptual framework for a context-specific programme for Cost Centre Managers is the first of its nature in South Africa. A qualitative, exploratory, descriptive design was followed. The target population included nurse managers (n = 35) formally appointed as cost centre managers with a dual role of delivering quality care and cost management. A focus group and individual interviews were conducted until data saturation occurred. Personal and professional distress, an empowering potential of being a cost centre manager, and the need for decentralized cost centre management were indicated as barriers for nurse managers that led to a framework for a context-specific training programme. There is a need for a context-specific training programme for cost centre managers in a hospital with cost centres. The training of cost centre managers for their dual role in cost centres could enhance cost effectiveness, quality care and staff satisfaction. © 2013 John Wiley & Sons Ltd.
IMHE-Info. OECD Programme on Institutional Management in Higher Education, December 2007
ERIC Educational Resources Information Center
OECD Publishing (NJ1), 2007
2007-01-01
IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) How Do Rankings Impact on Higher Education?; and (2) OECD International Assessment of Higher Education Outcomes. IMHE News, publications of interest and upcoming events are included.
IMHE-Info. OECD Programme on Institutional Management in Higher Education, No.1, 2003
ERIC Educational Resources Information Center
Lafon, Valerie, Ed.
2003-01-01
IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) Education, Internationalisation and Trade; and (2) The GATS (General Agreement on Trade in Services) Explained. IMHE News, publications of interest and upcoming events are included.
Safe or Unsafe? The Paradox of Action Learning
ERIC Educational Resources Information Center
Robertson, Jane; Bell, Diane
2017-01-01
Business Driven Action Learning (BDAL), as a learning philosophy that attempts to create real value for business is often used by executive education providers in their management development programmes. As the action learning facilitator, I found that the learning that took place during such a management development programme resulted in…
Bosch-Capblanch, Xavier; Marceau, Claudine
2014-12-01
To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which included additional support of equipment and supplies, seemed to improve selected quality of care outcomes. However, current evaluation and reporting practices need to be revised in a new research agenda to address the methodological challenges of iCCM evaluations.
Bosch–Capblanch, Xavier; Marceau, Claudine
2014-01-01
Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong components of training, supervision, which included additional support of equipment and supplies, seemed to improve selected quality of care outcomes. However, current evaluation and reporting practices need to be revised in a new research agenda to address the methodological challenges of iCCM evaluations. PMID:25520793
Chronic disease management programmes for adults with asthma.
Peytremann-Bridevaux, Isabelle; Arditi, Chantal; Gex, Grégoire; Bridevaux, Pierre-Olivier; Burnand, Bernard
2015-05-27
The burden of asthma on patients and healthcare systems is substantial. Interventions have been developed to overcome difficulties in asthma management. These include chronic disease management programmes, which are more than simple patient education, encompassing a set of coherent interventions that centre on the patients' needs, encouraging the co-ordination and integration of health services provided by a variety of healthcare professionals, and emphasising patient self-management as well as patient education. To evaluate the effectiveness of chronic disease management programmes for adults with asthma. Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, MEDLINE (MEDLINE In-Process and Other Non-Indexed Citations), EMBASE, CINAHL, and PsycINFO were searched up to June 2014. We also handsearched selected journals from 2000 to 2012 and scanned reference lists of relevant reviews. We included individual or cluster-randomised controlled trials, non-randomised controlled trials, and controlled before-after studies comparing chronic disease management programmes with usual care in adults over 16 years of age with a diagnosis of asthma. The chronic disease management programmes had to satisfy at least the following five criteria: an organisational component targeting patients; an organisational component targeting healthcare professionals or the healthcare system, or both; patient education or self-management support, or both; active involvement of two or more healthcare professionals in patient care; a minimum duration of three months. After an initial screen of the titles, two review authors working independently assessed the studies for eligibility and study quality; they also extracted the data. We contacted authors to obtain missing information and additional data, where necessary. We pooled results using the random-effects model and reported the pooled mean or standardised mean differences (SMDs). A total of 20 studies including 81,746 patients (median 129.5) were included in this review, with a follow-up ranging from 3 to more than 12 months. Patients' mean age was 42.5 years, 60% were female, and their asthma was mostly rated as moderate to severe. Overall the studies were of moderate to low methodological quality, because of limitations in their design and the wide confidence intervals for certain results.Compared with usual care, chronic disease management programmes resulted in improvements in asthma-specific quality of life (SMD 0.22, 95% confidence interval (CI) 0.08 to 0.37), asthma severity scores (SMD 0.18, 95% CI 0.05 to 0.30), and lung function tests (SMD 0.19, 95% CI 0.09 to 0.30). The data for improvement in self-efficacy scores were inconclusive (SMD 0.51, 95% CI -0.08 to 1.11). Results on hospitalisations and emergency department or unscheduled visits could not be combined in a meta-analysis because the data were too heterogeneous; results from the individual studies were inconclusive overall. Only a few studies reported results on asthma exacerbations, days off work or school, use of an action plan, and patient satisfaction. Meta-analyses could not be performed for these outcomes. There is moderate to low quality evidence that chronic disease management programmes for adults with asthma can improve asthma-specific quality of life, asthma severity, and lung function tests. Overall, these results provide encouraging evidence of the potential effectiveness of these programmes in adults with asthma when compared with usual care. However, the optimal composition of asthma chronic disease management programmes and their added value, compared with education or self-management alone that is usually offered to patients with asthma, need further investigation.
Coordination and Data Management of the International Arctic Buoy Programme (IABP)
2001-09-30
Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...analyzed geophysical fields. APPROACH Coordination of the IABP falls into the categories of information, resource management, and meeting...the Polar Science Center (PSC) via anonymous ftp. These data and other research products of the IABP are available on the World Wide Web at http
Schmid-Mohler, Gabriela; Fehr, Thomas; Witschi, Patrick; Albiez, Thomas; Biotti, Beatrice; Spirig, Rebecca
2013-06-01
In the first year after kidney transplantation patients are challenged with incorporating new behaviour patterns into their daily lives. Due to the higher risk of cardiovascular disease amongst kidney transplant recipients, behaviours such as preventing undesired weight gain, exercising, avoiding smoking, and managing medications take on crucial importance. The aim of the project was to develop a programme based on prevailing evidence to promote self-management skills in this patient population. To this end a participatory action research approach was chosen. The programme was developed with inter-professional collaboration under the direction of an advanced practice nurse. As theoretical framework for the development of the intervention models of behaviour change and self-management were chosen. The content is based on current literature and includes the viewpoints of both patients and nursing experts. The programme consists of three elements: 1) Educational brochures developed through inter-professional collaboration and evaluated in a pilot survey. These brochures provide a framework for appointments with nursing professionals. 2) The appointments are a forum in which the patient can gain access to relevant information and can be supported in putting sustainable health-related behaviours into practice in daily life. 3) A peer programme that uses treatment plans to encourage patients deviating from preferred health-related behaviours to make changes in their behaviour. The programme evaluation started in May of 2012. Results of the pilot study are expected in 2014.
NASA Astrophysics Data System (ADS)
Aldowaisan, Tariq; Allahverdi, Ali
2016-05-01
This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and update of the PEOs. For each PEO an assessment process is employed where performance measures are defined along with target attainment levels. Results from assessment tools are compared with the target attainment levels to measure performance with regard to the PEOs. The assessment indicates that the results meet or exceed the target attainment levels of the PEOs' performance measures.
Mills, Katie; Harte, Emma; Martin, Adam; MacLure, Calum; Griffin, Simon J; Mant, Jonathan; Meads, Catherine; Saunders, Catherine L; Walter, Fiona M; Usher-Smith, Juliet A
2017-11-15
To synthesise data concerning the views of commissioners, managers and healthcare professionals towards the National Health Service (NHS) Health Check programme in general and the challenges faced when implementing it in practice. A systematic review of surveys and interview studies with a descriptive analysis of quantitative data and thematic synthesis of qualitative data. An electronic literature search of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the International Standard Randomised Controlled Trial Number registry from 1 January 1996 to 9 November 2016 with no language restriction and manual screening of reference lists of all included papers. Primary research reporting views of commissioners, managers or healthcare professionals on the NHS Health Check programme and its implementation in practice. Of 18 524 citations, 15 articles met the inclusion criteria. There was evidence from both quantitative and qualitative studies that some commissioners and general practice (GP) healthcare professionals were enthusiastic about the programme, whereas others raised concerns around inequality of uptake, the evidence base and cost-effectiveness. In contrast, those working in pharmacies were all positive about programme benefits, citing opportunities for their business and staff. The main challenges to implementation were: difficulties with information technology and computer software, resistance to the programme from some GPs, the impact on workload and staffing, funding and training needs. Inadequate privacy was also a challenge in pharmacy and community settings, along with difficulty recruiting people eligible for Health Checks and poor public access to some venues. The success of the NHS Health Check Programme relies on engagement by those responsible for its commissioning, management and delivery. Recognising and addressing the challenges identified in this review, in particular the concerns of GPs, are important for the future of the programme. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
A regional programme to improve skin cancer management.
McGeoch, Graham R; Sycamore, Mark J; Shand, Brett I; Simcock, Jeremy W
2015-12-01
In 2008, public specialist and general practice services in Canterbury were unable to manage demand for skin cancer treatment. Local clinicians decided the solution was to develop a see-and-treat skin excision clinic staffed by plastic surgeons and general practitioners (GPs), and the introduction of subsidised excisions in general practice. This paper describes the collaboration between clinicians, managers and funders and the results and quality management measures of these initiatives. There is an increasing incidence of skin cancer. GPs in Canterbury were unable to meet increasing demand for skin cancer treatment because some lacked confidence and competence in skin cancer management. There was no public funding for primary care management of skin cancer, driving patients to fully funded secondary care services. Secondary care services were at capacity, with no coordinated programme across primary and secondary care. The programme has resulted in a greater number of skin cancers being treated by the public health system, a reduction in waiting times for treatment, and fewer minor skin lesions being referred to secondary care. Quality measures have been achieved and are improving steadily. Development of the programme has improved working relationships between primary and secondary care clinicians. The strategy was to facilitate the working relationship between primary and secondary care and increase the capacity for skin lesion excisions in both sectors. Skin cancer management can be improved by a coordinated approach between primary and secondary care.
Sibanyoni, J J; Tabit, F T
2017-08-01
The managers of school feeding programmes are responsible for ensuring the safety of the food which is provided to schoolchildren, but very few studies have been conducted on the food safety knowledge and awareness of these managers. The objective of this study is to evaluate the food safety attitudes and awareness of managers of the National School Nutrition Programme (NSNP) in schools in Mpumalanga, a province of South Africa. A cross-sectional survey study was conducted in which questionnaires were used to collect data from 300 NSNP food service managers. The majority of schools offering NSNP meals were located in informal settlements and most were found to lack basic resources such as electricity (power supplies to the food preparation facility) and potable tap water in their kitchens. No school was found to have implemented the hazard analysis and critical control points (HACCP) programme, and only a few staff had received food safety training. Food safety implementation is worst in informal schools in rural areas due to limited resources and infrastructure. The NSNP food service managers in some schools-especially those located in rural settlements-were found to have little knowledge and awareness of HACCP. These results indicate an urgent need to provide NSNP managers with food safety training and resources (potable water supplies, electricity, dedicated food preparation facilities), particularly in schools in rural settlements.
A new evidence-based model for weight management in primary care: the Counterweight Programme.
Laws, Rachel
2004-06-01
Obesity has become a global epidemic, and a major preventable cause of morbidity and mortality. Management strategies and treatment protocols are however poorly developed and evaluated. The aim of the Counterweight Programme is to develop an evidence-based model for the management of obesity in primary care. The Counterweight Programme is based on the theoretical model of Evidence-Based Quality Assessment aimed at improving the management of obese adults (18-75 years) in primary care. The model consists of four phases: (1) practice audit and needs assessment, (2) practice support and training, (3) practice nurse-led patient intervention, and (4) evaluation. Patient intervention consisted of screening and treatment pathways incorporating evidence-based approaches, including patient-centred goal setting, prescribed eating plans, a group programme, physical activity and behavioural approaches, anti-obesity medication and weight maintenance strategies. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Eighty practices were recruited of which 18 practices were randomized to act as controls and receive deferred intervention 2 years after the initial audit. By February 2004, 58 of the 62 (93.5%) intervention practices had been trained to run the intervention programme, 47 (75.8%) practices were active in implementing the model and 1256 patients had been recruited (74% female, 26% male, mean age 50.6 years, SD 14). At baseline, 75% of patients had at one or more co-morbidity, and the mean body mass index (BMI) was 36.9 kg/m(2) (SD 5.4). Of the 1256 patients recruited, 91% received one of the core lifestyle interventions in the first 12 months. For all patients followed up at 12 months, 34% achieved a clinical meaningful weight loss of 5% or more. A total of 51% of patients were classed as compliant in that they attended the required level of appointments in 3, 6, and 12 months. For fully compliant patients, weight loss improved with 43% achieving a weight loss of 5% or more at 12 months. The Counterweight Programme is an evidence-based weight management model which is feasible to implement in primary care.
A taxonomy and results from a comprehensive review of 28 maternal health voucher programmes.
Bellows, Ben W; Conlon, Claudia M; Higgs, Elizabeth S; Townsend, John W; Nahed, Matta G; Cavanaugh, Karen; Grainger, Corinne G; Okal, Jerry; Gorter, Anna C
2013-12-01
It is increasingly clear that Millennium Development Goal 4 and 5 will not be achieved in many low- and middle-income countries with the weakest gains among the poor. Recognizing that there are large inequalities in reproductive health outcomes, the post-2015 agenda on universal health coverage will likely generate strategies that target resources where maternal and newborn deaths are the highest. In 2012, the United States Agency for International Development convened an Evidence Summit to review the knowledge and gaps on the utilization of financial incentives to enhance the quality and uptake of maternal healthcare. The goal was to provide donors and governments of the low- and middle-income countries with evidence-informed recommendations on practice, policy, and strategies regarding the use of financial incentives, including vouchers, to enhance the demand and supply of maternal health services. The findings in this paper are intended to guide governments interested in maternal health voucher programmes with recommendations for sustainable implementation and impact. The Evidence Summit undertook a systematic review of five financing strategies. This paper presents the methods and findings for vouchers, building on a taxonomy to catalogue knowledge about voucher programme design and functionality. More than 120 characteristics under five major categories were identified: programme principles (objectives and financing); governance and management; benefits package and beneficiary targeting; providers (contracting and service pricing); and implementation arrangements (marketing, claims processing, and monitoring and evaluation). Among the 28 identified maternal health voucher programmes, common characteristics included: a stated objective to increase the use of services among the means-tested poor; contracted-out programme management; contracting either exclusively private facilities or a mix of public and private providers; prioritizing community-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.
A Taxonomy and Results from a Comprehensive Review of 28 Maternal Health Voucher Programmes
Conlon, Claudia M.; Higgs, Elizabeth S.; Townsend, John W.; Nahed, Matta G.; Cavanaugh, Karen; Grainger, Corinne G.; Okal, Jerry; Gorter, Anna C.
2013-01-01
It is increasingly clear that Millennium Development Goal 4 and 5 will not be achieved in many low- and middle-income countries with the weakest gains among the poor. Recognizing that there are large inequalities in reproductive health outcomes, the post-2015 agenda on universal health coverage will likely generate strategies that target resources where maternal and newborn deaths are the highest. In 2012, the United States Agency for International Development convened an Evidence Summit to review the knowledge and gaps on the utilization of financial incentives to enhance the quality and uptake of maternal healthcare. The goal was to provide donors and governments of the low- and middle-income countries with evidence-informed recommendations on practice, policy, and strategies regarding the use of financial incentives, including vouchers, to enhance the demand and supply of maternal health services. The findings in this paper are intended to guide governments interested in maternal health voucher programmes with recommendations for sustainable implementation and impact. The Evidence Summit undertook a systematic review of five financing strategies. This paper presents the methods and findings for vouchers, building on a taxonomy to catalogue knowledge about voucher programme design and functionality. More than 120 characteristics under five major categories were identified: programme principles (objectives and financing); governance and management; benefits package and beneficiary targeting; providers (contracting and service pricing); and implementation arrangements (marketing, claims processing, and monitoring and evaluation). Among the 28 identified maternal health voucher programmes, common characteristics included: a stated objective to increase the use of services among the means-tested poor; contracted-out programme management; contracting either exclusively private facilities or a mix of public and private providers; prioritizing community-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.
Integrated disease management: a critical review of foreign and Portuguese experience.
Coelho, Anabela; Leone, Cláudia; Ribeiro, Vanessa; Sá Moreira, Pedro; Dussault, Gilles
2014-01-01
The present article reviews findings from empirical evaluations of integrated disease management programmes. The objective is to provide insights on integration levels, priority interventions and their effect on patient outcomes. The literature review identified 1 251 articles, published from 2006 to 2011. Upon a detailed screening 61 articles were selected for bibliometric analysis and critical discussion. Among several findings, it can be noted that United States of America is the country with the highest amount of published evidence on the subject under study. The most frequently referred disease is diabetes mellitus and the main reported issue of integrated disease management is self-management support. The majority of the studies were developed and exclusively managed by managed care organizations, organized family doctors or hospitals. From a total of 360 interventions reported in studies, patient interventions are the most frequently used across all disease groups, followed by professional interventions. To monitor the effectiveness of the disease programmes, the most frequently used outcomes are patient physiological measures, service use and patient health status. Every country has its own way to implement the integrated disease management strategy. The focus of practice lies on patient empowerment, particularly through self-management. Physiological measures and service use are the outcomes with the highest rate of assessment, which are also the indicators that show higher impact among all integrated disease management programmes. The Portuguese health care system still faces challenges in the coordination and integration of care for patients with chronic disease thus improvements at integrated disease management programmes should be incorporate.
The integration of system specifications and program coding
NASA Technical Reports Server (NTRS)
Luebke, W. R.
1970-01-01
Experience in maintaining up-to-date documentation for one module of the large-scale Medical Literature Analysis and Retrieval System 2 (MEDLARS 2) is described. Several innovative techniques were explored in the development of this system's data management environment, particularly those that use PL/I as an automatic documenter. The PL/I data description section can provide automatic documentation by means of a master description of data elements that has long and highly meaningful mnemonic names and a formalized technique for the production of descriptive commentary. The techniques discussed are practical methods that employ the computer during system development in a manner that assists system implementation, provides interim documentation for customer review, and satisfies some of the deliverable documentation requirements.
Jones, Donna S; Tshimanga, Mufuta; Woelk, Godfrey; Nsubuga, Peter; Sunderland, Nadine L; Hader, Shannon L; St Louis, Michael E
2009-01-01
Background Increased funding for global human immunodeficiency virus prevention and control in developing countries has created both a challenge and an opportunity for achieving long-term global health goals. This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. Methods The programme used new HIV/AIDS programme-specific funds to build on the assets of a local education institution to strengthen and expand the general public health leadership capacity in Zimbabwe, simultaneously ensuring that they were trained in HIV interventions. Results The programme increased both numbers of graduates and retention of faculty. The expanded HIV/AIDS curriculum was associated with a substantial increase in trainee projects related to HIV. The increased number of public health professionals has led to a number of practically trained persons working in public health leadership positions in the ministry, including in HIV/AIDS programmes. Conclusion Investment of a modest proportion of new HIV/AIDS resources in targeted public health leadership training programmes can assist in building capacity to lead and manage national HIV and other public health programmes. PMID:19664268
Chinese Postgraduate Choices When Considering a UK Business and Management Programme
ERIC Educational Resources Information Center
Manns, Yihan; Swift, Jonathan
2016-01-01
This research investigated Chinese students' decision making processes for enrolling on a postgraduate taught business and management programme in a UK university, based on structured interviews, followed by a survey of just over 450 respondents. The validity and reliability of the research instrument were assessed prior to issuing the survey.…
An Innovative Supply Chain Management Programme Structure: Broadening the SCM Skill Set
ERIC Educational Resources Information Center
Okongwu, Uche
2007-01-01
This paper proposes a matrix structure for training Supply Chain Management (SCM) professionals. It is an innovative programme structure that combines two approaches: cross-border and inter-organisational. It enables the students to comprehend complex and specific business environments and to understand the diverse nature of SCM systems in both…
Efficacy of Using Career and Self-Construction to Help Learners Manage Career-Related Transitions
ERIC Educational Resources Information Center
Cook, A.; Maree, J. G.
2016-01-01
This article explores the extent to which an intervention programme helped learners from two contrasting educational settings manage career-related transitions. Forty-two learners from two schools were selected, using convenience and purposive sampling, to take part in an intervention programme. Two comparison groups comprised of 45 learners from…
The Winds of Change: Higher Education Management Programmes in Europe
ERIC Educational Resources Information Center
Pausits, Attila; Pellert, Ada
2009-01-01
Amid the Bologna Process and as a direct effect of it, European higher education institutions have to rethink their core institutional policies in order to effectively deal with the increasing demands and needs of their "customers" and society at large. The higher education management programmes across Europe, with some specific needs…
ERIC Educational Resources Information Center
Ikoya, Peter O.; Ikoya, Oluremi V.
2005-01-01
Purpose: The purpose of this research is to identify some determinants of rural-urban disparity in the implementation of decentralised educational management programmes in Nigeria. Design/methodology/approach: The study examines how political leadership's disposition to decentralised educational management, allocation of funds and physical…
Kawonga, Mary; Blaauw, Duane; Fonn, Sharon
2016-11-01
Administrative integration of disease control programmes (DCPs) within the district health system has been a health sector reform priority in South Africa for two decades. The reforms entail district managers assuming authority for the planning and monitoring of DCPs in districts, with DCP managers providing specialist support. There has been little progress in achieving this, and a dearth of research exploring why. Using a case study of HIV programme monitoring and evaluation (M&E), this article explores whether South Africa's health system is configured to support administrative integration. The article draws on data from document reviews and interviews with 54 programme and district managers in two of nine provinces, exploring their respective roles in decision-making regarding HIV M&E system design and in using HIV data for monitoring uptake of HIV interventions in districts. Using Mintzberg's configurations framework, we describe three organizational parameters: (a) extent of centralization (whether district managers play a role in decisions regarding the design of the HIV M&E system); (b) key part of the organization (extent to which sub-national programme managers vs district managers play the central role in HIV monitoring in districts); and (c) coordination mechanisms used (whether highly formalized and rules-based or more output-based to promote agency). We find that the health system can be characterized as Mintzberg's machine bureaucracy. It is centralized and highly formalized with structures, management styles and practices that promote programme managers as lead role players in the monitoring of HIV interventions within districts. This undermines policy objectives of district managers assuming this leadership role. Our study enhances the understanding of organizational factors that may limit the success of administrative integration reforms and suggests interventions that may mitigate this. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Assessment of a Targeted Trap-Neuter-Return Pilot Study in Auckland, New Zealand.
Zito, Sarah; Aguilar, Glenn; Vigeant, Shalsee; Dale, Arnja
2018-05-13
There is a need for effective and humane management tools to manage urban stray cats and minimise negative impacts associated with stray cats. One such tool is targeted trap-neuter-return (TTNR), but no concerted implementation of this technique or formal assessments have been reported. To address this deficit, a TTNR programme was implemented and assessed in one Auckland suburb from May 2015 to June 2016; the programme sterilised and returned 348 cats (4.2 cats/1000 residents). Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray felines, underage euthanasias, and unsocialised stray cat euthanasias were all reduced for the targeted suburb when compared for the years before and after the programme (the percentage reduction in these parameters was −39, −17, −34, −7, and −47, respectively). These outcome measures had a greater reduction in the targeted suburb compared to the Auckland suburbs not targeted by the TTNR programme ( p < 0.01), although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable, humane cat management tool in urban New Zealand, and further assessment is warranted.
Sambrook, Sally
2009-01-01
Management development programmes available to NHS managers focus on a performance orientation and sustain a culture of managerial and medical domination. This paper aims to question whether it is possible to consider NHS management development from a critical (empowerment culture) perspective. Features of the critical management studies approach (CMS) are identified. A new MSc is evaluated against these characteristics, examining the teaching and learning processes and students' perceptions of the programme. The aim is to develop critical thinkers who can return to their organizations and challenge existing power structures and practices to change local cultures and enhance health services. Empirical research employed anonymous student questionnaires and a focus group. Student evaluations suggest the MSc can deliver a critical pedagogy and help managers understand issues of power and empowerment, challenge dominant cultures, innovate and effect small, local changes in the NHS culture. There is a need to continue evaluating the programme and include other stakeholders. Longitudinal research should assess the impact of the managers' changed values, attitudes and behaviours on colleagues, clients and the local cultures. The paper identifies some of the tensions of developing "critical" health service managers, and the problems they encounter back in the "uncritical" NHS context, as well as some of the challenges in "facilitating" a critical curriculum. It questions the ethics of developing (or not) a critical perspective in a local context unfamiliar with CMS. Management development in the NHS largely ignores critical pedagogy. This paper makes a small and unique contribution to understanding how developing "critically thinking" managers can challenge the dominant culture. However, the limitations of such a small-scale study and ethical implications are noted.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Halsey, W
This report provides a summary for FY-2008 of activities, analyses and products from the Material Transportation, Storage and Disposal (M-TSD) sub-task of Systems Analysis within the Advanced Fuel Cycle Research & Development area of the Global Nuclear Energy Partnership. The objective of this work is to evaluate near-term material management requirements for initial GNEP facilities and activities, long-term requirements for large-scale GNEP technology deployment, and alternatives and paths forward to meet these needs. For FY-08, the work expanded to include the Integrated Waste Management Strategy as well as integration with the newly formed Waste Forms Campaign. The M-TSD team wasmore » expanded with the addition of support from Savannah River National Lab (SRNL) to the existing team of Lawrence Livermore National Lab (LLNL), Argonne National Lab (ANL), Idaho National Lab (INL), Sandia National Lab (SNL) and University of Nevada - Reno (UN-R). During the first half of the year, analysis was focused on providing supporting technical analysis and documentation to support anticipated high-level decisions on program direction. A number of analyses were conducted and reports prepared as program deliverables. This work is briefly summarized in this report. Analyses provided informally to other program efforts are included in this report to provide documentation. This year-end summary was planned primarily as a compilation of activities following the anticipated programmatic decisions. These decisions were deferred beyond the end of the year, and funds were reallocated in a number of areas, thus reducing the M-TSD activities. This report summarizes the miscellaneous 'ad-hoc' work conducted during the later part of the year, such as support to the draft Programmatic Environmental Impact Statement (PEIS), and support to other program studies. Major programmatic contributions from the M-TSD team during the year included: (1) Completion of the IWMS in March 2008 as the baseline for waste management calculations for the GNEP Programmatic Environmental Impact Statement (PEIS). The IWMS represents a collaborative effort between the Systems Analysis, Waste Forms, and Separations Campaigns with contributing authors from multiple laboratories. The IWMS reference is: 'Global Nuclear Energy Partnership Integrated Waste Management Strategy, D. Gombert, INL, et al, GNEP-WAST-WAST-AI-RT-2008-000214, March 2008'. (2) As input to the IWMS and support for program decisions, an evaluation of the current regulatory framework in the U.S. pertaining to the disposal of radioactive wastes under an advanced nuclear fuel cycle was completed by ANL. This evaluation also investigated potential disposal pathways for these wastes. The entire evaluation is provided in Appendix A of this report. (3) Support was provided to the development of the GNEP Programmatic Environmental Impact Statement from INL, SNL and ANL M-TSD staff. (4) M-TSD staff prepared input for DSARR (Dynamic Systems Analysis Report for Nuclear Fuel Recycle) report. The DSARR is an INL led report to examine the time-dependent dynamics for a transition from the current open fuel cycle to either a 1-tier or 2-tier closed fuel cycle. Section 5.3 Waste Management Impacts was provided to INL for incorporation into the DSARR. (5) SNL M-TSD staff prepared a M2 milestone report 'Material Transportation, Storage and Disposal Contribution for Secretarial Decision Package'. The report purpose was to comprehensively evaluate and discuss packaging, storage, and transportation for all potential nuclear and radioactive materials in the process and waste streams being considered by the GNEP program. In particular, a systems view was used to capture all packaging, storage, and transport operations needed to link the various functional aspects of the fuel cycle. (6) SRNL M-TSD staff developed a deliverable report 'Management of Decay Heat from Spent Nuclear Fuel'. This report evaluated a range of options for managing the near-term decay heat associated with Cs and Sr in spent nuclear fuel (SNF) reprocessing wastes. (7) M-TSD staff participated in a series of meetings of the US-Japan GNEP Working Group on Waste Management, developing the content for the first deliverable of the working group.« less
NASA Technical Reports Server (NTRS)
Whalen, Edward A.
2016-01-01
This document serves as the final report for the Flight Services and Aircraft Access task order NNL14AA57T as part of NASA Environmentally Responsible Aviation (ERA) Project ITD12A+. It includes descriptions of flight test preparations and execution for the Active Flow Control (AFC) Vertical Tail and Insect Accretion and Mitigation (IAM) experiments conducted on the 757 ecoDemonstrator. For the AFC Vertical Tail, this is the culmination of efforts under two task orders. The task order was managed by Boeing Research & Technology and executed by an enterprise-wide Boeing team that included Boeing Research & Technology, Boeing Commercial Airplanes, Boeing Defense and Space and Boeing Test and Evaluation. Boeing BR&T in St. Louis was responsible for overall Boeing project management and coordination with NASA. The 757 flight test asset was provided and managed by the BCA ecoDemonstrator Program, in partnership with Stifel Aircraft Leasing and the TUI Group. With this report, all of the required deliverables related to management of this task order have been met and delivered to NASA as summarized in Table 1. In addition, this task order is part of a broader collaboration between NASA and Boeing.
Zachariah, R; Reid, T; Srinath, S; Chakaya, J; Legins, K; Karunakara, U; Harries, A D
2011-11-01
Very limited operational research (OR) emerges from programme settings in low-income countries where the greatest burden of disease lies. The price paid for this void includes a lack of understanding of how health systems are actually functioning, not knowing what works and what does not, and an inability to propose adapted and innovative solutions to programme problems. We use the National Tuberculosis Control Programme as an example to advocate for strong programme-level leadership to steer OR and build viable relationships between programme managers, researchers and policy makers. We highlight the need to create a stimulating environment for conducting OR and identify some of the main practical challenges and enabling factors at programme level. We focus on the important role of an OR focal point within programmes and practical approaches to training that can deliver timely and quantifiable outputs. Finally, we emphasise the need to measure successful OR leadership development at programme level and we propose parameters by which this can be assessed. This paper 1) provides reasons why programmes should take the lead in coordinating and directing OR, 2) identifies the practical challenges and enabling factors for implementing, managing and sustaining OR and 3) proposes parameters for measuring successful leadership capacity development in OR.
Wall, Peter Dh; Dickenson, Edward J; Robinson, David; Hughes, Ivor; Realpe, Alba; Hobson, Rachel; Griffin, Damian R; Foster, Nadine E
2016-10-01
Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility. In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events. The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12-26 weeks in 6-10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events. PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839). ISRCTN 09754699. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Wall, Peter DH; Dickenson, Edward J; Robinson, David; Hughes, Ivor; Realpe, Alba; Hobson, Rachel; Griffin, Damian R; Foster, Nadine E
2016-01-01
Introduction Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility. Methods In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events. Results The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12–26 weeks in 6–10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events. Conclusion PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839). Trial registration number ISRCTN 09754699. PMID:27629405
[The National Programme for Disease Management Guidelines. Goals, contents, patient involvement].
Ollenschläger, G; Kopp, I; Lelgemann, M; Sänger, S; Klakow-Franck, R; Gibis, B; Gramsch, E; Jonitz, G
2007-03-01
The Programme for National Disease Management Guidelines (German DM-CPG Programme) aims at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. The programme, focussing on high priority healthcare topics, has been sponsored since 2003 by the German Medical Association (BAEK), the Association of the Scientific Medical Societies (AWMF), and by the National Association of Statutory Health Insurance Physicians (KBV). It is organised by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the programme is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health care provision and facilitating the coordination of care for the individual patient through time and across disciplines. Within this framework experts from national patient self-help groups have been developing patient guidance based upon the recommendations for healthcare providers. The article describes goals, topics and selected contents of the DM-CPG programme - using asthma as an example.
Asthma disease management: a provider's perspective.
Abisheganaden, J
2002-07-01
Asthma is a highly prevalent problem in Singapore, with an increasing societal and economic burden. However, asthma is also an eminently treatable condition, with evidence that integrated education-treatment efforts directed at important patient sub-groups can be cost-effective. What is important is a comprehensive and integrated asthma management programme, aimed at reducing the burden of asthma at all levels of the healthcare system, with the long-term goal of improving asthma care cost-effectively. This refers to asthma disease management. Asthma disease management should focus on identifying deficiencies in asthma management across the population diagnosed with the condition and establish a partnership between the patient, provider and the healthcare system to improve the overall quality of asthma care. The framework for implementing such a programme bridges key concepts and programmes that are already in place in the various institutions. These include patient and physician education, the use of clinical practice guidelines, clinical pathways, outcomes management, quality improvement processes, information technology, case management and existing asthma shared-care programmes and resources. In order to significantly reduce asthma morbidity, an integrated approach is required, involving individuals providing asthma care at various levels of care delivery. There is also a need to co-ordinate the efforts of such individuals and institutions involved so that there is good horizontal and vertical integration of care. The disease management approach described is intended to raise the overall standard of asthma care across a spectrum of patients with asthma.
Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; In 't Veen, Johannes C C M
2017-02-09
Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories 'the A-I of difficult-to-manage asthma' to resonate with an established Dutch 'A-E acronym for determining asthma control'. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme.
Clinical experience with a chronic pain management programme in Hong Kong Chinese patients.
Man, Alice K Y; Chu, M C; Chen, P P; Ma, M; Gin, Tony
2007-10-01
To describe experience with a chronic pain management programme in Hong Kong Chinese patients. Prospective study. Regional hospital, Hong Kong. Patients with chronic pain who participated in the first six Comprehensive Out-patient Pain Engagement programmes between 2002 and 2005. Comprehensive Out-patient Pain Engagement is a 14-day structured, multidisciplinary out-patient programme conducted over 6 weeks. It includes pain education, cognitive re-conceptualisation, training in communication skills and coping strategies, graded physical exercises and functional activities training. It aims to improve patient function and quality of life, despite persistent pain. Changes in scores from baseline values after joining the programme, with respect to several assessment tools. These included the following: visual analogue pain scale, Pain Catastrophizing Scale, Patient Self-efficacy Questionnaire, Canadian Occupational Performance Measure, Medical Outcome Survey-Short Form 36 Questionnaire, and duration of physical tolerances, medication utilisation, and work status records. Forty-five patients were available for analysis. After the Comprehensive Out-patient Pain Engagement programme, improvements in Medical Outcome Survey-Short Form 36 Questionnaire (role physical and vitality), Pain Catastrophizing Scale, Patient Self-efficacy Questionnaire, and Canadian Occupational Performance Measure were demonstrated (P<0.05). The duration of standing and sitting tolerances increased (P<0.05). An improvement in employment rate was also evident (P=0.01). The initial results of our management programme in Chinese patients with chronic pain are encouraging. This type of programme should be promoted more widely in this group of patients, as it appears to improve physical function, psychological well-being, and productivity.
Downey, Angela M; Sharp, David J
2007-06-01
There is extensive evidence that worksite health promotion (WHP) programmes reduce healthcare costs and improve employee productivity. In many countries, a large proportion of healthcare costs are borne by the state. While the full benefits of WHP are still created, they are shared between employers and the state, even though the employer bears the full (after-tax) cost. Employers therefore have a lower incentive to implement WHP activity. We know little about the beliefs of managers with decision responsibility for the approval and implementation of WHP programmes in this context. This article reports the results of a study of the attitudes of Canadian senior general managers (GMs) and human resource managers (HRMs) in the auto parts industry in Ontario, Canada towards the consequences of increasing discretionary spending on WHP, using Structural Equation Modelling and the Theory of Planned Behaviour. We identified factors that explain managers' intentions to increase discretionary spending on wellness programmes. While both senior GMs and HRMs are motivated primarily by their beliefs that WHP reduces indirect costs of health failure, GMs were also motivated by their moral responsibility towards employees (but surprisingly HRMs were not). Importantly, HRMs, who usually have responsibility for WHP, felt constrained by a lack of power to commit resources. Most importantly, we found no social expectation that organizations should provide WHP programmes. This has important implications in an environment where the adoption of WHP is very limited and cost containment within the healthcare system is paramount.
Clausen, Christina; Cummins, Kelly; Dionne, Kelley
2017-11-01
Collaborative leadership and management structures are critical to transforming care delivery. Both nurse and physician managers are uniquely positioned to co-lead. However, little is known on how to prepare and support individuals for these co-leader arrangements. The re-design of healthcare professional education focuses on interprofessional collaboration, mutual learning, and a competency-based approach. While competencies for interprofessional collaboration have been delineated, competencies for collaborative management practice have yet to be addressed. An integrative review of empirical studies on existing educational interventions was conducted to critically appraise and synthesise the results regarding collaborative competence among nurse and physician leaders. We reviewed how these interventions have been designed, implemented, and evaluated within workplace settings in order to inform our understanding of what components are effective or ineffective for the future development of an educational programme. This review reports on key characteristics of nine empirical studies and emphasises that: a uniprofessional approach to leadership development is predominant within educational programmes and that the assessment of shared learning experiences are not addressed; there are inconsistency in terms used to describe competencies by individual researchers and limitations within the competency frameworks used in the studies reviewed; and there is a lack of suitable instruments available to assess whether competencies have been achieved through the educational programmes. None of the studies discussed the process of how individuals learned specific competencies or whether learning outcome were achieved. Educational programmes were developed based on a perceived lack of leadership preparation and orientation programmes for leaders in formal management positions and used multiple interventions. Only two of the programmes involved organisational or systems level competencies. Interprofessional co-leading requires enhanced capabilities and capacity for managers. There is a need for developing an in-action education intervention that addresses the unique learning needs of co-leader arrangements particularly among nurses and physicians who are new to their role.
Coordination and Data Management of the International Arctic Buoy Programme (IABP)
1999-09-30
Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...Coordination of the IABP falls into the categories of information, resource management, and meeting planning. Information is primarily distributed via a...These data and other research products of the IABP are available on the World Wide Web at http://iabp.apl.washington.edu/. WORK COMPLETED Our recent
Coordination and Data Management of the International Arctic Buoy Programme (IABP)
2000-09-30
Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...Coordination of the IABP falls into the categories of information, resource management, and meeting planning. Information is primarily distributed via a monthly...data and other research products of the IABP are available on the World Wide Web at http://iabp.apl.washington.edu/. Report Documentation Page Form
Practical assessment of the SWMM programme
NASA Astrophysics Data System (ADS)
Hlustik, P.
2017-10-01
The article describes the advantages and disadvantages of the SWMM programme user environment when working with it. The Storm Water Management Model (SWMM) is a programme developed by the U.S. EPA (United States Environmental Protection Agency). The SWMM programme is used worldwide to plan, analyse and design rainfall-runoff, combined and separate sanitary sewage systems and other drainage systems in urban areas [1]. The programme is freely available to download from the U.S. EPA website [2].
Hunt, Kate; Gray, Cindy M; Maclean, Alice; Smillie, Susan; Bunn, Christopher; Wyke, Sally
2014-01-21
The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. A mixed-methods study analysing baseline data on 747 men aged 35-65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at 'very high' risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35-44, 45-54 and 55-64 years respectively). A further 21%, 16% and 13% were at 'extremely high' risk. Qualitative data revealed that the powerful 'draw' of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others 'like them' and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt 'right' rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity.
2014-01-01
Background The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. Methods A mixed-methods study analysing baseline data on 747 men aged 35–65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Results Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at ‘very high’ risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35–44, 45–54 and 55–64 years respectively). A further 21%, 16% and 13% were at ‘extremely high’ risk. Qualitative data revealed that the powerful ‘draw’ of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others ‘like them’ and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. Conclusions The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt ‘right’ rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity. PMID:24443845
2010-01-01
Background Acute coronary syndromes, including myocardial infarction and unstable angina, are important causes of premature mortality, morbidity and hospital admissions. Acute coronary syndromes consume large amounts of health care resources, and have a major negative economic and social impact through days lost at work, support for disability, and coping with the psychological consequences of illness. Several registries have shown that evidence based treatments are under-utilised in this patient population, particularly in high-risk patients. There is evidence that systematic educational programmes can lead to improvement in the management of these patients. Since application of the results of important clinical trials and expert clinical guidelines into clinical practice leads to improved patient care and outcomes, we propose to test a quality improvement programme in a general group of hospitals in Europe. Methods/Design This will be a multi-centre cluster-randomised study in 5 European countries: France, Spain, Poland, Italy and the UK. Thirty eight hospitals will be randomised to receive a quality improvement programme or no quality improvement programme. Centres will enter data for all eligible non-ST segment elevation acute coronary syndrome patients admitted to their hospital for a period of approximately 10 months onto the study database and the sample size is estimated at 2,000-4,000 patients. The primary outcome is a composite of eight measures to assess aggregate potential for improvement in the management and treatment of this patient population (risk stratification, early coronary angiography, anticoagulation, beta-blockers, statins, ACE-inhibitors, clopidogrel as a loading dose and at discharge). After the quality improvement programme, each of the eight measures will be compared between the two groups, correcting for cluster effect. Discussion If we can demonstrate important improvements in the quality of patient care as a result of a quality improvement programme, this could lead to a greater acceptance that such programmes should be incorporated into routine health training for health professionals and hospital managers. Trial registration Clinicaltrials.gov NCT00716430 PMID:20074348
Promoting Interdisciplinary Education: The Vienna Doctoral Programme on Water Resource Systems
NASA Astrophysics Data System (ADS)
Blöschl, Günter; Bucher, Christian; Carr, Gemma; Farnleitner, Andreas; Rechberger, Helmut; Wagner, Wolfgang; Zessner, Matthias
2010-05-01
An interdisciplinary approach is often described as a valuable strategy to assist in overcoming the existing and emerging challenges to water resource management. The development of educational approaches to instil a culture of interdisciplinarity in the future generation of water resource professionals will help to meet this strategic need. The Vienna Doctoral Programme on Water Resource Systems demonstrates how the adoption of an interdisciplinary education framework has been applied to a graduate programme in the water sciences. The interdisciplinary approach aims to provide doctoral research students with an understanding of the wide spectrum of processes relevant to water resource systems. This will enable them to bring together a range of ideas, strategies and methods to their current research and future careers. The education programme also aims to teach the softer skills required for successful interdisciplinary work such as the ability to communicate clearly with non-specialist professionals and the capacity to listen to and accommodate suggestions from experts in different disciplines, which have often not traditionally been grouped together. The Vienna Doctoral Programme achieves these aims through teaching an appreciation for a wide variety of approaches including laboratory analysis, field studies and numerical methods across the fields of hydrology, remote sensing, hydrogeology, structural mechanics, microbiology, water quality and resource management. Teaching takes the form of a detailed study programme on topics such as socio-economic concepts, resource and river basin management, modelling and simulation methods, health related water quality targets, urban water management, spatial data from remote sensing and basics for stochastic mechanics. Courses are also held by internationally recognised top scientists, and a guest scientist seminar series allows doctoral researchers to profit from the expertise of senior researchers from around the world. Through a structured one-on-one mentoring programme close interaction is ensured between the students and the internationally reputed staff of the programme. This gives the opportunity for the encouragement of interdisciplinary thinking at the individual level. Interdisciplinarity also evolves passively through interactions between the doctoral students in their daily research work, during journal clubs, meetings, workshops and courses. A total of 22 doctoral students are enrolled in the programme at any time which allows for cross-fertilisation across the wide range of research projects. Finally, the programme is holistic, incorporating all aspects of the hydrological system at the catchment and multi-catchment scale. The ultimate aim is to provide an education programme which not only equips the students with an understanding of the need for interdisciplinarity, but also with the skills required to deliver interdisciplinary work in keeping with the holistic catchment management paradigm adopted by the hydrological science community.
Keurhorst, Myrna; van Beurden, Ivonne; Anderson, Peter; Heinen, Maud; Akkermans, Reinier; Wensing, Michel; Laurant, Miranda
2014-04-17
General practitioners with more positive role security and therapeutic commitment towards patients with hazardous or harmful alcohol consumption are more involved and manage more alcohol-related problems than others. In this study we evaluated the effects of our tailored multi-faceted improvement implementation programme on GPs' role security and therapeutic commitment and, in addition, which professional related factors influenced the impact of the implementation programme. In a cluster randomised controlled trial, 124 GPs from 82 Dutch general practices were randomised to either the intervention or control group. The tailored, multi-faceted programme included combined physician, organisation, and patient directed alcohol-specific implementation strategies to increase role security and therapeutic commitment in GPs. The control group was mailed the national guideline and patients received feedback letters. Questionnaires were completed before and 12 months after start of the programme. We performed linear multilevel regression analysis to evaluate effects of the implementation programme. Participating GPs were predominantly male (63%) and had received very low levels of alcohol related education before start of the study (0.4 h). The programme increased therapeutic commitment (p = 0.005; 95%-CI 0.13 - 0.73) but not role security (p = 0.58; 95%-CI -0.31 - 0.54). How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, contributed to the effect of the programme on therapeutic commitment. A tailored, multi-faceted programme aimed at improving GP management of patients with hazardous and harmful alcohol consumption improved GPs' therapeutic commitment towards patients with alcohol-related problems, but failed to improve GPs' role security. How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, both increased the impact of the programme on therapeutic commitment. It might be worthwhile to monitor proceeding of role security and therapeutic commitment throughout the year after the implementation programme, to see whether the programme is effective on short term but faded out on the longer term. ClinicalTrials.gov Identifier: NCT00298220.
Saxena, Roopali; Yang, Chunhua; Rao, Mukkavilli; Turaga, Ravi Chakra; Garlapati, Chakravarthy; Gundala, Sushma Reddy; Myers, Kimberly; Ghareeb, Ahmed; Bhattarai, Shristi; Kamilinia, Golnaz; Bristi, Sangina; Su, Dan; Gadda, Giovanni; Rida, Padmashree C. G.; Cantuaria, Guilherme H.; Aneja, Ritu
2018-01-01
Purpose Most currently-available chemotherapeutic agents target rampant cell division in cancer cells, thereby affecting rapidly-dividing normal cells resulting in toxic side-effects. This non-specificity necessitates identification of novel cellular pathways that are reprogrammed selectively in cancer cells and can be exploited to develop pharmacologically superior and less-toxic therapeutics. Despite growing awareness on dysregulation of lipid metabolism in cancer cells, targeting lipid biosynthesis is still largely uncharted territory. Herein, we report development of a novel non-toxic orally-deliverable anticancer formulation of monoethanolamine (Etn), for prostate cancer by targeting the Kennedy pathway of phosphatidylethanolamine (PE) lipid biosynthesis. Experimental Design We first evaluated GI-tract stability, drug-drug interaction liability, pharmacokinetic and toxicokinetic properties of Etn to evaluate its suitability as a non-toxic orally-deliverable agent. We next performed in vitro and in vivo experiments to investigate efficacy and mechanism of action. Results Our data demonstrate that Etn exhibits excellent bioavailability, GI-tract stability, and no drug-drug interaction liability. Remarkably, orally-fed Etn inhibited tumor growth in four weeks by ~67% in mice bearing human prostate cancer PC-3 xenografts without any apparent toxicity. Mechanistically, Etn exploits selective overexpression of choline kinase in cancer cells, resulting in accumulation of phosphoethanolamine (PhosE), accompanied by downregulation of HIF-1α that induces metabolic stress culminating into cell death. Conclusions Our study provides first evidence for the superior anticancer activity of Etn, a simple lipid precursor formulation, whose non-toxicity conforms to FDA-approved standards, compelling its clinical development for prostate cancer management. PMID:28167510
Delivering bad news in emergency care medicine.
Maynard, Douglas W
2017-01-01
Forecasting is a strategy for delivering bad news and is compared to two other strategies, stalling and being blunt. Forecasting provides some warning that bad news is forthcoming without keeping the recipient in a state of indefinite suspense (stalling) or conveying the news abruptly (being blunt). Forecasting appears to be more effective than stalling or being blunt in helping a recipient to "realize" the bad news because it involves the deliverer and recipient in a particular social relation. The deliverer of bad news initiates the telling by giving an advance indication of the bad news to come; this allows the recipient to calculate the news in advance of its final presentation, when the deliverer confirms what the recipient has been led to anticipate. Thus, realization of bad news emerges from intimate collaboration, whereas stalling and being blunt require recipients to apprehend the news in a social vacuum. Exacerbating disruption to recipients' everyday world, stalling and being blunt increase the probability of misapprehension (denying, blaming, taking the situation as a joke, etc.) and thereby inhibit rather than facilitate realization. Particular attention is paid to the "perspective display sequence", a particular forecasting strategy that enables both confirming the recipient's perspective and using that perspective to affirm the clinical news. An example from acute or emergency medicine is examined at the close of the paper.
Thuesen, Leif; Galløe, Anders; Thayssen, Per; Rasmussen, Klaus; Kelbæk, Henning; Lassen, Jens Flensted; Hansen, Peter Riis; Pedersen, Knud Erik; Ravkilde, Jan; Helquist, Steffen; Abildgaard, Ulrik; Andersen, Henning Rud; Bøtker, Hans Erik; Kristensen, Steen Dalby; Hjort, Jacob; Krusell, Lars Romer
2005-11-01
To compare deliverability and in-hospital complications in implantation of BxSonic(R), Express(R), and Flexmaster(R) coronary stents in a randomized multicenter trial in five Danish interventional centres. Patients with planned stenting of at least one stenotic lesion in a native coronary artery were included in the study. There were 494 (664) patients (treated lesions) in the BxSonic(R), 499 (657) in the Express(R) and 500 (658) in the Flexmaster(R) groups. The groups were well matched with regard to age, sex, diabetes, smoking, hypercholesterolemia, hypertension, indication for PCI and coronary artery lesion complexity. The study stents were implanted with or without predilatation according to ordinary -clinical practice.Rates of successful stent implantation and in-hospital stent thrombosis, re-intervention, non-fatal myocardial infarction or death. The BxSonic(R), Express(R) and Flexmaster(R) stents were successfully implanted in 92,2%, 89,3% and 91,6% of all lesions (ns). There were no in-hospital deaths and the rates of in-hospital complications were similar in the three stent groups. We found similar deliverability and in-hospital complication rates of the BxSonic(R), Express(R) and Flexmaster(R) stents.
ERIC Educational Resources Information Center
Caillods, Francoise; And Others
This document provides materials prepared for and discussed at a workshop to analyze the problems facing Central and Eastern European countries in the management of the vocational education and training (VET) system. Part I gives an outline of the major research findings and reflects the discussions of the workshop. "Management of Vocational…
ERIC Educational Resources Information Center
Woods, Charlotte; Armstrong, Paul; Bragg, Joanna; Pearson, Diana
2013-01-01
This article examines illustrative cases of partnerships from a government-funded programme of experimental projects in England designed to test out the potential of senior business managers to provide leadership across a group of schools. The article places the programme within the context of international public service reforms and, more…
IMHE-Info. OECD Programme on Institutional Management in Higher Education, July 2007
ERIC Educational Resources Information Center
Lafon, Valerie, Ed.
2007-01-01
IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) Giving Knowledge for Free; The Emergence of Open Educational Resources; and (2) Education at a Glance 2007. IMHE News, publications of interest and upcoming events are included. (Contains 1 figure and 1 table.)
ERIC Educational Resources Information Center
Macphee, Paula-Louise; Fitz-Gerald, Ann
2014-01-01
This paper argues for the importance, benefits and wider impact of a donor-funded, locally supported postgraduate programme in security sector management (SSM) for government officials in Ethiopia. With the exception of specialised education and training programmes within the field of peace and conflict studies, the role of education in…
ERIC Educational Resources Information Center
Spanos, Dimitrios; Hankey, Catherine R.; Melville, Craig A.
2016-01-01
Background: The evidence base for weight management programmes incorporating a weight loss and a weight maintenance phase for adults with intellectual disabilities (ID) is limited. This study describes the weight maintenance phase of a multicomponent weight management programme for adults with intellectual disability and obesity (TAKE 5).…
ERIC Educational Resources Information Center
Hodgson, Sarah; Papatheodorou, Theodora; James, Mary
2014-01-01
The article aims to discuss preliminary findings from a participatory monitoring and evaluation (M&E) framework, used in a community-based early childhood development (ECD) programme in KwaZulu-Natal South Africa, and their implications for leadership and management. The purposes of the M&E were for LETCEE, the implementing organization,…
USDA-ARS?s Scientific Manuscript database
While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impa...
Rethinking Leadership Learning in Postgraduate Public Management Programmes
ERIC Educational Resources Information Center
Briggs, Ian; Raine, John
2013-01-01
Leadership forms a key component of the curriculum of most Master of Public Administration and other public management programmes, usually doing so on the basis of assumptions that leadership is (a) both a subject and a responsibility that all such students might expect to embrace in the course of their careers; and (b) in some respects at least,…
Adapting Project Management Practices to Research-Based Projects
NASA Technical Reports Server (NTRS)
Bahr, P.; Baker, T.; Corbin, B.; Keith, L.; Loerch, L.; Mullenax, C.; Myers, R.; Rhodes, B.; Skytland, N.
2007-01-01
From dealing with the inherent uncertainties in outcomes of scientific research to the lack of applicability of current NASA Procedural Requirements guidance documentation, research-based projects present challenges that require unique application of classical project management techniques. If additionally challenged by the creation of a new program transitioning from basic to applied research in a technical environment often unfamiliar with the cost and schedule constraints addressed by project management practices, such projects can find themselves struggling throughout their life cycles. Finally, supplying deliverables to a prime vehicle customer, also in the formative stage, adds further complexity to the development and management of research-based projects. The Biomedical Research and Countermeasures Projects Branch at NASA Johnson Space Center encompasses several diverse applied research-based or research-enabling projects within the newly-formed Human Research Program. This presentation will provide a brief overview of the organizational structure and environment in which these projects operate and how the projects coordinate to address and manage technical requirements. We will identify several of the challenges (cost, technical, schedule, and personnel) encountered by projects across the Branch, present case reports of actions taken and techniques implemented to deal with these challenges, and then close the session with an open forum discussion of remaining challenges and potential mitigations.
NASA Technical Reports Server (NTRS)
Howell, Gregory A.
2005-01-01
Commitments are between people, not schedules. Project management as practiced today creates a "commitment-free zone," because it assumes that people will commit to centrally managed schedules without providing a mechanism to ensure their work can be done. So they give it their best, but something always seems to come up ..."I tried, but you know how it is." This form of project management does not provide a mechanism to ensure that what should be done, can in fact be done at the required moment. Too often, promises reliable promise. made in coordination meetings are conditional and unreliable. It has been my experience that at times trust can be low and hard to build in this environment. The absence of reliable promises explains why on well-run projects, people are often only completing 30-50 percent of the deliverables they d promised for the week. We all know what a promise is; we have plenty of experience making them and receiving them from others. So what s the problem? The sad fact is that the project environment-like many other work environments- is often so filled with systemic dishonesty, that we don t expect promises that are reliable. Project managers excel when they manage their projects as networks of commitments and help their people learn to elicit and make reliable promises.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kirlik, G; D’Souza, W; Zhang, H
2016-06-15
Purpose: To present a novel multi-criteria optimization (MCO) solution approach that generates treatment plans with deliverable apertures using column generation. Methods: We demonstrate our method with 10 locally advanced head-and-neck cancer cases retrospectively. In our MCO formulation, we defined an objective function for each structure in the treatment volume. This resulted in 9 objective functions, including 3 distinct objectives for primary target volume, high-risk and low-risk target volumes, 5 objectives for each of the organs-at-risk (OARs) (two parotid glands, spinal cord, brain stem and oral cavity), and one for the non-target non-OAR normal tissue. Conditional value-at-risk (CVaR) constraints were utilizedmore » to ensure at least certain fraction of the target volumes receiving the prescription doses. To directly generate deliverable plans, column generation algorithm was embedded within our MCO approach for aperture shape generation. Final dose distributions for all plans were generated using a Monte Carlo kernel-superposition dose calculation. We compared the MCO plans with the clinical plans, which were created by clinicians. Results: At least 95% target coverage was achieved by both MCO plans and clinical plans. However, the average conformity indices of clinical plans and the MCO plans were 1.95 and 1.35, respectively (31% reduction, p<0.01). Compared to the conventional clinical plan, the proposed MCO method achieved average reductions in left parotid mean dose of 5% (p=0.06), right parotid mean dose of 18% (p<0.01), oral cavity mean dose of 21% (p=0.03), spinal cord maximum dose of 20% (p<0.01), brain stem maximum dose of 61% (p<0.01), and normal tissue maximum dose of 5% (p<0.01), respectively. Conclusion: We demonstrated that the proposed MCO method was able to obtain deliverable IMRT treatment plans while achieving significant improvements in dosimetric plan quality.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wagar, M; Friesen, S; Mannarino, E
2014-06-01
Purpose: Collision between the gantry and the couch or patient during Radiotherapy is not a common concern for conventional RT (static fields or arc). With the increase in the application of stereotactic planning techniques to the body, collisions have become a greater concern. Non-coplanar beam geometry is desirable in stereotatic treatments in order to achieve sharp gradients and a high conformality. Non-coplanar geometry is less intuitive in the body and often requires an iterative process of planning and dry runs to guarantee deliverability. Methods: Purpose written software was developed in order to predict the likelihood of collision between the headmore » of the gantry and the couch, patient or stereotatic body frame. Using the DICOM plan and structures set, exported by the treatment planning system, this software is able to predict the possibility of a collision. Given the plan's isocenter, treatment geometry and exterior contours, the software is able to determine if a particular beam/arc is clinically deliverable or if collision is imminent. Results: The software was tested on real world treatment plans with untreatable beam geometry. Both static non-coplanar and VMAT plans were tested. Of these, the collision prediction software could identify all as having potentially problematic geometry. Re-plans of the same cases were also tested and validated as deliverable. Conclusion: This software is capable of giving good initial indication of deliverability for treatment plans that utilize complex geometry (SBRT) or have lateral isocenters. This software is not intended to replace the standard pre-treatment QA dry run. The effectiveness is limited to those portions of the patient and immobilization devices that have been included in the simulation CT and contoured in the planning system. It will however aid the planner in reducing the iterations required to create complex treatment geometries necessary to achieve ideal conformality and organ sparing.« less
Shen, Lanxiao; Chen, Shan; Zhu, Xiaoyang; Han, Ce; Zheng, Xiaomin; Deng, Zhenxiang; Zhou, Yongqiang; Gong, Changfei; Xie, Congying; Jin, Xiance
2018-03-01
A multidimensional exploratory statistical method, canonical correlation analysis (CCA), was applied to evaluate the impact of complexity parameters on the plan quality and deliverability of volumetric-modulated arc therapy (VMAT) and to determine parameters in the generation of an ideal VMAT plan. Canonical correlations among complexity, quality and deliverability parameters of VMAT, as well as the contribution weights of different parameters were investigated with 71 two-arc VMAT nasopharyngeal cancer (NPC) patients, and further verified with 28 one-arc VMAT prostate cancer patients. The average MU and MU per control point (MU/CP) for two-arc VMAT plans were 702.6 ± 55.7 and 3.9 ± 0.3 versus 504.6 ± 99.2 and 5.6 ± 1.1 for one-arc VMAT plans, respectively. The individual volume-based 3D gamma passing rates of clinical target volume (γCTV) and planning target volume (γPTV) for NPC and prostate cancer patients were 85.7% ± 9.0% vs 92.6% ± 7.8%, and 88.0% ± 7.6% vs 91.2% ± 7.7%, respectively. Plan complexity parameters of NPC patients were correlated with plan quality (P = 0.047) and individual volume-based 3D gamma indices γ(IV) (P = 0.01), in which, MU/CP and segment area (SA) per control point (SA/CP) were weighted highly in correlation with γ(IV) , and SA/CP, percentage of CPs with SA < 5 × 5 cm2 (%SA < 5 × 5 cm2) and PTV volume were weighted highly in correlation with plan quality with coefficients of 0.98, 0.68 and -0.99, respectively. Further verification with one-arc VMAT plans demonstrated similar results. In conclusion, MU, SA-related parameters and PTV volume were found to have strong effects on the plan quality and deliverability.
Shen, Lanxiao; Chen, Shan; Zhu, Xiaoyang; Han, Ce; Zheng, Xiaomin; Deng, Zhenxiang; Zhou, Yongqiang; Gong, Changfei; Jin, Xiance
2018-01-01
Abstract A multidimensional exploratory statistical method, canonical correlation analysis (CCA), was applied to evaluate the impact of complexity parameters on the plan quality and deliverability of volumetric-modulated arc therapy (VMAT) and to determine parameters in the generation of an ideal VMAT plan. Canonical correlations among complexity, quality and deliverability parameters of VMAT, as well as the contribution weights of different parameters were investigated with 71 two-arc VMAT nasopharyngeal cancer (NPC) patients, and further verified with 28 one-arc VMAT prostate cancer patients. The average MU and MU per control point (MU/CP) for two-arc VMAT plans were 702.6 ± 55.7 and 3.9 ± 0.3 versus 504.6 ± 99.2 and 5.6 ± 1.1 for one-arc VMAT plans, respectively. The individual volume-based 3D gamma passing rates of clinical target volume (γCTV) and planning target volume (γPTV) for NPC and prostate cancer patients were 85.7% ± 9.0% vs 92.6% ± 7.8%, and 88.0% ± 7.6% vs 91.2% ± 7.7%, respectively. Plan complexity parameters of NPC patients were correlated with plan quality (P = 0.047) and individual volume-based 3D gamma indices γ(IV) (P = 0.01), in which, MU/CP and segment area (SA) per control point (SA/CP) were weighted highly in correlation with γ(IV) , and SA/CP, percentage of CPs with SA < 5 × 5 cm2 (%SA < 5 × 5 cm2) and PTV volume were weighted highly in correlation with plan quality with coefficients of 0.98, 0.68 and −0.99, respectively. Further verification with one-arc VMAT plans demonstrated similar results. In conclusion, MU, SA-related parameters and PTV volume were found to have strong effects on the plan quality and deliverability. PMID:29415196
Brosseau, Lucie; Thevenot, Odette; MacKiddie, Olivia; Taki, Jade; Wells, George A; Guitard, Paulette; Léonard, Guillaume; Paquet, Nicole; Aydin, Sibel Z; Toupin-April, Karine; Cavallo, Sabrina; Moe, Rikke Helene; Shaikh, Kamran; Gifford, Wendy; Loew, Laurianne; De Angelis, Gino; Shallwani, Shirin Mehdi; Aburub, Ala' S; Mizusaki Imoto, Aline; Rahman, Prinon; Álvarez Gallardo, Inmaculada C; Cosic, Milkana Borges; Østerås, Nina; Lue, Sabrina; Hamasaki, Tokiko; Gaudreault, Nathaly; Towheed, Tanveer E; Koppikar, Sahil; Kjeken, Ingvild; Mahendira, Dharini; Kenny, Glen P; Paterson, Gail; Westby, Marie; Laferrière, Lucie; Longchamp, Guy
2018-06-01
To identify programmes involving therapeutic exercise that are effective for the management of hand osteoarthritis and to provide stakeholders with updated, moderate to high-quality recommendations supporting exercises for hand osteoarthritis. A systematic search and adapted selection criteria included comparable trials with exercise programmes for managing hand osteoarthritis. Based on the evaluated evidence, a panel of experts reached consensus through a Delphi approach endorsing the recommendations. A hierarchical alphabetical grading system (A, B, C+, C, C-, D-, D, D+, E, F) was based on clinical importance (≥15%) and statistical significance ( P < 0.05). Ten moderate- to high-quality studies were included. Eight studies with programmes involving therapeutic exercise (e.g. range of motion (ROM) + isotonic + isometric + functional exercise) seemed to be effective. Forty-six positive grade recommendations (i.e. A, B, C+) were obtained during short-term (<12 weeks) trials for pain, stiffness, physical function, grip strength, pinch strength, range of motion, global assessment, pressure pain threshold, fatigue and abductor pollicis longus moment and during long-term (>12 weeks) trials for physical function and pinch strength. Despite that many programmes involving exercise with positive recommendations for clinical outcomes are available to healthcare professionals and hand osteoarthritis patients that aid in the management of hand osteoarthritis, there is a need for further research to isolate the specific effect of exercise components.
Irvine, Kenneth; Weigelhofer, Gabriele; Popescu, Ioana; Pfeiffer, Ellen; Păun, Andrei; Drobot, Radu; Gettel, Gretchen; Staska, Bernadette; Stanica, Adrian; Hein, Thomas; Habersack, Helmut
2016-02-01
Sustainable river basin management depends on knowledge, skills and education. The DANCERS project set out to identify feasible options for achieving education for sustainable water management across the Danube river basin, and its integration with broader education and economic development. The study traced the historic, regulatory and educational landscape of water management in the basin, contrasting it with the complex political decision-making, data-heavy decision support, learning-centred collaboration, and information-based participation that are all inherent components of Integrated Water Resource Management (IWRM). While there is a wide range of educational opportunities and mobility schemes available to individuals, there is no coherent network related to training in water management and sustainable development in the study region. Progress in addressing the multi-layered environmental challenges within the basin requires further aligning of economic, environmental and educational policies, advancing the EU Bologna Process across the region, and the development of dedicated training programmes that combine technical and relational skills. The DANCERS project identified key short and medium term needs for education and research to support progressive adoption of sustainable development, and the necessary dialogue across the public and private sectors to align policies. These include the development of new education networks for masters and PhD programmes, including joint programmes; improved access to technical training and life-long learning programmes for skills development; developing formalized and certified competency structures and associated accreditation of institutions where such skilled individuals work; and developing a co-ordinated research infrastructure and pan-basin programme for research for water management and sustainable development. Copyright © 2015 Elsevier B.V. All rights reserved.
Detaille, Sarah I; van der Gulden, Joost W J; Engels, Josephine A; Heerkens, Yvonne F; van Dijk, Frank J H
2010-06-21
Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme. The method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed. The intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease) and work-related personal factors (such as self-efficacy at work). The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease. Intervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.
Creating meaningful business continuity management programme metrics.
Strong, Brian
2010-11-01
The popular axiom, 'what gets measured gets done', is often applied in the quality management and continuous improvement disciplines. This truism is also useful to business continuity practitioners as they continually strive to prove the value of their organisation's investment in a business continuity management (BCM) programme. BCM practitioners must also remain relevant to their organisations as executives focus on the bottom line and maintaining stakeholder confidence. It seems that executives always find a way, whether in a hallway or elevator, to ask BCM professionals about the company's level of readiness. When asked, they must be ready with an informed response. The establishment of a process to measure business continuity programme performance and organisational readiness has emerged as a key component of US Department of Homeland Security 'Voluntary Private Sector Preparedness (PS-Prep) Program' standards where the overarching goal is to improve private sector preparedness for disasters and emergencies. The purpose of this paper is two-fold: to introduce continuity professionals to best practices that should be considered when developing a BCM metrics programme as well as providing a case study of how a large health insurance company researched, developed and implemented a process to measure BCM programme performance and company readiness.
Birnbaum, Dana Sophie; Braun, Sebastian
2010-01-01
Evaluation represents a substantial component of the concept of Disease Management Programmes. This and the fact that the implementation of Disease Management Programmes constitutes a major change in the German healthcare system require that the criteria established by the German Federal Social Insurance Authority (Bundesversicherungsamt) be carefully reviewed. The present paper focuses on the evaluation method and the economic data. The pre-/-post study design used in the evaluation is known to be vulnerable to threats to internal validity. The objective of this paper is to analyze whether these threats to internal validity which have been known theoretically are confirmed by the results of the final reports. A review of the final reports of health insurance companies like the AOK, Barmer and a group of the BKK in Westfalen-Lippe shows that this question can be answered in the affirmative. The pre-/-post design without control groups is unable to recognize the failure or success of the Disease Management concept. The reasons include a high drop-out rate as well as the lack of consideration of the characteristics of chronic disease. Hence the evaluation method has failed to prove the quality of Disease Management Programmes in Germany. This is why consistent further development is needed.
Petersson, Kristoffer; Ceberg, Crister; Engström, Per; Knöös, Tommy
2011-01-01
A new type of treatment planning system called SHAREPLAN has been studied, which enables the transfer of treatment plans generated for helical tomotherapy delivery to plans that can be delivered on C-arm linacs. The purpose is to ensure continuous patient treatment during periods of unscheduled downtime for the TomoTherapy unit, particularly in clinics without a backup unit. The purpose of this work was to verify that the plans generated in this novel planning system are deliverable and accurate. The work consists primarily of beam commissioning, verification of the beam model, and measurements verifying that generated plans are deliverable with sufficient accuracy. The beam commissioning process involves input of general geometric properties of the modeled linac, profiles and depth dose curves for a specific photon nominal energy (6 MV), and the automated modeling of other beam properties. Some manual tuning of the beam model is required. To evaluate its accuracy, the confidence limit concept [J. Venselaar et al., "Tolerances for the accuracy of photon beam dose calculations of treatment planning systems," Radiother. Oncol. 60, 191-201 (2001)] was used, which is a method supported by ESTRO. Measurements were conducted with a 2D diode array at the commissioned linac as a final check of the beam model and to evaluate whether the generated plans were deliverable and accurate. The comparison and evaluation of calculated data points and measured data according to the method applied confirmed the accuracy of the beam model. The profiles had a confidence limit of 1.1% and the depth dose curves had a confidence limit of 1.7%, both of which were well below the tolerance limit of 2%. Plan specific QC measurements and evaluation verified that different plans generated in the TPS were deliverable with sufficient accuracy at the commissioned linac, as none of the 160 beams for the 20 different plans evaluated had a fraction of approved data points below 90%, the local clinical approval criterion for delivery QA measurements. This study is a validation of the new TPS as it verifies that the generated plans are deliverable at a commissioned linac with adequate accuracy. A thorough investigation of the treatment plan quality will require a separate study. The TPS is proving to be a useful and time-saving complement, especially for clinics having a single unit for helical delivery among its conventional linacs.
Rutherford, Merrin E; Ruslami, Rovina; Anselmo, Melissa; Alisjahbana, Bachti; Yulianti, Neti; Sampurno, Hedy; van Crevel, Reinout; Hill, Philip C
2013-12-01
To investigate qualitatively and quantitatively the performance of a programme for managing the child contacts of adult tuberculosis patients in Indonesia. A public health evaluation framework was used to assess gaps in a child contact management programme at a lung clinic. Targets for programme performance indicators were derived from established programme indicator targets, the scientific literature and expert opinion. Compliance with tuberculosis screening, the initiation of isoniazid preventive therapy in children younger than 5 years, the accuracy of tuberculosis diagnosis and adherence to preventive therapy were assessed in 755 child contacts in two cohorts. In addition, 22 primary caregivers and 34 clinic staff were interviewed to evaluate knowledge and acceptance of child contact management. The cost to caregivers was recorded. Gaps between observed and target indicator values were quantified. THE GAPS BETWEEN OBSERVED AND TARGET PERFORMANCE INDICATORS WERE: 82% for screening compliance; 64 to 100% for diagnostic accuracy, 50% for the initiation of preventive therapy, 54% for adherence to therapy and 50% for costs. Many staff did not have adequate knowledge of, or an appropriate attitude towards, child contact management, especially regarding isoniazid preventive therapy. Caregivers had good knowledge of screening but not of preventive therapy and had difficulty travelling to the clinic and paying costs. The study identified widespread gaps in the performance of a child contact management system in Indonesia, all of which appear amenable to intervention. The public health evaluation framework used could be applied in other settings where child contact management is failing.
Longitudinal analysis on the development of hospital quality management systems in the Netherlands.
Dückers, Michel; Makai, Peter; Vos, Leti; Groenewegen, Peter; Wagner, Cordula
2009-10-01
Many changes have been initiated in the Dutch hospital sector to optimize health-care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment combinations, intensified monitoring of quality and a multi-layered organizational development programme based on quality improvement collaboratives. The objective is to answer the question as to whether these changes were accompanied by a further development of hospital quality management systems and to what extent did the development within the multi-layered programme hospitals differ from that in other hospitals. Longitudinal data were collected in 1995, 2000, 2005 and 2007 using a validated questionnaire. Descriptive analyses and multi-level modelling were applied to test whether: (1) quality management system development stages in hospitals differ over time, (2) development stages and trends differ between hospitals participating or not participating in the multi-layered programme and (3) hospital size has an effect on development stage. Dutch hospital sector between 1995 and 2007. Hospital organizations. Changes through time. Quality management system development stage. Since 1995, hospital quality management systems have reached higher development levels. Programme participants have developed their quality management system more rapidly than have non-participants. However, this effect is confounded by hospital size. Study results suggest that the combination of policy measures at macro level was accompanied by an increase in hospital size and the further development of quality management systems. Hospitals are entering the stage of systematic quality improvement.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Michael Ebert
This is the final report for the DOE-NETL grant entitled 'Creating New Incentives for Risk Identification & Insurance Processes for the Electric Utility Industry' and later, 'Energy & Risk Transfer Assessment'. It reflects work done on projects from 15 August 2004 to 29 February 2008. Projects were on a variety of topics, including commercial insurance for electrical utilities, the Electrical Reliability Organization, cost recovery by Gulf State electrical utilities after major hurricanes, and review of state energy emergency plans. This Final Technical Report documents and summarizes all work performed during the award period, which in this case is from 15more » August 2004 (date of notification of original award) through 29 February 2008. This report presents this information in a comprehensive, integrated fashion that clearly shows a logical and synergistic research trajectory, and is augmented with findings and conclusions drawn from the research as a whole. Four major research projects were undertaken and completed during the 42 month period of activities conducted and funded by the award; these are: (1) Creating New Incentives for Risk Identification and Insurance Process for the Electric Utility Industry (also referred to as the 'commercial insurance' research). Three major deliverables were produced: a pre-conference white paper, a two-day facilitated stakeholders workshop conducted at George Mason University, and a post-workshop report with findings and recommendations. All deliverables from this work are published on the CIP website at http://cipp.gmu.edu/projects/DoE-NETL-2005.php. (2) The New Electric Reliability Organization (ERO): an examination of critical issues associated with governance, standards development and implementation, and jurisdiction (also referred to as the 'ERO study'). Four major deliverables were produced: a series of preliminary memoranda for the staff of the Office of Electricity Delivery and Energy Reliability ('OE'), an ERO interview protocol and stakeholder/experts interviews, a formal research paper, and a data quality and availability study of North American Electric Reliability Corporation/ERO's disturbances and outages working group ('DAWG') databases. (3) Critical Electric Power Infrastructure Recovery and Reconstruction: Issues & New Policy Initiatives in Four Gulf Coast States After 2005's Catastrophic Hurricanes (also referred to as the 'Gulf Coast cost recovery study'). Four deliverables were produced: the original research paper providing preliminary findings and recommendations (29 September 2006), a formal presentation of that report to officials, staff and invited guests at OE's Washington, DC headquarters, a series of update memoranda and quarterly activity updates (1 November 2006 through Q3-2007), and a final cumulative update of the original research report (February 2008). Documentation and information on these research activities can be found on the CIP website at http://cipp.gmu.edu/projects/DoE-NETL-2006.php. (4) Evaluation of State Energy Emergency Response Plans (also referred to as the 'SEERP project'). Two major deliverables were produced: an evaluation of 47 SEERPs with findings, statistical analyses, geospatial renderings (mappings of the States whose plans were evaluated with statistical analysis underpinnings) and recommendations (17 September 2007), and a major revision to the original deliverable to include one additional plan (Missouri), with fully updated findings, statistical analyses, geospatial renderings, and recommendations (Revision 1, 29 February 2008).« less
Park, So-Yeon; Kim, Il Han; Ye, Sung-Joon; Carlson, Joel; Park, Jong Min
2014-11-01
Texture analysis on fluence maps was performed to evaluate the degree of modulation for volumetric modulated arc therapy (VMAT) plans. A total of six textural features including angular second moment, inverse difference moment, contrast, variance, correlation, and entropy were calculated for fluence maps generated from 20 prostate and 20 head and neck VMAT plans. For each of the textural features, particular displacement distances (d) of 1, 5, and 10 were adopted. To investigate the deliverability of each VMAT plan, gamma passing rates of pretreatment quality assurance, and differences in modulating parameters such as multileaf collimator (MLC) positions, gantry angles, and monitor units at each control point between VMAT plans and dynamic log files registered by the Linac control system during delivery were acquired. Furthermore, differences between the original VMAT plan and the plan reconstructed from the dynamic log files were also investigated. To test the performance of the textural features as indicators for the modulation degree of VMAT plans, Spearman's rank correlation coefficients (rs) with the plan deliverability were calculated. For comparison purposes, conventional modulation indices for VMAT including the modulation complexity score for VMAT, leaf travel modulation complexity score, and modulation index supporting station parameter optimized radiation therapy (MISPORT) were calculated, and their correlations were analyzed in the same way. There was no particular textural feature which always showed superior correlations with every type of plan deliverability. Considering the results comprehensively, contrast (d = 1) and variance (d = 1) generally showed considerable correlations with every type of plan deliverability. These textural features always showed higher correlations to the plan deliverability than did the conventional modulation indices, except in the case of modulating parameter differences. The rs values of contrast to the global gamma passing rates with criteria of 2%/2 mm, 2%/1 mm, and 1%/2 mm were 0.536, 0.473, and 0.718, respectively. The respective values for variance were 0.551, 0.481, and 0.688. In the case of local gamma passing rates, the rs values of contrast were 0.547, 0.578, and 0.620, respectively, and those of variance were 0.519, 0.527, and 0.569. All of the rs values in those cases were statistically significant (p < 0.003). In the cases of global and local gamma passing rates, MISPORT showed the highest correlations among the conventional modulation indices. For global passing rates, rs values of MISPORT were -0.420, -0.330, and -0.632, respectively, and those for local passing rates were -0.455, -0.490 and -0.502. The values of rs of contrast, variance, and MISPORT with the MLC errors were -0.863, -0.828, and 0.795, respectively, all with statistical significances (p < 0.001). The correlations with statistical significances between variance and dose-volumetric differences were observed more frequently than the others. The contrast (d = 1) and variance (d = 1) calculated from fluence maps of VMAT plans showed considerable correlations with the plan deliverability, indicating their potential use as indicators for assessing the degree of modulation of VMAT plans. Both contrast and variance consistently showed better performance than the conventional modulation indices for VMAT.
Natural Stream Channel Design Techniques and Review
Need for a Review Checklist: Stream restoration problems include; design complexity, many different design methodologies, inconsistency in design deliverables, communication difficulties, many failed projects
Sheringham, Jessica; Solmi, Francesca; Ariti, Cono; Baim-Lance, Abigail; Morris, Steve; Fulop, Naomi J.
2017-01-01
Background Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in ‘real-world’ rather than research settings. Materials and methods This mixed-methods study tested a retrospective theory-based approach to evaluate a ‘real-world’ programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care. Quantitative analyses comprised controlled before-and-after analyses to test ‘early’ and evolved’ programme theories with comparators grounded in each theory. ‘Early’ theory predicted the programme would reduce emergency hospital admissions (EHA). It was tested using national analysis of standardized borough-level EHA rates between programme and comparator boroughs. ‘Evolved’ theory predicted practices with higher programme participation would increase guideline adherence and reduce EHA and costs. It was tested using a difference-in-differences analysis with linked primary and secondary care data to compare changes in diagnosis, management, EHA and costs, over time and by programme participation. Results Contrary to programme planners’ predictions in ‘early’ and ‘evolved’ programme theories, admissions did not change following the programme. However, consistent with ‘evolved’ theory, higher guideline adoption occurred in practices with greater programme participation. Conclusions Retrospectively constructing theories based on the ideas of programme planners can enable evaluators to address some limitations encountered when evaluating programmes without a theoretical base. Prospectively articulating theory aided by existing models and mid-range implementation theories may strengthen guideline adoption efforts by prompting planners to scrutinise implementation methods. Benefits of deriving programme theory, with or without the aid of mid-range implementation theories, however, may be limited when the evidence underpinning guidelines is flawed. PMID:28328942
Malaria community health workers in Myanmar: a cost analysis.
Kyaw, Shwe Sin; Drake, Tom; Thi, Aung; Kyaw, Myat Phone; Hlaing, Thaung; Smithuis, Frank M; White, Lisa J; Lubell, Yoel
2016-01-25
Myanmar has the highest malaria incidence and attributed mortality in South East Asia with limited healthcare infrastructure to manage this burden. Establishing malaria Community Health Worker (CHW) programmes is one possible strategy to improve access to malaria diagnosis and treatment, particularly in remote areas. Despite considerable donor support for implementing CHW programmes in Myanmar, the cost implications are not well understood. An ingredients based micro-costing approach was used to develop a model of the annual implementation cost of malaria CHWs in Myanmar. A cost model was constructed based on activity centres comprising of training, patient malaria services, monitoring and supervision, programme management, overheads and incentives. The model takes a provider perspective. Financial data on CHWs programmes were obtained from the 2013 financial reports of the Three Millennium Development Goal fund implementing partners that have been working on malaria control and elimination in Myanmar. Sensitivity and scenario analyses were undertaken to outline parameter uncertainty and explore changes to programme cost for key assumptions. The range of total annual costs for the support of one CHW was US$ 966-2486. The largest driver of CHW cost was monitoring and supervision (31-60% of annual CHW cost). Other important determinants of cost included programme management (15-28% of annual CHW cost) and patient services (6-12% of annual CHW cost). Within patient services, malaria rapid diagnostic tests are the major contributor to cost (64% of patient service costs). The annual cost of a malaria CHW in Myanmar varies considerably depending on the context and the design of the programme, in particular remoteness and the approach to monitoring and evaluation. The estimates provide information to policy makers and CHW programme planners in Myanmar as well as supporting economic evaluations of their cost-effectiveness.
Tang, T S; Sohal, P S; Garg, A K
2013-06-01
The purpose of this single-cohort study was to implement and evaluate a programme that trains peers to deliver a diabetes self-management support programme for South-Asian adults with Type 2 diabetes and to assess the perceived efficacy of and satisfaction with this programme. We recruited eight South-Asian adults who completed a 20-h peer-leader training programme conducted over five sessions (4 h per session). The programme used multiple instructional methods (quizzes, group brainstorming, skill building, group sharing, role-play and facilitation simulation) and provided communication, facilitation, and behaviour change skills training. To graduate, participants were required to achieve the pre-established competency criteria in four training domains: active listening, empowerment-based facilitation, five-step behavioural goal-setting, and self-efficacy. Participants were given three attempts to pass each competency domain. On the first attempt six (75%), eight (100%), five (63%) and five (63%) participants passed active listening, empowerment-based facilitation, five-step behavioural goal-setting, and self-efficacy, respectively. Those participants who did not pass a competency domain on the first attempt were successful in passing on the second attempt. As a result, all eight participants graduated from the training programme and became peer leaders. Satisfaction ratings for programme length, balance between content and skills development, and preparation for leading support activities were uniformly high. Ratings for the instructional methods ranged between effective and very effective. Findings suggest it is feasible to train and graduate peer leaders with the necessary skills to facilitate a diabetes self-management support intervention. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.
ERIC Educational Resources Information Center
Gordon, Ian
2016-01-01
This article explores a university knowledge exchange programme for small and medium-sized enterprise (SME) owner-managers. Specifically, it considers why a programme designed to achieve growth in a group of SMEs through the creation of a network high in social capital may have become a constraint on the programme's effectiveness over a period of…
The effect of participation in a weight loss programme on short-term health resource utilization.
van Walraven, Carl; Dent, Robert
2002-02-01
Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervised weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, multifaceted weight loss programme in a universal health care system were studied. Patient information was anonymously linked with administrative databases to measure health resource utilization for 1 year before and after the programme. Mean body mass index (BMI) decreased by more than 15%. The mean annual physician visits (pre = 9.6, post = 9.4) did not change significantly after the programme. However, patients saw a significantly fewer number of different physicians per year following the programme (pre = 4.5, post = 3.9; P < 0.001). Mean annual number of emergency visits (pre = 0.2; post = 0.2) and hospital admissions (pre = 0.05; post = 0.08) did not change. Neither baseline BMI, nor its change during the programme, influenced changes in health resource utilization. Our study suggests that weight loss in a supervised weight management programme does not necessarily decrease short-term health resource utilization. Further study is required to determine if patients who maintain their weight loss experience a decrease in health utilization.
Linden, Ariel; Adams, John L; Roberts, Nancy
2006-04-01
Although disease management (DM) has been in existence for over a decade, there is still much uncertainty as to its effectiveness in improving health status and reducing medical cost. The main reason is that most programme evaluations typically follow weak observational study designs that are subject to bias, most notably selection bias and regression to the mean. The regression discontinuity (RD) design may be the best alternative to randomized studies for evaluating DM programme effectiveness. The most crucial element of the RD design is its use of a 'cut-off' score on a pre-test measure to determine assignment to intervention or control. A valuable feature of this technique is that the pre-test measure does not have to be the same as the outcome measure, thus maximizing the programme's ability to use research-based practice guidelines, survey instruments and other tools to identify those individuals in greatest need of the programme intervention. Similarly, the cut-off score can be based on clinical understanding of the disease process, empirically derived, or resource-based. In the RD design, programme effectiveness is determined by a change in the pre-post relationship at the cut-off point. While the RD design is uniquely suitable for DM programme evaluation, its success will depend, in large part, on fundamental changes being made in the way DM programmes identify and assign individuals to the programme intervention.
Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; in ’t Veen, Johannes C C M
2017-01-01
Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories ‘the A–I of difficult-to-manage asthma’ to resonate with an established Dutch ‘A–E acronym for determining asthma control’. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme. PMID:28184039
Disease management programme for diabetes mellitus in Nepal.
Dulal, R K; Karki, S
2009-01-01
The prevalence of diabetes in elderly is being out-numbered and continuously rising. Individuals expect miracles from their health care providers as everything is curable in the eyes of the patient. Disease Management Programme for diabetes mellitus is sensible from the medical and economic point of view since it organizes care in multidisciplinary, multicomponent, proactive approach focusing on the whole course of a disease, using evidence-based standards of care that reduce health care costs and hospital stay. In Nepal, health care professionals today need to be aware that the patients are more and more aware about their disease and technology and their increased awareness demand innovative services. Authenticated data used for the purpose of projection were drawn purely from urban or rural hospital-based. To estimate the prevalence of diabetes mellitus (DM), the data in pairs (i.e. prevalence and year) were fed into IDL - an inbuilt mathematical software program for best-fit regression. Literatures on DM prevalence and Disease Management Programme were examined. The overall projection for the DM prevalence in Nepal suggests that the prevalence of diagnosed DM will be 12.73%, 15.11% and 17.49% in 2010, 2015 and 2020 respectively. Diabetes disease management programme appeared to be helpful in reduction of health care costs and hospital stay. If the attributing factor for DM remains as it is today, many new cases of DM will be added each year. There is a need of effective disease management programme in the country. The increased level of awareness among the patients demands innovative services in future.
NASA Astrophysics Data System (ADS)
Patel, Gayatri; Clapp, Matthew; Salter, Mike; Waltham, Nick; Beardsley, Sarah
2016-08-01
World Space Observatory Ultraviolet (WSO-UV) is a major international collaboration led by Russia and will study the universe at ultraviolet wavelengths between 115 nm and 320 nm. The WSO Ultraviolet Spectrograph (WUVS) subsystem is led by a consortium of Russian institutes and consists of three spectrographs. RAL Space is contracted by e2v technologies Ltd to provide the CCD readout electronics for each of the three WUVS channels. The programme involves the design, manufacturing, assembly and testing of each Camera Electronics Box (CEB), its associated Interconnection Module (ICM), Electrical Ground Support Equipment (EGSE) and harness. An overview of the programme will be presented, from the initial design phase culminating in the development of an Engineering Model (EM) through qualification whereby an Engineering Qualification Model (EQM) will undergo environmental testing to characterize the performance of the CEB against the space environment, to the delivery of the Flight Models (FMs). The paper will discuss the challenges faced managing a large, dynamic project. This includes managing significant changes in fundamental requirements mid-programme as a result of external political issues which forced a complete re-design of an existing CEB with extensive space heritage but containing many ITAR controlled electronic components to a new, more efficient solution, free of ITAR controlled parts. The methodology and processes used to ensure the demanding schedule is maintained through each stage of the project will be presented including an insight into planning, decision-making, communication, risk management, and resource management; all essential to the continued success of the programme.
Professional development of Russian HEIs' management and faculty in CDIO standards application
NASA Astrophysics Data System (ADS)
Chuchalin, Alexander; Malmqvist, Johan; Tayurskaya, Marina
2016-07-01
The paper presents the approach to complex training of managers and faculty staff for system modernisation of Russian engineering education. As a methodological basis of design and implementation of the faculty development programme, the CDIO (Conceive-Design-Implement-Operate) Approach was chosen due to compliance of its concept to the purposes and tasks of engineering education development in Russia. The authors describe the structure, the content and implementation technology of the programme designed by Tomsk Polytechnic University and Skolkovo Institute of Science and Technology with the assistance of Chalmers University of Technology and KTH Royal Institute of Technology and other members of the CDIO Initiative. The programme evaluation based on the questionnaire results showed that the programme content is relevant, has high practical value and high level of novelty for all categories of participants. Therefore, the CDIO approach was recommended for implementation to improve various elements of the engineering programme such as learning outcomes, content and structure, teaching, learning and assessment methods. Besides, the feedback results obtained through programme participants' survey contribute to identification of problems preventing development of engineering education in Russia and thus serve as milestones for further development of the programme.
A leadership programme for critical care.
Crofts, Linda
2006-08-01
This paper describes the genesis, design and implementation of a leadership programme for critical care. This was an initiative funded by the National Health Service (NHS) Nursing Leadership Project and had at the core of its design flexibility to meet the needs of the individual hospitals, which took part in it. Participation was from the multi-disciplinary critical care team. Six NHS hospitals took part in the programme which was of 20 days duration and took place on hospital sites. The programme used the leadership model of as its template and had a number of distinct components; a baseline assessment, personal development, principles of leadership and critical case reviews. The programme was underpinned by three themes; working effectively in multi-professional teams to provide patient focussed care, managing change through effective leadership and developing the virtual critical care service. Each group set objectives pertinent to their own organisation's needs. The programme was evaluated by a self-reporting questionnaire; group feedback and feedback from stakeholders. Programme evaluation was positive from all the hospitals but it was clear that the impact of the programme varied considerably between the groups who took part. It was noted that there was some correlation between the success of the programme and organisational 'buy in' as well as the organisational culture within which the participants operated. A key feature of the programme success was the critical case reviews, which were considered to be a powerful learning tool and medium for group learning and change management.
2013-01-01
Background The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the development and optimization of the Football Fans in Training (FFIT) programme, which aims to help overweight men (many of them football supporters) lose weight through becoming more active and adopting healthier eating habits. Methods The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases. In Phase 1, a multidisciplinary working group developed the pilot programme (p-FFIT) and used a scoping review to summarize previous research and identify the target population. Phase 2 involved a process evaluation of p-FFIT in 11 Scottish Premier League (SPL) clubs. Participant and coach feedback, focus group discussions and interviews explored the utility/acceptability of programme components and suggestions for changes. Programme session observations identified examples of good practice and problems/issues with delivery. Together, these findings informed redevelopment of the optimized programme (FFIT), whose components were mapped onto specific behaviour change techniques using an evidence-based taxonomy. Results p-FFIT comprised 12, weekly, gender-sensitised, group-based weight management classroom and ‘pitch-side’ physical activity sessions. These in-stadia sessions were complemented by an incremental, pedometer-based walking programme. p-FFIT was targeted at men aged 35-65 years with body mass index ≥ 27 kg/m2. Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components, and valued the camaraderie and peer-support offered by the programme. Coaches appreciated the simplicity of the key healthy eating and physical activity messages. Suggestions for improvements that were incorporated into the optimized FFIT programme included: more varied in-stadia physical activity with football-related components; post-programme weight management support (emails and a reunion session); and additional training for coaches in SMART goal setting and the pedometer-based walking programme. Conclusions The Football Fans in Training programme is highly acceptable to participants and SPL coaches, and is appropriate for evaluation in a randomised controlled trial. PMID:23496915
ERIC Educational Resources Information Center
Leckey, Yvonne; Hyland, Lynda; Hickey, Gráinne; Lodge, Anne; Kelly, Paul; Bywater, Tracey; Comiskey, Catherine; Donnelly, Michael; McGilloway, Sinéad
2016-01-01
Inappropriate, aggressive and disruptive behaviour in the classroom can be detrimental to child and teacher well-being. This study involved a longer-term evaluation of the "Incredible Years Teacher [Classroom Management]" programme (IYTP) undertaken mainly within disadvantaged schools in south-west Ireland. The IYTP is designed to…
ERIC Educational Resources Information Center
Mohammed, Feruz
2018-01-01
Attention-Deficit/Hyperactivity Disorder (ADHD) is a persistent pattern of behaviours characterized by inattention, hyperactivity and impulsivity. This study evaluates the effects of a tailored Incredible Years Teacher Classroom Management (IYTCM) programme aimed to improve participating children's on-task behaviour in a group of 6 to 10 year old…
ERIC Educational Resources Information Center
Løndal, Knut; Greve, Anne
2015-01-01
This article explores the nature of teachers' involvement in child-managed play. We approached this didactic issue through analysis of interactional situations in a kindergarten and an after-school programme and by drawing on relational theory and the concept of "pedagogical tact". Qualitative material was gathered from observations and…
ERIC Educational Resources Information Center
Etse, Daniel; Ingley, Coral
2016-01-01
Purpose: The purpose of this study is to determine the degree of attention to and the nature of sustainability issues in the curriculum of the Higher National Diploma (HND) Purchasing and Supply Management programme of Ghana. Design/Methodology/Approach: Documentary research is the approach used to analyse the curriculum document for the programme…
ERIC Educational Resources Information Center
Narwana, Kamlesh
2015-01-01
In post-Jomtien phase, community participation in school education management has appeared as one of the most prominent features in all educational development programmes at global level. In line with this trend, India has also placed a significant focus on local communities in school management through various programmes such as LokJumbish,…
ERIC Educational Resources Information Center
Thomas, Mark; O'Sullivan, Patrick; Zahner, Martin; Silvestre, Joelle
2015-01-01
Purpose: The purpose of this paper is to describe an innovative international management programme that has been developed across four countries for Master-level students. It first analyses the advantages and disadvantages of two of the most common forms of internationalisation in higher education; the student exchange and full-scale offshore…
Lemmens, Karin; Strating, Mathilde; Huijsman, Robbert; Nieboer, Anna
2009-08-01
The aim of this exploratory study was to investigate to what extent primary care professionals are able to change their systems for delivering care to chronic obstructive pulmonary disease (COPD) patients and what professional and organizational factors are associated with the degree of process implementation. Quasi-experimental design with 1 year follow-up after intervention. Three regional COPD management programmes in the Netherlands, in which general practices cooperated with regional hospitals. All participating primary care professionals (n = 52). COPD management programme. Professional commitment, organizational context and degree of process implementation. Professionals significantly changed their systems for delivering care to COPD patients, namely self-management support, decision support, delivery system design and clinical information systems. Associations were found between organizational factors, professional commitment and changes in processes of care. Group culture and professional commitment appeared to be, to a moderate degree, predictors of process implementation. COPD management was effective; all processes improved significantly. Moreover, theoretically expected associations between organizational context and professional factors with the implementation of COPD management were indeed confirmed to some extent. Group culture and professional commitment are important facilitators.
Optimal position of the transmitter coil for wireless power transfer to the implantable device.
Jinghui Jian; Stanaćević, Milutin
2014-01-01
The maximum deliverable power through inductive link to the implantable device is limited by the tissue exposure to the electromagnetic field radiation. By moving away the transmitter coil from the body, the maximum deliverable power is increased as the magnitude of the electrical field at the interface with the body is kept constant. We demonstrate that the optimal distance between the transmitter coil and the body is on the order of 1 cm when the current of the transmitter coil is limited to 1 A. We also confirm that the conditions on the optimal frequency of the power transmission and the topology of the transmission coil remain the same as if the coil was directly adjacent to the body.
Burkow, Tatjana M; Vognild, Lars K; Østengen, Geir; Johnsen, Elin; Risberg, Marijke Jongsma; Bratvold, Astrid; Hagen, Tord; Brattvoll, Morten; Krogstad, Trine; Hjalmarsen, Audhild
2013-03-05
The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers.This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user's own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home. The digital health diary was used as background information in the individual consultations and by some participants as a self-management tool. Participant retention was high, with no dropouts. None of the participants reported that the six-week duration of the home programmes was too long. The Internet-enabled programmes for home-based groups in pulmonary rehabilitation and diabetes education were generally well accepted by the participants. Our findings indicate that conventional programmes have the potential to be delivered in socially supportive group settings at home.
2013-01-01
Background The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers. This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. Methods We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user’s own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Results Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home. The digital health diary was used as background information in the individual consultations and by some participants as a self-management tool. Participant retention was high, with no dropouts. None of the participants reported that the six-week duration of the home programmes was too long. Conclusions The Internet-enabled programmes for home-based groups in pulmonary rehabilitation and diabetes education were generally well accepted by the participants. Our findings indicate that conventional programmes have the potential to be delivered in socially supportive group settings at home. PMID:23496829
2013-01-01
Background The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. Methods The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. Results The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Conclusions Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Trial registration Clinicaltrials.gov identifier: NCT01228708. PMID:24090189
Smidth, Margrethe; Christensen, Morten Bondo; Fenger-Grøn, Morten; Olesen, Frede; Vedsted, Peter
2013-10-03
The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Clinicaltrials.gov identifier: NCT01228708.
Beentjes, Titus A A; van Gaal, Betsie G I; Goossens, Peter J J; Schoonhoven, Lisette
2016-01-19
E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. One possible solution might be to blend e-health with face-to-face delivery of a recovery-oriented treatment, like the Illness Management & Recovery (IMR) programme. This paper describes the development of an e-health application for the IMR programme and the design of an early clustered randomized controlled trial. We developed the e-IMR intervention according to the six-step protocol of Intervention Mapping. Consumers joined the development group to address important and relevant issues for the target group. Decisions during the six-step development process were based on qualitative evaluations of the Illness Management & Recovery programme, structured interviews, discussion in the development group, and literature reviews on qualitative papers concerning consumers with severe mental illness, theoretical models, behavioural change techniques, and telemedicine for consumers with severe mental illness. The aim of the e-IMR intervention is to help consumers with severe mental illness to involve others, manage achieving goals, and prevent relapse. The e-IMR intervention consists of face-to-face delivery of the Illness Management & Recovery programme and an e-health application containing peer-testimonials on videos, follow up on goals and coping strategies, monitoring symptoms, solving problems, and communication opportunities. We designed an early cluster randomized controlled trial that will evaluate the e-IMR intervention. In the control condition the Illness Management & Recovery programme is provided. The main effect-study parameters are: illness management, recovery, psychiatric symptoms severity, self-management, quality of life, and general health. The process of the IMR program will be evaluated on fidelity and feasibility in semi-structured interviews with participants and trainers. Intervention Mapping provided a systematic procedure for the development of this e-health intervention for consumers with severe mental illness and the preparation of an early randomized controlled trial. The trial is registered in the Dutch Trial Register: NTR4772 .
Primary School Teachers' Views on Constructive Classroom Management
ERIC Educational Resources Information Center
Ari, Ercan; Kizilaslan Tunçer, Berfu; Demir, Mehmet Kaan
2016-01-01
Behavioural teaching programmes that had long been used in Turkey began changing in 2005. In a significant development, new programmes based on constructivism have come to the fore. The adaptation of teachers in this transitional process and their internalization of this new approach have been of utmost importance for the success of the programme.…
Defense Automation Resources Management Manual
1988-09-01
Electronic Command Signals Programmer, Plugboard Programmers Punch, Card Punch, Paper Tape Reader, Character Reader-Generator, Time Cards Reader...Multiplexor-Shift Register Group Multiplier Panel Control, Plugboard Panel, Interconnection, Digital Computer Panel, Meter-Attenuator, Tape Recorder PC Cards...Perforator, Tape Plug-In Unit Potentiometer, Coefficient, Analog Computer Programmer, Plugboard Punch, Paper Tape Racks Reader, Time Code Reader
Mentees' Views of a Structured Mentoring Programme at Unisa
ERIC Educational Resources Information Center
Schulze, S.
2010-01-01
The Management of one college at Unisa initiated a structured mentoring programme to develop researchers, among others. This article reports the views of 43 mentees of the programme one year after implementation. The research design was a survey. The items in a questionnaire were influenced by the self-efficacy theory and the constructivist views…
Challenges of Administering Teacher Education Programme in Kenyan Universities
ERIC Educational Resources Information Center
Genvieve, Nasimiyu
2017-01-01
Proper management of logistical issues in Teacher education programme tends to promote the quality of preparation of school teachers. The main objective of the study was to investigate challenges of administering teacher education programmes in Kenyan universities. The theoretical framework of the study was adopted as used by Koehler and Mishra's…
Evaluation of Eco Schools Scotland. SCRE Research Report No. 124
ERIC Educational Resources Information Center
Pirrie, Anne; Elliot, Dely; McConnell, Fraser; Wilkinson, J. Eric
2006-01-01
In October 2005, Keep Scotland Beautiful commissioned the SCRE Centre at the University of Glasgow to undertake an evaluation of the Eco Schools Programme in Scotland. Eco Schools is a programme for environmental management, certification and sustainable development education. It is an international programme that was developed in 1994 in response…
Sharkey, Alyssa B; Martin, Sandrine; Cerveau, Teresa; Wetzler, Erica; Berzal, Rocio
2014-12-01
We present the approaches used in and outcomes resulting from integrated community case management (iCCM) programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care-seeking within 24 hours and care-seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers' ability to assess and treat illnesses can lead to improved care-seeking and utilisation, and community ownership for iCCM.
Lin, Pi-Chu; Chiang, Hsiao-Wen; Chiang, Ting-Ting; Chen, Chyang-Shiong
2008-08-01
The purpose of this study was to assess the effectiveness of a pain management education programme in improving the nurses' knowledge about, attitude towards and application of relaxation therapy. Pain of surgical patients has long been an existing problem of health care. Nursing staff need to be educated continuously to develop the professional ability of pain management. A quasi-study design with pre- and posttest and post- and posttest was used. Subjects were chosen from a medical centre in Taipei by convenience sampling. The total sample size of 81 was segregated into a study group of 42 and control group of 39 participants. The study group attended a seven-session pain management programme totalling 15 hours. The control group received no pain management training. Scaled measurements were taken on pain management knowledge and attitude and relaxation therapy practice. (1) Scores for pain management knowledge differed significantly between the two groups (F = 40.636, p = 0.001). (2) Attitudes towards pain management differed between the two groups (F = 8.328, p = 0.005) and remained stable over time (F = 1.603, p = 0.205). (3) Relaxation therapy practice differed significantly between the two groups, with the study group better than the control group (F = 4.006, p = 0.049). (4) Relaxation therapy was applied to nearly all (97.5%) of the patients cared for by study group nurses. All of the instructed patients performed this technique one to three times per day postsurgery. Continuing education can improve nurses' knowledge about, attitude towards and behaviour of pain management. Results of this study could be used to guide the development and implementation of continuing education programmes for nursing staff to enhance patients' care knowledge and skills.
Grimsrud, Anna; Kaplan, Richard; Bekker, Linda-Gail; Myer, Landon
2014-09-01
Models of care utilizing task shifting and decentralization are needed to support growing ART programmes. We compared patient outcomes between a doctor-managed clinic and a nurse-managed down-referral site in Cape Town, South Africa. Analysis included all adults who initiated ART between 2002 and 2011 within a large public sector ART service. Stable patients were eligible for down-referral. Outcomes [mortality, loss to follow-up (LTFU), virologic failure] were compared under different models of care using proportional hazards models with time-dependent covariates. Five thousand seven hundred and forty-six patients initiated ART and over 5 years 41% (n = 2341) were down-referred; the median time on ART before down-referral was 1.6 years (interquartile range, 0.9-2.6). The nurse-managed down-referral site reported lower crude rates of mortality, LTFU and virologic failure compared with the doctor-managed clinic. After adjustment, there was no difference in the risk of mortality or virologic failure by model of care. However, patients who were down-referred were more likely to be LTFU than those retained at the doctor-managed site (adjusted hazard ratio, 1.36; 95% CI, 1.09-1.69). Increased levels of LTFU in the nurse-managed vs. doctor-managed service were observed in subgroups of male patients, those with advanced disease at initiation and those who started ART in the early years of the programme. Reorganization of ART maintenance by down-referral to nurse-managed services is associated with programme outcomes similar to those achieved using doctor-driven primary care services. Further research is necessary to identify optimal models of care to support long-term retention of patients on ART in resource-limited settings. © 2014 John Wiley & Sons Ltd.
Oku, Afiong; Oyo-Ita, Angela; Glenton, Claire; Fretheim, Atle; Ames, Heather; Muloliwa, Artur; Kaufman, Jessica; Hill, Sophie; Cliff, Julie; Cartier, Yuri; Owoaje, Eme; Bosch-Capblanch, Xavier; Rada, Gabriel; Lewin, Simon
2017-01-01
Effective vaccination communication with parents is critical in efforts to overcome barriers to childhood vaccination, tackle vaccine hesitancy and improve vaccination coverage. Health workers should be able to provide information to parents and other caregivers and support them in reaching decisions about vaccinating their children. Limited information exists regarding the perceptions of caregivers and health workers on the vaccination communication strategies employed in Nigeria. This study, which forms part of the 'Communicate to vaccinate' (COMMVAC) project, aims to explore the perceptions and experiences of caregivers and health workers in Nigeria on vaccination communication strategies implemented in their settings. We conducted the study in two States: Bauchi in Northern Nigeria and Cross River in the south. We carried out observations (n = 40), in-depth interviews (n = 14) and focus group discussions (FGDs) (n = 12) amongst 14 purposively selected health workers, two community leaders and 84 caregivers in the two states. We transcribed data verbatim and analysed the data using a framework analysis approach. Caregivers were informed about vaccination activities through three main sources: health facilities (during health education sessions conducted at antenatal or immunization clinics); media outlets; and announcements (in churches/mosques, communities and markets). Caregivers reported that the information received was very useful. Their preferred sources of information included phone text messages, town announcers, media and church/mosque announcements. Some caregivers perceived the clinic environment, long waiting times and health worker attitudes as barriers to receiving vaccination information.When delivering communication interventions, health workers described issues tied to poor communication skills; poor motivation; and attitudes of community members, including vaccine resistance. Communication about vaccination involves more than the message but is also influenced by the environment and the attitudes of the deliverer and receiver. It is pertinent for health policy makers and programme managers to understand these factors so as to effectively implement communication approaches.
Oyo-Ita, Angela; Glenton, Claire; Fretheim, Atle; Ames, Heather; Muloliwa, Artur; Kaufman, Jessica; Hill, Sophie; Cliff, Julie; Cartier, Yuri; Owoaje, Eme; Bosch-Capblanch, Xavier; Rada, Gabriel; Lewin, Simon
2017-01-01
Background Effective vaccination communication with parents is critical in efforts to overcome barriers to childhood vaccination, tackle vaccine hesitancy and improve vaccination coverage. Health workers should be able to provide information to parents and other caregivers and support them in reaching decisions about vaccinating their children. Limited information exists regarding the perceptions of caregivers and health workers on the vaccination communication strategies employed in Nigeria. This study, which forms part of the ‘Communicate to vaccinate’ (COMMVAC) project, aims to explore the perceptions and experiences of caregivers and health workers in Nigeria on vaccination communication strategies implemented in their settings. Methodology We conducted the study in two States: Bauchi in Northern Nigeria and Cross River in the south. We carried out observations (n = 40), in-depth interviews (n = 14) and focus group discussions (FGDs) (n = 12) amongst 14 purposively selected health workers, two community leaders and 84 caregivers in the two states. We transcribed data verbatim and analysed the data using a framework analysis approach. Results Caregivers were informed about vaccination activities through three main sources: health facilities (during health education sessions conducted at antenatal or immunization clinics); media outlets; and announcements (in churches/mosques, communities and markets). Caregivers reported that the information received was very useful. Their preferred sources of information included phone text messages, town announcers, media and church/mosque announcements. Some caregivers perceived the clinic environment, long waiting times and health worker attitudes as barriers to receiving vaccination information.When delivering communication interventions, health workers described issues tied to poor communication skills; poor motivation; and attitudes of community members, including vaccine resistance. Conclusion Communication about vaccination involves more than the message but is also influenced by the environment and the attitudes of the deliverer and receiver. It is pertinent for health policy makers and programme managers to understand these factors so as to effectively implement communication approaches. PMID:29117207
McFadyen, Tameka; Kingsland, Melanie; Tindall, Jennifer; Rowland, Bosco; Sherker, Shauna; Gillham, Karen; Heaton, Rachael; Clinton-McHarg, Tara; Lecathelinais, Christophe; Brooke, Daisy; Wiggers, John
2018-01-01
Introduction Community-based interventions have been found to effectively increase the implementation of alcohol management practices and reduce excessive alcohol use and alcohol-related harm at sports clubs. However, once implementation support ceases there may be a reduction in such intervention effects. Thus, ongoing contribution to improving the health of the community is diminished; sustaining practice implementation is a key determinant to address this. One possible solution to the strategic and logistical challenges of sustainability involves the use of the web. The primary aim of this study is to assess the effectiveness of a web-based programme in sustaining the implementation of alcohol management practices by community football clubs. The secondary aim is to assess the effectiveness of the programme in preventing excessive alcohol consumption and alcohol-related harm among members of community football clubs. Methods and analysis The study will employ a repeat randomised controlled trial design and be conducted in regional and metropolitan areas within two states of Australia. Community level football clubs who are currently accredited with an existing alcohol management programme (‘Good Sports’) and implementing at least 10 of the 13 core alcohol management practices (eg, not serving alcohol to <18-year-olds) required by the programme will be recruited and randomised to either a web-based sustainability programme or a ‘minimal contact’ programme. The primary outcome measures are the proportion of football clubs implementing ≥10 of the 13 required alcohol management practices and the mean number of those practices being implemented at 3-year follow-up. Secondary outcomes include: the proportion of club members who report risky drinking at their club, the Alcohol Use Disorder Identification Test (AUDIT) score and mean AUDIT score of club members. Outcome data will be collected via observation at the club during a 1-day visit to a home game, conducted by trained research assistants at baseline and follow-up. Ethics and dissemination The study was approved by The University of Newcastle Human Research Ethics Committee (reference: H-2013-0429). Study findings will be disseminated widely through peer-reviewed publications and conference presentations. Trial registration number ACTRN12614000746639; Pre-results. PMID:29362250
Maidment, Ian; Booth, Andrew; Mullan, Judy; McKeown, Jane; Bailey, Sylvia; Wong, Geoffrey
2017-07-03
Medication-related adverse events have been estimated to be responsible for 5700 deaths and cost the UK £750 million annually. This burden falls disproportionately on older people. Outcomes from interventions to optimise medication management are caused by multiple context-sensitive mechanisms. The MEdication Management in Older people: REalist Approaches BAsed on Literature and Evaluation (MEMORABLE) project uses realist synthesis to understand how, why, for whom and in what context interventions, to improve medication management in older people on complex medication regimes residing in the community, work. This realist synthesis uses secondary data and primary data from interviews to develop the programme theory. A realist logic of analysis will synthesise data both within and across the two data sources to inform the design of a complex intervention(s) to help improve medication management in older people. 1. Literature review The review (using realist synthesis) contains five stages to develop an initial programme theory to understand why processes are more or less successful and under which situations: focussing of the research question; developing the initial programme theory; developing the search strategy; selection and appraisal based on relevance and rigour; and data analysis/synthesis to develop and refine the programme theory and context, intervention and mechanism configurations. 2. Realist interviews Realist interviews will explore and refine our understanding of the programme theory developed from the realist synthesis. Up to 30 older people and their informal carers (15 older people with multi-morbidity, 10 informal carers and 5 older people with dementia), and 20 care staff will be interviewed. 3. Developing framework for the intervention(s) Data from the realist synthesis and interviews will be used to refine the programme theory for the intervention(s) to identify: the mechanisms that need to be 'triggered', and the contexts related to these mechanisms. Intervention strategies that change the contexts so the mechanisms are triggered to produce desired outcomes will be developed. Feedback on these strategies will be obtained. This realist synthesis aims to develop a framework (underpinned by our programme theory) for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens. PROSPERO CRD42016043506.
Jolly, Kate; Lewis, Amanda; Beach, Jane; Denley, John; Adab, Peymane; Deeks, Jonathan J; Daley, Amanda; Aveyard, Paul
2011-11-03
To assess the effectiveness of a range of weight management programmes in terms of weight loss. Eight arm randomised controlled trial. Primary care trust in Birmingham, England. 740 obese or overweight men and women with a comorbid disorder identified from general practice records. Weight loss programmes of 12 weeks' duration: Weight Watchers; Slimming World; Rosemary Conley; group based, dietetics led programme; general practice one to one counselling; pharmacy led one to one counselling; choice of any of the six programmes. The comparator group was provided with 12 vouchers enabling free entrance to a local leisure (fitness) centre. The primary outcome was weight loss at programme end (12 weeks). Secondary outcomes were weight loss at one year, self reported physical activity, and percentage weight loss at programme end and one year. Follow-up data were available for 658 (88.9%) participants at programme end and 522 (70.5%) at one year. All programmes achieved significant weight loss from baseline to programme end (range 1.37 kg (general practice) to 4.43 kg (Weight Watchers)), and all except general practice and pharmacy provision resulted in significant weight loss at one year. At one year, only the Weight Watchers group had significantly greater weight loss than did the comparator group (2.5 (95% confidence interval 0.8 to 4.2) kg greater loss,). The commercial programmes achieved significantly greater weight loss than did the primary care programmes at programme end (mean difference 2.3 (1.3 to 3.4) kg). The primary care programmes were the most costly to provide. Participants allocated to the choice arm did not have better outcomes than those randomly allocated to a programme. Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective. Trial registration Current Controlled Trials ISRCTN25072883.
Perceptions and attitudes toward SLMTA amongst laboratory and hospital professionals in Ethiopia.
Lulie, Adino D; Hiwotu, Tilahun M; Mulugeta, Achamyeleh; Kebede, Adisu; Asrat, Habtamu; Abebe, Abnet; Yenealem, Dereje; Abose, Ebise; Kassa, Wondwossen; Kebede, Amha; Linde, Mary K; Ayana, Gonfa
2014-01-01
Strengthening Laboratory Management Toward Accreditation (SLMTA) is a competency-based management training programme. Assessing health professionals' views of SLMTA provides feedback to inform program planning, implementation and evaluation of SLMTA's training, communication and mentorship components. To assess laboratory professionals' and hospital chief executive officers' (CEOs) perceptions and attitudes toward the SLMTA programme in Ethiopia. A cross-sectional descriptive survey was conducted in March 2013 using a structured questionnaire to collect qualitative data from 72 laboratory professionals and hospital CEOs from 17 health facilities, representing all regions and two city administrations in Ethiopia. Focus groups were conducted with laboratory professionals and hospital administration to gain insight into the strengths and challenges of the SLMTA programme so as to guide future planning and implementation. Ethiopian laboratory professionals at all levels had a supportive attitude toward the SLMTA programme. They believed that SLMTA substantially improved laboratory services and acted as a catalyst for total healthcare reform and improvement. They also noted that the SLMTA programme achieved marked progress in laboratory supply chain, sample referral, instrument maintenance and data management systems. In contrast, nearly half of the participating hospital CEOs, especially those associated with low-scoring laboratories, were sceptical about the SLMTA programme, believing that the benefits of SLMTA were outweighed by the level of human resources and time commitment required. They also voiced concerns about the cost and sustainability of SLMTA. This study highlights the need for stronger engagement and advocacy with hospital administration and the importance of addressing concerns about the cost and sustainability of the SLMTA programme.
Johnston, Catherine L; Maxwell, Lyndal J; Boyle, Eileen; Maguire, Graeme P; Alison, Jennifer A
2013-01-01
To evaluate the impact of a chronic lung disease management training programme, Breathe Easy Walk Easy (BEWE), for rural and remote health-care practitioners. Quasi-experimental, before and after repeated measures design. Health-care practitioners (n = 33) from various professional backgrounds who attended the BEWE training workshop were eligible to participate. Breathe Easy Walk Easy, an interactive educational programme, consisted of a training workshop, access to online resources, provision of community awareness-raising materials and ongoing telephone/email support. Participant confidence, knowledge and attitudes were assessed via anonymous questionnaire before, immediately after and at 3 and 12 months following the BEWE workshop. At 12 months, local provision of pulmonary rehabilitation services and patient outcome data (6-min walk test results before and after pulmonary rehabilitation) were also recorded. Measured knowledge (score out of 19) improved significantly after the workshop (mean difference 7.6 correct answers, 95% confidence interval: 5.8-9.3). Participants' self-rated confidence and knowledge also increased. At 12-month follow up, three locally run pulmonary rehabilitation programmes had been established. For completing patients, there was a significant increase in 6-min walk distance following rehabilitation of 48 m (95% confidence interval: 18-70 m). The BEWE programme increased rural and remote health-care practitioner knowledge and confidence in delivering management for people living with chronic lung disease and facilitated the establishment of effective pulmonary rehabilitation programmes in regional and remote Australian settings where access to such programmes is limited. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Code of Federal Regulations, 2011 CFR
2011-04-01
... duly authorized representatives, shall have access to any books, documents, papers, and records of the... Corps deliverers, or their subcontractors using Federal auditors or independent public accountants. Such...
Code of Federal Regulations, 2012 CFR
2012-04-01
... duly authorized representatives, shall have access to any books, documents, papers, and records of the... Corps deliverers, or their subcontractors using Federal auditors or independent public accountants. Such...
A qualitative evidence synthesis on the management of male obesity
Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Stewart, Fiona; Robertson, Clare; Boyers, Dwayne; Avenell, Alison
2015-01-01
Objectives To investigate what weight management interventions work for men, with which men, and under what circumstances. Design Realist synthesis of qualitative studies. Data sources Sensitive searches of 11 electronic databases from 1990 to 2012 supplemented by grey literature searches. Study selection Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m2 in all settings. Results 22 studies were identified, including 5 qualitative studies linked to randomised controlled trials of weight maintenance interventions and 8 qualitative studies linked to non-randomised intervention studies, and 9 relevant UK-based qualitative studies not linked to any intervention. Health concerns and the perception that certain programmes had ‘worked’ for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematising their weight until labelled ‘obese’; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design. Conclusions Men's perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition. PMID:26459486
A qualitative evidence synthesis on the management of male obesity.
Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Stewart, Fiona; Robertson, Clare; Boyers, Dwayne; Avenell, Alison
2015-10-12
To investigate what weight management interventions work for men, with which men, and under what circumstances. Realist synthesis of qualitative studies. Sensitive searches of 11 electronic databases from 1990 to 2012 supplemented by grey literature searches. Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m(2) in all settings. 22 studies were identified, including 5 qualitative studies linked to randomised controlled trials of weight maintenance interventions and 8 qualitative studies linked to non-randomised intervention studies, and 9 relevant UK-based qualitative studies not linked to any intervention. Health concerns and the perception that certain programmes had 'worked' for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematising their weight until labelled 'obese'; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design. Men's perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Hudon, Catherine; Chouinard, Maud-Christine; Couture, Martine; Brousselle, Astrid; Couture, Eva Marjorie; Dubois, Marie-France; Fortin, Martin; Freund, Tobias; Loignon, Christine; Mireault, Jean; Pluye, Pierre; Roberge, Pasquale; Rodriguez, Charo
2014-01-01
Introduction Case management allows us to respond to the complex needs of a vulnerable clientele through a structured approach that promotes enhanced interaction between partners. Syntheses on the subject converge towards a need for a better description of the relationships between programmes and their local context, as well as the characteristics of the clienteles and programmes that contribute to positive impacts. The purpose of this project is thus to describe and evaluate the case management programmes of four health and social services centres in the Saguenay-Lac- Saint-Jean region of Québec, Canada, in order to inform their improvement while creating knowledge on case management that can be useful in other contexts. Methods and analysis This research relies on a multiple embedded case study design based on a developmental evaluation approach. We will work with the case management programme for high users of hospital services of each centre. Three different units of analysis will be interwoven to obtain an in-depth understanding of each case, that is: (1) health and social services centre and local services network, (2) case management programme and (3) patients who are high users of services. Two strategies for programme evaluation (logic models and implementation analysis) will guide the mixed data collection based on qualitative and quantitative methods. This data collection will rely on: (1) individual interviews and focus groups; (2) participant observation; (3) document analysis; (4) clinical and administrative data and (5) questionnaires. Description and comparison of cases, and integration of qualitative and quantitative data will be used to guide the data analysis. Ethics and dissemination The study protocol was approved by the Ethics Research Boards of the four health and social services centres (HSSCs) involved. Findings will be disseminated by publications in peer-reviewed journals, conferences, and policy and practice partners in local and national government. PMID:25468510
Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi
2018-03-01
Little is known about the effectiveness of a psychosocial behaviour management programme on home-dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home-dwelling people with dementia. A cluster-randomized controlled trial was conducted with home care providers from 3 different districts in Tokyo. Each provider recruited persons with dementia aged 65 years or older to receive home care in the BASE programme in August 2016. An online monitoring and assessment system was introduced to the intervention group for repeated measures of challenging behaviour with a total score of the Neuropsychiatric Inventory. Care professionals in both the intervention and control groups evaluated challenging behaviour of persons with dementia at baseline (September 2016) and follow-up (February 2017). A majority of persons with dementia had Alzheimer disease (59.3%). One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. Multilevel modelling revealed a significant reduction in challenging behaviour in the intervention group after 6 months (mean score, 18.3 to 11.2) compared with that of the control group (11.6 to 10.8; P < .05). The implementation of the BASE programme resulted in a reduction of challenging behaviour of home-dwelling people with dementia. Future research should examine the long-term effects of behaviour management programmes on behaviour, nursing home placement, and hospital admission of home-dwelling people with dementia. Copyright © 2017 John Wiley & Sons, Ltd.
Anaesthetic training programmes in the UK: the role of the programme director.
Barker, I
1998-02-01
Schools of anaesthesia provide anaesthetic training in the UK. Each school has at least one programme director undertaking some or all of the management duties. Most programme directors appears to be unresourced volunteers whose roles have developed in response to local requirements. A postal questionnaire was sent to all anaesthetic training programme directors in the UK, asking about their role. Respondents had a wide variation in duties and responsibilities towards anaesthetic training schemes. Few had terms of reference, clear lines of responsibility, remuneration or resources to undertake the role.
Ells, L; Watson, P; Carlebach, S; O'Malley, C; Jones, D; Machaira, T; Whittaker, V; Clements, H; Walker, P; Needham, K; Summerbell, C; Coulton, V; Araujo-Soares, V
2018-06-01
Adult obesity in the UK remains a public health priority. Current guidance recommends local areas provide multicomponent interventions to treat adults with overweight and obesity; however, there is currently a dearth of published evidence on the evaluation of these programmes. This study reports on a mixed method evaluation of seven tier 2 weight management programmes funded by a local authority in the North of England through their public health grant (a lifestyle multicomponent weight management programme for the treatment of adults with overweight and obesity, but not severe obesity, or obesity with severe co-morbidities). Data collected from over 2000 participants demonstrated that the proportion of participants achieving 5% initial body weight loss was comparable to that reported in recent UK weight management trials. Two services exceeded national criteria of 30% of participants achieving 5% initial body weight loss at 12 weeks, although long term data was limited. Greater weight loss was also observed in participants aged 35-44 and those without co-morbidities. This study provides important learning points for improvements in real world weight management services, these include: standardised data collection and management tools; staff training and communication requirements; the importance of programmes that are joined up to wider support services; and the importance of providing ongoing peer and provider support, continuous monitoring and feedback, and physical activities tailored to user needs. © 2018 World Obesity Federation.
Moreno, J P; Johnston, C A; Hernandez, D C; LeNoble, J; Papaioannou, M A; Foreyt, J P
2016-10-01
While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school-based weight management programme. Sixty-one Mexican-American children participated in a 24-week school-based weight management intervention which took place in 2005-2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively. Within-group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P < .001) or one obese (F = 4.99, P < .05) parent. Between-group comparisons indicated that children with zero and one obese parents demonstrated greater decreases in zBMI compared to children with two obese parents at every time point. The school-based weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts. © 2015 World Obesity.
Lamb, S E; Toye, F; Barker, K L
2008-02-01
To establish (1) the efficacy of a six-week chronic disease management programme for knee osteoarthritis and (2) whether previous physiotherapy or being wait listed for surgery moderated the outcome of the programme. A pretest, posttest design with multivariate statistical modelling. One hundred and twenty-one people with severe osteoarthritis who were waiting, or being considered, for surgery. Western Ontario Osteoarthritis Index (WOMAC) scores, arthritis self-efficacy, distress and a patient-rated global indicator of response were collected at baseline, 6 and 12 weeks. History of previous physiotherapy, waiting list status, symptom duration, New Zealand disease severity score, radiographic changes and self-perceived need for surgery were recorded at baseline. There were moderate improvements in most outcomes; WOMAC function decreased by 0.29, WOMAC pain by 0.27, pain self-efficacy by 4.4, function self-efficacy by 5.6 and visual analogue scale (VAS) distress by 0.2 (effect sizes ranging from 0.3 to 0.5 at 12 weeks). Waiting list status was a significant modifier for function, pain, distress and self-related outcomes. Participants on the waiting list for surgery experienced lesser improvements. Previous physiotherapy was associated with greater improvements in WOMAC scores at six weeks, but not at 12 weeks. The chronic disease management programme could be considered for people with severe knee osteoarthritis, but should be given prior to referral and placement on the waiting list for surgery. Previous physiotherapy should not preclude people from participating in a chronic disease management programme.
Upstream Optioneering: Optimising Higher Activity Waste Management
DOE Office of Scientific and Technical Information (OSTI.GOV)
McTeer, Jennifer; Morris, Jenny; Wickham, Stephen
2013-07-01
The Upstream Optioneering project was created by the Nuclear Decommissioning Authority (NDA) Radioactive Waste Management Directorate (RWMD) to support the development and implementation of opportunities to optimise the management of UK higher activity waste, spent fuel and other materials that may be disposed of in a geological disposal facility. The project works in an integrative manner with the NDA, RWMD and waste producers, and was split into three phases: - In Phase 1 waste management opportunities were identified and collated from across the NDA estate. - In Phase 2, opportunities collated during Phase 1, were further consolidated, analysed and prioritisedmore » to develop a three year work programme. Prioritisation ensured that resources were deployed appropriately and opportunities can be realised before the potential benefit diminishes. - Phase 3, which began in April 2012, comprises a three year work programme to address the prioritised opportunities. Work varies from direct implementation of opportunities to scoping studies that may pave the way for more detailed subsequent work by Site Licence Companies. The work programme is flexible and, subject to change control, varies depending on the needs of project sponsors (RWMD, NDA Strategy and NDA Delivery). This paper provides an overview of the Upstream Optioneering project (focusing particularly on Phases 2 and 3), summarises work carried out to date within the three year work programme, and provides some examples of the main findings concerning specific opportunities from Year One of the Phase 3 work programme. (authors)« less
Coordination and Data Management of the International Arctic Buoy Programme (IABP)
2002-09-30
for forcing, validation and assimilation into numerical climate models , and for forecasting weather and ice conditions. TRANSITIONS Using IABP ...Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...analyzed geophysical fields. APPROACH The IABP is a collaboration between 25 different institutions from 8 different countries, which work together
Coordination and Data Management of the International Arctic Buoy Programme (IABP)
1998-01-01
estimate the mean surface wind, which can drive sea ice models , and for input into climate change studies. Recent research using the IABP databases includes...Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor Polar Science Center, Applied Physics Laboratory...the National Center for Environmental Projection underlayed. APPROACH Coordination of the IABP involves distribution of information, resource
ERIC Educational Resources Information Center
Hickey, Grainne; McGilloway, Sinead; Hyland, Lynda; Leckey, Yvonne; Kelly, Paul; Bywater, Tracey; Comiskey, Catherine; Lodge, Anne; Donnelly, Michael; O'Neill, Donal
2017-01-01
Teachers frequently struggle to cope with conduct problems in the classroom. The aim of this study was to assess the effectiveness of the Incredible Years Teacher Classroom Management Training Programme for improving teacher competencies and child adjustment. The study involved a group randomised controlled trial which included 22 teachers and 217…
Ruslami, Rovina; Anselmo, Melissa; Alisjahbana, Bachti; Yulianti, Neti; Sampurno, Hedy; van Crevel, Reinout; Hill, Philip C
2013-01-01
Abstract Objective To investigate qualitatively and quantitatively the performance of a programme for managing the child contacts of adult tuberculosis patients in Indonesia. Methods A public health evaluation framework was used to assess gaps in a child contact management programme at a lung clinic. Targets for programme performance indicators were derived from established programme indicator targets, the scientific literature and expert opinion. Compliance with tuberculosis screening, the initiation of isoniazid preventive therapy in children younger than 5 years, the accuracy of tuberculosis diagnosis and adherence to preventive therapy were assessed in 755 child contacts in two cohorts. In addition, 22 primary caregivers and 34 clinic staff were interviewed to evaluate knowledge and acceptance of child contact management. The cost to caregivers was recorded. Gaps between observed and target indicator values were quantified. Findings The gaps between observed and target performance indicators were: 82% for screening compliance; 64 to 100% for diagnostic accuracy, 50% for the initiation of preventive therapy, 54% for adherence to therapy and 50% for costs. Many staff did not have adequate knowledge of, or an appropriate attitude towards, child contact management, especially regarding isoniazid preventive therapy. Caregivers had good knowledge of screening but not of preventive therapy and had difficulty travelling to the clinic and paying costs. Conclusion The study identified widespread gaps in the performance of a child contact management system in Indonesia, all of which appear amenable to intervention. The public health evaluation framework used could be applied in other settings where child contact management is failing. PMID:24347732
Londoño, Teresa; Trabado, Verónica; García-Rodríguez, Alejo; Balfagón, Pere; Villalbí, Joan R
2018-04-21
This paper describes the use of focus groups as part of the evaluation of programmes to control food allergy and intolerance (FAI) in school settings in the city of Barcelona (Spain). After fostering their adoption and as a qualitative component of their evaluation, the public health services ran two focus groups, one with people from schools that manage their own kitchen, and another from companies that outsource this service. There were 28 participants from 46% of the centres invited. All the schools seem to have implemented a self-control programme on FAI. Although outsourcing companies already had a programme, the schools that managed their own service mostly adopted the programme promoted by the public health services. The number of schoolchildren with reported FAI reduced after the programme, as it required more rigorous documentation from families. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
77 FR 40023 - 36(b)(1) Arms Sales Notification
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-06
... vision goggle compatible and sun light readable. The pilots and aircrew have common programmable keysets... pilots and aircrew have common programmable keysets, a mass memory unit, mission and flight management...
Darrah, J; Wiart, L; Magill-Evans, J; Ray, L; Andersen, J
2012-01-01
Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada. Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes. All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports. Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite attending the same programme. Standardized programme processes and policies may provide a starting point to ensure that all families have equitable opportunities to participate in their child's rehabilitation programme. © 2010 Blackwell Publishing Ltd.
Managerial perceptions of the incentives inherent in National Health Service capital charging.
Heald, D; Scott, D A
1997-08-01
Capital charging was introduced into the National Health Service (NHS) in 1991 in order to stop capital being treated as a 'free' good and to encourage managers to use their assets more efficiently. This article seeks to examine the extent to which managerial thinking has been influenced. It uses as evidence interviews with NHS managers conducted in Scotland in 1994. The following uses of capital charges data are explored: capital programme; disposal programme; maintenance programme; contract pricing; and budgetary devolution. New capital programmes required more justification and capital charges were seen as relevant to estate rationalization. Less effect was found with regard to the maintenance programme, though this may have been due to a downgrading of the estates function in most Trusts. Although the capital charge costs included in contract prices affect the competitive position of providers, there was criticism of the lack of development of the purchasing function. Budgetary devolution was proceeding relatively slowly but, among those Trusts which had devolved capital charges, evidence was found that some clinicians were becoming aware of the full costs of equipment use. This article concludes, with cautious optimism, that capital charges are beginning to influence decisions and that, despite some incentives being dysfunctional, they will lead to a better managed NHS.
Lian, J X; McGhee, S M; Chau, J; Wong, Carlos K H; Lam, Cindy L K; Wong, William C W
2017-05-01
A review of cost-effectiveness studies on self-management education programmes for Type 2 diabetes mellitus. Cochrane, PubMed and PsycINFO databases were searched for papers published from January 2003 through September 2015. Further hand searching using the reference lists of included papers was carried out. In total, 777 papers were identified and 12 papers were finally included. We found eight programmes whose effectiveness analyses were based on randomised controlled trials and whose costs were comprehensively estimated from the stated perspective. Among these eight, four studies showed a cost per unit reduction in clinical risk factors (HbA1c or BMI) of US$491 to US$7723 or cost per glycaemic symptom day avoided of US$39. In three studies the cost per QALY gained, as estimated from a life-time model, was less than US$50,000. However, one study found the programme was not cost-effective despite a gain in QALYs at the one-year follow up. A small number of cost-effectiveness studies were identified with only eight of sufficiently good quality. The cost of a self-management education programme achieving reduction in clinical risk factors seems to be modest and is likely to be cost-effective in the long-term. Copyright © 2017 Elsevier B.V. All rights reserved.
Lum, Alvin Wm; Kwok, Kian Woon; Chong, Siow Ann
2008-02-01
The aim of our programme was to right site a selected group of patients to the care of the primary sector for follow-up management. Mental disorders are recognised as a major public health problem worldwide which places an enormous burden on health services. Patients on treatment in the hospitals are largely managed by specialists either in the restructured hospitals or in private practice with minimal involvement of general practitioners (GPs). Yet, there are many patients with chronic mental illnesses who are stable, require maintenance medications and are best managed in the community. GPs were given appropriate training and support to help them manage patients with mental illnesses in their clinics. The training involved in-depth, comprehensive training on mental illness, providing the GPs with the skills necessary to manage the stable patients within the community. It also facilitated Early Detection Intervention by enhancing the GPs capabilities to detect and manage the mentally ill. Patients screened by psychiatrists who fulfill the referral criteria agreed upon by both the specialist team and the GP partners were referred to the GPs with initial support from case managers when required. The benefits to patients include: increased convenience, savings in terms of transport costs and travel time, the flexibility of being seen during after office hours, less stigma and the option of managing their other medical conditions, if any, by the same doctor. To date, a total of 200 patients have been successfully referred to the 30 GPs in the programme. This represents an average savings of more than 1000 consultation visits to the hospital per year. The programme allows for the right siting of care for patients and allows the hospital to channel precious resources to more appropriate uses.
NASA Astrophysics Data System (ADS)
Aldowaisan, Tariq; Allahverdi, Ali
2016-07-01
This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been applied to the results of four assessment tools and other data sources to improve performance. Important improvements include the need to reconsider two student outcomes as they were difficult to implement in courses. In addition, through benchmarking and the engagement of Alumni and Employers, key decisions were made to improve the curriculum and enhance employability.
Modernizing the Mobility Air Force for Tomorrow’s Air Traffic Management System
2012-01-01
Decision Support System GLONASS Global’naya Navigatsionnaya Sputnikovaya Sistema [Global Navigation Satellite System] GPS Global Positioning System HF high...spreadsheet, November 2009. Eurocontrol, “Link 2000+ Programme: Frequently Asked Questions,” web page, undated(a). As of June 5, 2012: http...www.eurocontrol.int/faq/link2000 ———, “Link 2000+ Programme,” web page, undated(b). As of June 5, 2012: http://www.eurocontrol.int/programmes/link-2000-programme
Frantz, José M; Bezuidenhout, Juanita; Burch, Vanessa C; Mthembu, Sindi; Rowe, Michael; Tan, Christina; Van Wyk, Jacqueline; Van Heerden, Ben
2015-03-03
In 2008 the sub-Saharan FAIMER Regional Institute launched a faculty development programme aimed at enhancing the academic and research capacity of health professions educators working in sub-Saharan Africa. This two-year programme, a combination of residential and distance learning activities, focuses on developing the leadership, project management and programme evaluation skills of participants as well as teaching the key principles of health professions education-curriculum design, teaching and learning and assessment. Participants also gain first-hand research experience by designing and conducting an education innovation project in their home institutions. This study was conducted to determine the perceptions of participants regarding the personal and professional impact of the SAFRI programme. A retrospective document review, which included data about fellows who completed the programme between 2008 and 2011, was performed. Data included fellows' descriptions of their expectations, reflections on achievements and information shared on an online discussion forum. Data were analysed using Kirkpatrick's evaluation framework. Participants (n=61) came from 10 African countries and included a wide range of health professions educators. Five key themes about the impact of the SAFRI programme were identified: (1) belonging to a community of practice, (2) personal development, (3) professional development, (4) capacity development, and (5) tools/strategies for project management and/or advancement. The SAFRI programme has a positive developmental impact on both participants and their respective institutions.
Margitai, Barnabás; Dózsa, Csaba; Bárdos-Csenteri, Orsolya Karola; Sándor, János; Gáll, Tibor; Gődény, Sándor
2018-01-01
Objective Quantitative studies have shown the various benefits for having accreditation in hospitals. However, neither of these explored the general conditions before applying for an accreditation. To close this gap, this study aimed to investigate the possible association between joining an accreditation programme with various hospital characteristics. Design A cross-sectional study was implemented using the databases of the 2013 Hungarian hospital survey and of the Hungarian State Treasury. Setting Public general hospitals in Hungary. Participants The analysis involved 44 public general hospitals, 14 of which joined the preparatory project for a newly developed accreditation programme. Main outcome measures The outcomes included the percentage of compliance in quality management, patient information and identification, internal professional regulation, safe surgery, pressure sore prevention, infection control, the opinions of the heads of quality management regarding the usefulness of quality management and clinical audits, and finally, the total debt of the hospital per bed and per discharged patient. Results According to our findings, the general hospitals joining the preparatory project of the accreditation programme performed better in four of the six investigated activities, the head of quality management had a better opinion on the usefulness of quality management, and both the debt per bed number and the debt per discharged patient were lower than those who did not join. However, no statistically significant differences between the two groups were found in any of the examined outcomes. Conclusions The findings suggest that hospitals applying for an accreditation programme do not differ significantly in characteristics from those which did not apply. This means that if in the future the accredited hospitals become better than other hospitals, then the improvement could be solely contributed to the accreditation. PMID:29391381
Smith, R A; Griffin, D D; Dargatz, D A
1997-08-01
There are currently no scientifically defined critical management points or critical control points to manage foodborne pathogens at the pre-harvest level. Research is ongoing: much of the pre-harvest research is funded by producer organisations. The beef industry has Beef Quality Assurance (BQA) programmes in place and these are dynamic. Groups of cattlemen have made a very strong commitment to reducing foodborne pathogens in beef. Fewer Escherichia coli O157:H7 organisms are shed by feedlot cattle near the end of the feeding period than by newly arrived cattle. Moreover, there is less shedding of the organisms in cattle of slaughter age than in younger cattle. The prevalence of E. coli O157:H7 in feedlot cattle is similar to that in range cattle. This suggests that concentrating cattle in feedlot dirt pens does not increase the risk of shedding E. coli organisms. Pen maintenance, considered a good management practice, appears to be an adequate means of keeping pathogen levels in pens low. It is not likely that pre-harvest food safety programmes will eliminate the threat of pathogens such as E. coli O157:H7 or Salmonella. The management of foodborne pathogens will become part of an integrated programme to enhance food safety which includes the producer, the packer, the distributors, retailers and the consumer. The feedlot industry initiated a residue avoidance programme several years ago. As a result, the risk of chemical residues in beef from feedlots in the United States of America is near zero. Hazard analysis and critical control point-type prevention programmes, using scientifically based critical management points, will help ensure that the risk remains negligible.
Wong, Frances Kam Yuet; Chow, Susan Ka Yee; Chan, Tony Moon Fai
2010-03-01
Patients with end stage renal failure require dialysis and strict adherence to treatment plans to sustain life. However, non-adherence is a common and serious problem among patients with chronic kidney disease. There is a scarcity of studies in examining the effects of disease management programmes on patients with chronic kidney disease. This paper examines whether the study group receiving the disease management programme have better improvement than the control group, comparing outcomes at baseline (O1), at 7 weeks at the completion of the programme (O2) and at 13 weeks (O3). This is a randomized controlled trial. The outcome measures were non-adherence in diet, fluid, dialysis and medication, quality of life, satisfaction, symptom control, complication control and health service utilisation. There was no significant difference between the control and study group for the baseline measures, except for sleep. Significant differences (p<0.05) were found between the control and study group at O2 in the outcome measures of diet degree non-adherence, sleep, symptom, staff encouragement, overall health and satisfaction. Sustained effects at O3 were noted in the outcome measures of continuous ambulatory peritoneal dialysis (CAPD) non-adherence degree, sleep, symptom, and effect of kidney disease. Many studies exploring chronic disease management have neglected the group with end stage renal failure and this study fills this gap. This study has employed an innovative model of skill mix using specialist and general nurses and demonstrated patient improvement in diet non-adherence, CAPD non-adherence, aspects of quality of life and satisfaction with care. Redesigning chronic disease management programmes helps to optimize the use of different levels of skills and resources to bring about positive outcomes. Copyright 2009 Elsevier Ltd. All rights reserved.
Yang, Chiu-Yueh; Lee, Tien-Hao; Lo, Su-Chen; Beckstead, Jason W
2015-12-01
To examine the effectiveness of an auditory hallucinatory symptom management programme in patients with chronic schizophrenia. Thirty per cent of chronic schizophrenia patients are still disturbed by hallucinations, which influence their psychological and social well-being, even when they take medication regularly. Fifty-eight people experiencing schizophrenia with auditory hallucinations from psychiatric inpatient rehabilitation wards in northern Taiwan participated in the study, with 29 in the experimental group and 29 in the control group. The experimental group received an auditory hallucinatory symptom management programme. The auditory hallucinatory symptom management programme involved 60-minute meetings once a week, for a total of 10 meetings. The control group received routine care, which included free recreation for 40 minutes and walking for 20 minutes. The participants completed three self-report questionnaires: the Beck Depressive Inventory II, the Beck Anxiety Inventory and the Characteristics of Auditory Hallucinations Questionnaire. Data were collected at baseline, immediately following the intervention and at 3 months and 6 months post intervention. Data collection occurred between March 2010-May 2013. The experimental group showed a non-significant improvement in anxiety symptoms over time. Generalized estimating equations revealed that the experimental group achieved a greater drop in Characteristics of Auditory Hallucinations Questionnaire score than the controls at three and 6 months post intervention. Beck Depressive Inventory II scores in the experimental group (n = 29) had significantly improved in 3 months. The auditory hallucinatory symptom management programme seems to be effective in improving auditory hallucinatory symptoms and depressive symptoms in patients with schizophrenia. © 2015 John Wiley & Sons Ltd.
Vareilles, Gaëlle; Marchal, Bruno; Kane, Sumit; Petrič, Taja; Pictet, Gabriel; Pommier, Jeanine
2015-01-01
Objectives This paper presents the results of a realist evaluation that aimed to understand how, why and under what circumstances a Red Cross (RC) capacity-building intervention influences the motivation and the performance of RC community health volunteers involved in the delivery of an immunisation programme in Kampala, Uganda. Method Given the complexity of the intervention, we adopted realist evaluation as our methodological approach and the case study as our study design. Data collection included document review, participant observation and interviews. The constant comparative method was used for the analysis. Two contrasted cases were selected within the five Kampala districts. Each case covers the management of the immunisation programme implemented at a RC branch. In each case, a programme manager and 15 RC volunteers were interviewed. The selection of the volunteers was purposive. Results We found that a capacity-building programme including supervision supportive of autonomy, skills and knowledge enhancement, and adapted to the different subgroups of volunteers, leads to satisfaction of the three key drivers of volunteer motivation: feelings of autonomy, competence and connectedness. This contributes to higher retention, and better task performance and well-being among the volunteers. Enabling contextual conditions include the responsiveness of the Uganda Red Cross Society (URCS) to community needs, and recognition of the work of the volunteers, from the URCS and the community. Conclusions A management approach that caters for the different motivational states and changing needs of the volunteers will lead to better performance. The findings will inform not only the management of community health volunteers, but also the management of all kinds of health workers. PMID:26525721
Niesink, A; Trappenburg, J C A; de Weert-van Oene, G H; Lammers, J W J; Verheij, T J M; Schrijvers, A J P
2007-11-01
Chronic disease management for patients with chronic obstructive pulmonary disease (COPD) may improve quality, outcomes and access to care. To investigate effectiveness of chronic disease management programmes on the quality-of-life of people with COPD. Medline and Embase (1995-2005) were searched for relevant articles, and reference lists and abstracts were searched for controlled trials of chronic disease management programmes for patients with COPD. Quality-of-life was assessed as an outcome parameter. Two reviewers independently reviewed each paper for methodological quality and extracted the data. We found 10 randomized-controlled trials comparing chronic disease management with routine care. Patient populations, health-care professionals, intensity, and content of the intervention were heterogeneous. Different instruments were used to assess quality of life. Five out of 10 studies showed statistically significant positive outcomes on one or more domains of the quality of life instruments. Three studies, partly located in primary care, showed positive results. All chronic disease management projects for people with COPD involving primary care improved quality of life. In most of the studies, aspects of chronic disease management were applied to a limited extent. Quality of randomized-controlled trials was not optimal. More research is needed on chronic disease management programmes in patients with COPD across primary and secondary care.
Hauptig, S; Collste, L; Hammar, M; Calltorp, J; Frischer, J; Haase, H; Lindquist, I; Andersson, C
1999-12-08
A recent survey of medical management programmes at universities across the country showed manifest national differences to exist, both quantitative and qualitative. Using a questionnaire, the Swedish Society of Medical Management examined the programmes for physiotherapists, occupational therapists, social workers, nurses and physicians, with respect to such issues as leadership, self-awareness and communication, health economics, and administration. It was concluded that knowledge acquired differs between fields; that physiotherapy programmes tend to have a very didactic approach; that nurses are taught the importance of participation in developmental processes; that doctors are exposed to somewhat the same approach but to a large extent on a voluntary basis; and that social workers obtain good insight into the administrative skills necessary to their work. In the article it is concluded that students would benefit from orientation in the diverse approaches used in the other fields than their own, and that pooling of resources among different programmes might be a more economic alternative to current practice.
Barkema, H W; Orsel, K; Nielsen, S S; Koets, A P; Rutten, V P M G; Bannantine, J P; Keefe, G P; Kelton, D F; Wells, S J; Whittington, R J; Mackintosh, C G; Manning, E J; Weber, M F; Heuer, C; Forde, T L; Ritter, C; Roche, S; Corbett, C S; Wolf, R; Griebel, P J; Kastelic, J P; De Buck, J
2018-05-01
In the last decades, many regional and country-wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were not followed, including the introduction of infected replacement cattle, because tests to identify infected animals were unreliable, and uptake by farmers was not high enough because of a perceived low return on investment. In the absence of a cure or effective commercial vaccines, control of JD is currently primarily based on herd management strategies to avoid infection of cattle and restrict within-farm and farm-to-farm transmission. Although JD control programmes have been implemented in most developed countries, lessons learned from JD prevention and control programmes are underreported. Also, JD control programmes are typically evaluated in a limited number of herds and the duration of the study is less than 5 year, making it difficult to adequately assess the efficacy of control programmes. In this manuscript, we identify the most important gaps in knowledge hampering JD prevention and control programmes, including vaccination and diagnostics. Secondly, we discuss directions that research should take to address those knowledge gaps. © 2017 Blackwell Verlag GmbH.
Härter, Martin; Bermejo, Isaac; Ollenschläger, Günter; Schneider, Frank; Gaebel, Wolfgang; Hegerl, Ulrich; Niebling, Wilhelm; Berger, Mathias
2006-04-01
Depressive disorders are of great medical and political significance. The potential inherent in achieving better guideline orientation and a better collaboration between different types of care is clear. Throughout the 1990s, educational initiatives were started for implementing guidelines. Evidence-based guidelines on depression have been formulated in many countries. This article presents an action programme for structural, educational, and research-related measures to implement evidence-based care of depressive disorders in the German health system. The starting points of the programme are the 'Guidelines Critical Appraisal Reports' of the 'Guideline Clearing House' and measures from the 'Competence Network on Depression and Suicidality' (CNDS) funded by the Federal Ministry of Education and Research. The article gives an overview of the steps achieved as recommended by the Guidelines Critical Appraisal Reports and the ongoing transfer process into the German health care system. The action programme shows that comprehensive interventions to develop and introduce evidence-based guidelines for depression can achieve benefits in the care of depression, e.g. in recognition, management, and clinical outcome. It was possible to implement the German Action Programme in selected care settings, and initial evaluation results suggest some improvements. The action programme provides preliminary work, materials, and results for developing a future 'Disease Management Programme' (DMP) for depression.
Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool
2018-01-16
Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.
Takoo, Sarla; Chhugani, Manju; Sharma, Veena
2013-01-01
The present study was conducted to evaluate the effectiveness of an Information, Education and Communication (IEC) programme on knowledge of pregnant mothers regarding prevention and management of warning signs during pregnancy in a selected health care setting at New Delhi. An evaluative research approach with one group pre-test and post-test design was adopted for the present study. A structured interview schedule was prepared. Purposive non-probability sampling technique was employed to interview 30 pregnant mothers who attended antenatal clinic. Data gathered was analysed and interpreted using both descriptive and inferential statistics. The study revealed that there was maximum knowledge deficit regarding warning signs of pregnancy. IEC programme was effective in enhancing the knowledge of pregnant mothers on prevention and management of warning signs during pregnancy.
Under-treatment of cancer pain.
Fairchild, Alysa
2010-03-01
Cancer pain remains inadequately treated, despite internationally accepted management guidelines and a myriad of treatment options. Risk factors for undertreatment are reviewed, along with possible explanations. Recent studies documenting the scope of the problem as well as investigating solutions are discussed with clinical-practice recommendations outlined. Women over 65 years of age representative of a cultural minority, with earlier stage disease, cared for at home, and with high-school education or less are at highest risk of having uncontrolled cancer pain. Optimal treatment is impeded by patients' maladaptive beliefs, nonadherence, underreporting or miscommunication with caregivers; from a healthcare provider perspective, it may be due to inadequate assessment, documentation, knowledge, and communication. Emerging data support the vital influence of lay caregivers on appropriate pain management. Although home-education programs may decrease pain and improve quality of life, there are also less intensive approaches deliverable by individuals to holistically address pain. Prospective study of barriers to both delivery and receipt of adequate pain management is needed, as the majority of published literature is based on survey studies. Treatment must be individualized based on clinical circumstances and patient wishes, with the goal of maximizing function and quality of life.
Automated Procurement System (APS): Project management plan (DS-03), version 1.2
NASA Technical Reports Server (NTRS)
Murphy, Diane R.
1994-01-01
The National Aeronautics and Space Administration (NASA) Marshall Space Flight Center (MSFC) is implementing an Automated Procurement System (APS) to streamline its business activities that are used to procure goods and services. This Project Management Plan (PMP) is the governing document throughout the implementation process and is identified as the APS Project Management Plan (DS-03). At this point in time, the project plan includes the schedules and tasks necessary to proceed through implementation. Since the basis of APS is an existing COTS system, the implementation process is revised from the standard SDLC. The purpose of the PMP is to provide the framework for the implementation process. It discusses the roles and responsibilities of the NASA project staff, the functions to be performed by the APS Development Contractor (PAI), and the support required of the NASA computer support contractor (CSC). To be successful, these three organizations must work together as a team, working towards the goals established in this Project Plan. The Project Plan includes a description of the proposed system, describes the work to be done, establishes a schedule of deliverables, and discusses the major standards and procedures to be followed.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Park, So-Yeon; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744; Biomedical Research Institute, Seoul National University College of Medicine, Seoul 110-744
Purpose: Texture analysis on fluence maps was performed to evaluate the degree of modulation for volumetric modulated arc therapy (VMAT) plans. Methods: A total of six textural features including angular second moment, inverse difference moment, contrast, variance, correlation, and entropy were calculated for fluence maps generated from 20 prostate and 20 head and neck VMAT plans. For each of the textural features, particular displacement distances (d) of 1, 5, and 10 were adopted. To investigate the deliverability of each VMAT plan, gamma passing rates of pretreatment quality assurance, and differences in modulating parameters such as multileaf collimator (MLC) positions, gantrymore » angles, and monitor units at each control point between VMAT plans and dynamic log files registered by the Linac control system during delivery were acquired. Furthermore, differences between the original VMAT plan and the plan reconstructed from the dynamic log files were also investigated. To test the performance of the textural features as indicators for the modulation degree of VMAT plans, Spearman’s rank correlation coefficients (r{sub s}) with the plan deliverability were calculated. For comparison purposes, conventional modulation indices for VMAT including the modulation complexity score for VMAT, leaf travel modulation complexity score, and modulation index supporting station parameter optimized radiation therapy (MI{sub SPORT}) were calculated, and their correlations were analyzed in the same way. Results: There was no particular textural feature which always showed superior correlations with every type of plan deliverability. Considering the results comprehensively, contrast (d = 1) and variance (d = 1) generally showed considerable correlations with every type of plan deliverability. These textural features always showed higher correlations to the plan deliverability than did the conventional modulation indices, except in the case of modulating parameter differences. The r{sub s} values of contrast to the global gamma passing rates with criteria of 2%/2 mm, 2%/1 mm, and 1%/2 mm were 0.536, 0.473, and 0.718, respectively. The respective values for variance were 0.551, 0.481, and 0.688. In the case of local gamma passing rates, the r{sub s} values of contrast were 0.547, 0.578, and 0.620, respectively, and those of variance were 0.519, 0.527, and 0.569. All of the r{sub s} values in those cases were statistically significant (p < 0.003). In the cases of global and local gamma passing rates, MI{sub SPORT} showed the highest correlations among the conventional modulation indices. For global passing rates, r{sub s} values of MI{sub SPORT} were −0.420, −0.330, and −0.632, respectively, and those for local passing rates were −0.455, −0.490 and −0.502. The values of r{sub s} of contrast, variance, and MI{sub SPORT} with the MLC errors were −0.863, −0.828, and 0.795, respectively, all with statistical significances (p < 0.001). The correlations with statistical significances between variance and dose-volumetric differences were observed more frequently than the others. Conclusions: The contrast (d = 1) and variance (d = 1) calculated from fluence maps of VMAT plans showed considerable correlations with the plan deliverability, indicating their potential use as indicators for assessing the degree of modulation of VMAT plans. Both contrast and variance consistently showed better performance than the conventional modulation indices for VMAT.« less
Boeras, Debrah I; Peeling, Rosanna W; Onyebujoh, Philip; Yahaya, Ali A; Gumede-Moeletsi, Hieronyma N; Ndihokubwayo, Jean B
2016-01-01
External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events of international public health importance.
Qualitative evaluation of a delirium prevention and management programme.
Kang, Yun; Moyle, Wendy; Cooke, Marie; O'Dwyer, Siobhan
2017-12-01
To evaluate the effect of an educational programme on registered nurses' knowledge and attitude in delirium care for hospitalised older adults with and without dementia, and to examine the strengths and weaknesses of the programme from the participants' perspectives. Providing care for patients with delirium or delirium superimposed on dementia often poses particular challenges such as distinguishing between delirium and dementia for nurses. A descriptive qualitative study was used. A delirium educational programme based on adult learning principles was provided to the participants. A purposive sample of 12 registered nurses who participated in the educational programme undertook individual interviews. Content analysis was conducted to identify unique and common themes indicative of registered nurse perceptions. Registered nurses reported improved knowledge and attitude towards the delirium care of hospitalised older adults with dementia and at risk of delirium. Active learning in the programme facilitated the participants' learning processes. This active learning included deep learning, collaborative learning and application of new concepts to practice. Most participants felt that they had inadequate management support to apply their new knowledge in practice, and this included staff resource and policies and protocols. The qualitative findings indicated that the delirium education had benefited the participants by improving their knowledge and attitude towards the delirium care of hospitalised older adults with dementia and at risk of delirium. This study provided an understanding of the strengths and limitations of the educational programme delivered to registered nurses in South Korea. Registered nurses in South Korea should need not only appropriate education, but also adequate resources, policies and guidelines as well as support from managers and from all other healthcare professionals. © 2017 John Wiley & Sons Ltd.
Yahaya, Ali A.; Gumede-Moeletsi, Hieronyma N.
2016-01-01
External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events of international public health importance. PMID:28879135
Loop, Carole
2013-01-01
Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.
ERIC Educational Resources Information Center
Mac Cobb, Siobhan; Fitzgerald, Brian; Lanigan-O'Keeffe, Carolyn
2014-01-01
This article reports on Phase 1 of a pilot programme on self-management of behaviour with challenging class groups of students as part of the evidence-informed practice of the National Behaviour Support Service. The Alert Program is a structured active learning programme using an engine analogy. The person's engine runs on high, low or just right…
Nordström, Anna; Fjellman-Wiklund, Anncristine; Grysell, Tomas
2011-09-28
One of the toughest tasks in any profession is the deliverance of death notification. Marathon Death is an exercise conducted during the fourth year of medical school in northern Sweden to prepare students for this responsibility. The exercise is designed to enable students to gain insight into the emotional and formal procedure of delivering death notifications. The exercise is inspired by Augusto Boal's work around Forum Theatre and is analyzed using video playback. The aim of the study was to explore reflections, attitudes and ideas toward training in delivering death notifications among medical students who participate in the Marathon Death exercise based on forum play. After participation in the Marathon Death exercise, students completed semi-structured interviews. The transcribed interviews were analyzed using the principles of qualitative content analysis including a deductive content analysis approach with a structured matrix based on Bloom's taxonomy domains. The Marathon Death exercise was perceived as emotionally loaded, realistic and valuable for the future professional role as a physician. The deliverance of a death notification to the next of kin that a loved one has died was perceived as difficult. The exercise conjured emotions such as positive expectations and sheer anxiety. Students perceived participation in the exercise as an important learning experience, discovering that they had the capacity to manage such a difficult situation. The feedback from the video playback of the exercise and the feedback from fellow students and teachers enhanced the learning experience. The exercise, Marathon Death, based on forum play with video playback is a useful pedagogical tool that enables students to practice delivering death notification. The ability to practice under realistic conditions contributes to reinforce students in preparation for their future professional role.
Programmable valve shunts: are they really better?
Kataria, Rashim; Kumar, Vimal; Mehta, Veer Singh
2012-01-01
Programmable valve shunts allows selection of opening pressure of shunt valve. In the presented article, a unique complication pertaining to programmable shunts has been discussed. A 5-year-old boy who had tectal plate low grade glioma with obstructive hydrocephalus was managed with Codman programmable ventriculoperitoneal shunt. There was a spontaneous change in the opening pressure of the shunt valve leading to shunt malfunction. Routinely used household appliances produce a magnetic field strong enough to cause change in the setting of shunt valve pressure and may lead to valve malfunction. Other causes of programmable valve malfunction also discussed.
Development and implementation of a business continuity management risk index.
Kadar, Michael
This paper will present the building blocks for developing and implementing the BCM risk index; whether it is used as a comprehensive metric for risk or preparedness. This paper introduces the concept of a business continuity management (BCM) risk index--a comprehensive metric that measures and reports the status of the primary 'intended outcome' of the BCM programme to top management. In addition to measuring the primary programme output,;the BCM risk index can be used to demonstrate the overall value of the BCM programme to executive management. This is accomplished because the BCM risk index allows quantitative measurement of current risk levels and their comparison with established risk tolerances. The BCM Risk Index can provide executive management with reports on the risk level of individual business units, departments, subsidiaries or the enterprise in a way that drives both risk management and BCM initiatives. The name 'risk index' can be misleading, however. The BCM risk index concept can also be used to measure preparedness levels. In fact, implementation at DTE Energy has resulted in calling it the 'preparedness index', which is used to measure and report preparedness levels rather than risk levels.
2013-09-30
data from the IABP ); 2.) Forecasting weather and sea ice conditions; 3.) Forcing, assimilation and validation of global weather and climate models ...International Arctic Buoy Programme ( IABP ) A US Interagency Arctic Buoy Programme (USIABP) contribution to the IABP Dr. Ignatius G. Rigor Polar...ice motion. These observations are assimilated into Numerical Weather Prediction (NWP) models that are used to forecast weather on synoptic time
2012-09-30
International Arctic Buoy Programme ( IABP ) A US Interagency Arctic Buoy Programme (USIABP) contribution to the IABP Dr. Ignatius G. Rigor Polar...observations of surface meteorology and ice motion. These observations are assimilated into Numerical Weather Prediction (NWP) models that are used to...distribution of sea ice. Over the Arctic Ocean, this fundamental observing network is maintained by the IABP , and is a critical component of the
ERIC Educational Resources Information Center
Yego, Helen J. C.
2016-01-01
This paper examines the expansion and management of quality of parallel programmes in Kenya's public universities. The study is based on Privately Sponsored Students Programmes (PSSP) at Moi University and its satellite campuses in Kenya. The study was descriptive in nature and adopted an ex-post facto research design. The study sample consisted…
Open-Book Tests to Complement Assessment-Programmes: Analysis of Open and Closed-Book Tests
ERIC Educational Resources Information Center
Heijne-penninga, M.; Kuks, J. B. M.; Schonrock-adema, J.; Snijders, T. A. B.; Cohen-schotanus, J.
2008-01-01
Today's health sciences educational programmes have to deal with a growing and changing amount of knowledge. It is becoming increasingly important for students to be able to use and manage knowledge. We suggest incorporating open-book tests in assessment programmes to meet these changes. This view on the use of open-book tests is discussed and the…
First Things First: Anger Management Group Work in a Mainstream High School Setting
ERIC Educational Resources Information Center
Wiseman, Martin; O'Gorman, Shannon
2017-01-01
In an attempt to support the emotional development and behavioural choices of young students in grades 7-10, a six session therapeutic group programme was devised--culminating in a written manual to enable future replication of the programme. This pilot programme was introduced as a once-weekly, morning session aimed at prioritising a student's…
ERIC Educational Resources Information Center
Unterberger, Barbara
2012-01-01
Internationalisation processes have accelerated the implementation of English-medium programmes (EMPs) across European higher education institutions. The field of business and management studies has been particularly affected by this trend (Wachter & Maiworm 2008: 46) with numerous new EMPs introduced each year. This paper presents key…
The impact of a nursing transitions programme on retention and cost savings.
Hillman, Lynne; Foster, Rhonda R
2011-01-01
To identify the benefits and essential elements of a new graduate residency programme. Retention of nurses is a global nursing concern. New graduate nurses have the lowest retention rates and, therefore, the present study focused on the unique needs of this group. Valid and reliable tools were utilized to evaluate work satisfaction, clinical decision making, organizational commitment and skill development during and after each residency. We also compared resident retention and associated cost savings. The adoption and implementation of the residency programme represented a change in culture. Hiring and education practices for new nurses changed dramatically. Before the development of a new graduate transition programme, our 1-year retention rate was as low as 50%. Five years after programme adoption, retention increased to 72.5%, resulting in major cost savings to the organization. Nursing Management must be creative and transformational in their thinking in order to address nursing retention. Implications for nurse managers who are considering residency programmes include the potential for significant cost savings for the hospital, increased resident, nursing and unit satisfaction and a demand for nurses who desire to work at their hospitals. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
Neurogenic bowel management after spinal cord injury: Malaysian experience.
Engkasan, Julia Patrick; Sudin, Siti Suhaida
2013-02-01
To describe the bowel programmes utilized by individuals with spinal cord injury; and to determine the association between the outcome of the bowel programmes and various interventions to facilitate defecation. A cross-sectional study. Individuals with spinal cord injury who have neurogenic bowel dysfunction. Face-to-face interviews were conducted using a self-constructed questionnaire that consisted of: (i) demographic and clinical characteristics of the participants; (ii) interventions to facilitate defecation; (iii) bowel care practices; (iv) outcome of the bowel programme (incidence of incontinence and duration of the evacuation procedure); and (v) participant satisfaction with their bowel programme. The majority (79.2%) of subjects used multiple interventions for bowel care. Duration of the evacuation procedure was more than 60 min in 28.0% of participants. Water intake of more than 2 l/day was associated with longer duration of bowel care. Only 8.0% of participants had at least one episode of incontinence per month. The majority of participants (84.8%) were satisfied with their bowel programme. Patients used multiple interventions to manage their bowels and spent a substantial amount of time performing bowel care. Nevertheless, the incidence of incontinence was low and satisfaction with their bowel programme was high.
Sharkey, Alyssa B; Martin, Sandrine; Cerveau, Teresa; Wetzler, Erica; Berzal, Rocio
2014-01-01
Aim We present the approaches used in and outcomes resulting from integrated community case management (iCCM) programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. Methods We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Results Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care–seeking within 24 hours and care–seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. Conclusions iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers’ ability to assess and treat illnesses can lead to improved care–seeking and utilisation, and community ownership for iCCM. PMID:25520800
Disease management: definitions, difficulties and future directions.
Pilnick, A.; Dingwall, R.; Starkey, K.
2001-01-01
The last decade has seen a wide range of experiments in health care reform intended to contain costs and promote effectiveness. In the USA, managed care and disease management have been major strategies in this endeavour. It has been argued that their apparent success has strong implications for reform in other countries. However, in this paper we ask whether they are so easily exportable. We explain the concepts involved and set the development of managed care and disease management programmes in the context of the USA. The constituent elements of disease management are identified and discussed. Disease management is considered from the perspectives of the major stakeholders in the United Kingdom, and the differences between the models of health care in the United Kingdom's National Health Service and the USA are noted. A review is presented of evaluations of disease management programmes and of the weaknesses they highlight. The prospects for disease management in Europe are also discussed. PMID:11545333
Roets-Merken, Lieve M; Zuidema, Sytse U; Vernooij-Dassen, Myrra J F J; Teerenstra, Steven; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L
2018-01-01
Objective To evaluate the effectiveness of a nurse-supported self-management programme to improve social participation of dual sensory impaired older adults in long-term care homes. Design Cluster randomised controlled trial. Setting Thirty long-term care homes across the Netherlands. Participants Long-term care homes were randomised into intervention clusters (n=17) and control clusters (n=13), involving 89 dual sensory impaired older adults and 56 licensed practical nurses. Intervention Nurse-supported self-management programme. Measurements Effectiveness was evaluated by the primary outcome social participation using a participation scale adapted for visually impaired older adults distinguishing four domains: instrumental activities of daily living, social-cultural activities, high-physical-demand and low-physical-demand leisure activities. A questionnaire assessing hearing-related participation problems was added as supportive outcome. Secondary outcomes were autonomy, control, mood and quality of life and nurses’ job satisfaction. For effectiveness analyses, linear mixed models were used. Sampling and intervention quality were analysed using descriptive statistics. Results Self-management did not affect all four domains of social participation; however. the domain ‘instrumental activities of daily living’ had a significant effect in favour of the intervention group (P=0.04; 95% CI 0.12 to 8.5). Sampling and intervention quality was adequate. Conclusions A nurse-supported self-management programme was effective in empowering the dual sensory impaired older adults to address the domain ‘instrumental activities of daily living’, but no differences were found in addressing the other three participation domains. Self-management showed to be beneficial for managing practical problems, but not for those problems requiring behavioural adaptations of other persons. Trial registration number NCT01217502; Results. PMID:29371264
Littlewood, Chris; Bateman, Marcus; Brown, Kim; Bury, Julie; Mawson, Sue; May, Stephen; Walters, Stephen J
2016-07-01
To evaluate the clinical effectiveness of a self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy. Multi-centre pragmatic unblinded parallel group randomised controlled trial. UK National Health Service. Patients with a clinical diagnosis of rotator cuff tendinopathy. The intervention was a programme of self-managed exercise prescribed by a physiotherapist in relation to the most symptomatic shoulder movement. The control group received usual physiotherapy treatment. The primary outcome measure was the Shoulder Pain & Disability Index (SPADI) at three months. Secondary outcomes included the SPADI at six and twelve months. A total of 86 patients (self-managed loaded exercise n=42; usual physiotherapy n=44) were randomised. Twenty-six patients were excluded from the analysis because of lack of primary outcome data at the 3 months follow-up, leaving 60 (n=27; n=33) patients for intention to treat analysis. For the primary outcome, the mean SPADI score at three months was 32.4 (SD 20.2) for the self-managed group, and 30.7 (SD 19.7) for the usual physiotherapy treatment group; mean difference adjusted for baseline score: 3.2 (95% Confidence interval -6.0 to +12.4 P = 0.49).By six and twelve months there remained no significant difference between the groups. This study does not provide sufficient evidence of superiority of one intervention over the other in the short-, mid- or long-term and hence a self-management programme based around a single exercise appears comparable to usual physiotherapy treatment. © The Author(s) 2015.
Conflict coaching training for nurse managers: a case study of a two-hospital health system.
Brinkert, Ross
2011-01-01
This study evaluated the application of the Comprehensive Conflict Coaching model in a hospital environment. Conflict coaching involves a coach working with a client to improve the client's conflict understanding, interaction strategies and/or interaction skills. The training of nurse managers as conflict coaches is an innovative continuing education programme that partially addresses conflict-related concerns in nursing. Twenty nurse managers trained as conflict coaches and each coached a supervisee. Qualitative data were gathered from nurse managers, supervisees and senior nursing leaders over an 8-month period and organized using standard programme evaluation themes. Benefits included supervisor conflict coaching competency and enhanced conflict communication competency for nurse managers and supervisees facing specific conflict situations. Challenges included the management of programme tensions. Additional benefits and challenges are discussed, along with study limitations. Conflict coaching was a practical and effective means of developing the conflict communication competencies of nurse managers and supervisees. Additional research is needed. Conflict is common in nursing. Conflict coaching is a new conflict communication and supervision intervention that demonstrates initial promise. Conflict coaching seems to work best when supported by a positive conflict culture and integrated with other conflict intervention processes. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
Trubey, R J; Chestnutt, I G
2013-03-01
This study used Q-sort methodology to determine the views of staff involved in a national school-based daily toothbrushing programme. Q-methodology is a mixed-method approach in which participants are asked to sort a collection of statements according to degree of agreement with them. Factor analysis identified subgroups of like-minded participants and revealed areas of consensus and disagreement. 24 Community Dental Service staff managing or delivering the toothbrushing programme were asked to rank 49 statements derived from previous qualitative interviews. Varimax rotation produced a three-factor solution with five/six participants loading significantly into each group. Groups divided largely according to staff role: Factor 1, mainly support workers (assistants with no oral-health background); Factor 2, managers; and factor 3, oral health educators (dental nurses with teaching qualifications). As staff new to the area of oral-health, the views of support workers were of particular interest. Unlike others, this group saw Designed to Smile as a unique health promotion scheme and wanted to involve as many children as possible, regardless of oral-disease risk. Managers' perceptions of issues affecting the establishment of the programme differed from those staff in day-to-day contact with the 515 schools in which the toothbrushing took place. This study used a long established but little used technique to ascertain the commonality of views of staff These data may be of value not only in managing the current programme, but for anyone who may be considering developing such a toothbrushing scheme.
Experiences of a commercial weight-loss programme after primary care referral: a qualitative study.
Allen, Jodie T; Cohn, Simon R; Ahern, Amy L
2015-04-01
Referral to a commercial weight-loss programme is a cost-effective intervention that is already used within the NHS. Qualitative research suggests this community-based, non-medical intervention accords with participants' view of weight management as a lifestyle issue. To examine the ways in which participants' attitudes and beliefs about accessing a commercial weight management programme via their doctor relate to their weight-loss experience, and to understand how these contextual factors influence motivation and adherence to the intervention. A qualitative study embedded in a randomised controlled trial evaluating primary care referral to a commercial weight-loss programme in adults who are overweight or obese in England. The study took place from June-September 2013. Twenty-nine participants (body mass index [BMI] ≥28 kg/m(2); age ≥18 years), who took part in the WRAP (Weight Loss Referrals for Adults in Primary Care) trial, were recruited at their 3-month assessment appointment to participate in a semi-structured interview about their experience of the intervention and weight management more generally. Interviews were audiorecorded, transcribed verbatim, and analysed inductively using a narrative approach. Although participants view the lifestyle-based, non-medical commercial programme as an appropriate intervention for weight management, the referral from the GP and subsequent clinical assessments frame their experience of the intervention as medically pertinent with clear health benefits. Referral by the GP and follow-up assessment appointments were integral to participant experiences of the intervention, and could be adapted for use in general practice potentially to augment treatment effects. © British Journal of General Practice 2015.
Trollip, Andre; Erni, Donatelle; Kao, Kekeletso
2017-01-01
Background Quality-assured tuberculosis laboratory services are critical to achieve global and national goals for tuberculosis prevention and care. Implementation of a quality management system (QMS) in laboratories leads to improved quality of diagnostic tests and better patient care. The Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has led to measurable improvements in the QMS of clinical laboratories. However, progress in tuberculosis laboratories has been slower, which may be attributed to the need for a structured tuberculosis-specific approach to implementing QMS. We describe the development and early implementation of the Strengthening Tuberculosis Laboratory Management Toward Accreditation (TB SLMTA) programme. Development The TB SLMTA curriculum was developed by customizing the SLMTA curriculum to include specific tools, job aids and supplementary materials specific to the tuberculosis laboratory. The TB SLMTA Harmonized Checklist was developed from the World Health Organisation Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist, and incorporated tuberculosis-specific requirements from the Global Laboratory Initiative Stepwise Process Towards Tuberculosis Laboratory Accreditation online tool. Implementation Four regional training-of-trainers workshops have been conducted since 2013. The TB SLMTA programme has been rolled out in 37 tuberculosis laboratories in 10 countries using the Workshop approach in 32 laboratories in five countries and the Facility-based approach in five tuberculosis laboratories in five countries. Conclusion Lessons learnt from early implementation of TB SLMTA suggest that a structured training and mentoring programme can build a foundation towards further quality improvement in tuberculosis laboratories. Structured mentoring, and institutionalisation of QMS into country programmes, is needed to support tuberculosis laboratories to achieve accreditation. PMID:28879165
The United Nations programme on space applications: priority thematic areas
NASA Astrophysics Data System (ADS)
Haubold, H.
The Third United Nations Conference on the Exploration and Peaceful Uses of Outer Space (UNISPACE III) was held in 1999 with efforts to identify world wide benefits of developing space science and technology, particularly in the developing nations. One of the main vehicles to implement recommendations of UNISPACE III is the United Nations Programme on Space Applications of the Office for Outer Space Affairs at UN Headquarters in Vienna. Following a process of prioritization by Member States, the Programme focus its activities on (i) knowledge-based themes as space law and basic space science, (ii) application-based themes as disaster management, natural resources management, environmental monitoring, tele-health, and (iii) enabling technologies such as remote sensing satellites, communications satellites, global navigation satellite systems, and small satellites. Current activities of the Programme will be reviewed. Further information available at http://www.oosa.unvienna.org/sapidx.html
El-Gilany, A-H; El-Shaer, S; Khashaba, E; El-Dakroory, S A; Omar, N
2017-06-01
A quasi-experimental study was performed on 20 technicians working in the Faculty of Medicine, Mansoura University, Egypt. The knowledge, attitude, and practice (KAP) of laboratory technicians was measured before and two months after enrolling them in an intervention programme about laboratory best practice procedures. The programme addressed laboratory safety and medical waste management. The assessment was performed using a validated Arabic self-administered questionnaire. Pre- and post-intervention scores were compared using non-parametric tests. There are significant increases in the scores of KAP after implementation of the training programme. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Interdisciplinary science for future governance and management of forests.
Nordin, Annika; Sandström, Camilla
2016-02-01
The sustainable use of forests constitutes one of the great challenges for the future due to forests' large spatial coverage, long-term planning horizons and inclusion of many ecosystem services. The mission of the Future Forests programme is to provide a scientifically robust knowledge base for sustainable governance and management of forests preparing for a future characterized by globalization and climate change. In this introduction to the Special Issue, we describe the interdisciplinary science approach developed in close collaboration with actors in the Future Forests programme, and discuss the potential impacts of this science on society. In addition, we introduce the 13 scientific articles and present results produced by the programme.
Adini, B; Laor, D; Aharonson-Daniel, L
2014-08-01
Numerous interventions seeking to increase preparedness for pandemic influenza have been implemented, but low compliance of healthcare providers has been reported in many instances. The aim of this study was to identify factors that affect preparedness for pandemic influenza by examining: hospital managers' perceptions of measures implemented to promote preparedness for pandemic influenza; hospital managers' assessments of the readiness and capability of their hospitals to manage pandemic influenza; and the effectiveness of a national pandemic preparedness programme in Israel over time. A quasi-experiment was conducted following implementation of a national pandemic preparedness programme in Israel. A survey assessed hospital managers' perceptions of the effectiveness of the programme, and the preparedness and capacity of their hospitals to manage pandemic influenza. Two independent evaluations of preparedness for biological threats were conducted, based on a validated tool that included 60 objective parameters. Correlations between perceived preparedness and capacity and components of the preparedness programme were analysed using Statistical Package for the Social Sciences Version 17. Stepwise logistic regression was used to determine the components that influence preparedness and capability to manage pandemic influenza. All general hospital managers in Israel were approached twice (first and second evaluations). Ninety-one percent rated themselves as highly/very highly prepared for pandemic influenza, and 87% rated themselves as highly/very highly capable of dealing with pandemic influenza. Strong correlation was found between hospital managers' perceived preparedness and capacity to manage pandemic influenza (rho = 0.761, P = 0.000), and between perceived preparedness and familiarity with the disease (rho = 0.605, P = 0.003). Familiarity with guidelines accounted for 35% of the variance in perceived capability (adjusted R(2) = 0.346, P = 0.002). Inclusion of preparedness evaluations explained an additional 15% of the variance (R(2) change = 0.146, P = 0.026). An increase in mean total score for emergency preparedness was found in the second evaluation compared with the first evaluation. Familiarity with guidelines and preparedness evaluations affect the perceptions of healthcare managers regarding preparedness and capability to manage pandemic influenza. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Perrone, L A; Confer, D; Scott, E; Livingston, L; Bradburn, C; McGee, A; Furtwangler, T; Downer, A; Mokdad, A H; Flandin, J F; Shotorbani, S; Asghar, H; Tolbah, H E; Ahmed, H J; Alwan, A; Martin, R
2017-02-01
Laboratories need leaders who can effectively utilize the laboratories' resources, maximize the laboratories'capacity to detect disease, and advocate for laboratories in a fluctuating health care environment. To address this need, the University of Washington, USA, created the Certificate Program in Laboratory Leadership and Management in partnership with WHO Regional Office for the Eastern Mediterranean, and implemented it with 17 participants and 11 mentors from clinical and public health laboratories in 10 countries (Egypt, Iraq, Jordan, Lebanon, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, and Yemen) in 2014. Designed to teach leadership and management skills to laboratory supervisors, the programme enabled participants to improve laboratory testing quality and operations. The programme was successful overall, with 80% of participants completing it and making impactful changes in their laboratories. This success is encouraging and could serve as a model to further strengthen laboratory capacity in the Region.
Free mate choice enhances conservation breeding in the endangered giant panda
Martin-Wintle, Meghan S.; Shepherdson, David; Zhang, Guiquan; Zhang, Hemin; Li, Desheng; Zhou, Xiaoping; Li, Rengui; Swaisgood, Ronald R.
2015-01-01
Conservation breeding programmes have become an increasingly important tool to save endangered species, yet despite the allocation of significant resources, efforts to create self-sustaining populations have met with limited success. The iconic giant panda (Ailuropoda melanoleuca) embodies the struggles associated with ex situ species conservation. Here we show that behavioural mate preferences in giant pandas predict reproductive outcomes. Giant pandas paired with preferred partners have significantly higher copulation and birth rates. Reproductive rates increase further when both partners show mutual preference for one another. If managers were to incorporate mate preferences more fully into breeding management, the production of giant panda offspring for China's reintroduction programme might be greatly expedited. When extended to the increasing numbers of species dependent on ex situ conservation breeding to avoid extinction, our findings highlight that mate preference and other aspects of informed behavioural management could make the difference between success and failure of these programmes. PMID:26670381
Free mate choice enhances conservation breeding in the endangered giant panda.
Martin-Wintle, Meghan S; Shepherdson, David; Zhang, Guiquan; Zhang, Hemin; Li, Desheng; Zhou, Xiaoping; Li, Rengui; Swaisgood, Ronald R
2015-12-15
Conservation breeding programmes have become an increasingly important tool to save endangered species, yet despite the allocation of significant resources, efforts to create self-sustaining populations have met with limited success. The iconic giant panda (Ailuropoda melanoleuca) embodies the struggles associated with ex situ species conservation. Here we show that behavioural mate preferences in giant pandas predict reproductive outcomes. Giant pandas paired with preferred partners have significantly higher copulation and birth rates. Reproductive rates increase further when both partners show mutual preference for one another. If managers were to incorporate mate preferences more fully into breeding management, the production of giant panda offspring for China's reintroduction programme might be greatly expedited. When extended to the increasing numbers of species dependent on ex situ conservation breeding to avoid extinction, our findings highlight that mate preference and other aspects of informed behavioural management could make the difference between success and failure of these programmes.
Gunn, Hilary; Endacott, Ruth; Haas, Bernhard; Marsden, Jonathan; Freeman, Jennifer
2017-08-07
To utilise stakeholder input to inform the structure, format and approach of a multiple sclerosis (MS) balance, safe mobility and falls management programme. Using a three-round nominal group technique, participants individually rated their agreement with 20 trigger statements, followed by a facilitated group discussion and re-rating. Three mixed groups included service users (n = 15) and providers (n = 19). Quantitative analysis determined agreement, whilst qualitative responses were analysed thematically. Median scores for each of the 20 trigger statements did not change significantly over sequential rounds, however, deviations around the medians indicated more agreement amongst participants over time. Key recommendations were: Aims and approach: The programme should be tailored to the needs of people with MS. Falls and participation-based outcomes are equally important. Structure and format: The programme should balance expected burden and anticipated benefit, moving away from models requiring weekly attendance and promoting and supporting self-efficacy. Optimising engagement: Support to maintain engagement and intensity of practice over the long term is essential. Sustainability: Adequate funding is necessary. Staff should have MS specific knowledge and experience. Participants collaboratively identified critical components of a MS balance, safe mobility and falls management programme. They also highlighted the importance of a collaborative, user-centred, MS-specific approach. Implications for Rehabilitation People with multiple sclerosis need condition-specific interventions focussed on maximising balance and safe mobility and reducing falls. Programme design should support self-efficacy and flexible engagement. Adequate support and funding are seen as essential by both service users and providers.
A comprehensive review of the SLMTA literature part 2: Measuring success.
Luman, Elizabeth T; Yao, Katy; Nkengasong, John N
2014-01-01
Since its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented in 617 laboratories in 47 countries. We completed a systematic review of the published literature on SLMTA. The review consists of two companion papers; this article examines quantitative evidence presented in the publications along with a meta-analysis of selected results. We identified 28 published articles with data from SLMTA implementation. The SLMTA programme was evaluated through audits based on a standard checklist, which is divided into 12 sections corresponding to the 12 Quality System Essentials (QSEs). Several basic service delivery indicators reported by programmes were also examined. Results for various components of the programme were reviewed and summarised; a meta-analysis of QSE results grouped by the three stages of the quality cycle was conducted for 126 laboratories in 12 countries. Global programme data show improved quality in SLMTA laboratories in every country, with average improvements on audit scores of 25 percentage points. Meta-analysis identified Improvement Management as the weakest stage, with internal audit (8%) and occurrence management (16%) showing the lowest scores. Studies documented 19% - 95% reductions in turn-around times, 69% - 93% reductions in specimen rejection rates, 76% - 81% increases in clinician satisfaction rates, 67% - 85% improvements in external quality assessment results, 50% - 66% decreases in nonconformities and 67% increases in staff punctuality. The wide array of results reported provides a comprehensive picture of the SLMTA programme overall, suggesting a substantive impact on provision of quality laboratory services and patient care. These comprehensive results establish a solid data-driven foundation for program improvement and further expansion.
48 CFR 223.7303 - Prohibition.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Hexavalent Chromium 223.7303 Prohibition. (a) Except as provided in 223.7304 and 223.7305, no contract may... than 0.1 percent hexavalent chromium by weight in any homogeneous material in the deliverable or...
ERIC Educational Resources Information Center
Dorothy, J. S.; Kumar, Ashwini
2014-01-01
Indira Gandhi National Open University (IGNOU) which was established initially as a Single mode Distance Teaching Institution (DTI) in the year 1985 opened its campus to face-to-face education in the year 2008 and thus now is a Dual mode Distance Teaching Institution (DTI). The Post Graduate Programme (Master of Science) in Dietetics and Food…
ERIC Educational Resources Information Center
Mc Kenna, Declan; Mooney Simmie, Geraldine
2017-01-01
The School Completion Programme (SCP) was first established in Ireland in 2002 with what appeared to resemble a "bottom up" model of support. The programme was based on authentic effort at partnership with schools, parents and relevant agencies through local management committees and enjoyed a fair share of autonomy in how they would…
Morell, Anna L; Kiem, Sandra; Millsteed, Melanie A; Pollice, Almerinda
2014-03-06
Australians living in rural and remote communities experience relatively poor health status in comparison to the wider Australian population (Med J Aust 185:37-38, 2006). This can be attributed in part to issues of access to health services arising from difficulties in recruiting and retaining health professionals in these areas. The Rural Health Professionals Program is an initiative designed to increase the number of allied health and nursing professionals in rural and remote Australia by providing case managed recruitment and retention support services. This paper reports on early analysis of available programme data to build knowledge of factors related to the recruitment and distribution of health professionals in rural and remote Australia. Administrative programme data were collected monthly from 349 health professionals over the first 13 months of programme operation. These data were collated and quantitative analysis was conducted using SPSS software. Sixty-nine percent of recruits were women, and recruits had a mean age of 32.85 (SD = 10.92). Sixty percent of recruits were domestically trained, and the top two professions recruited were nurses (29%) and physiotherapists (21%). Eighty-seven percent were recruited to regional areas, with the remaining 13% recruited to remote areas. Among reasons for interest in the programme, financial support factors were most commonly cited by recruits (51%). Recruitment to a remote location was associated with being domestically trained, having previously lived in a rural or remote location, being a nurse (as opposed to an allied health professional) and older age. The findings provide early support for a case managed recruitment programme to improve distribution of health professionals, and some directions for future marketing and promotion of the programme. It is recommended that an outcome evaluation be conducted to determine the impact of the programme on recruitment and distribution outcomes. The findings herein begin to address gaps in the literature relating to the effectiveness of interventions to improve the distribution of health professionals. While this provides some preliminary indication that case managed recruitment and retention programmes have capacity to improve distribution, further research and evaluation is required to confirm the impact of the programme on retention.
Long, Aidan; Lungu, Joyce Chipili; Machila, Elizabeth; Schwaninger, Sherri; Spector, Jonathan; Tadmor, Brigitta; Fishman, Mark; Mayosi, Bongani M; Musuku, John
Rheumatic heart disease is highly prevalent and associated with substantial morbidity and mortality in many resource-poor areas of the world, including sub-Saharan Africa. Primary and secondary prophylaxis with penicillin has been shown to significantly improve outcomes and is recognised to be the standard of care, with intra-muscular benzathine penicillin G recommended as the preferred agent by many technical experts. However, ensuring compliance with therapy has proven to be challenging. As part of a public-private partnership initiative in Zambia, we conducted an educational and access-to-medicine programme aimed at increasing appropriate use of benzathine penicillin for the prevention and management of rheumatic heart disease, according to national guidelines. The programme was informed early on by identification of potential barriers to the administration of injectable penicillin, which included concern by health workers about allergic events. We describe this programme and report initial signs of success, as indicated by increased use of benzathine penicillin. We propose that a similar approach may have benefits in rheumatic heart disease programmes in other endemic regions.
Long, Aidan; Lungu, Joyce Chipili; Machila, Elizabeth; Musuku, John; Schwaninger, Sherri; Spector, Jonathan; Tadmor, Brigitta; Fishman, Mark; Mayosi, Bongani M
2017-01-01
Summary Rheumatic heart disease is highly prevalent and associated with substantial morbidity and mortality in many resourcepoor areas of the world, including sub-Saharan Africa.Primary and secondary prophylaxis with penicillin has beenshown to significantly improve outcomes and is recognisedto be the standard of care, with intra-muscular benzathine penicillin G recommended as the preferred agent by many technical experts. However, ensuring compliance with therapyhas proven to be challenging. As part of a public–privatepartnership initiative in Zambia, we conducted an educationaland access-to-medicine programme aimed at increasing appropriate use of benzathine penicillin for the preventionand management of rheumatic heart disease, according tonational guidelines. The programme was informed early onby identification of potential barriers to the administration ofinjectable penicillin, which included concern by health workers about allergic events. We describe this programme andreport initial signs of success, as indicated by increased useof benzathine penicillin. We propose that a similar approach may have benefits in rheumatic heart disease programmes in other endemic regions. PMID:28906539
The Chocuhaler: sweet deliverance in asthma management.
Hayden, M J; Wildhaber, J H; Eber, E; Devadason, S G
To determine the characteristics of a new cocoa-based edible spacer device for the delivery of aerosol bronchodilator. In-vitro comparison of two spacer devices (standard and edible) and determination of bronchodilator response using the edible spacer. A university children's hospital in Western Australia. Two volunteers with moderate asthma. Compared with a standard spacer, the edible spacer delivered significantly more bronchodilator in droplets of a size likely to enter the respiratory tract. A significant bronchodilator response occurred in two out of two subjects when salbutamol was inhaled orally via the chocolate spacer. No significant bronchodilator response occurred in either subject when the spacer was eaten at the end of the study. The chocolate spacer used in this study is a suitable device to deliver salbutamol by inhalation. However, there may be potential drawbacks of weight gain in some patients and meltdown in hot climates.
Reservoir model for Hillsboro gas storage field management
Udegbunam, Emmanuel O.; Kemppainen, Curt; Morgan, Jim; ,
1995-01-01
A 3-dimensional reservoir model is used to understand the behavior of the Hillsboro Gas Storage Field and to investigate the field's performance under various future development. Twenty-two years of the gas storage reservoir history, comprising the initial gas bubble development and seasonal gas injection and production cycles, are examined with a full-field, gas water, reservoir simulation model. The results suggest that the gas-water front is already in the vicinity of the west observation well that increasing the field's total gas-in-place volume would cause gas to migrate beyond the east, north and west observation well. They also suggest that storage enlargement through gas injection into the lower layers may not prevent gas migration. Moreover, the results suggest that the addition of strategically-located new wells would boost the simulated gas deliverabilities.
Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L
2016-01-01
Objectives To gain insights into the process of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Design Qualitative study alongside a cluster randomised controlled trial. Setting 17 long-term care homes spread across the Netherlands. Participants 34 licensed practical nurses supporting 54 dual sensory impaired older adults. Intervention A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Primary outcomes Nurses’ perceptions on relevance and feasibility of the self-management programme collected from nurses’ semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers’ reports. Results Nurses’ initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults’ autonomy needs. However, nurses’ initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Conclusions Longitudinal data collection enabled exploration of nurses’ changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond ‘protocol thinking’, discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should acknowledge that change is a process rather than an event, and should include self-evaluations of professional behaviours over a period of time. Trial registration number NCT01217502, Post-results. PMID:27856482
Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L
2016-11-17
To gain insights into the process of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Qualitative study alongside a cluster randomised controlled trial. 17 long-term care homes spread across the Netherlands. 34 licensed practical nurses supporting 54 dual sensory impaired older adults. A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Nurses' perceptions on relevance and feasibility of the self-management programme collected from nurses' semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers' reports. Nurses' initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults' autonomy needs. However, nurses' initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Longitudinal data collection enabled exploration of nurses' changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond 'protocol thinking', discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should acknowledge that change is a process rather than an event, and should include self-evaluations of professional behaviours over a period of time. NCT01217502, Post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Hudon, Catherine; Chouinard, Maud-Christine; Couture, Martine; Brousselle, Astrid; Couture, Eva Marjorie; Dubois, Marie-France; Fortin, Martin; Freund, Tobias; Loignon, Christine; Mireault, Jean; Pluye, Pierre; Roberge, Pasquale; Rodriguez, Charo
2014-12-02
Case management allows us to respond to the complex needs of a vulnerable clientele through a structured approach that promotes enhanced interaction between partners. Syntheses on the subject converge towards a need for a better description of the relationships between programmes and their local context, as well as the characteristics of the clienteles and programmes that contribute to positive impacts. The purpose of this project is thus to describe and evaluate the case management programmes of four health and social services centres in the Saguenay-Lac- Saint-Jean region of Québec, Canada, in order to inform their improvement while creating knowledge on case management that can be useful in other contexts. This research relies on a multiple embedded case study design based on a developmental evaluation approach. We will work with the case management programme for high users of hospital services of each centre. Three different units of analysis will be interwoven to obtain an in-depth understanding of each case, that is: (1) health and social services centre and local services network, (2) case management programme and (3) patients who are high users of services. Two strategies for programme evaluation (logic models and implementation analysis) will guide the mixed data collection based on qualitative and quantitative methods. This data collection will rely on: (1) individual interviews and focus groups; (2) participant observation; (3) document analysis; (4) clinical and administrative data and (5) questionnaires. Description and comparison of cases, and integration of qualitative and quantitative data will be used to guide the data analysis. The study protocol was approved by the Ethics Research Boards of the four health and social services centres (HSSCs) involved. Findings will be disseminated by publications in peer-reviewed journals, conferences, and policy and practice partners in local and national government. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Taylor, Kaitlyn; Catroppa, Cathy; Godfrey, Celia; McKinlay, Audrey; Ponsford, Jennie; Matthews, Jan; Anderson, Vicki
2017-01-01
Traumatic brain injury (TBI) in children is associated with a range of poor long-term outcomes, including behavioural disturbances. Parents can experience high levels of stress and injury-related burden, and evidence suggests that distressed parents are less likely to adopt positive parenting styles to manage their child's behaviour. The 'Signposts for Building Better Behaviour' program is a parenting programme that was originally developed to assist parents of children with an intellectual disability in managing their child's behaviour. More recently, it has been adapted to include a TBI module, to assist parents in managing post-TBI behaviour. However, geographical and financial barriers remain, preventing many parents from accessing the programme in the standard face-to-face modality. This project aims to investigate the feasibility and acceptability of the programme when delivered with clinician support via videoconferencing. The sample for this feasibility study will be recruited from the Royal Children's Hospital, Melbourne, and the Victorian Paediatric Rehabilitation Service. Participants will be the parents of a child who sustained a TBI between the ages of 2.0 and 6.11, within the previous 2 years. The parents of 15 children will complete the programme, with clinician support via videoconferencing, while the parents of a further 15 children will form a treatment as usual wait-list control group. Parents complete questionnaires assessing their child's behaviour, as well as assessing their own mental health, sense of parenting competency, disciplinary style, and family functioning. These will be completed upon enrolment in the study regarding their child's pre-injury behaviour and then again pre-intervention, immediately post-intervention, and 4 months post-intervention. Parents who complete the intervention will also complete questionnaires assessing their satisfaction with the programme and its delivery. Information will be collected on the feasibility, clinical practicality, and acceptability of the programme when delivered through this medium. This study is the first to investigate the feasibility of delivering post-child TBI behavioural intervention via videoconferencing in Australia. Preliminary findings from this study may support the development of a larger randomised controlled trial. It is hoped that programme delivery through this medium would facilitate better access to the programme, enabling improved long-term outcomes for families. ANZCTR, ACTRN12616001574437.
Women's attitudes towards a pre-conception healthy lifestyle programme.
Funk, K L; LeBlanc, E S; Vesco, K K; Stevens, V J
2015-04-01
Nearly half of US women begin pregnancy overweight or obese and more than half of overweight or obese pregnant women experience excessive gestational weight gain. Recent lifestyle intervention programmes have helped women avoid excessive weight gain during pregnancy, but helping women lose weight before pregnancy may be a more effective way to improve pregnancy outcomes. This study assessed women's attitudes towards pre-conception diet and weight management interventions. An anonymous survey was conducted in patients waiting in a health maintenance organization's obstetrics and primary care waiting rooms. It focused on attitudes towards participating in a pre-conception, lifestyle change programme. Eighty percent of the 126 women surveyed were pregnant or considering pregnancy within 5 years. Of the 126 respondents, 60 (48%) were overweight or obese. Of these, 96% rated healthy diet and healthy weight before pregnancy as very important or important and 77% favoured a healthy lifestyle programme (diet, weight management and physical activity) before becoming pregnant. Likewise, overweight or obese women reported being likely or highly likely to participate in specific intervention programme aspects such as keeping phone appointments (77%), using a programme website (70%) and keeping food and exercise records (63%). Survey results show that women in this population believe that adopting a healthy lifestyle and losing weight are important before pregnancy and that they are enthusiastic about programmes that will help them achieve those goals in preparation for pregnancy. © 2015 World Obesity.
Gibson, Irene; Flaherty, Gerard; Cormican, Sarah; Jones, Jennifer; Kerins, Claire; Walsh, Anne Marie; Costello, Caroline; Windle, Jane; Connolly, Susan; Crowley, James
2014-03-01
The aim of this observational, descriptive study is to evaluate the impact of an intensive, evidence-based preventive cardiology programme on medical and lifestyle risk factors in patients at high risk of developing cardiovascular disease (CVD). Increased CVD risk patients and their family members/partners were invited to attend a 16-week programme consisting of a professional multidisciplinary lifestyle intervention, with appropriate risk factor and therapeutic management in a community setting. Smoking, dietary habits, physical activity levels, waist circumference and body mass index, and medical risk factors were measured at initial assessment, at end of programme, and at 1-year follow up. Adherence to the programme was high, with 375 (87.2%) participants and 181 (84.6%) partners having completed the programme, with 1-year data being obtained from 235 (93.6%) patients and 107 (90.7%) partners. There were statistically significant improvements in both lifestyle (body mass index, waist circumference, physical activity, Mediterranean diet score, fish, fruit, and vegetable consumption, smoking cessation rates), psychosocial (anxiety and depression scales and quality of life indices), and medical risk factors (blood pressure, lipid and glycaemic targets) between baseline and end of programme, with these improvements being sustained at 1-year follow up. These findings demonstrate how a holistic model of CVD prevention can improve cardiovascular risk factors by achieving healthier lifestyles and optimal medical management.
NASA Astrophysics Data System (ADS)
Daud, Shahidah Md; Ramli, Razamin; Kasim, Maznah Mat; Kayat, Kalsom; Razak, Rafidah Abd
2015-12-01
Malaysian Homestay is very unique. It is classified as Community Based Tourism (CBT). Homestay Programme which is a community events where a tourist stays together with a host family for a period of time and enjoying cultural exchange besides having new experiences. Homestay programme has booming the tourism industry since there is over 100 Homestay Programme currently being registered with the Ministry of Culture and Tourism Malaysia. However, only few Homestay Programme enjoying the benefits of success Homestay Programme. Hence, this article seeks to identify the critical success factors for a Homestay Programme in Malaysia. An Arithmetic Average method is utilized to further evaluate the identified success factors in a more meaningful way. The findings will help Homestay Programme function as a community development tool that manages tourism resources. Thus, help the community in improving local economy and creating job opportunities.
Nøhr, C; Bygholm, A; Hejlesen, O
1998-06-01
Education is essentially giving people new skills and qualifications to fulfil certain tasks. In planning and managing educational programmes it is crucial to know what skills and what qualifications are needed to carry out the tasks in question, not to mention the importance of knowing what tasks are relevant to carry out. The programme in health informatics at Aalborg University produces health informatics professionals. The students are developing skills in solving informatics problems in health care organisations. The programme has been running for 3 years now and to maintain the perception of the aim for the programme a number of activities have been launched. In the following, the programme will be presented, the activities to obtain information on how to keep the programme targeted and updated will be described and the changes that are going to be introduced will be outlined.
Artificial intelligence applications in logistics information systems : final report
DOT National Transportation Integrated Search
1990-04-01
This report is the principal deliverable from the LIMSS-AI project. It summarizes the results of a survey of existing applications and discusses the feasibility and benefits of specific candidate logistics applications.
The Web-based Electronic Data Review (WebEDR) application performs automated data evaluation on ERLN electronic data deliverables (EDDs). It uses test derived from the National Functional Guidelines combined with method-defined limits to measure data.
Appendix 4 : listing of deliverables.
DOT National Transportation Integrated Search
2004-07-01
In 1994, the U.S. Department of Transportation (DOT) and Mexicos Secretariat of Communications and Transportation (Secretara de Comunicaciones y Transportes (SCT)) signed a Memorandum of Understanding (MOU) outlining the creation of the Joint Wo...
Elsworth, Gerald R; Osborne, Richard H
2017-01-01
Objective: Participant self-report data play an essential role in the evaluation of health education activities, programmes and policies. When questionnaire items do not have a clear mapping to a performance-based continuum, percentile norms are useful for communicating individual test results to users. Similarly, when assessing programme impact, the comparison of effect sizes for group differences or baseline to follow-up change with effect sizes observed in relevant normative data provides more directly useful information compared with statistical tests of mean differences and the evaluation of effect sizes for substantive significance using universal rule-of-thumb such as those for Cohen’s ‘d’. This article aims to assist managers, programme staff and clinicians of healthcare organisations who use the Health Education Impact Questionnaire interpret their results using percentile norms for individual baseline and follow-up scores together with group effect sizes for change across the duration of typical chronic disease self-management and support programme. Methods: Percentile norms for individual Health Education Impact Questionnaire scale scores and effect sizes for group change were calculated using freely available software for each of the eight Health Education Impact Questionnaire scales. Data used were archived responses of 2157 participants of chronic disease self-management programmes conducted by a wide range of organisations in Australia between July 2007 and March 2013. Results: Tables of percentile norms and three possible effect size benchmarks for baseline to follow-up change are provided together with two worked examples to assist interpretation. Conclusion: While the norms and benchmarks presented will be particularly relevant for Australian organisations and others using the English-language version of the Health Education Impact Questionnaire, they will also be useful for translated versions as a guide to the sensitivity of the scales and the extent of the changes that might be anticipated from attendance at a typical chronic disease self-management or health education programme. PMID:28560039
Zerah, Simone; McMurray, Janet; Bousquet, Bernard; Baum, Hannsjorg; Beastall, Graham H; Blaton, Vic; Cals, Marie-Josèphe; Duchassaing, Danielle; Gaudeau-Toussaint, Marie-Françoise; Harmoinen, Aimo; Hoffmann, Hans; Jansen, Rob T; Kenny, Desmond; Kohse, Klaus P; Köller, Ursula; Gobert, Jean-Gérard; Linget, Christine; Lund, Erik; Nubile, Giuseppe; Opp, Matthias; Pazzagli, Mario; Pinon, Georges; Queralto, José M; Reguengo, Henrique; Rizos, Demetrios; Szekeres, Thomas; Vidaud, Michel; Wallinder, Hans
2006-01-01
The EC4 Syllabus for Postgraduate Training is the basis for the European Register of Specialists in Clinical Chemistry and Laboratory Medicine. The syllabus: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. The syllabus is not primarily meant to be a training guide, but on the basis of the overview given (common minimal programme), national societies should formulate programmes that indicate where knowledge and experience is needed. The main points of this programme are: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory management; and Quality insurance management. The aim of this version of the syllabus is to be in accordance with the Directive of Professional Qualifications published on 30 September 2005. To prepare the common platforms planned in this directive, the disciplines are divided into four categories: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory management; and Quality insurance management. General chemistry, encompassing biochemistry, endocrinology, chemical (humoral), immunology, toxicology, and therapeutic drug monitoring; Haematology, covering cells, transfusion serology, coagulation, and cellular immunology; Microbiology, involving bacteriology, virology, parasitology, and mycology; Genetics and IVF.