Space strategy and governance of ESA small member states

NASA Astrophysics Data System (ADS)

Sagath, Daniel; Papadimitriou, Angeliki; Adriaensen, Maarten; Giannopapa, Christina

2018-01-01

The European Space Agency (ESA) has twenty-two Member States with a variety of governance structures and strategic priorities regarding their space activities. The objective of this paper is to provide an up-to date overview and a holistic assessment of the national space governance structures and strategic priorities of the eleven smaller Member States (based on annual ESA contributions). A link is made between the governance structure and the main strategic objectives. The specific needs and interests of small and new Member States in the frame of European Space Integration are addressed. The first part of the paper focuses on the national space governance structures in the eleven smaller ESA Member States. The governance models of these Member States are identified including the responsible ministries and the entities entrusted with the implementation of space strategy/policy and programmes of the country. The second part of this paper focuses on the content and analysis of the national space strategies and indicates the main priorities and trends in the eleven smaller ESA Member States. The priorities are categorised with regards to technology domains, the role of space in the areas of sustainability and the motivators for space investments. In a third and final part, attention is given to the specific needs and interests of the smaller Member States in the frame of European space integration. ESA instruments are tailored to facilitate the needs and interests of the eleven smaller and/or new Member States.

Uptake of enhanced recovery practices by SAGES members: a survey.

PubMed

Keller, Deborah S; Delaney, Conor P; Senagore, Anthony J; Feldman, Liane S

2017-09-01

The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery. An online survey designed by SMART committee members to define SAGES member's awareness and use of enhanced recovery principles and practice was emailed to all SAGES members. Reminders were sent 2 and 3 weeks later, encouraging completion of the survey. The web-based survey included 48 questions and took an estimated 20 min to complete. A total of 229 members completed the survey. Respondents were primarily general/MIS surgeons (82.6%) working in an urban location (85.5%), with a bell-shaped age distribution (median 35-44). Almost half regularly used some elements of ERPs (48.7%), but 30% were unfamiliar with the concept. Wide variety in the specific ERP elements used and discharge criteria were reported. The majority had to create and implement their own plan (70.4%). Roadblocks to implementation were inconsistencies with partners/covering physicians (56.3%), nursing education (46.6%), and resources (34.7%). When implemented, members saw improvements in length of stay (88%), patient satisfaction (54.7%), postoperative pain (53.3%), time to return of bowel function (52.7%), and readmissions (16.7%). A need for education and standardization was especially seen in preoperative care, with 74.4% fasting patients from midnight the night before surgery. Wide variations were also reported in pain management practices. An overwhelming majority (89%) reported that having a protocol endorsed by a national organization, such as SAGES, would help with implementation. From this survey of SAGES members, there is a need for education, tools, and standardized protocols to increase awareness, support implementation, and encourage wider utilization of ERP. The overwhelming majority stated having a protocol endorsed by a national organization, such as SAGES, would facilitate implementation.

Emerging and Disruptive Technologies for Education: An Analysis of Planning, Implementation, and Diffusion in Florida's Eleven State University System Institutions

ERIC Educational Resources Information Center

Bradford, Deborah J.

2010-01-01

The purpose of the study was to understand and appreciate the methodologies and procedures used in determining the extent to which an information technology (IT) organization within the eleven member State University Systems (SUS) of Florida planned, implemented, and diffused emerging educational technologies. Key findings found how critical it…

Protecting health from climate change in the WHO European Region.

PubMed

Wolf, Tanja; Martinez, Gerardo Sanchez; Cheong, Hae-Kwan; Williams, Eloise; Menne, Bettina

2014-06-16

"How far are we in implementing climate change and health action in the WHO European Region?" This was the question addressed to representatives of WHO European Member States of the working group on health in climate change (HIC). Twenty-two Member States provided answers to a comprehensive questionnaire that focused around eight thematic areas (Governance; Vulnerability, impact and adaptation (health) assessments; Adaptation strategies and action plans; Climate change mitigation; Strengthening health systems; Raising awareness and building capacity; Greening health services; and Sharing best practices). Strong areas of development are climate change vulnerability and impact assessments, as well as strengthening health systems and awareness raising. Areas where implementation would benefit from further action are the development of National Health Adaptation Plans, greening health systems, sharing best practice and reducing greenhouse gas emissions in other sectors. At the Parma Conference in 2010, the European Ministerial Commitment to Act on climate change and health and the European Regional Framework for Action to protect health from climate change were endorsed by fifty three European Member States. The results of this questionnaire are the most comprehensive assessment so far of the progress made by WHO European Member States to protecting public health from climate change since the agreements in Parma and the World Health Assembly Resolution in 2008.

Library Service in Delaware.

ERIC Educational Resources Information Center

Humphry, John A.; Humphry, James, III

This study which gives detailed recommendations for the implementation of a state-wide library improvement program for Delaware is based on visits to all types of libraries and library agencies in the state and conference with members of the State Library Commission, library trustees, state and local officials, librarians and interested laymen.…

Regulatory requirements for biocides on the market in the European Union according to Directive 98/8/EC.

PubMed

Rasmussen, K; Chemin, P; Haastrup, P

1999-06-30

In early 1998, the European Commission and Parliament adopted a new Directive concerning the placing on the market of biocidal products. The Directive is to be implemented in the member states by May 2000. The member states are currently concerned with the national implementation into legislation whereas the Commission is setting up the proposal for a review programme for the existing active substances and the products in which they are used. This paper describes the effort currently undertaken (up to the end of December 1998) to define the procedures to be used and characterise the substances covered. Copyright 1999 Elsevier Science B.V.

Assessing the Legality of State Tournament Bans in Interscholastic Athletics

ERIC Educational Resources Information Center

Scott, Beau

2017-01-01

State high school athletic associations are tasked with facilitating equitable athletic opportunities for all member schools. To accomplish this task, state associations implement rules designed to ensure competitive balance (Johnson, Tracy, & Pierce, 2015). With over 7.8 million participants, interscholastic athletics are extremely popular…

Monitoring the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel.

PubMed

Siyam, Amani; Zurn, Pascal; Rø, Otto Christian; Gedik, Gulin; Ronquillo, Kenneth; Joan Co, Christine; Vaillancourt-Laflamme, Catherine; dela Rosa, Jennifer; Perfilieva, Galina; Dal Poz, Mario Roberto

2013-11-01

To present the findings of the first round of monitoring of the global implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel ("the Code"), a voluntary code adopted in 2010 by all 193 Member States of the World Health Organization (WHO). WHO requested that its Member States designate a national authority for facilitating information exchange on health personnel migration and the implementation of the Code. Each designated authority was then sent a cross-sectional survey with 15 questions on a range of topics pertaining to the 10 articles included in the Code. A national authority was designated by 85 countries. Only 56 countries reported on the status of Code implementation. Of these, 37 had taken steps towards implementing the Code, primarily by engaging relevant stakeholders. In 90% of countries, migrant health professionals reportedly enjoy the same legal rights and responsibilities as domestically trained health personnel. In the context of the Code, cooperation in the area of health workforce development goes beyond migration-related issues. An international comparative information base on health workforce mobility is needed but can only be developed through a collaborative, multi-partnered approach. Reporting on the implementation of the Code has been suboptimal in all but one WHO region. Greater collaboration among state and non-state actors is needed to raise awareness of the Code and reinforce its relevance as a potent framework for policy dialogue on ways to address the health workforce crisis.

APPLYING LESSONS LEARNED FROM THE UNITED STATES SPECIAL OPERATIONS COMMAND’S HUMAN PERFORMANCE PROGRAM TO THE UNITED STATES AIR FORCES COMPREHENSIVE AIRMAN FITNESS

DTIC Science & Technology

2016-04-01

implementation, focusing physical training on the mission specific requirements of the individual similar to an athletic sports model, increasing access to...initiative as a mechanism to help maintain the resiliency, health, and welfare of its force.1 As Air Force Instruction (AFI) 90-506 states, the strategy ...implementation of Tactical Athlete Programs, which provide tailored workout plans and nutrition education that prepare service members to meet the physical

Management, regulation and environmental impacts of nitrogen fertilization in Northwestern Europe under the Nitrates Directive; a benchmark study

NASA Astrophysics Data System (ADS)

van Grinsven, H. J. M.; ten Berge, H. F. M.; Dalgaard, T.; Fraters, B.; Durand, P.; Hart, A.; Hofman, G.; Jacobsen, B. H.; Lalor, S. T. J.; Lesschen, J. P.; Osterburg, B.; Richards, K. G.; Techen, A.-K.; Vertès, F.; Webb, J.; Willems, W. J.

2012-06-01

Implementation of the Nitrates Directive (NiD) and its environmental impacts were compared for member states in the Northwest of the European Union (Ireland, UK, Denmark, The Netherlands, Belgium, Northern France and Germany). The main sources of data were national reports for the third reporting period for the NiD (2004-2007) and results of the MITERRA-EUROPE model. Implementation of the NiD in the considered member states is fairly comparable regarding restrictions for where and when to apply fertilizer and manure, but very different regarding application limits for N fertilization. Issues of concern and improvement of the implementation of the NiD are accounting for the fertilizer value of nitrogen in manure, and relating application limits for total nitrogen (N) to potential crop yield and N removal. The most significant environmental effect of the implementation of the NiD since 1995 is a major contribution to the decrease of the soil N balance (N surplus), particularly in Belgium, Denmark, Ireland, The Netherlands and the UK. This decrease is accompanied by a modest decrease of nitrate concentrations since 2000 in fresh surface waters in most countries. This decrease is less prominent for groundwater in view of delayed response of nitrate in deep aquifers. In spite of improved fertilization practices, the southeast of The Netherlands, the Flemish Region and Brittany remain to be regions of major concern in view of a combination of a high nitrogen surplus, high leaching fractions to groundwater and tenacious exceedance of the water quality standards. On average the gross N balance in 2008 for the seven member states in EUROSTAT and in national reports was about 20 kg N ha-1 lower than by MITERRA. The major cause is higher estimates of N removal in national reports which can amount to more than 50kg N ha-1. Differences between procedures in member states to assess nitrogen balances and water quality and a lack of cross boundary policy evaluations are handicaps when benchmarking the effectiveness of the NiD. This provides a challenge for the European Commission and its member states as the NiD remains an important piece of legislation for protecting drinking water quality in regions with many private or small public production facilities and controlling aquatic eutrophication from agricultural sources.

Management, regulation and environmental impacts of nitrogen fertilization in northwestern Europe under the Nitrates Directive; a benchmark study

NASA Astrophysics Data System (ADS)

van Grinsven, H. J. M.; ten Berge, H. F. M.; Dalgaard, T.; Fraters, B.; Durand, P.; Hart, A.; Hofman, G.; Jacobsen, B. H.; Lalor, S. T. J.; Lesschen, J. P.; Osterburg, B.; Richards, K. G.; Techen, A.-K.; Vertès, F.; Webb, J.; Willems, W. J.

2012-12-01

Implementation of the Nitrates Directive (NiD) and its environmental impacts were compared for member states in the northwest of the European Union (Ireland, United Kingdom, Denmark, the Netherlands, Belgium, Northern France and Germany). The main sources of data were national reports for the third reporting period for the NiD (2004-2007) and results of the MITERRA-EUROPE model. Implementation of the NiD in the considered member states is fairly comparable regarding restrictions for where and when to apply fertilizer and manure, but very different regarding application limits for N fertilization. Issues of concern and improvement of the implementation of the NiD are accounting for the fertilizer value of nitrogen in manure, and relating application limits for total nitrogen (N) to potential crop yield and N removal. The most significant environmental effect of the implementation of the NiD since 1995 is a major contribution to the decrease of the soil N balance (N surplus), particularly in Belgium, Denmark, Ireland, the Netherlands and the United Kingdom. This decrease is accompanied by a modest decrease of nitrate concentrations since 2000 in fresh surface waters in most countries. This decrease is less prominent for groundwater in view of delayed response of nitrate in deep aquifers. In spite of improved fertilization practices, the southeast of the Netherlands, the Flemish Region and Brittany remain to be regions of major concern in view of a combination of a high nitrogen surplus, high leaching fractions to groundwater and tenacious exceedance of the water quality standards. On average the gross N balance in 2008 for the seven member states in EUROSTAT and in national reports was about 20 kg N ha-1 yr-1 lower than by MITERRA. The major cause is higher estimates of N removal in national reports which can amount to more than 50 kg N ha-1 yr-1. Differences between procedures in member states to assess nitrogen balances and water quality and a lack of cross-boundary policy evaluations are handicaps when benchmarking the effectiveness of the NiD. This provides a challenge for the European Commission and its member states, as the NiD remains an important piece of legislation for protecting drinking water quality in regions with many private or small public production facilities and controlling aquatic eutrophication from agricultural sources.

A Holocaust Exhibit ePortfolio: Actively Engaging Students

ERIC Educational Resources Information Center

Jordine, Melissa

2015-01-01

California State University, Fresno is currently considering implementing an ePortfolio requirement for all undergraduate students. The ePortfolio requirement would be introduced primarily to engage students in a HIP (high impact practice) but would also be used for assessment purposes. As a faculty member and a member of the CSU Fresno ePortfolio…

Planning/Budgeting/Evaluation Manual. An Operation Manual for Staff Members Concerning the Implementation of the Planning/Budgeting/Evaluation Cycle Within the Missouri State Department of Education.

ERIC Educational Resources Information Center

Missouri State Dept. of Education, Jefferson City.

This manual identifies and systematizes the sequence of events necessary for the State Department of Education to effectively plan, implement, and evaluate its varied programs. The report (1) describes the cycle, (2) outlines the flow of events, (3) delineates offices responsible for each event, and (4) discusses overlapping phases of event cycles…

Hospital Exemption for Advanced Therapy Medicinal Products: Issue in Application in the European Union Member States.

PubMed

Ivaskiene, Tatjana; Mauricas, Mykolas; Ivaska, Justinas

2017-01-01

Regulation (EC) 1394/2007 of the European Parliament and the Council on advanced therapy medicinal products and amending Directive 2001/83/EC and Regulation (EC) No 726/2004 allowed the use of non - authorized advanced therapy medicinal products under the certain circumstances. This socalled hospital exemption rule needs to be applied in the each Member State of the European Union individually and for this purpose Member States should provide national procedures and control measures. The aim of this article is to clear up the criteria for hospital exemption listed in Regulation (EC) 1394/2007 and to contrast the difference in implementing hospital exemption rule into national legal regimes on examples of the United Kingdom, Lithuania and Poland.

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

NASA Astrophysics Data System (ADS)

Grath, Johannes; Ward, Rob; Hall, Anna

2013-04-01

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

Creating an Education Research Acculturation Theory for Research Implementation in School

ERIC Educational Resources Information Center

Chua, Yan Piaw; Tie, Fatt Hee; Don, Zuraidah Mohd

2013-01-01

This study investigates the implementation of educational research among urban secondary schools in Malaysia. The respondents include school teachers and administrators, lecturers in education institutions, and committee members of the state education departments. Data collected from interviews were coded and analyzed using open, axial and…

Constraints, challenges and prospects of public-private partnership in health-care delivery in a developing economy.

PubMed

Anyaehie, Usb; Nwakoby, Ban; Chikwendu, C; Dim, Cc; Uguru, N; Oluka, Cpi; Ogugua, C

2014-01-01

In Nigeria, concerns on the quality and financing of health-care delivery especially in the public sector have initiated reforms including support for public-private partnerships (PPP) at the Federal Ministry of Health. Likewise, Enugu State has developed a draft policy on PPP since 2005. However, non-validation and non-implementation of this policy might have led to loss of interest in the partnership. The aim of this study was to provide evidence for planning the implementation of PPP in Enugu State health system via a multi-sectoral identification of challenges, constraints and prospects. Pre-tested questionnaires were administered to 466 respondents (251 health workers and 215 community members), selected by multi-stage sampling method from nine Local Government Areas of Enugu State, Nigeria, over a study period of April 2011 to September 2011. Data from the questionnaires were collated manually and quantitative data analyzed using SPSS version 15 (Chicago, IL, USA). Only 159 (34.1%, 159/466) of all respondents actually understood the meaning of PPP though 251 (53.9%) of them had claimed knowledge of the concept. This actual understanding was higher among health workers (57.8%, 145/251) when compared with the community members (6.5%, 14/215) (P < 0.001). Post-PPP enlightenment reviews showed a more desire for PPP implementation among private health-care workers (89.4%, 101/113) and community leaders/members (55.4%, 119/215). PPP in health-care delivery in Enugu State is feasible with massive awareness, elaborate stakeholder's engagements and well-structured policy before implementation. A critical challenge will be to convince the public sector workers who are the anticipated partners to accept and support private sector participation.

36 CFR 61.3 - Implementation of this part.

Code of Federal Regulations, 2012 CFR

2012-07-01

... State, tribal, or local government system establishes and maintains accounting standards substantially...) member whom the Secretary has approved as meeting “the Secretary's (Historic Preservation) Professional...

36 CFR 61.3 - Implementation of this part.

Code of Federal Regulations, 2014 CFR

2014-07-01

... State, tribal, or local government system establishes and maintains accounting standards substantially...) member whom the Secretary has approved as meeting “the Secretary's (Historic Preservation) Professional...

36 CFR 61.3 - Implementation of this part.

Code of Federal Regulations, 2013 CFR

2013-07-01

... State, tribal, or local government system establishes and maintains accounting standards substantially...) member whom the Secretary has approved as meeting “the Secretary's (Historic Preservation) Professional...

36 CFR 61.3 - Implementation of this part.

Code of Federal Regulations, 2010 CFR

2010-07-01

... State, tribal, or local government system establishes and maintains accounting standards substantially...) member whom the Secretary has approved as meeting “the Secretary's (Historic Preservation) Professional...

36 CFR 61.3 - Implementation of this part.

Code of Federal Regulations, 2011 CFR

2011-07-01

... State, tribal, or local government system establishes and maintains accounting standards substantially...) member whom the Secretary has approved as meeting “the Secretary's (Historic Preservation) Professional...

The European Working Time Directive: effect on education and clinical care.

PubMed

Waurick, René; Weber, Thomas; Bröking, Katrin; Van Aken, Hugo

2007-12-01

In 2009 the European Working Time Directive limits the weekly working hours to an average of 48 in all European Union member states. The recent published effects on education and patient care are discussed. In European Union member states with traditional long working hours for hospital doctors the reduced working hours led to a decrease in trainee case loads. A negative effect on patients care is only suspected, but not yet measured. In particular, British anesthetists started a discussion about the required changes in training and assessment to counterbalance the lack of practice. European Surgical Disciplines demand for 48 h working time and 12 h teaching and education time per week for trainees. So far many member states have delayed the implementation of European laws in national laws. There are less measured clinical facts than political statements published. The actual working time directives in the European Union member states are inconsistent and further political development on this topic across the European Union remains unclear.

Changes in Teaching Hospitals' Community Benefit Spending After Implementation of the Affordable Care Act.

PubMed

Alberti, Philip M; Sutton, Karey M; Baker, Matthew

2018-05-22

U.S. teaching hospitals that qualify as 501(c)(3) organizations (a not-for-profit designation) are required to demonstrate community benefit annually. Increases in health insurance access driven by Affordable Care Act (ACA) implementation, along with new regulations, research opportunities, and educational expectations, may be changing hospitals' allocations of community benefit dollars. This study aimed to describe changes in teaching hospitals' community benefit spending between 2012 (pre-ACA implementation) and 2015 (post-ACA implementation), and to explore differences in spending changes between hospitals in Medicaid expansion and non-expansion states. In 2017, for each teaching hospital member of the Association of American Medical Colleges' (AAMC's) Council of Teaching Hospitals and Health Systems required to submit Form 990s to the Internal Revenue Service, the authors sought community benefit spending data for 2012 and 2015 as reported on Schedule H. The analysis included 169 pairs of Form 990s representing 184 AAMC member teaching hospitals (93% of 198 eligible hospitals). Compared with 2012, hospitals in 2015 spent $3.1 billion (20.14%) more on community benefit despite spending $804 million (16.17%) less on charity care. Hospitals in Medicaid expansion states increased spending on subsidized health services and Medicaid shortfalls at rates higher than hospitals in non-expansion states. The latter increased spending at higher rates on community health improvement and cash/in-kind contributions. After ACA implementation, teaching hospitals increased their overall community benefit spending while their charity care spending declined. Changes in community benefit spending differed according to states' Medicaid expansion status, demonstrating hospitals' responsiveness to state and local realities.

Monitoring the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel

PubMed Central

Zurn, Pascal; Rø, Otto Christian; Gedik, Gulin; Ronquillo, Kenneth; Joan Co, Christine; Vaillancourt-Laflamme, Catherine; dela Rosa, Jennifer; Perfilieva, Galina; Dal Poz, Mario Roberto

2013-01-01

Abstract Objective To present the findings of the first round of monitoring of the global implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”), a voluntary code adopted in 2010 by all 193 Member States of the World Health Organization (WHO). Methods WHO requested that its Member States designate a national authority for facilitating information exchange on health personnel migration and the implementation of the Code. Each designated authority was then sent a cross-sectional survey with 15 questions on a range of topics pertaining to the 10 articles included in the Code. Findings A national authority was designated by 85 countries. Only 56 countries reported on the status of Code implementation. Of these, 37 had taken steps towards implementing the Code, primarily by engaging relevant stakeholders. In 90% of countries, migrant health professionals reportedly enjoy the same legal rights and responsibilities as domestically trained health personnel. In the context of the Code, cooperation in the area of health workforce development goes beyond migration-related issues. An international comparative information base on health workforce mobility is needed but can only be developed through a collaborative, multi-partnered approach. Conclusion Reporting on the implementation of the Code has been suboptimal in all but one WHO region. Greater collaboration among state and non-state actors is needed to raise awareness of the Code and reinforce its relevance as a potent framework for policy dialogue on ways to address the health workforce crisis. PMID:24347705

The existing situation and challenges regarding the use of plastic carrier bags in Europe.

PubMed

Kasidoni, Maria; Moustakas, Konstantinos; Malamis, Dimitris

2015-05-01

Since day one, retailers and consumers have favoured plastic carrier bags. However, owing to the numerous environmental disadvantages, lightweight plastic carrier bags have been drawing the attention of the European Union competent authorities. Therefore, many European Union member states have taken action so as to reduce the use of plastic carrier bags. Based on the existing legislation and voluntary initiatives for the reduction of lightweight plastic carrier bags, the challenges and achieved outcomes from the implemented policy options in the various European Union member states are discussed and commented regarding the forthcoming transposition of the 'Directive 94/62/EC on packaging and packaging waste to reduce the consumption of lightweight plastic carrier bags' into the European Union member states' national law. © The Author(s) 2015.

3 CFR - Provision of Defense Articles and Services to Vetted Members of the Syrian Opposition for Use in...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Provision of Defense Articles and Services to Vetted... and Related Materials, Organizations Implementing U.S. Department of State or U.S. Agency for... Determination No. 2013-15 of September 16, 2013 Provision of Defense Articles and Services to Vetted Members of...

Reluctant to Learn? The Use of Evaluation to Improve EU Cohesion Policy Implementation in Polish and Spanish Regions

ERIC Educational Resources Information Center

Wojtowicz, Dominika Maria; Kupiec, Tomasz

2018-01-01

For many European Union (EU) member states, the Cohesion Policy (CP) was the channel through which the practice of evaluation was transmitted into domestic administration. Studies have shown that the EU member countries differ in terms of their evaluation capacity and activity. None of those studies, however, addresses regional governments, which…

Iowa's Medicaid Expansion Promoted Healthy Behaviors But Was Challenging To Implement And Attracted Few Participants.

PubMed

Askelson, Natoshia M; Wright, Brad; Bentler, Suzanne; Momany, Elizabeth T; Damiano, Peter

2017-05-01

As part of Iowa's Medicaid expansion, the Healthy Behaviors Program was designed to provide members with incentives to complete specified healthy activities in return for waiving monthly premiums. We used claims data and interviews to document the first year (2014) of the program's implementation. Healthy activities completion rates did not exceed 17 percent. Interviews with members and clinic managers revealed low levels of awareness of the program's existence, deficits in knowledge about how the program works, and a variety of barriers to activity completion. Our findings suggest that the lack of knowledge hindered the state's ability to incentivize activities and that it subjected beneficiaries to premium expenses and potential disenrollment. These results should guide federal and state policy makers in devising more effective ways of educating Medicaid beneficiaries and providers about programs that incentivize responsibility for healthy behaviors. The results suggest that efforts by federal and state governments to reform Medicaid by shifting responsibility onto program members for healthy behaviors are unlikely to succeed, especially without careful thought and design of premiums, penalties, and incentives for participants. Project HOPE—The People-to-People Health Foundation, Inc.

Biosafety and Biosecurity in European Containment Level 3 Laboratories: Focus on French Recent Progress and Essential Requirements.

PubMed

Pastorino, Boris; de Lamballerie, Xavier; Charrel, Rémi

2017-01-01

Even if European Union (EU) Member States are obliged to implement EU Directives 2000/54/EC on the protection of workers from risks related to exposure to biological agents at work , national biosafety regulations and practices varied from country to country. In fact, EU legislation on biological agents and genetically modified microorganisms is often not specific enough to ensure harmonization leading to difficulties in implementation for most laboratories. In the same way, biosecurity is a relatively new concept and a few EU Member States are known to have introduced national laboratory biosecurity legislation. In France, recent regulations have reinforced biosafety/biosecurity in containment level 3 (CL-3) laboratories but they concern a specific list of pathogens with no correlation in other European Members States. The objective of this review was to summarize European biosafety/biosecurity measures concerning CL-3 facilities focusing on French specificities. Essential requirements needed to preserve efficient biosafety measures when manipulating risk group 3 biological agents are highlighted. In addition, International, European and French standards related to containment laboratory planning, operation or biosafety equipment are described to clarify optimal biosafety and biosecurity requirements.

Biosafety and Biosecurity in European Containment Level 3 Laboratories: Focus on French Recent Progress and Essential Requirements

PubMed Central

Pastorino, Boris; de Lamballerie, Xavier; Charrel, Rémi

2017-01-01

Even if European Union (EU) Member States are obliged to implement EU Directives 2000/54/EC on the protection of workers from risks related to exposure to biological agents at work, national biosafety regulations and practices varied from country to country. In fact, EU legislation on biological agents and genetically modified microorganisms is often not specific enough to ensure harmonization leading to difficulties in implementation for most laboratories. In the same way, biosecurity is a relatively new concept and a few EU Member States are known to have introduced national laboratory biosecurity legislation. In France, recent regulations have reinforced biosafety/biosecurity in containment level 3 (CL-3) laboratories but they concern a specific list of pathogens with no correlation in other European Members States. The objective of this review was to summarize European biosafety/biosecurity measures concerning CL-3 facilities focusing on French specificities. Essential requirements needed to preserve efficient biosafety measures when manipulating risk group 3 biological agents are highlighted. In addition, International, European and French standards related to containment laboratory planning, operation or biosafety equipment are described to clarify optimal biosafety and biosecurity requirements. PMID:28620600

Work and Childcare: Implementing the Council Recommendation on Childcare. A Guide to Good Practice. Social Europe Supplement.

ERIC Educational Resources Information Center

Commission des Communautes Europeennes (Luxembourg).

In 1992, the Council of European Community Member States adopted the Childcare Recommendation, describing the elements of effective childcare systems, to assist in the development of public policy to help parents reconcile work and family roles. This guide provides detailed suggestions for implementing these elements. Following an introduction…

Fire in the OR--developing a fire safety plan.

PubMed

McCarthy, Patricia M; Gaucher, Kenneth A

2004-03-01

Approximately 100 operating room fire occur each year in the United States. Although rare, fire in a perioperative setting can be disastrous for both patients and staff members. It is crucial that all perioperative departments have a well thought out and previously rehearsed fire plan in place. Multidisciplinary planning and implementation of regularly scheduled and scripted fire drills are essential to prevent adverse outcomes. Fire drills ensure that all staff members are familiar with the use and location of fire pull stations, fire extinguishers, and fire blankets. Fire drills also prepare staff members to evacuate the OR area if necessary. This article provides the information and framework necessary to develop and implement comprehensive OR fire safety plans that could make the difference between life and death in a fire emergency.

[The Pan American Health Organization's gender equality policy].

PubMed

2006-02-01

The 46th Directing Council of the Pan American Health Organization (PAHO) approved this past September a document entitled " Proposed PAHO gender equality policy" and urged Member States to implement specific policies accordingly, in collaboration with other government sectors, international organizations, and interested parties from civil society. The approved policy is rooted in principles of gender equality and gender equity, the empowerment of men and women, respect for diversity, and gender mainstreaming. PAHO will integrate and support among its Member States the perspective of gender equality in planning, implementing, monitoring, and evaluating policies, programs, projects, and research. The aim is among other things, to attain the highest possible health and well-being for men and women during their whole life cycle, as well as in all population groups. Hopefully these measures will help propel the Region toward the attainment of true gender equality.

Similarities, Divergence, and Incapacity in the Bologna Process Reform Implementation by the Former-Socialist Countries: The Self-Defeat of State Regulations

ERIC Educational Resources Information Center

Soltys, Dennis

2015-01-01

This qualitative analysis describes the socialist legacy in the governance of higher education within the former Soviet-led member countries that entered the European Higher Education Area (EHEA) between 2001 and 2010. In joining the EHEA these countries signed on for the Bologna Process (BP), but are not members of the European Union. The…

78 FR 9589 - Disclosures To Participate in State Prescription Drug Monitoring Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... patient information in order to implement VA's authority to participate in State Prescription Drug... the Act amended 38 U.S.C. 5701, which governs the confidential nature of VA claims and information of present and former members of the Armed Forces and their dependents in VA's possession, by adding a new...

Trends in State Implementation of the Common Core State Standards: Making the Shift to Better Tests. NGA Paper

ERIC Educational Resources Information Center

Nielson, Kate

2014-01-01

The Common Core State Standards (CCSS) for K-12 English language arts/literacy and mathematics, released in 2010, have been adopted by 49 states and territories; the District of Columbia; and the U.S. Department of Defense schools, which serve the children of U.S. service members around the world. The widespread adoption of the CCSS is a major…

Grants for adaptive sports programs for disabled veterans and disabled members of the Armed Forces. Final rule.

PubMed

2015-05-04

This final rule amends Department of Veterans Affairs (VA) regulations to establish a new program to provide grants to eligible entities to provide adaptive sports activities to disabled veterans and disabled members of the Armed Forces. This rulemaking is necessary to implement a change in the law that authorizes VA to make grants to entities other than the United States Olympic Committee for adaptive sports programs. It establishes procedures for evaluating grant applications under this grant program, and otherwise administering the grant program. This rule implements section 5 of the VA Expiring Authorities Extension Act of 2013.

Innovative funding of educational outreach by a state agency

USGS Publications Warehouse

Kopaska-Merkel, D. C.

2001-01-01

The educational role of state geological surveys is increasing yet state funding for this role is commonly lacking. Staff members of the Geological Survey of Alabama/State Oil and Gas Board of Alabama have developed and implemented a succesful Outside Funding Model to support educational outreach programs. Staff members created an informal organization within the agency and raised money specifically for educational outreach. The primary vehicles for fund raising are an annual charity golf tournament, sales of t-shirts and field-trip guidebooks, and small grants awarded by a variety of organizations. The money raised is used to fund a wide variety of educational activities that would not be possible otherwise. The Alabama Outside Funding Model could be duplicated by surveys or similar agencies in other states.

Voices from the Field: Implementing and Scaling-Up Universal Design for Learning in Teacher Preparation Programs

ERIC Educational Resources Information Center

Moore, Eric J.; Smith, Frances G.; Hollingshead, Aleksandra; Wojcik, Brian

2018-01-01

There is increasing pressure on universities in the United States to meet the needs of diverse learners. This fact increases the urgency for implementation and scaling up of Universal Design for Learning (UDL) in higher education. This qualitative study draws two major insights from interviews with six faculty members from universities and…

The Fidelity of Implementation of the Response to Intervention (RTI) Process in Missouri Public Schools

ERIC Educational Resources Information Center

Drury, Debra A.

2014-01-01

The purpose of this problem-based study was to gather data which analyzed the degree of fidelity of implementation of Response to Intervention as reported by building principals in the State of Missouri. The project began when team members, providing professional development for the Response to Intervention process, came to the conclusion there…

The Future of NATO Enlargement

DTIC Science & Technology

1998-01-01

Baltic states, Estoma , Latvia and Llthuama, as well as Albania and states of the former Yugoslatla are also generally consldered to be part of...Rornama, Slovema. Slovakia, Bulgaria. Macedoma Albania, Estoma , Latvia and Llthuama) decided to participate. The exceptions were the three states...reforms. Estoma 1s already a strong candidate for NATO member&up Latvia and Lrthuama are havmg greater drfficulties in implementing reforms, but then

32 CFR 144.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF THE ARMED FORCES ON STATE AND LOCAL JURIES § 144.1 Purpose. This part implements 10 U.S.C. 982 to establish uniform DoD policies for jury service by members of the Armed Forces on active duty. ...

76 FR 44265 - Approval and Disapproval and Promulgation of State Implementation Plan Revisions; Infrastructure...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-25

..., regulated entities, or members of the public to be under the misconception that the Agency's approval of the... 22, 2011 containing comments from WildEarth Guardians (WEG), an environmental organization. The...

[The EU law on genetically modified organisms: the European Commission changes the strategy in order to allow, restrict, or prohibit its culture].

PubMed

González Vaqué, Luis

2010-01-01

On July 13 2010, the European Commission adopted a series of measures which outline a new approach on Genetically Modified Organisms (GMOs) cultivation in the Member States. This proposal, which still retains the basis of the existing science-based GMO authorisation system, will be implemented through: a Communication from the Commission, explaining the new approach on the freedom for Member States to decide on the cultivation of genetically modified crops; the "Proposal for a Regulation of the European Parliament and of the Council amending Directive 2001/18/EC as regards the possibility for the Member States to restrict or prohibit the cultivation of GMOs in their territory"; and a new "European Commission Recommendation (2010/C 200/01) of 13 July 2010 on guidelines for the development of national co-existence measures to avoid the unintended presence of GMOs in conventional and organic crops".

76 FR 43918 - Approval and Promulgation of State Implementation Plan Revisions; Infrastructure Requirements for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

... entities, or members of the public to be under the misconception that the Agency's approval of the...Earth Guardians (WG), an environmental organization. The significant comments made in WG's June 20, 2011...

What factors influence smoking prevalence and smoke free policy enactment across the European Union Member States.

PubMed

Bogdanovica, Ilze; McNeill, Ann; Murray, Rachael; Britton, John

2011-01-01

Smoking prevention should be a primary public health priority for all governments, and effective preventive policies have been identified for decades. The heterogeneity of smoking prevalence between European Union (EU) Member States therefore reflects, at least in part, a failure by governments to prioritise public health over tobacco industry or possibly other financial interests, and hence potentially government corruption. The aims of this study were to test the hypothesis that smoking prevalence is higher in countries with high levels of public sector corruption, and explore the ecological association between smoking prevalence and a range of other national characteristics in current EU Member States. Ecological data from 27 EU Member States were used to estimate univariate and multivariate correlations between smoking prevalence and the Transparency International Corruption Perceptions Index, and a range of other national characteristics including economic development, social inclusion, quality of life and importance of religion. We also explored the association between the Corruption Perceptions Index and measures of the extent to which smoke-free policies have been enacted and are enforced. In univariate analysis, smoking prevalence was significantly higher in countries with higher scores for corruption, material deprivation, and gender inequality; and lower in countries with higher per capita Gross Domestic Product, social spending, life satisfaction and human development scores. In multivariate analysis, only the corruption perception index was independently related to smoking prevalence. Exposure to tobacco smoke in the workplace was also correlated with corruption, independently from smoking prevalence, but not with the measures of national smoke-free policy implementation. Corruption appears to be an important risk factor for failure of national tobacco control activity in EU countries, and the extent to which key tobacco control policies have been implemented. Further research is needed to assess the causal relationships involved.

Qualification Requirement Perceptions of the United States Army Acquisition Workforce Since Implementation of the Defense Acquisition Workforce Improvement Act (DAWIA)

DTIC Science & Technology

2013-11-09

in part to the formalized entry-level training that military service members receive. The entry-level training does count towards certification in...Acquisition Assignments The survey requested information regarding whether the workforce members had served in an assignment that did not count ...towards DAWIA certification. Approximately 14.1% of the respondents indicated that they had held assignments that did not count towards certification

East is east and West is west? Management of marine bioinvasions in the Mediterranean Sea

NASA Astrophysics Data System (ADS)

Galil, Bella S.; Marchini, Agnese; Occhipinti-Ambrogi, Anna

2018-02-01

At 726 the number of recorded multicellular non indigenous species (NIS) in the Mediterranean Sea is far higher than in other European Seas. Of these, 614 have established populations in the sea. 384 are considered Erythraean NIS, the balance are mostly ship and culture-introductions. In order to effectively implement EU Regulation on the prevention and management of the introduction and spread of invasive NIS and the Marine Strategy Framework Directive in the Mediterranean Sea it is crucial that this priority pathway is appropriately managed. Three potential impediments - incomplete and inaccurate data; unknown impacts; policy mismatch - hinder implementation. Current geographical, taxonomical and impact data gaps will be reduced only by instituting harmonized standards and methodologies for monitoring NIS populations in all countries bordering the Mediterranean Sea, prioritizing bridgehead sites and dispersal hubs. The option of implementing European environmental policies concerning marine NIS in member states alone may seem expedient, but piecemeal protection is futile. Since only 9 of the 23 states bordering the Mediterranean are EU member states, the crucial element for an effective strategy for slowing the influx of NIS is policy coordination with the Regional Sea Convention (Barcelona Convention) to ensure consistency in legal rules, standards and institutional structures to address all major vectors/pathways.

The Multi-Sector Sustainability Browser (MSSB): Planning and Developing Sustainability Initiatives Affecting Land Use

EPA Science Inventory

The United States Environmental Protection Agency (EPA) Sustainable and Healthy Communities (SHC) Research Program develops methodologies, resources, and tools to assist local and regional community planners, community members, and local decision makers in implementing sustainabl...

Measles elimination – review of event notifications sent to National IHR Focal Point between 2010 and 2016

PubMed

Izdebski, Radosław; Henszel, Łukasz; Janiec, Janusz; Radziszewski, Franciszek

The Member States of the World Health Organization (WHO) in accordance with International Health Regulations (2005) were obliged to appoint National IHR Focal Points (N IHR FP), of which tasks include obtaining information concerning public health emergencies of international concern which occurred abroad or within the country. The aim of this work is the review of WHO, ECDC, National IHR Focal Points from the WHO Member States and The State Sanitary Inspection notifications related to measles received by National IHR Focal Point in Poland in the period from 2010 to 2016. During this period N IHR FP was informed about 79 events related to measles. These events include: 36 related to the outbreaks in different countries, 27 concerning individual cases, 14 related to the exposure in contact with a measles case during air travel and two concerning the implementation of the MMR vaccination programs. Despite the progress in implementing the measures included in the elimination of measles programs in Europe, there was a significant increase in the number of measles cases and outbreaks particularly in years 2010-2011.

Strategies for the Legal Implementation of the International Code of Marketing of Breast-Milk Substitutes: Report on a WHO Meeting (Copenhagen, Denmark, November 10-12, 1982).

ERIC Educational Resources Information Center

World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

For various reasons, several countries have had difficulty implementing the International Code of Marketing of Breast-milk Substitutes. To address those problems, a meeting was convened under the auspices of the World Health Organization. Specific purposes of the meeting were to inform member states about the Code and to develop national…

Institutional framework for integrated Pharmaceutical Benefits Management: results from a systematic review

PubMed Central

Hermanowski, Tomasz Roman; Drozdowska, Aleksandra Krystyna; Kowalczyk, Marta

2015-01-01

Objectives In this paper, we emphasised that effective management of health plans beneficiaries access to reimbursed medicines requires proper institutional set-up. The main objective was to identify and recommend an institutional framework of integrated pharmaceutical care providing effective, safe and equitable access to medicines. Method The institutional framework of drug policy was derived on the basis of publications obtained by systematic reviews. A comparative analysis concerning adaptation of coordinated pharmaceutical care services in the USA, the UK, Poland, Italy, Denmark and Germany was performed. Results While most European Union Member States promote the implementation of selected e-Health tools, like e-Prescribing, these efforts do not necessarily implement an integrated package. There is no single agent who would manage an insured patients’ access to medicines and health care in a coordinated manner, thereby increasing the efficiency and safety of drug policy. More attention should be paid by European Union Member States as to how to integrate various e-Health tools to enhance benefits to both individuals and societies. One solution could be to implement an integrated “pharmacy benefit management” model, which is well established in the USA and Canada and provides an integrated package of cost-containment methods, implemented within a transparent institutional framework and powered by strong motivation of the agent. PMID:26528099

[What is the situation with human rights of the elderly? : UN Open-ended Working Group on Ageing - review and prospects].

PubMed

Mahler, Claudia

2017-06-01

In November 2010 the United Nations General Assembly set up a working group to strengthen the protection of human rights for older persons (UN Open-ended Working Group on Ageing) with the United Nations Resolution A/C.3/65/L.8/Rev.1. In December 2016 the members of the working group met for the seventh time and discussed how they can approach the fulfillment of the mandate. In addition to better implementation, the strengthening of rights can consist of closing existing gaps or further differentiation of the rights in order to give the member states better guidance on how to implement them. To improve the human rights of older persons a task of the members of the working group would be to examine the existing rights and, where possible, adjust them to the real needs of the group. One of the major challenges facing the working group is already apparent: who belongs to the group of older persons and how could the group be described? This article deals with the presentation of the international process, new developments at the regional level and the attitudes of the member states and the civil society. A further aim is to present the possibilities and effects of a comprehensive legally binding instrument.

Integrating Research, Quality Improvement, and Medical Education for Better Handoffs and Safer Care: Disseminating, Adapting, and Implementing the I-PASS Program.

PubMed

Starmer, Amy J; Spector, Nancy D; West, Daniel C; Srivastava, Rajendu; Sectish, Theodore C; Landrigan, Christopher P

2017-07-01

In 2009 the I-PASS Study Group was formed by patient safety, medical education, health services research, and clinical experts from multiple institutions in the United States and Canada. When the I-PASS Handoff Program, which was developed by the I-PASS Study Group, was implemented in nine hospitals, it was associated with a 30% reduction in injuries due to medical errors and significant improvements in handoff processes, without any adverse effects on provider work flow. To effectively disseminate and adapt I-PASS for use across specialties and disciplines, a series of federally and privately funded dissemination and implementation projects were carried out following the publication of the initial study. The results of these efforts have informed ongoing initiatives intended to continue adapting and scaling the program. As of this writing, I-PASS Study Group members have directly worked with more than 50 hospitals to facilitate implementation of I-PASS. To further disseminate I-PASS, Study Group members delivered hundreds of academic presentations, including plenaries at scientific meetings, workshops, and institutional Grand Rounds. Some 3,563 individuals, representing more than 500 institutions in the 50 states in the United States, the District of Columbia, Puerto Rico, and 57 other countries, have requested access to I-PASS materials. Most recently, the I-PASS SM Patient Safety Institute has developed a virtual immersion training platform, mobile handoff observational tools, and processes to facilitate further spread of I-PASS. Implementation of I-PASS has been associated with substantial improvements in patient safety and can be applied to a variety of disciplines and types of patient handoffs. Widespread implementation of I-PASS has the potential to substantially improve patient safety in the United States and beyond. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Assessing the Effectiveness of On-Farm and Abattoir Interventions in Reducing Pig Meat-Borne Salmonellosis within E.U. Member States.

PubMed

Hill, Andrew A; Simons, Robin L; Swart, Arno N; Kelly, Louise; Hald, Tine; Snary, Emma L

2016-03-01

As part of the evidence base for the development of national control plans for Salmonella spp. in pigs for E.U. Member States, a quantitative microbiological risk assessment was funded to support the scientific opinion required by the EC from the European Food Safety Authority. The main aim of the risk assessment was to assess the effectiveness of interventions implemented on-farm and at the abattoir in reducing human cases of pig meat-borne salmonellosis, and how the effects of these interventions may vary across E.U. Member States. Two case study Member States have been chosen to assess the effect of the interventions investigated. Reducing both breeding herd and slaughter pig prevalence were effective in achieving reductions in the number of expected human illnesses in both case study Member States. However, there is scarce evidence to suggest which specific on-farm interventions could achieve consistent reductions in either breeding herd or slaughter pig prevalence. Hypothetical reductions in feed contamination rates were important in reducing slaughter pig prevalence for the case study Member State where prevalence of infection was already low, but not for the high-prevalence case study. The most significant reductions were achieved by a 1- or 2-log decrease of Salmonella contamination of the carcass post-evisceration; a 1-log decrease in average contamination produced a 90% reduction in human illness. The intervention analyses suggest that abattoir intervention may be the most effective way to reduce human exposure to Salmonella spp. However, a combined farm/abattoir approach would likely have cumulative benefits. On-farm intervention is probably most effective at the breeding-herd level for high-prevalence Member States; once infection in the breeding herd has been reduced to a low enough level, then feed and biosecurity measures would become increasingly more effective. © 2016 Society for Risk Analysis.

State and Local Governments: Fiscal Pressures Could Have Implications for Future Delivery of Intergovernmental Programs. Report to the Ranking Member, Committee on the Budget, House of Representatives. GAO-10-899

ERIC Educational Resources Information Center

Czerwinski, Stanley J.

2010-01-01

State and local governments work in partnership with the federal government to implement numerous intergovernmental programs. Fiscal pressures for state and local governments may exist when spending is expected to outpace revenues for the long term. GAO (Government Accountability Office) was asked to examine (1) the long-term fiscal pressures…

Implementation of the Patients' Rights in Cross-border Healthcare directive in Latvia.

PubMed

Olsena, Solvita

2014-03-01

Latvia, being one of the EU Member States, has an obligation to implement the rules stated by the Directive 2011/24/EU on Patients' Rights in Cross-border Healthcare (hereinafter--the Directive) before 25 October 2013 in existing national legislation and practice. Implementation was carried out under pressured circumstances. A National Contact Point has been established, information is provided for patients in Latvian and to some extent in English, the Medical Treatment Risk Fund will start operations to provide compensation for harm, and the restrictions and procedure for prior authorisation have been stated. The need to secure quality of care and patient safety and well as privacy protection are the most challenging tasks for Latvia. It can be concluded that some progress in patients' rights can be achieved, but it is doubtful if patients' mobility will be stimulated.

Implementing Health and Safety Policy Changes at the High School Level From a Leadership Perspective.

PubMed

Pagnotta, Kelly D; Mazerolle, Stephanie M; Pitney, William A; Burton, Laura J; Casa, Douglas J

2016-04-01

Although consensus statements and recommendations from professional organizations aim to reduce the incidence of injury or sudden death in sport, nothing is mandated at the high school level. This allows states the freedom to create and implement individual policies. An example of a recommended policy is heat acclimatization. Despite its efficacy in reducing sudden death related to heat stroke, very few states follow the recommended guidelines. To retroactively examine why and how 3 states were able to facilitate the successful creation and adoption of heat-acclimatization guidelines. Qualitative study. High school athletic associations in Arkansas, Georgia, and New Jersey. Eight men and 3 women (n = 11; 6 athletic trainers; 2 members of high school athletic associations; 2 parents; 1 physician) participated. Participant recruitment ceased when data saturation was reached. All phone interviews were digitally recorded and transcribed verbatim. A grounded-theory approach guided analysis and multiple analysts and peer review were used to establish credibility. Each state had a different catalyst to change (student-athlete death, empirical data, proactivity). Recommendations from national governing bodies guided the policy creation. Once the decision to implement change was made, the states displayed 2 similarities: shared leadership and open communication between medical professionals and members of the high school athletic association helped overcome barriers. The initiating factor that spurred the change varied, yet shared leadership and communication fundamentally allowed for successful adoption of the policy. Our participants were influenced by the recommendations from national governing bodies, which align with the institutional change theory. As more states begin to examine and improve their health and safety policies, this information could serve as a valuable resource for athletic trainers in other states and for future health and safety initiatives.

Implementing the recommended curriculum in biochemistry and molecular biology at a regional comprehensive university through a biology/chemistry double major: The minnesota state university moorhead experience*.

PubMed

Wallert, Mark; Brisch, Ellen; Chastain, Chris; Malott, Michelle; Provost, Joseph

2004-05-01

Minnesota State University Moorhead (MSUM) is a regional comprehensive university that is part of the Minnesota State Colleges and Universities (MnSCU) system. The current student population consists of ∼7,600 full- and part-time students who are enrolled in one of 135 majors that lead to baccalaureate degrees. MSUM is committed to excellence in science teaching and research for undergraduates. It is an institutional member of the Council on Undergraduate Research and has three faculty members participating in Project Kaleidoscope (PKAL) Faculty for the 21st Century. Fourteen years ago, MSUM renewed its effort to have faculty participate in active research. All science faculty members hired since that time have been required to establish research programs. The primary purpose for the faculty engaging in ongoing research projects is to involve undergraduates in a meaningful research experience, thus training these students to become scientists. Copyright © 2004 International Union of Biochemistry and Molecular Biology, Inc.

"To See With My Own Eyes": Experiences of Family Visits During Phase 1 Recovery.

PubMed

Wendler, M Cecilia; Smith, Katherine; Ellenburg, Wanda; Gill, Rita; Anderson, Lea; Spiegel-Thayer, Kim

2017-02-01

Long separations are a characteristic of the day of surgery, keeping patients and their family members waiting and apart. At a time of high vulnerability, these separations can cause anxiety and worry. The purpose of this study was to identify the outcomes and experiences of patients and family members who engaged in a 5- to 10-minute supervised family visit during phase I postanesthesia recovery. This was a descriptive, single-group, mixed-methods study. Quantitative data, gathered on the day of surgery, was obtained from patients (vital signs, state anxiety scores) and their designated family members (state anxiety scores); satisfaction with the visit was also measured. An optional second, qualitative phase included a semi-structured interview examining the remembered experiences of patients and family members. A statistically significant drop in state anxiety was discovered after the visit, and satisfaction with the visit was exceedingly high. Qualitatively, patients and family members described their overwhelming relief to be able "to see with my own eyes" how well each was doing. This study supports that family visits in the postanesthesia care unit are safe and profoundly important as an independent nursing intervention. Recommendations include implementation of family visits during postanesthesia care unit recovery for all patients and family members who desire them. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

NEC*TAS Financing Workbook: An Interagency Process for Planning and Implementing a Financing System for Early Intervention and Preschool Services.

ERIC Educational Resources Information Center

Williams, Sarah; Kates, Donald A.

This workbook addresses the need for information and guidance that can help states and communities meet the short-term and long-term challenges of developing community-oriented financing for early intervention and preschool special education services. It is intended for state officials, advocates, and task force members who carry out or assist…

The implementation of the Strategy Europe 2020 objectives in European Union countries: the concept analysis and statistical evaluation.

PubMed

Stec, Małgorzata; Grzebyk, Mariola

2018-01-01

The European Union (EU), striving to create economic dominance on the global market, has prepared a comprehensive development programme, which initially was the Lisbon Strategy and then the Strategy Europe 2020. The attainment of the strategic goals included in the prospective development programmes shall transform the EU into the most competitive economy in the world based on knowledge. This paper presents a statistical evaluation of progress being made by EU member states in meeting Europe 2020. For the basis of the assessment, the authors proposed a general synthetic measure in dynamic terms, which allows to objectively compare EU member states by 10 major statistical indicators. The results indicate that most of EU countries show average progress in realisation of Europe's development programme which may suggest that the goals may not be achieved in the prescribed time. It is particularly important to monitor the implementation of Europe 2020 to arrive at the right decisions which will guarantee the accomplishment of the EU's development strategy.

Research to Advance the Development of River Information Services (RIS) Technologies

DTIC Science & Technology

2016-12-01

RIS implementation in Europe. Both the legal as well as the technical framework are been presented and analyzed. Special attention has been given to...and legal environments on both continents and take into account the organ- izational situation in the U.S. and the existing capabilities. Research...rective” Europe has set the legal and technical framework which guarantees harmonized implementation of RIS in all member states as well as a minimum

Discrepant perceptions of communication, teamwork and situation awareness among surgical team members.

PubMed

Wauben, L S G L; Dekker-van Doorn, C M; van Wijngaarden, J D H; Goossens, R H M; Huijsman, R; Klein, J; Lange, J F

2011-04-01

To assess surgical team members' differences in perception of non-technical skills. Questionnaire design. Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT. Ratings for 'communication' were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for 'teamwork' differed significantly between all team members (P ≤ 0.005). Within 'situation awareness' significant differences were mainly observed for 'gathering information' between surgeons and other team members (P < 0.001). Finally, 72-90% of anaesthetists, OT nurses and nurse anaesthetists rated routine team briefings and debriefings as inadequate. This study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.

The European Union, Education Governance and International Education Surveys

ERIC Educational Resources Information Center

Volante, Louis; Ritzen, Jo

2016-01-01

The European Union--comprising 28 member states with individual sovereignty in the formation and implementation of education policy--has developed research and communication strategies to facilitate the exchange of best practices, gathering and dissemination of education statistics and, perhaps most importantly, advice and support for national…

Information Network Development.

ERIC Educational Resources Information Center

Mahon, F. V.

The International Bureau of Education (IBE) and Unesco, together with their member states, are faced with the task of implementing a proposed network--the International Network for Educational Information (INED)--for the better use of information resources for educational development. This review of issues that need to be considered in the…

New Mexico Math Remediation Taskforce Report

ERIC Educational Resources Information Center

New Mexico Higher Education Department, 2016

2016-01-01

The Math Remediation Task Force is comprised of faculty from two-year, four-year comprehensive, and four-year flagship higher education institutions throughout the state of New Mexico. Its members have varying levels of experience with designing/implementing multiple math remediation programs including traditional, co-requisite and acceleration…

Elicitation of State and Local User Needs for Future Moderate Resolution Earth Observations: The AmericaView Contribution

NASA Astrophysics Data System (ADS)

French, N. H. F.; Lawrence, R. L.

2017-12-01

AmericaView is a nationwide partnership of remote sensing scientists who support the use of Landsat and other public domain remotely sensed data through applied remote sensing research, K-12 and higher STEM education, workforce development, and technology transfer. The national AmericaView program currently has active university-lead members in 39 states, each of which has a "stateview" consortium consisting of some combination of university, agency, non-profit, and other members. This "consortium of consortia" has resulted in a strong and unique nationwide network of remote sensing practitioners. AmericaView has used this network to contribute to the USGS Requirements Capabilities & Analysis for Earth Observations. Participating states have conducted interviews of key remote sensing end users across the country to provide key input at the state and local level for the design and implementation of future U.S. moderate resolution Earth observations.

Experiences from the implementation of a biosafety system in Slovenia.

PubMed

Milavec, Mojca; Racman, Darja Stanic

2007-09-01

The development and implementation of an effective national biosafety system is important for several key reasons: to ensure safe access to products of modern biotechnology, to build public confidence, to encourage the growth of domestic modern biotechnology, and to comply with international standards and agreements. There is no single best approach in the development and implementation of a national biosafety system and each country is faced with unique challenges. Slovenia is a small country and a new EU Member State. However, it has developed and implemented an efficient national biosafety system. The key elements of this system are administrative procedure, risk assessment, enforcement, and public participation and information.

Challenges to the implementation of International Health Regulations (2005) on Preventing Infectious Diseases: experience from Julius Nyerere International Airport, Tanzania

PubMed Central

Bakari, Edith; Frumence, Gasto

2013-01-01

Background The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. Country points of entry (POEs) have been identified as potential areas for effective interventions to prevent the transmission of infectious diseases across borders. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam. Design A cross-sectional, descriptive study, employing qualitative methods, was conducted at the Ministry of Health and Social Welfare (MoHSW), WHO, and JNIA. In-depth interviews, focus group discussions (FGDs) and documentary reviews were used to obtain relevant information. Respondents were purposively enrolled into the study. Thematic analysis was used to generate study findings. Results Several challenges that hamper implementation of the IHR (2005) were identified: (1) none of the 42 Tanzanian POEs have been specifically designated to implement IHR (2005). (2) Implementation of the IHR (2005) at the POE was complicated as it falls under various uncoordinated government departments. Although there were clear communication channels at JNIA that enhanced reliable risk communication, the airport lacked isolated rooms specific for emergence preparedness and response to public health events. Conclusions JNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should also ensure that implementation of the IHR (2005) follow the policy implementation framework, particularly the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy. PMID:23958240

Challenges to the implementation of International Health Regulations (2005) on preventing infectious diseases: experience from Julius Nyerere International Airport, Tanzania.

PubMed

Bakari, Edith; Frumence, Gasto

2013-08-16

The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. Country points of entry (POEs) have been identified as potential areas for effective interventions to prevent the transmission of infectious diseases across borders. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam. A cross-sectional, descriptive study, employing qualitative methods, was conducted at the Ministry of Health and Social Welfare (MoHSW), WHO, and JNIA. In-depth interviews, focus group discussions (FGDs) and documentary reviews were used to obtain relevant information. Respondents were purposively enrolled into the study. Thematic analysis was used to generate study findings. Several challenges that hamper implementation of the IHR (2005) were identified: (1) none of the 42 Tanzanian POEs have been specifically designated to implement IHR (2005). (2) Implementation of the IHR (2005) at the POE was complicated as it falls under various uncoordinated government departments. Although there were clear communication channels at JNIA that enhanced reliable risk communication, the airport lacked isolated rooms specific for emergence preparedness and response to public health events. JNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should also ensure that implementation of the IHR (2005) follow the policy implementation framework, particularly the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy.

Poster Project to Emphasize Public Health in the Pharmacy Curriculum

PubMed Central

Werremeyer, Amy B.

2011-01-01

Objective To implement and assess a required public health poster project in a doctor of pharmacy (PharmD) program. Design Third-year PharmD students collaborated in pairs to research a public health topic relating to pharmacy practice. Each student group prepared an informational poster, while receiving feedback from a faculty mentor at each stage of the project. The students presented their completed posters at a statewide pharmacy conference. Assessment Faculty members evaluated the posters with a grading rubric, and students completed a survey instrument that assessed the overall experience. In general, faculty members rated the class highly across all domains of the grading rubric. The class generally agreed that the poster project increased their awareness of public health issues related to pharmacy practice, overall knowledge of public health, and presentation skills. Conclusion The implementation of a poster project was well received by students and faculty members as an effective method for enhancing public health instruction in the PharmD program at North Dakota State University. PMID:21451754

Poster project to emphasize public health in the pharmacy curriculum.

PubMed

Kelsch, Michael P; Werremeyer, Amy B

2011-02-10

To implement and assess a required public health poster project in a doctor of pharmacy (PharmD) program. Third-year PharmD students collaborated in pairs to research a public health topic relating to pharmacy practice. Each student group prepared an informational poster, while receiving feedback from a faculty mentor at each stage of the project. The students presented their completed posters at a statewide pharmacy conference. Faculty members evaluated the posters with a grading rubric, and students completed a survey instrument that assessed the overall experience. In general, faculty members rated the class highly across all domains of the grading rubric. The class generally agreed that the poster project increased their awareness of public health issues related to pharmacy practice, overall knowledge of public health, and presentation skills. The implementation of a poster project was well received by students and faculty members as an effective method for enhancing public health instruction in the PharmD program at North Dakota State University.

Welfare Reform: States' Efforts To Expand Child Care Programs. United States General Accounting Office Report to the Ranking Minority Member, Subcommittee on Children and Families, Committee on Labor and Human Resources, U.S. Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

The sweeping changes of welfare reform embodied in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and which created the Child Care and Development Block Grant, raise many questions about how states will implement subsidy programs to help an increasing number of low-income families meet their child care needs. At the…

Report Summary--Rio Political Declaration on Social Determinants of Health: A Snapshot of Canadian Actions 2015.

PubMed

Stankiewicz, A; Herel, M; DesMeules, M

2015-09-01

In 2012, Canada and other United Nations (UN) Member States endorsed the "Rio Political Declaration on Social Determinants of Health" (Rio Declaration), a non-binding pledge which calls on World Health Organization (WHO) Member States to improve/influence the working and living conditions that affect health and well-being. The Rio Declaration sets out actions to address health inequities in five themes: to adopt better governance for health and development; to promote participation in policy making and implementation; to further reorient the health sector towards reducing health inequities; to strengthen global governance and collaboration; and to monitor and increase accountability. In 2013, following the endorsement of the Rio Declaration, the Government of Canada released a report to begin to document Canadian actions related to its five themes. Building on this first report, and in anticipation of WHO reporting on Member State implementation of the Rio Declaration at the May 2015 World Health Assembly, the Government of Canada developed the report, Rio Political Declaration on Social Determinants of Health: A Snapshot of Canadian Actions 2015, which showcases Canada's recent actions since 2013 contributing to the advancement of the five Rio Declaration themes. The report provides a current picture of the diverse spectrum of activities undertaken across levels of government and sectors to advance health equity and address social determinants of health in Canada, and intends to stimulate global and domestic exchange and uptake of promising practices to advance health equity.

Guiding District Implementation of Common Core State Standards: Innovation Configuration Maps

ERIC Educational Resources Information Center

Roy, Patricia; Killion, Joellen

2011-01-01

Leadership Networks are regional and content-specific networks focused on the preparation of college- and career-ready students. Each network includes teacher leaders, school administrators, central office staff, regional cooperatives, and institutes of higher education. Network members work collaboratively to focus their efforts on regional needs…

Lifelong Learning Policy in Two National Contexts

ERIC Educational Resources Information Center

Rasmussen, Palle

2014-01-01

This article describes and discusses the development of lifelong learning policy in two EU member states, Denmark and Portugal. The purpose is to show how different societal and historical contexts shape the development and implementation of lifelong learning policies, even though these policies have significant common elements. As a basis for the…

Reforming Science Instruction in California: A Primer

ERIC Educational Resources Information Center

EdSource, 2017

2017-01-01

As schools across the state implement the Next Generation Science Standards, this EdSource primer provides an easy-to-read guide for parents and other community members to understand the rationale for the standards and their potential to affect science instruction in California schools. California adopted the Next Generation Science Standards, or…

Definitional Ceremonies: Integrating Community into Multicultural Counseling Sessions

ERIC Educational Resources Information Center

Bitter, James Robert; Robertson, Patricia E.; Roig, Grace; Disqueact, J. Graham

2004-01-01

Definitional Ceremonies are used as a forum for integrating members of diverse cultures into multicultural counseling sessions. The authors provide a philosophical foundation, implementation process, and excerpts from a typescript of a recent definitional ceremony involving a women and her mother, both recently in the United States from Panama.

Implementing School Reform: "Making Middle Grades Work" for All Students

ERIC Educational Resources Information Center

Cooney, Sondra; Lasater, Beth

2006-01-01

"Making Middle Grades Work" ("MMGW") is a school improvement design developed by the Southern Regional Education Board (SREB) and its member states. "MMGW" is built on research-based instructional practices and policies. The design combines challenging yet attainable goals with accountability that encourages teachers, supports students and results…

What Factors Influence Smoking Prevalence and Smoke Free Policy Enactment across the European Union Member States

PubMed Central

Bogdanovica, Ilze; McNeill, Ann; Murray, Rachael; Britton, John

2011-01-01

Background Smoking prevention should be a primary public health priority for all governments, and effective preventive policies have been identified for decades. The heterogeneity of smoking prevalence between European Union (EU) Member States therefore reflects, at least in part, a failure by governments to prioritise public health over tobacco industry or possibly other financial interests, and hence potentially government corruption. The aims of this study were to test the hypothesis that smoking prevalence is higher in countries with high levels of public sector corruption, and explore the ecological association between smoking prevalence and a range of other national characteristics in current EU Member States. Methods Ecological data from 27 EU Member States were used to estimate univariate and multivariate correlations between smoking prevalence and the Transparency International Corruption Perceptions Index, and a range of other national characteristics including economic development, social inclusion, quality of life and importance of religion. We also explored the association between the Corruption Perceptions Index and measures of the extent to which smoke-free policies have been enacted and are enforced. Results In univariate analysis, smoking prevalence was significantly higher in countries with higher scores for corruption, material deprivation, and gender inequality; and lower in countries with higher per capita Gross Domestic Product, social spending, life satisfaction and human development scores. In multivariate analysis, only the corruption perception index was independently related to smoking prevalence. Exposure to tobacco smoke in the workplace was also correlated with corruption, independently from smoking prevalence, but not with the measures of national smoke-free policy implementation. Conclusions Corruption appears to be an important risk factor for failure of national tobacco control activity in EU countries, and the extent to which key tobacco control policies have been implemented. Further research is needed to assess the causal relationships involved. PMID:21909375

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

PubMed Central

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-01-01

Background: Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods: The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results: The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion: This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care) perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability. PMID:29179292

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

NASA Astrophysics Data System (ADS)

Suseno, Gijanto Purbo; Nataliningsih

2017-09-01

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

Assessing the effectiveness of strategies to implement clinical guidelines for the management of chronic diseases at primary care level in EU Member States: a systematic review.

PubMed

Brusamento, Serena; Legido-Quigley, Helena; Panteli, Dimitra; Turk, Eva; Knai, Cecile; Saliba, Vanessa; Car, Josip; McKee, Martin; Busse, Reinhard

2012-10-01

This review aimed to evaluate the effectiveness of strategies to implement clinical guidelines for chronic disease management in primary care in EU Member States. We conducted a systematic review of interventional studies assessing the implementation of clinical guidelines. We searched five databases (EMBASE, MEDLINE, CENTRAL, Eppi-Centre and Clinicaltrials.gov) following a strict Cochrane methodology. We included studies focusing on the management of chronic diseases in adults in primary care. A total of 21 studies were found. The implementation strategy was fully effective in only four (19%), partially effective in eight (38%), and not effective in nine (43%). The probability that an intervention would be effective was only slightly higher with multifaceted strategies, compared to single interventions. However, effect size varied across studies; therefore it was not possible to determine the most successful strategy. Only eight studies evaluated the impact on patients' health and only two of those showed significant improvement, while in five there was an improvement in the process of care which did not translate into an improvement in health outcomes. Only four studies reported any data on the cost of the implementation but none undertook a cost-effectiveness analysis. Only one study presented data on the barriers to the implementation of guidelines, noting a lack of awareness and agreement about clinical guidelines. Our results reveal that there are only a few rigorous studies which assess the effectiveness of a strategy to implement clinical guidelines in Europe. Moreover, the results are not consistent in showing which strategy is the most appropriate to facilitate their implementation. Therefore, further research is needed to develop more rigorous studies to evaluate health outcomes associated with the implementation of clinical guidelines; to assess the cost-effectiveness of implementing clinical guidelines; and to investigate the perspective of service users and health service staff. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2016-03-01

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

Patterns of decision making by wives of patients with life-threatening cardiac disease.

PubMed

Hall, Patricia; Sanford, Julie T; Demi, Alice S

2008-08-01

Implementation of the Patient Self-Determination Act (PSDA) in the United States has transferred decision making from the responsibility of health care professionals to the responsibility of family members. Dilemmas occurring as a result of this responsibility may cause stress and conflict among family members. The purpose of this study is to describe the patterns of decision making by family members of patients with life-threatening cardiac disease. Purposive sampling is used to select 10 wives of patients with life-threatening cardiovascular disease. Data are gathered through unstructured interviews and are analyzed using grounded theory and theory triangulation. Analysis of the data reveal three patterns of decision making: advocacy, acquiescence, and abdication.

Educational Telecommunications in Small Rural Schools. State of New York Pilot Program for Assessment and Implementation of Educational Telecommunications Applications as an Alternative to Strengthen Small Rural Schools.

ERIC Educational Resources Information Center

Delaware-Chenango-Madison-Otsego Board of Cooperative Educational Services, Albany, NY.

The use of communications technology as an influential educational tool to meet such pressing concerns as increased academic requirements and shrinking financial resources will be tested in one of the most geographically remote areas of rural New York State. The pilot laboratory will consist of an 18-member school district consortium that is…

Vocational Training and Innovative Practices in the Environmental Sector: A Comparison of Ten EU [European Union] Member States with Specimen Cases. Synthesis Report in the Context of the "Observing Innovations in Vocational Training" Project. CEDEFOP Panorama.

ERIC Educational Resources Information Center

Loos, Roland

This report provides specialist information and application-oriented recommendations to implement innovative environmental vocational education and training (VET) measures and practices. Chapter 1 explains study method and structure. Chapter 2 provides an overview of the current state of environmental VET in Austria, Denmark, Finland, Germany,…

The Republic of Macedonia: Implementing the Ohrid Framework Agreement and Reforming the State

DTIC Science & Technology

2008-09-01

that included members of the goverment . • The “capacity building/weakening’ school. Argument is the organized crime elements united and recruited...115 Republic of Macedonia State Statistical Office, Tourism in the Republic of Macedonia, http://www.stat.gov.mk/english/statistiki_eng.asp?ss...essential for improving the economy. The ROM must invest wisely the funds received by the EU towards infrastructure, business development and tourism

Combating Gangs: Federal Agencies Have Implemented a Central American Gang Strategy, but Could Strengthen Oversight and Measurement of Efforts. Report to Congressional Requesters. GAO-10-395

ERIC Educational Resources Information Center

Larence, Eileen R.

2010-01-01

Thousands of gang members in the United States belong to gangs such as MS-13 and 18th Street that are also active in Central American countries. Federal entities with responsibilities for addressing Central American gangs include the National Security Council (NSC); the Departments of Homeland Security (DHS), Justice (DOJ), and State; and the U.S.…

Evaluation of the Mobile Training Team Projects (1996-2003): Final Report

ERIC Educational Resources Information Center

Online Submission, 2005

2005-01-01

Background: For more than 30 years since 1972, the Government of Japan has contributed funds to UNESCO for implementation of the Mobile Training Team (MTT) projects. The MTT assists Member States enhance their capacity in development oriented educational innovation through intra-country study visits, training courses, workshops and technical…

78 FR 46549 - Approval and Promulgation of Implementation Plans; Idaho: State Board Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

... such board or body or the head of an executive agency with similar powers be adequately disclosed.'' 42... Requirements Idaho Code Sec. 39-107, Board--Composition--Officers-- Compensation--Powers--Subpoena--Depositions... regard to their knowledge of and interest in solid waste; two (2) members shall be chosen for their...

Activating the Disadvantaged. Variations in Addressing Youth Transitions across Europe

ERIC Educational Resources Information Center

Pohl, Axel; Walther, Andreas

2007-01-01

The term activation refers to a shift in social policies, through which individuals are given more responsibility for their own social inclusion. This article provides a comparative analysis of the different ways in which EU member states interpret and implement the concept of activation by addressing the transitions of disadvantaged young people…

Staff Member Perceptions of Bullying in an Afterschool Center

ERIC Educational Resources Information Center

Thegg, Sherrich Monsher

2017-01-01

Peer-to-peer bullying negatively impacts over 20% of school-aged children annually. While much literature exists on bullying on school premises, peer-to-peer bullying outside of the classroom is still relatively understudied. Despite states' implementation of antibullying legislation, peer-to-peer bullying has continued in schools and other areas…

76 FR 18826 - Unified Carrier Registration Plan Board of Directors; Request for Nominations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-05

... four members from such State agencies, one from each of FMCSA's four service areas. As authorized by 49... 20590. Office hours are between 9 a.m. and 5 p.m., ET, Monday through Friday, except Federal holidays..., Federal, and industry representatives responsible for developing, implementing, and administering the UCRA...

Reconceptualising Childhood: Children's Rights and Youth Participation in Schools

ERIC Educational Resources Information Center

Johnny, Leanne

2006-01-01

Article 12 of the United Nations Convention on the Rights of the Child holds that young people have a right to participate in matters affecting them. While all members of the United Nations have ratified the Convention (with the exception of the United States and Somalia), there are numerous challenges associated with implementing the…

Implementing Health and Safety Policy Changes at the High School Level From a Leadership Perspective

PubMed Central

Pagnotta, Kelly D.; Mazerolle, Stephanie M.; Pitney, William A.; Burton, Laura J.; Casa, Douglas J.

2016-01-01

Context:  Although consensus statements and recommendations from professional organizations aim to reduce the incidence of injury or sudden death in sport, nothing is mandated at the high school level. This allows states the freedom to create and implement individual policies. An example of a recommended policy is heat acclimatization. Despite its efficacy in reducing sudden death related to heat stroke, very few states follow the recommended guidelines. Objective:  To retroactively examine why and how 3 states were able to facilitate the successful creation and adoption of heat-acclimatization guidelines. Design:  Qualitative study. Setting:  High school athletic associations in Arkansas, Georgia, and New Jersey. Patients or Other Participants:  Eight men and 3 women (n = 11; 6 athletic trainers; 2 members of high school athletic associations; 2 parents; 1 physician) participated. Participant recruitment ceased when data saturation was reached. Data Collection and Analysis:  All phone interviews were digitally recorded and transcribed verbatim. A grounded-theory approach guided analysis and multiple analysts and peer review were used to establish credibility. Results:  Each state had a different catalyst to change (student-athlete death, empirical data, proactivity). Recommendations from national governing bodies guided the policy creation. Once the decision to implement change was made, the states displayed 2 similarities: shared leadership and open communication between medical professionals and members of the high school athletic association helped overcome barriers. Conclusions:  The initiating factor that spurred the change varied, yet shared leadership and communication fundamentally allowed for successful adoption of the policy. Our participants were influenced by the recommendations from national governing bodies, which align with the institutional change theory. As more states begin to examine and improve their health and safety policies, this information could serve as a valuable resource for athletic trainers in other states and for future health and safety initiatives. PMID:27002250

The Global Health Policies of the EU and its Member States: A Common Vision?

PubMed Central

Steurs, Lies; Van de Pas, Remco; Delputte, Sarah; Orbie, Jan

2018-01-01

Background: This article assesses the global health policies of the European Union (EU) and those of its individual member states. So far EU and public health scholars have paid little heed to this, despite the large budgets involved in this area. While the European Commission has attempted to define the ‘EU role in Global Health’ in 2010, member states are active in the domain of global health as well. Therefore, this article raises the question to what extent a common ‘EU’ vision on global health exists. Methods: This is examined through a comparative framing analysis of the global health policy documents of the European Commission and five EU member states (France, Germany, the United Kingdom, Belgium, and Denmark). The analysis is informed by a two-layered typology, distinguishing global health from international health and four ‘global health frames,’ namely social justice, security, investment and charity. Results: The findings show that the concept of ‘global health’ has not gained ground the same way within European policy documents. Consequently, there are also differences in how health is being framed. While the European Commission, Belgium, and Denmark clearly support a social justice frame, the global health strategies of the United Kingdom, Germany, and France put an additional focus on the security and investment frames. Conclusion: There are different understandings of global/international health as well as different framings within relevant documents of the EU and its member states. Therefore, the existence of an ‘EU’ vision on global health is questionable. Further research is needed on how this impacts on policy implementation. PMID:29764107

Cervical carcinoma in the European Union: an update on disease burden, screening program state of activation, and coverage as of March 2014.

PubMed

Altobelli, Emma; Lattanzi, Amedeo

2015-03-01

Cervical cancer (CC) is defined as a disease of disparity. This is due to marked differences in CC incidence and mortality between developed and developing countries. As a continent, Europe is no exception. This study examines the state of activation of CC screening in the European Union as of March 2014, reviews CC incidence and mortality data, and highlights the initiatives adopted to extend program coverage to nonresponders. The present study is based on the most recent data available from PubMed-indexed journals, the Web sites of the health ministries of each member state, and the Web sites of national cancer observatories; failing these sources, information was sought in scientific journals published in the local language. In 2003, the European Council recommended that priority be given to organized screening program activation. Nonetheless, a number of European Union member states still lack population-based organized screening programs, and few have implemented programs directed at disadvantaged populations. Several investigations have demonstrated that the women at higher CC risk are unscreened and underscreened ones. Since then, several member states have made significant efforts to set up effective prevention programs by adopting international quality standards and centralizing screening organization and result evaluation. Several developed countries and some new central-eastern European member states have poorly organized prevention programs that result in poor women's health. Diagnosis of CC is emotionally traumatic, but it is highly preventable. When CC is found early, it is highly treatable and associated with long survival and good quality of life.

Towards a results-based management approach for capacity-building in space science, technology and applications to support the implementation of the 2030 agenda for sustainable development

NASA Astrophysics Data System (ADS)

Balogh, Werner R.; St-Pierre, Luc; Di Pippo, Simonetta

2017-10-01

The United Nations Office for Outer Space Affairs (UNOOSA) has the mandate to assist Member States with building capacity in using space science, technology and their applications in support of sustainable economic, social and environmental development. From 20 to 21 June 2018 the international community will gather in Vienna for UNISPACE + 50, a special segment of the 61st session of the Committee on the Peaceful Uses of Outer Space (COPUOS), to celebrate the 50th anniversary of the first UNISPACE conference and to reach consensus on a global space agenda for the next two decades. ;Capacity-building for the twenty-first century; is one of the seven thematic priorities of UNISPACE + 50, identified and agreed upon by COPUOS. The Committee has tasked UNOOSA with undertaking the work under this thematic priority and with reporting regularly to the Committee and its Subcommittees on the progress of its work. It is therefore appropriate, in this context, to take stock of the achievements of the capacity-building activities of the Office, to review the relevant mandates and activities and to consider the necessity to strengthen and better align them with the future needs of the World and in particular with the 2030 Agenda for Sustainable Development. This paper describes the efforts on-going at UNOOSA, building on its experiences with implementing the United Nations Programme on Space Applications and the United Nations Platform for Space-based Information for Disaster Management and Emergency Response (UN-SPIDER) and working with Member States and other United Nations entities, to develop a results-based management approach, based on an indicator framework and a database with space solutions, for promoting the use of space-based solutions to help Member States achieve the Sustainable Development Goals (SDGs) and successfully implement the 2030 Agenda for Sustainable Development.

The impact of the EU Directive on patients' rights and cross border health care in Malta.

PubMed

Azzopardi-Muscat, Natasha; Aluttis, Christoph; Sorensen, Kristine; Pace, Roderick; Brand, Helmut

2015-10-01

The patients' rights and cross-border health care directive was implemented in Malta in 2013. Malta's transposition of the directive used the discretionary elements allowable to retain national control on cross-border care to the fullest extent. This paper seeks to analyse the underlying dynamics of this directive on the Maltese health care system through the lens of key health system stakeholders. Thirty-three interviews were conducted. Qualitative content analysis of the interviews reveals six key themes: fear from the potential impact of increased patient mobility, strategies employed for damage control, opportunities exploited for health system reform, moderate enhancement of patients' rights, negligible additional patient mobility and unforeseen health system reforms. The findings indicate that local stakeholders expected the directive to have significant negative effects and adopted measures to minimise these effects. In practice the directive has not affected patient mobility in Malta in the first months following its implementation. Government appears to have instrumentalised the implementation of the directive to implement certain reforms including legislation on patients' rights, a health benefits package and compulsory indemnity insurance. Whilst the Maltese geo-demographic situation precludes automatic generalisation of the conclusions from this case study to other Member States, the findings serve to advance our understanding of the mechanisms through which European legislation on health services is influencing health systems, particularly in small EU Member States. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

A framework to start the debate on neonatal screening policies in the EU: an Expert Opinion Document.

PubMed

Cornel, Martina C; Rigter, Tessel; Weinreich, Stephanie S; Burgard, Peter; Hoffmann, Georg F; Lindner, Martin; Gerard Loeber, J; Rupp, Kathrin; Taruscio, Domenica; Vittozzi, Luciano

2014-01-01

The European Union (EU) Council Recommendation on rare diseases urged the member states to implement national and EU collaborative actions to improve the health care of rare disease patients. Following this recommendation, the European Commission launched a tender on newborn screening (NBS) to report on current practices of laboratory testing, form a network of experts and provide guidance on how to further implement NBS screening in a responsible way, the latter of which was provided in an Expert Opinion document. After consultation of experts from EU member states, (potential) candidate member states and European Free Trade Association countries, in a consensus meeting in June 2011, 70 expert opinions were finalized. They included the need to develop case definitions for all disorders screened for to facilitate assessment and international outcome studies. Decision whether a screening program should be performed can be based on screening criteria updated from the traditional Wilson and Jungner (1968) criteria, relating to disease, treatment, test and cost. The interest of the child should be central in the assessment of pros and cons. A European NBS body should assess evidence on (new) screening candidate disorders. For rare conditions, best level evidence should be used. The health system should ensure treatment to cases diagnosed by screening, controlled and revised by follow-up outcome studies. Screening methodology should aim to avoid unintended findings, such as mild forms and carrier status information, as much as possible. Activities to improve NBS in Europe, such as training and scientific evaluation, could benefit from collaboration at EU level and beyond.

Navigating and circumventing a fragmented health system: the patient's pathway in the Sierra Madre Region of Chiapas, Mexico.

PubMed

Molina, Rose Leonard; Palazuelos, Daniel

2014-03-01

Mexico has implemented several important reforms in how health care for its poorest is financed and delivered. Seguro Popular, in particular, a recently implemented social insurance program, aims to provide new funds for a previously underfunded state-based safety net system. Through in-depth ethnographic structured interviews with impoverished farmers in the state of Chiapas, this article presents an analysis of Seguro Popular from the perspective of a highly underserved beneficiary group. Specific points of tension among the various stakeholders--the government system (including public clinics, hospitals, and vertical programs), community members, private doctors, and pharmacies--are highlighted and discussed. Ethnographic data presented in this article expose distinct gaps between national health policy rhetoric and the reality of access to health services at the community level in a highly marginalized municipality in one of Mexico's poorest states. These insights have important implications for the structure and implementation of on-going reforms. © 2014 by the American Anthropological Association.

[When state authorisation was introduced for medical doctors in Norway].

PubMed

Haave, Per

2007-12-13

In 1927, a law was implemented in Norway that for the first time required medical students to be state authorised before they could practice medicine and use the title medical doctor. The question of authorisation split the professional elite, both the Norwegian Medical Association and the Medical Faculty at the University of Oslo. Those very few members of the professional elite that advocated authorisation did, however, convince the government as well as the parliament that authorisation should be given and recalled by the state. State authorisation was first of all aimed at protecting the medical profession against "unfit" members; it was not a question of monopolising medical work or preventing other groups from working within the healthcare services. To put this into context, one should know that there had been a transition from a bureaucratic to a free labour market and most doctors were no longer engaged by the State, but had to practise in a private market. One feared that this would undermine the doctors' authority and status. In this situation, authorisation by the state was considered necessary to safeguard the public's confidence in doctors and their work.

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Retired Reserve for members of the Retired Reserve. Interim final rule with comment period.

PubMed

2010-08-06

This interim final rule establishes requirements and procedures for implementation of TRICARE Retired Reserve. This interim final rule addresses provisions of the National Defense Authorization Act for Fiscal Year 2010 (NDAA-10). The purpose of this interim final rule is to establish the TRICARE Retired Reserve program that implements section 705 of the NDAA-10. Section 705 allows members of the Retired Reserve who are qualified for non-regular retirement, but are not yet 60 years of age, to qualify to purchase medical coverage equivalent to the TRICARE Standard (and Extra) benefit unless that member is either enrolled in, or is eligible to enroll in, a health benefit plan under Chapter 89 of Title 5, United States Code, as well as certain survivors. The amount of the premium that qualified members pay to purchase these benefits will represent the full cost as determined on an appropriate actuarial basis for coverage under the TRICARE Standard (and Extra) benefit including the cost of the program administration. There will be one premium for member-only coverage and a separate premium for member and family coverage. The rules and procedures otherwise outlined in Part 199 of 32 CFR relating to the operation and administration of the TRICARE Standard and Extra programs including the required cost-shares, deductibles and catastrophic caps for retired members and their dependents will apply to this program. The rule is being published as an interim final rule with comment period in order to comply with statutory effective dates.

Development, implementation, and impact of a collaborative junior faculty engagement and professional growth program: The Young Faculty Leadership Initiative.

PubMed

Pate, Adam; Smith, Jennifer; Caldwell, David; Horace, Alexis; Zagar, Michelle

2018-03-01

To develop, implement, and evaluate the effect of a faculty engagement and professional growth program targeted at junior faculty members. A faculty engagement and growth program based on adult learning theory was piloted in a clinical sciences department. Effect of the model was evaluated using a pre/post-survey evaluating faculty output and work engagement using the Utrecht Work Engagement Scale (UWES). Average number of publications/projects with cross-campus collaboration increased (0.58 versus 1.25, P = 0.03, 95%CI 0.059-1.264). Involvement in national/state organizations, number of accepted poster presentations, and grants submitted and/or funded all increased (p>0.05). Total UWES score increased (4.13 vs. 4.495 p = 0.21) with the greatest subscale increase in vigor (3.833 vs 4.347, P = 0.1). A faculty engagement and growth program targeting junior faculty members using adult learning theory as a framework may provide a novel and economic way for schools to support the development of these critical team members. Copyright © 2017 Elsevier Inc. All rights reserved.

Complex governance structures and incoherent policies: Implementing the EU water framework directive in Sweden.

PubMed

Söderberg, Charlotta

2016-12-01

Contemporary processes of environmental policymaking in general span over several territorial tiers. This also holds for the EU Water Framework Directive system of environmental quality standards (EQS), which are part of a complex multi-level institutional landscape, embracing both EU, national and sub-national level. Recent evaluations show that many EU member states, including Sweden, have not reached the ecological goals for water in 2015. Departing from theories on policy coherence and multi-level governance, this paper therefore analyses Swedish water governance as a case to further our understanding of policy implementation in complex governance structures: how does policy coherence (or the lack thereof) affect policy implementation in complex governance structures? To answer this question, the paper maps out the formal structure of the water governance system, focusing on power directions within the system, analyses policy coherence in Swedish water governance through mapping out policy conflicts between the EQS for water and other goals/regulations and explore how they are handled by national and sub-national water bureaucrats. The study concludes that without clear central guidance, 'good ecological status' for Swedish water will be difficult to achieve since incoherent policies makes policy implementation inefficient due to constant power struggles between different authorities, and since environmental goals are often overridden by economic and other societal goals. Further research is needed in order to explore if similar policy conflicts between water quality and other objectives occur in other EU member states and how bureaucrats handle such conflicts in different institutional settings. This study of the Swedish case indicates that the role of the state as a navigator and rudder-holder is important in order to improve policy implementation in complex governance structures - otherwise; bureaucrats risk being lost in an incoherent archipelago of ecological, social and economic goals. Copyright © 2016 Elsevier Ltd. All rights reserved.

75 FR 2785 - Naturalization for Certain Persons in the U.S. Armed Forces

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

... 1615-AB85 Naturalization for Certain Persons in the U.S. Armed Forces AGENCY: U.S. Citizenship and... length of time a member of the United States Armed Forces has to serve to qualify for naturalization through service in the Armed Forces. In addition, this rule amends DHS regulations by implementing a...

Social Media as a Practical Approach in Engaging Key Stakeholders in School Crisis Communication Plans: A Qualitative Analysis

ERIC Educational Resources Information Center

Agozzino, Alisa; Kaiser, Candace

2014-01-01

The current study examined how public relations specialists within school systems are developing, implementing, and revising their communication crisis plans in an effort to fully engage all key stakeholders. Four research questions and two hypotheses were posed. Members from a state public relations association for schools were asked to…

NATO Stanag Language Proficiency Levels for Joint Missions and Its Implementations at a State Organization

ERIC Educational Resources Information Center

Solak, Ekrem

2013-01-01

Turkish Armed Forces have been participating in joint missions together with other nations for decades. Since English is the medium of instruction in these missions, participating members should have NATO Standards in terms of language proficiency levels in four skills. Therefore, this study aims to specify personnel's views and their language…

Communists, Humboldtians, Neoliberals and Dissidents: Or the Path to a Post-Communist Homo Oeconomicus

ERIC Educational Resources Information Center

Kascak, Ondrej

2017-01-01

The neoliberalisation of higher education in post-communist central and eastern Europe, the new EU member states, is not seen as being distinct. Implementation of the Bologna Process and Lisbon Strategy means it has become part of the competitive global sphere of higher education. The transformation of post-communist higher education has attracted…

The Decision-Making Process Used by Central Office Administrators as They Implement Full Day Kindergarten

ERIC Educational Resources Information Center

Palte, Suzanne C.

2014-01-01

The State of Michigan, as of 2012-2013, requires school districts to enroll students in full day kindergarten to receive full funding. This study investigated the decision-making process that was used by public school districts to determine kindergarten programs in their district. Specifically, how did administrators and staff members use the…

Discrepant perceptions of communication, teamwork and situation awareness among surgical team members

PubMed Central

Wauben, L.S.G.L.; Dekker-van Doorn, C.M.; van Wijngaarden, J.D.H.; Goossens, R.H.M.; Huijsman, R.; Klein, J.; Lange, J.F.

2011-01-01

Objective To assess surgical team members’ differences in perception of non-technical skills. Design Questionnaire design. Setting Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. Participants Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. Methods All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT. Results Ratings for ‘communication’ were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for ‘teamwork’ differed significantly between all team members (P ≤ 0.005). Within ‘situation awareness’ significant differences were mainly observed for ‘gathering information’ between surgeons and other team members (P < 0.001). Finally, 72–90% of anaesthetists, OT nurses and nurse anaesthetists rated routine team briefings and debriefings as inadequate. Conclusions This study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system. PMID:21242160

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes.

PubMed

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-03-06

Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care) perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Plant protection means used in organic farming throughout the European Union.

PubMed

Matyjaszczyk, Ewa

2018-03-01

Following the obligatory implementation of integrated pest management in the European Union (EU), the plant protection means suitable for application in organic agriculture attracted the attention of quite a wide group of potential users. In spite of the common rules of organic production, as well as the uniform principles of placing plant protection products on the market, the availability of products that can be legally used in organic crop protection differs significantly among the Member States. There is a uniform list of 10 basic substances that can be used in the protection of organic crops throughout the entire EU. Twelve Member States have official registers of plant protection products for use in organic agriculture, and the total number of qualified products per country varies from 11 in Lithuania to 576 in Italy. Some products that improve plant vigour or resistance and may be of use in protection of organic crops are placed on the market as biostimulants. They fall under the law that governs fertilisers and the systems of their registration vary widely among the Member States. In addition, there exist a number of products that have been legally introduced onto the markets of some Member States without registration as a consequence of a loophole in the law. The use of unregistered products in organic agriculture raises some doubts, but currently it seems that there is no legal basis on which to explicitly prohibit the practice. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Plant protection in Poland on the eve of obligatory integrated pest management implementation.

PubMed

Matyjaszczyk, Ewa

2013-09-01

Integrated pest management (IPM) will be obligatory in all European Union (EU) member states from January 1, 2014. Successful IPM implementation will depend not only on the sound guidelines and goodwill of the farmers, but also on conditions in farmers' environment. This paper presents the most important factors influencing IPM implementation in Poland. The most favorable aspects on the eve of obligatory IPM implementation are the relatively low use of plant protection products and popularity of some non-chemical methods of pest control, such as sowing cereal in mixture. The most important challenges are the improvement of advisory service and the crop structure with almost three-quarters of sown area covered by cereals. © 2013 Society of Chemical Industry.

The Washington State Technology Plan for the K-12 Common School System. Sections 701-703, Chapter 336, Laws of 1993 (Engrossed Substitute House Bill 1209) as Amended by Chapter 245, Laws of 1994. Report to the Legislature.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

This final report for the Washington State Technology Plan for K-12 Common Schools provides a vision, long-term framework, and recommendations for implementation. Following an executive summary and a list of committee members, the first section of the report discusses technology in K-12 schools of tomorrow, including legislative charge, vision,…

Response to Intervention: An Investigation of Training, Perceptions, and Fidelity of Implementation

ERIC Educational Resources Information Center

Latacha, Kathryn N.

2013-01-01

The authors investigated the extent to which the amount of training in Response to Intervention (RtI) impacts staff members' perceptions of RtI, how staff members' perceptions of RtI relate to their fidelity of implementation, and to what degree staff members' involvement in training influences their fidelity of implementation. A convenience…

International cooperation and support in environmental remediation - is there any room for improvement?

PubMed

Fernandes, Horst Monken; Recio, Manuel Santamaria; Forsstrom, Hans; Carson, Philip Michael

2013-05-01

The challenges faced by states seeking to implement Environmental Remediation works are many. To this end, the International Atomic Energy Agency attempts to provide assistance and guidance to Member States wherever possible. This review article provides a brief overview of these challenges and highlights the international sources of financial and implementation support discussed at an international conference on the topic in Astana, Kazakhstan in 2009. The conference concluded the importance of institutional structures as a pre-requisite for remediation work, recognized privatization as a useful but limited financing tool for remediation and illustrated the need for better coordination between international funding organizations to reduce overlap and optimization of resources to secure the best outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Design and Implementation of an International Nurse Faculty Partnership.

PubMed

Tuxbury, Janis S; Vilton, Yves; Hays, Antoinette; Street, Nancy

2016-01-01

Haiti has the highest rates of infant, under 5 years old, and maternal mortality in the Americas. More nurses are needed throughout the country, but there is a deficit of nursing faculty. Increasing numbers and quality of nursing faculty members will ensure a sustainable, positive impact on the country's nursing profession. The International Nurse Faculty Partnership Initiative was designed to educate a total of 36 current Haitian nurse faculty members at the master's-degree level. The first cohort of 12 nurse faculty members completed the program of study in February 2014, graduating with a master's degree in nursing from the State University of Haiti. Performance evaluation by their respective deans revealed that the Haitian nursing faculty members demonstrated increases in teaching effectiveness and critical thinking in comparison to their premaster's-degree skill levels. The International Nurse Faculty Partnership Initiative expects to graduate a total of 36 master's-level-prepared nurse educators. Currently, program graduates and nursing leaders from Haiti's Ministry of Health are working with the State University of Haiti to establish the faculty of nursing within the institution, creating a system for the ongoing delivery of baccalaureate-level and master-level nursing education within that country. Copyright © 2016 Elsevier Inc. All rights reserved.

The Effect of Florida Medicaid's State-Mandated Formulary Provision on Prescription Drug Use and Health Plan Costs in a Medicaid Managed Care Plan.

PubMed

Munshi, Kiraat D; Mager, Douglas; Ward, Krista M; Mischel, Brian; Henderson, Rochelle R

2018-02-01

Formulary or preferred drug list (PDL) management is an effective strategy to ensure clinically efficient prescription drug management by managed care organizations (MCOs). Medicaid MCOs participating in Florida's Medicaid program were required to use a state-mandated PDL between May and August 2014. To examine differences in prescription drug use and plan costs between a single Florida Medicaid managed care (MMC) health plan that implemented a state-mandated PDL policy on July 1, 2014, and a comparable MMC health plan in another state without a state-mandated PDL, controlling for sociodemographic confounders. A retrospective analysis with a pre-post design was conducted using deidentified administrative claims data from a large pharmacy benefit manager. The prepolicy evaluation period was January 1 through June 30, 2014, and the postpolicy period was January 1 through June 30, 2015. Continuously eligible Florida MMC plan members were matched on sociodemographic and health characteristics to their counterparts enrolled in a comparable MMC health plan in another state without a state-mandated formulary. Outcomes were drug use, measured as the number of 30-day adjusted nonspecialty drug prescriptions per member per period, and total drug plan costs per member per period for all drugs, with separate measures for generic and brand drugs. Bivariate comparisons were conducted using t-tests. Employing a difference-in-differences (DID) analytic approach, multivariate negative binomial regression and generalized estimating equation models were used to analyze prescription drug use and costs. The final analytical sample consisted of 18,372 enrollees, evenly divided between the 2 groups. In the postpolicy evaluation period, overall and generic use declined, while brand use increased for members in the Florida health plan. Drug costs, especially for brands, significantly increased for Florida health plan members. No significant changes were observed over the same time period in the control health plan members. DID analyses indicated that the decline in overall drug use was 6% lower (P = 0.020), and the increase in plan costs was 27% higher (P = 0.002) among Florida health plan members compared with control group members. Members in a Florida Medicaid health plan with a state-mandated PDL saw declines in overall and generic drug use and an increase in drug plan costs. States considering a state-mandated PDL should take into account potential effects of decreased generic drug use and increases in prescription drug plan costs. Funding for this study was provided internally by Express Scripts Holding Company. The authors and acknowledged contributors are employees of Express Scripts Holding Company. All authors contributed to the study concept, and study design was provided by Munshi, Mager, and Henderson. Munshi and Mager collected the data, and Munshi provided the statistical analysis. Data interpretation was performed by Munshi, Mager, and Henderson. The manuscript was written by Munshi, Henderson, and Mager and revised by Munshi, Ward, Mischel, and Henderson.

Extent of Implementing the Total Quality Management Principles by Academic Departments Heads at Najran University from Faculty Members' Perspectives

ERIC Educational Resources Information Center

Al-Din, Hesham Moustafa Kamal; Abouzid, Mohamed Mahmoud

2016-01-01

This study aimed to identify the implementing degree of Total Quality Management (TQM) principals by Academic Departmental Heads (ADH) at the Najran University from faculty members' perspectives. It also aimed to determine significant differences between the average estimate of sample section of faculty members about the implementing degree of TQM…

A Sequential Ensemble Prediction System at Convection Permitting Scales

NASA Astrophysics Data System (ADS)

Milan, M.; Simmer, C.

2012-04-01

A Sequential Assimilation Method (SAM) following some aspects of particle filtering with resampling, also called SIR (Sequential Importance Resampling), is introduced and applied in the framework of an Ensemble Prediction System (EPS) for weather forecasting on convection permitting scales, with focus to precipitation forecast. At this scale and beyond, the atmosphere increasingly exhibits chaotic behaviour and non linear state space evolution due to convectively driven processes. One way to take full account of non linear state developments are particle filter methods, their basic idea is the representation of the model probability density function by a number of ensemble members weighted by their likelihood with the observations. In particular particle filter with resampling abandons ensemble members (particles) with low weights restoring the original number of particles adding multiple copies of the members with high weights. In our SIR-like implementation we substitute the likelihood way to define weights and introduce a metric which quantifies the "distance" between the observed atmospheric state and the states simulated by the ensemble members. We also introduce a methodology to counteract filter degeneracy, i.e. the collapse of the simulated state space. To this goal we propose a combination of resampling taking account of simulated state space clustering and nudging. By keeping cluster representatives during resampling and filtering, the method maintains the potential for non linear system state development. We assume that a particle cluster with initially low likelihood may evolve in a state space with higher likelihood in a subsequent filter time thus mimicking non linear system state developments (e.g. sudden convection initiation) and remedies timing errors for convection due to model errors and/or imperfect initial condition. We apply a simplified version of the resampling, the particles with highest weights in each cluster are duplicated; for the model evolution for each particle pair one particle evolves using the forward model; the second particle, however, is nudged to the radar and satellite observation during its evolution based on the forward model.

Effect of unaffordable medical need on distress level of family member: analyses of 1997-2013 United States National Health Interview Surveys.

PubMed

Chih, Hui Jun; Liang, Wenbin

2017-09-02

Reduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels. Data of a total of 262,843 participants were obtained from 17 waves (1997-2013) of the United States National Health Interview Survey. Multinomial logistic regression was used to investigate psychological distress level as a result of having family members who experienced unmet medical needs due to cost. Among participants without family members who experienced unmet needs for medical care due to cost, risks of having 'moderate' (score of 5-12) or 'serious' (score of 13 or above) level of psychological distress were 1.0% and 11.5%, respectively. Risks of having 'moderate' or 'serious' level of psychological distress were 3.1% and 23.4%, respectively among participants with family members who experienced unmet needs. The adjusted relative risk ratio of 'moderate' and 'serious', as compared to 'normal' level of psychological distress, were 1.58 (95% confidence interval: 1.47-1.69) and 2.09 (95% confidence interval: 1.78-2.45) if one's family members experienced unmet medical needs. Unmet medical needs due to cost increases risk of distress levels experienced by family members. Careful planning and adequate funding to public health care system could be implemented to prevent any unnecessary detrimental effect on mental health among family members of the unwell and any further increment of the prevalence of mental illnesses. This recommendation aligns with the World Health Organization Mental Health Action Plan 2013-2020.

12 CFR 714.10 - What other laws must you comply with when engaged in leasing?

Code of Federal Regulations, 2010 CFR

2010-01-01

... leasing? You must comply with the Consumer Leasing Act, 15 U.S.C. 1667-67f, and its implementing... the extent that the state leasing laws are consistent with the Consumer Leasing Act, 15 U.S.C. 1667e, or provide the member with greater protections or benefits than the Consumer Leasing Act. You are...

Caring and Learning Together: Exploring the Relationship between Parental Leave and Early Childhood Education and Care

ERIC Educational Resources Information Center

Moss, Peter

2012-01-01

Parental leave and early childhood education and care (ECEC) are two policies widely proposed and implemented to support working parents with young children. This article examines entitlement to leave and ECEC in 25 European countries, including 22 EU Member and Accession States, and the relationship between them, in particular to what degree…

Consultation Process on the European Commission's "Memorandum on Lifelong Learning": Analysis of National Reports. CEDEFOP Panorama Series.

ERIC Educational Resources Information Center

Ni Cheallaigh, Martina, Ed.

This document presents outcomes of a review of the Memorandum on Lifelong Learning (LL) consultation reports from member states of the European Commission and EEA (European Economic Area) countries that collected all views on how best to make progress in implementing LL at local, regional, and national levels. Section 1 provides an overview of…

European Innovation Policy Concepts and the Governance of Innovation: Slovenia and the Struggle for Organizational Readiness at the National Level

ERIC Educational Resources Information Center

Gebhardt, Christiane; Stanovnik, Peter

2016-01-01

This paper examines the interdependency of European Policy and governance of innovation. The authors elaborate on the policy implementation context of Slovenia, a small and less advanced European member state in a transition process. The literature on innovation policy, governance and existing innovation concepts aiming to accelerate economic…

Societal constraints related to environmental remediation and decommissioning programmes.

PubMed

Perko, Tanja; Monken-Fernandes, Horst; Martell, Meritxell; Zeleznik, Nadja; O'Sullivan, Patrick

2017-06-20

The decisions related to decommissioning or environmental remediation projects (D/ER) cannot be isolated from the socio-political and cultural environment. Experiences of the IAEA Member States point out the importance of giving due attention to the societal aspects in project planning and implementation. The purpose of this paper is threefold: i) to systematically review societal constraints that some organisations in different IAEA Member States encounter when implementing D/ER programmes, ii) to identify different approaches to overcome these constraints and iii) to collect examples of existing practices related to the integration of societal aspects in D/ER programmes worldwide. The research was conducted in the context of the IAEA project Constraints to Decommissioning and Environmental Remediation (CIDER). The research results show that societal constraints arise mostly as a result of the different perceptions, attitudes, opinions and concerns of stakeholders towards the risks and benefits of D/ER programmes and due to the lack of stakeholder involvement in planning. There are different approaches to address these constraints, however all approaches have common points: early involvement, respect for different views, mutual understanding and learning. These results are relevant for all on-going and planned D/ER programmes. Copyright © 2017 Elsevier Ltd. All rights reserved.

UNESCO's activities in ethics.

PubMed

ten Have, Henk A M J

2010-03-01

UNESCO is an intergovernmental organization with 193 Member States. It is concerned with a broad range of issues regarding education, science and culture. It is the only UN organisation with a mandate in science. Since 1993 it is addressing ethics of science and technology, with special emphasis on bioethics. One major objective of the ethics programme is the development of international normative standards. This is particularly important since many Member States only have a limited infrastructure in bioethics, lacking expertise, educational programs, bioethics committees and legal frameworks. UNESCO has recently adopted the Universal Declaration on Bioethics and Human Rights. The focus of current activities is now on implementation of this Declaration. Three activities are discussed that aim at improving and reinforcing the ethics infrastructure in relation to science and technology: the Global Ethics Observatory, the Ethics Education Programme and the Assisting Bioethics Committees project.

World Trade Organization, ILO conventions, and workers' compensation.

PubMed

LaDou, Joseph

2005-01-01

The World Trade Organization, the World Bank, and the International Monetary Fund can assist in the implementation of ILO Conventions relating to occupational safety and health in developing countries. Most countries that seek to trade globally receive permission to do so from the WTO. If the WTO required member countries to accept the core ILO Conventions relating to occupational safety and health and workers' compensation, it could accomplish something that has eluded international organizations for decades. International workers' compensation standards are seldom discussed, but may at this time be feasible. Acceptance of a minimum workers' compensation insurance system could be a requirement imposed on applicant nations by WTO member states.

Interprofessional Team's Perception of Care Delivery After Implementation of a Pediatric Pain and Sedation Protocol.

PubMed

Staveski, Sandra L; Wu, May; Tesoro, Tiffany M; Roth, Stephen J; Cisco, Michael J

2017-06-01

Pain and agitation are common experiences of patients in pediatric cardiac intensive care units. Variability in assessments by health care providers, communication, and treatment of pain and agitation creates challenges in management of pain and sedation. To develop guidelines for assessment and treatment of pain, agitation, and delirium in the pediatric cardiac intensive unit in an academic children's hospital and to document the effects of implementation of the guidelines on the interprofessional team's perception of care delivery and team function. Before and after implementation of the guidelines, interprofessional team members were surveyed about the members' perception of analgesia, sedation, and delirium management RESULTS: Members of the interprofessional team felt more comfortable with pain and sedation management after implementation of the guidelines. Team members reported improvements in team communication on patients' comfort. Members thought that important information was less likely to be lost during transfer of care. They also noted that the team carried out comfort management plans and used pharmacological and nonpharmacological therapies better after implementation of the guidelines than they did before implementation. Guidelines for pain and sedation management were associated with perceived improvements in team function and patient care by members of the interprofessional team. ©2017 American Association of Critical-Care Nurses.

The accession countries benefit in the field of plant protection products.

PubMed

Stanek, A

2004-04-01

Ten candidate countries are expected to join EU in 2004. In the field of plant protection product (PPP) regulation, at EU level, acceding states will have roles in evaluation for listing of active substances in Annex I of Directive 91/414/EEC and ensuring that at national level, regulatory procedures comply with the acquis communautaire. This paper briefly outlines the impact of the acquis on the roles of Member States at both EU and national levels. It then briefly explains the current Czech Republic regulatory system as operated by the State Phytosanitary Administration and the National Institute of Public Health and the steps that the Czech Republic will have to take to implement the acquis requirements. Finally it makes an assessment as to how successful implementation of the acquis will prove beneficial to the acceding states and the parties which rely on the service that the regulatory authorities provide (i.e. the public, farmers and growers and the agrochemical industry).

Anticipated and Actual Implementation of Case-Based Learning by Dental Faculty Members During and After Training.

PubMed

Behar-Horenstein, Linda S; Catalanotto, Frank A; Nascimento, Marcelle M

2015-09-01

The aims of this study were to describe the processes used to train dental faculty members in case-based learning (CBL) and to determine their beliefs about the anticipated implementation of CBL and perceptions of actual implementation following use of the CBL approach. Participants were dental faculty members at the University of Florida who received a four-day intensive training course in the use of CBL. Two focus groups were conducted. The first occurred during training to assess how the participants anticipated using CBL. The second was conducted during the faculty members' implementation of CBL. All 19 trainees participated in focus group 1 (100%). During the course of the study, two faculty members left the school; of the remaining 17, 12 participated in focus group 2 (participation rate of 71%). The findings showed that initially the faculty members were hesitant and uncertain about using CBL. Following implementation, those issues dissipated, as the participants began to consider how to optimize the effectiveness of CBL as a legitimate method for fostering student ownership of learning and active participation. Understanding what CBL means for individual educators at varying stages of change will likely allow the dental education community to better anticipate and address tensions and challenges that faculty members are likely to experience.

Net benefits: assessing the effectiveness of clinical networks in Australia through qualitative methods

PubMed Central

2012-01-01

Background In the 21st century, government and industry are supplementing hierarchical, bureaucratic forms of organization with network forms, compatible with principles of devolved governance and decentralization of services. Clinical networks are employed as a key health policy approach to engage clinicians in improving patient care in Australia. With significant investment in such networks in Australia and internationally, it is important to assess their effectiveness and sustainability as implementation mechanisms. Methods In two purposively selected, musculoskeletal clinical networks, members and stakeholders were interviewed to ascertain their perceptions regarding key factors relating to network effectiveness and sustainability. We adopted a three-level approach to evaluating network effectiveness: at the community, network, and member levels, across the network lifecycle. Results Both networks studied are advisory networks displaying characteristics of the ‘enclave’ type of non-hierarchical network. They are hybrids of the mandated and natural network forms. In the short term, at member level, both networks were striving to create connectivity and collaboration of members. Over the short to medium term, at network level, both networks applied multi-disciplinary engagement in successfully developing models of care as key outputs, and disseminating information to stakeholders. In the long term, at both community and network levels, stakeholders would measure effectiveness by the broader statewide influence of the network in changing and improving practice. At community level, in the long term, stakeholders acknowledged both networks had raised the profile, and provided a ‘voice’ for musculoskeletal conditions, evidencing some progress with implementation of the network mission while pursuing additional implementation strategies. Conclusions This research sheds light on stakeholders’ perceptions of assessing clinical network effectiveness at community, network, and member levels during the network’s timeline, and on the role of networks and their contribution. Overall, stakeholders reported positive momentum and useful progress in network growth and development, and saw their networks as providing valuable mechanisms for meeting instrumental goals and pursuing collaborative interests. Network forms can prove their utility in addressing ‘wicked problems,’ and these Australian clinical networks present a practical approach to the difficult issue of clinician engagement in state-level implementation of best practice for improving patient care and outcomes. PMID:23122000

Managing change within the healthcare environment.

PubMed

Lipcamon, James D

2003-01-01

In the healthcare environment, there are many catalysts for change, including federal and state regulations, increased utilization, patients' expectations, competition, declining reimbursement and the technologist shortage. Regardless of what organization you work in, change creates pressure internally. This is especially true of organizations that have not had to deal with much change. The three most common responses are: 1) senior managers tend to isolate themselves from the effects of change on staff members; 2) middle managers tend to feel squeezed between the need to implement change and the need to support staff members; and 3) employees tend to feel attacked and betrayed by change. The following five steps will help you work with your staff as you introduce and implement change: prepare your employees, plan thoroughly, develop a transitional line of authority, stay flexible during implementation, and encourage self-management, acknowledging those who helped make the change work. When change is implemented, it is important to understand that people will move through four stages of reaction: denial, resistance, exploration and commitment. As a general rule, individuals will go through all four stages, but the speed at which they move through them will be different. Managers need to assist employees who get stuck in certain stages. To implement change as successfully as possible, follow these four steps: communicate about change, deal with resistance, increase team involvement, and use visionary leadership.

Design and implementation of active members for precision space structures

NASA Technical Reports Server (NTRS)

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

1992-01-01

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

Race to the Top: Education Could Better Support Grantees and Help Them Address Capacity Challenges. Report to the Ranking Member, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Committee on Appropriations, House of Representatives. GAO-15-295

ERIC Educational Resources Information Center

Nowicki, Jacqueline M.

2015-01-01

The Department of Education (Education) created Race To the Top (RTT) under the American Recovery and Reinvestment Act of 2009. From 2010 through 2011, Education awarded $4 billion in competitive grant funds to 19 states to reform core areas of K-12 education. RTT states also committed to building capacity to implement and sustain reforms. GAO and…

Implementation of the Cross-border Care Directive in EU Member States: Luxembourg.

PubMed

Schwebag, Mike

2014-03-01

The Cross-border Care Directive sets up basic patient rights in case of cross-border healthcare. These rights concern both the country of affiliation and the country of treatment of the patient. The article briefly describes the state of the transposition in Luxembourg, with a focus on the draft act on patients' rights and obligations. This new act on patient rights and obligations will apply without distinction to domestic and cross-border patients, thus transposing most of Luxembourg's obligations as a country of treatment of a cross-border patient.

Policies of Adult Education in Portugal and France: The European Agenda of Validation of Non-Formal and Informal Learning

ERIC Educational Resources Information Center

Cavaco, C.; Lafont, P.; Pariat, M.

2014-01-01

This article analyses the influence of the European Union's educational policies on the implementation of devices for the recognition and the validation of informal and non-formal learning within public policies on education and training for adults in European Union Member States. Portugal and France are taken as examples. The European Union's…

National Strategies for Implementing Lifelong Learning (LLL)--The Gap between Policy and Reality: An International Perspective

ERIC Educational Resources Information Center

Bengtsson, Jarl

2013-01-01

In this article, the late Jarl Bengtsson briefly traces the evolution of the concept of lifelong learning within the member states of the Organisation for Economic Co-operation and Development (OECD). He points out that on the one hand lifelong learning is accepted, in policy terms, by all OECD countries and many other countries, but on the other…

Healthcare rationing: issues and implications.

PubMed

Cypher, D P

1997-01-01

What methods, if any, should be used to practice healthcare rationing? This article looks at healthcare rationing in the United States, identifies ethical issues associated with implementing healthcare rationing, and addresses legal implications. The author utilizes sources from published literature and her own experience. Society must recognize that it does not have the resources available to fulfill all healthcare needs of all its members. Resolution will bring conflict and compromise.

Reducing Drinking Among Junior Enlisted Air Force Members in Five Communities: Early Findings of the EUDL Program's Influence on Self-Reported Drinking Behaviors*

PubMed Central

Spera, Christopher; Franklin, Keita; Uekawa, Kazuaki; Kunz, John F.; Szoc, Ronald Z.; Thomas, Randall K.; Cambridge, Milton H.

2010-01-01

Objective: In the fall of 2006, the Office of Juvenile Justice and Delinquency Prevention awarded discretionary grants to five communities in four states as part of the Enforcing Underage Drinking Laws initiative. These 3-year grants were designed to support implementation of a set of interventions using an environmental strategies approach to reduce drinking and associated alcohol-related misconducts among active-duty Air Force members ages 18–25, with a specific focus on the underage population. The current article presents findings from Year 1 of the evaluation. Method: Data on alcohol use were obtained from a large-scale, anonymous survey that fielded in the spring of 2006 (i.e., pretest) and the spring of 2008 (i.e., posttest) from a stratified random sample of Air Force members at five demonstration and five comparison communities. Results: The percentage of junior enlisted personnel at risk for an alcohol problem dropped 6.6% in the Air Force overall during the last 2 years but dropped as much as 13.6% and 9.8% in two Arizona demonstration communities that implemented the intervention. Conclusions: The first-year results suggest that the Enforcing Underage Drinking Laws intervention may have been one factor that helped to reduce the percentage of junior enlisted Air Force members at risk for an alcohol problem in the demonstration communities. PMID:20409431

Reducing drinking among junior enlisted Air Force members in five communities: early findings of the EUDL program's influence on self-reported drinking behaviors.

PubMed

Spera, Christopher; Franklin, Keita; Uekawa, Kazuaki; Kunz, John F; Szoc, Ronald Z; Thomas, Randall K; Cambridge, Milton H

2010-05-01

In the fall of 2006, the Office of Juvenile Justice and Delinquency Prevention awarded discretionary grants to five communities in four states as part of the Enforcing Underage Drinking Laws initiative. These 3-year grants were designed to support implementation of a set of interventions using an environmental strategies approach to reduce drinking and associated alcohol-related misconducts among active-duty Air Force members ages 18-25, with a specific focus on the underage population. The current article presents findings from Year 1 of the evaluation. Data on alcohol use were obtained from a large-scale, anonymous survey that fielded in the spring of 2006 (i.e., pretest) and the spring of 2008 (i.e., posttest) from a stratified random sample of Air Force members at five demonstration and five comparison communities. The percentage of junior enlisted personnel at risk for an alcohol problem dropped 6.6% in the Air Force overall during the last 2 years but dropped as much as 13.6% and 9.8% in two Arizona demonstration communities that implemented the intervention. The first-year results suggest that the Enforcing Underage Drinking Laws intervention may have been one factor that helped to reduce the percentage of junior enlisted Air Force members at risk for an alcohol problem in the demonstration communities.

Innovation and Technology: Electronic Intensive Care Unit Diaries.

PubMed

Scruth, Elizabeth A; Oveisi, Nazanin; Liu, Vincent

2017-01-01

Hospitalization in the intensive care unit can be a stressful time for patients and their family members. Patients' family members often have difficulty processing all of the information that is given to them. Therefore, an intensive care unit diary can serve as a conduit for synthesizing information, maintaining connection with patients, and maintaining a connection with family members outside the intensive care unit. Paper intensive care unit diaries have been used outside the United States for many years. This article explores the development of an electronic intensive care unit diary using a rapid prototyping model to accelerate the process. Initial results of design testing demonstrate that it is feasible, useful, and desirable to consider the implementation of electronic intensive care unit diaries for patients at risk for post-intensive care syndrome. ©2017 American Association of Critical-Care Nurses.

A Model-Based Prioritisation Exercise for the European Water Framework Directive

PubMed Central

Daginnus, Klaus; Gottardo, Stefania; Payá-Pérez, Ana; Whitehouse, Paul; Wilkinson, Helen; Zaldívar, José-Manuel

2011-01-01

A model-based prioritisation exercise has been carried out for the Water Framework Directive (WFD) implementation. The approach considers two aspects: the hazard of a certain chemical and its exposure levels, and focuses on aquatic ecosystems, but also takes into account hazards due to secondary poisoning, bioaccumulation through the food chain and potential human health effects. A list provided by EU Member States, Stakeholders and Non-Governmental Organizations comprising 2,034 substances was evaluated according to hazard and exposure criteria. Then 78 substances classified as “of high concern” where analysed and ranked in terms of risk ratio (Predicted Environmental Concentration/Predicted No-Effect Concentration). This exercise has been complemented by a monitoring-based prioritization exercise using data provided by Member States. The proposed approach constitutes the first step in setting the basis for an open modular screening tool that could be used for the next prioritization exercises foreseen by the WFD. PMID:21556195

Situational analysis: preliminary regional review of the Mental Health Atlas 2014.

PubMed

Gater, R; Chew, Z; Saeed, K

2015-09-28

The WHO comprehensive Mental Health Action Plan 2013-2020 established goals and objectives that Member States have agreed to meet by 2020. To update the Atlas of Mental Health 2011, specific indicators from the Mental Health Action Plan and additional indicators on service coverage were incorporated into the questionnaire for the Atlas 2014. The data will help facilitate improvement in information gathering and focus efforts towards implementation of the Mental Health Action Plan. The questionnaire was completed by the national mental health focal point of each country. This preliminary review seeks to consolidate data from the initial response to the Atlas 2014 questionnaire by Member States in the Eastern Mediterranean Region. Data for this review were analysed for the whole Region, by health systems groupings and by individual countries. Where possible, data are compared with the Mental Health Atlas 2011 to give a longitudinal perspective.

A theory of organizational readiness for change

PubMed Central

Weiner, Bryan J

2009-01-01

Background Change management experts have emphasized the importance of establishing organizational readiness for change and recommended various strategies for creating it. Although the advice seems reasonable, the scientific basis for it is limited. Unlike individual readiness for change, organizational readiness for change has not been subject to extensive theoretical development or empirical study. In this article, I conceptually define organizational readiness for change and develop a theory of its determinants and outcomes. I focus on the organizational level of analysis because many promising approaches to improving healthcare delivery entail collective behavior change in the form of systems redesign--that is, multiple, simultaneous changes in staffing, work flow, decision making, communication, and reward systems. Discussion Organizational readiness for change is a multi-level, multi-faceted construct. As an organization-level construct, readiness for change refers to organizational members' shared resolve to implement a change (change commitment) and shared belief in their collective capability to do so (change efficacy). Organizational readiness for change varies as a function of how much organizational members value the change and how favorably they appraise three key determinants of implementation capability: task demands, resource availability, and situational factors. When organizational readiness for change is high, organizational members are more likely to initiate change, exert greater effort, exhibit greater persistence, and display more cooperative behavior. The result is more effective implementation. Summary The theory described in this article treats organizational readiness as a shared psychological state in which organizational members feel committed to implementing an organizational change and confident in their collective abilities to do so. This way of thinking about organizational readiness is best suited for examining organizational changes where collective behavior change is necessary in order to effectively implement the change and, in some instances, for the change to produce anticipated benefits. Testing the theory would require further measurement development and careful sampling decisions. The theory offers a means of reconciling the structural and psychological views of organizational readiness found in the literature. Further, the theory suggests the possibility that the strategies that change management experts recommend are equifinal. That is, there is no 'one best way' to increase organizational readiness for change. PMID:19840381

[The control of foodstuffs at the beginning of 1993].

PubMed

Babusiaux, C

1992-11-01

The 1st January 1993 the frontiers between the Member States of the European Community and the customs controls will disappear. The abolition of this type of control won't affect the food security. The french administration has strong legal rules to ensure the protection of consumer's health. The regulations prepared by European Community in order to allow the free circulation of goods also ensure a high level of consumer's protection. In case of harmonization, each Member state keeps some rights when there are risks for consumer's health. In absence of community regulations the principal of mutual acknowledgement aiming to avoid the barriers to trade can then not be applied for health and security necessities. The authorities controls are now resolutely inserted in an european context: priority to controls during production, harmonized methods of intervention to promote the required acknowledgement of controls enforced in each Member state, involvement in an european alert system, and development of the cooperation between the national administrative authorities of inspection. Regarding the matter of food security the authorities need the assistance of the scientific community and of its national and international representative organisations. They take an essential part in diagnosing, emergency and advice during the elaboration of regulations. Their power should be even greater with the implementation of the european scientific cooperation.

From identification and review to action--maternal mortality review in the United States.

PubMed

Berg, Cynthia J

2012-02-01

The maternal mortality review process is an ongoing quality improvement cycle with 5 steps: identification of maternal deaths, collection of medical and other data on the events surrounding the death, review and synthesis of the data to identify potentially alterable factors, the development and implementation of interventions to decrease the risk of future deaths, and evaluation of the results. The most important step is utilization of the data to identify and implement evidence-based actions; without this step, the rest of the work will not have an impact. The review committee ideally is based in the health department of a state (or large city) as a core public health function. This provides stability for the process as well as facilitates implementation of the review committees' recommendations. The review committee should be multidisciplinary, with its members being official representatives of their organizations or departments, again to improve buy-in of the stakeholders. Published by Elsevier Inc.

Establishment of a Multi-State Experiential Pharmacy Program Consortium

PubMed Central

Unterwagner, Whitney L.; Byrd, Debbie C.

2008-01-01

In 2002, a regional consortium was created for schools and colleges of pharmacy in Georgia and Alabama to assist experiential education faculty and staff members in streamlining administrative processes, providing required preceptor development, establishing a professional network, and conducting scholarly endeavors. Five schools and colleges of pharmacy with many shared experiential practice sites formed a consortium to help experiential faculty and staff members identify, discuss, and solve common experience program issues and challenges. During its 5 years in existence, the Southeastern Pharmacy Experiential Education Consortium has coordinated experiential schedules, developed and implemented uniform evaluation tools, coordinated site and preceptor development activities, established a work group for educational research and scholarship, and provided opportunities for networking and professional development. Several consortium members have received national recognition for their individual experiential education accomplishments. Through the activities of a regional consortium, members have successfully developed programs and initiatives that have streamlined administrative processes and have the potential to improve overall quality of experiential education programs. Professionally, consortium activities have resulted in 5 national presentations. PMID:18698386

Will the EU Clinical Trials Regulation Support the Innovative Industry in Bringing New Medicines Faster to Patients?

PubMed

Atzor, Sabine; Gokhale, Surendra; Doherty, Michael

2013-04-01

A perspective from the innovative industry is provided in this article about the long awaited legal proposal for a Clinical Trial Regulation ("Proposal"), adopted in July 2012. With this Proposal, the European Commission reacted to a call by all stakeholders for more harmonization and streamlining of the provisions for conducting clinical trials in the EU. Discrepant approaches between Member States, a failure to respect legal timelines, and a lack of formal coordination mechanisms within and between Member States have resulted in an increased workload for the industry and contributed to a decline in Europe's attractiveness as a place to carry out research and development. The Proposal introduces a concept whereby the sponsor makes a single submission of the clinical trial application dossier to an EU portal, which is followed by a single assessment based on cooperation between Member States. A possibility for the sponsor to choose a 'reporting Member State' to take the lead on key aspects of the assessment is expected to support excellence building and work sharing of Competent Authorities in the EU. The Proposal respects the fact that certain aspects need to be reviewed nationally. The new process aims to lead to a single decision per clinical trial per concerned Member State. The rules are built on the principle of strict adherence to timelines for authorization. The timelines are ambitious but at the same time competitive, as the process builds in mechanisms that strengthen compliance. The rules have been designed to encourage sponsors to file complete submission packages, since any substantial modification to a trial would lead to delays in its commencement. Sponsors need to streamline their internal processes accordingly. In the end, streamlining is an effort that needs to be accepted by all parties involved. The Proposal does not detail how Member States organize the involvement of different bodies, such as Competent Authorities and Ethics Committees, because according to the EU Treaty, the EU cannot legislate on aspects falling into pure Member State competence. The Proposal, however, establishes the assessment objectives on the basis of Good Clinical Practices set by the International Conference on Harmonisation (ICH) and the Declaration of Helsinki by the World Medical Association. As such, the new legislation is likely to have implications on Member States' internal organization. In addition, Ethics Committees in Europe would benefit from an EU platform for best practice exchange-a concept that would need to be requested by the Council and the European Parliament through the legislative process. A single decision system for the entire EU per clinical trial has been discussed as an option, but such an approach was difficult to achieve while respecting national competencies. In this situation, the Proposal represents an acceptable compromise, provided its proposed mechanisms, processes, and timelines are retained upon implementation. As the Proposal is now on the table for discussion by the 27 Member States' governments and by the European Parliament, co-legislators and stakeholders should be aware that any dilution of these provisions would be detrimental to the objective to ensure patient access and make the conditions for clinical research in Europe attractive and fit for the future.

12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

Code of Federal Regulations, 2014 CFR

2014-01-01

... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

Code of Federal Regulations, 2013 CFR

2013-01-01

... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

Code of Federal Regulations, 2011 CFR

2011-01-01

... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

Code of Federal Regulations, 2012 CFR

2012-01-01

... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

The Indiana Chronic Disease Management Program's impact on medicaid claims: a longitudinal, statewide evaluation.

PubMed

Katz, Barry P; Holmes, Ann M; Stump, Timothy E; Downs, Steven M; Zillich, Alan J; Ackermann, Ronald T; Inui, Thomas S

2009-02-01

: Disease management programs have grown in popularity over the past decade as a strategy to curb escalating healthcare costs for persons with chronic diseases. : To evaluate the effect of the Indiana Chronic Disease Management Program (ICDMP) on the longitudinal changes in Medicaid claims statewide. : Phased implementation of a chronic disease management program in 3 regions of the state. Fourteen repeated cohorts of Medicaid members were drawn over a period of 3.5 years and the trends in claims were evaluated using a repeated measures model. : A total of 44,218 Medicaid members with diabetes and/or congestive heart failure in 3 geographic regions in Indiana. : Across all 3 regions and both disease classes, we found a flattening of cost trends between the pre- and post-ICDMP-initiation periods. This change in the slopes was significant for all of the models except for congestive heart failure in southern Indiana. Thus, the average per member claims paid was increasing at a faster rate before ICDMP but slowed once the program was initiated. To distinguish shorter and longer-term effects related to ICDMP, we estimated annual slopes within the pre- and post-ICDMP- time periods. A similar pattern was found in all regions: claims were increasing before ICDMP, flattened in the years around program initiation, and remained flat in the final year of follow-up. : This analysis shows that the trend in average total claims changed significantly after the implementation of ICDMP, with a decline in the rate of increase in claims paid observed for targeted Medicaid program populations across the state of Indiana.

Stress Reduction in Postcardiac Surgery Family Members: Implementation of a Postcardiac Surgery Tool Kit.

PubMed

Breisinger, Lauren; Macci Bires, Angela; Cline, Thomas W

The intensive care unit (ICU) can be a place of stress, anxiety, and emotional instability for both patients and families. Medical and nursing care during this acute time is patient focused, and family members are often left in the dark. Unintentional exclusion from information results in high levels of stress, anxiety, and uncertainty for families. Due to the acuity of illness, family members of cardiac surgery patients experience the highest levels of stress. Spouses may experience intense psychosomatic symptoms such as depression, anxiety, and fear for several months after the surgery. The purpose of this study was aimed at decreasing those feelings of anxiety in family members with postcardiac surgery through the use of a cardiac surgery tool kit. The study was a quality improvement project utilizing a convenience sample of 83 participants 18 years and older. Participants were asked to use the State Trait Anxiety Inventory (STAI) Form Y-1 (state anxiety) to rate their anxiety level preintervention and then again postintervention. Data were collected over a 6-month period. Descriptive data including age, education level, ethnicity, relationship, experience in the ICU, and active diagnoses of mental disorders did not affect the changes in the pre- and posttest data. A paired t test was conducted on the sample to assess changes in state anxiety, using the STAI Form Y-1. The results were statistically significant (t = 11.97, df = 81, P < .001). Respondents' scores decreased significantly from pre intervention (mean = 53.01, standard deviation = 12.19) to postintervention (mean = 37.38, standard deviation = 10.94). The data suggest that the use of a postcardiac surgery tool kit is a low-risk measure that can decrease the anxiety in family members of postcardiac surgery patients.

Offsetting Faculty and Institutional Inflexibility: A Case Study in Developing an Alternative to Tenure with Reference to Faculty Development and Evaluation.

ERIC Educational Resources Information Center

Steinkrauss, Philip J.

This in-progress program and resource study presents an actual case study in developing an alternative to tenure. The College of St. Francis implemented during the 1979-80 academic year an alternative system, the Three Year Rolling Contract. It stated that all faculty members have academic freedom under any form of appointment; upon appointment as…

Cross-border healthcare directive: Assessing stakeholders' perspectives in Poland and Portugal.

PubMed

Helena, Ricardo

2016-04-01

Within the context of the EU, a succession of rulings from the European Court of Justice addressed the gap of specific healthcare legislation. These rulings shook the member states assumption of health provision autonomy and led the European Commission to produce a specific directive concerning cross-border healthcare. In spite of different viewpoints of member states, including Poland and Portugal, the directive was approved and expected to be implemented by October 2013. The objective of this study was to analyse stakeholders' perspective towards the directive, unveiling the factors that supported a different viewpoint, and to identify challenges and assess the expected impact associated with the directive implementation on Poland and Portugal, using the WHO health systems conceptual framework. Information was collected through a literature review, identifying potential stakeholders. Primary qualitative analysis was conducted through the dissemination of open-ended questionnaires. Content and critical analysis was performed considering the available literature intertwined with the WHO health systems conceptual framework. The directive appears to be positive regarding patient rights, increased transparency, and potential to set new information technologies and healthcare networks. However, it also seems to potentially generate access inequalities between home and foreign patients, and increase healthcare costs due to the short-term investments needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

DNS load balancing in the CERN cloud

NASA Astrophysics Data System (ADS)

Reguero Naredo, Ignacio; Lobato Pardavila, Lorena

2017-10-01

Load Balancing is one of the technologies enabling deployment of large-scale applications on cloud resources. A DNS Load Balancer Daemon (LBD) has been developed at CERN as a cost-effective way to balance applications accepting DNS timing dynamics and not requiring persistence. It currently serves over 450 load-balanced aliases with two small VMs acting as master and slave. The aliases are mapped to DNS subdomains. These subdomains are managed with DDNS according to a load metric, which is collected from the alias member nodes with SNMP. During the last years, several improvements were brought to the software, for instance: support for IPv6, parallelization of the status requests, implementing the client in Python to allow for multiple aliases with differentiated states on the same machine or support for application state. The configuration of the Load Balancer is currently managed by a Puppet type. It discovers the alias member nodes and gets the alias definitions from the Ermis REST service. The Aiermis self-service GUI for the management of the LB aliases has been produced and is based on the Ermis service above that implements a form of Load Balancing as a Service (LBaaS). The Ermis REST API has authorisation based in Foreman hostgroups. The CERN DNS LBD is Open Software with Apache 2 license.

The reorganisation of European pharmacovigilance. Part 2. From spontaneous reports to agency reviews and decisions.

PubMed

2015-02-01

Despite the fact that adverse effects are vastly under-reported, spontaneous reporting remains the foundation of pharmacovigilance. A small series of properly documented cases, when very specific, can suffice to constitute a signal. In France, reporting adverse effects to Regional Pharmacovigilance Centres (CRPVs) permits high-quality analysis of pharmacovigilance signals, so that they can be brought to the attention of the national agency responsible for making decisions about drugs, the French Health Products Agency (ANSM). The ANSM can use this information to protect patients by implementing the measures within its power or by initiating a European referral. When a decision taken at the national level concerns a drug marketed in several Member States of the European Union, a "harmonisation" procedure results in a decision taken at community level, applicable in all Member States. This means that a safety issue raised by a single Member State sometimes leads to a decision that protects the population of the entire European Union. But it also means that other European decisions can compel national agencies to allow back onto the market a drug that they sought to withdraw in order to protect their citizens. Negotiations with other Member States, the European Medicines Agency (EMA) and the European Commission must be supported by robust data: this is yet another reason for each country to have its own effective national pharmacovigilance database, the contents of which should be publicly accessible. This is unfortunately not yet the case in France in 2014. It also provides another good reason for healthcare professionals and patients to report adverse effects, so that the details can be recorded in national and European databases.

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

PubMed

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

2015-12-01

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

Comparative analysis of diabetes self-management education programs in the European Union Member States.

PubMed

Saha, Sarama; Riemenschneider, Henna; Müller, Gabriele; Levin-Zamir, Diane; Van den Broucke, Stephan; Schwarz, Peter E H

2017-12-01

Diabetes self-management education (DSME) is generally considered as an integral part of diabetes care. The availability of different types of self-management in the European Union Member States (EUMS) remains uncertain. The aim of this study is to perform a comparative analysis of existing DSME programs (DSMEP) implemented in EUMS. Unpublished data regarding DSME in the EUMS was assessed with Diabetes Literacy Survey using wiki tool (WT) targeting patients and different stakeholders. An additional literature review (LR) was performed in PubMed to identify published studies regarding DSMEP in the EUMS from 2004 to 2014. A total of 102 DSMEP implemented in EUMS were reported in the WT and 154 programs were identified from the LR. Comparative analysis of the data indicated that a majority of programs are aimed at adults and only a minority at children and elderly. Only a small percentage of the programs utilize information technology for teaching and learning, and only one out of five programs pay attention to depression. The identified DSMEP aimed primarily to empower patients through increasing knowledge and changing attitudes and beliefs towards diabetes. This study provides an overview of the present state-of-the-art on diabetes self-management education programs in the 28 EUMS. To increase participation, existing DSMEP should be made more accessible to the patients as well as tailored to specific patient groups. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

When East meets the West: differences in approach and mentality between old and new EU member countries

NASA Astrophysics Data System (ADS)

Matenco, Liviu

2017-04-01

There are marked differences in the management and system of research across various EU member countries. While older member states have gradually learn their differences in research systems, approach and mentality, they generally know very little on marked differences with EU13 that have a very strong impact in the design, organisation, evaluation and implementation of collaborative or European programmes. Such differences result from the organisation of the national research system, funding agencies, supervision and methods of evaluation. In particular the latter impose a markedly different career management by the promotion of local or regional journals, institutes and faculty organisation, system of promotion and management of research. In this contribution, I share my experiences in crossing the east-west mentality border, in particular discussing pre-conceived mentalities, underlying differences and suggesting better ways of promoting integrated research across European systems.

Impact of Evidence-Based Dentistry Workshops on Educators' Use of Evidence in Teaching and Practice: A Pilot Study.

PubMed

Moreira, Narjara C F; Leonardi-Dutra, Kamile; Feres, Murilo F N; Colangelo, Erica A M; Balevi, Ben; Matthews, Debora; Flores-Mir, Carlos

2018-06-01

The aims of this pilot study were to evaluate the short-term impact of evidence-based dentistry (EBD) workshops on educators' use of clinical evidence in their clinical practice and educational activities and to identify barriers they encountered in implementing evidence in their teaching and clinical practice. Between April 2012 and January 2014, a series of EBD workshops was delivered to 31 dental faculty members and postdoctoral students at three Canadian dental schools. Survey I, assessing participants' perceptions of various aspects of the workshops, was administered immediately following the workshops. Survey II, evaluating the impact of the workshops on participants' EBD implementation, was conducted 10 to 31 months after their completion. Survey I was completed by all 31 participants (100% response rate); their mean scores ranged from 3.94 to 4.65 on a five-point scale. Survey II was completed by 20 participants (64.5% response rate; five postdoctoral students and 15 faculty members), using an online 20-item questionnaire. Of the respondents, 19 (95%) reported implementing EBD in their professional activities at that time, and 14 (70%) stated that the workshops had positively helped with EBD implementation. Eight respondents (40%) reported having experienced barriers to EBD implementation, while 15 (75%) reported that their patients/students welcomed use of EBD. The respondents reported believing that strategies such as increasing EBD education and dissemination and improving quality and accessibility of evidence would facilitate the transition to EBD practice. Reported barriers to EBD implementation included resistance and criticism from colleagues, difficulty in changing current practice model, and lack of time.

Community Prevention Coalition Context and Capacity Assessment: Comparing the United States and Mexico.

PubMed

Brown, Louis D; Chilenski, Sarah M; Ramos, Rebeca; Gallegos, Nora; Feinberg, Mark E

2016-04-01

Effective planning for community health partnerships requires understanding how initial readiness-that is, contextual factors and capacity-influences implementation of activities and programs. This study compares the context and capacity of drug and violence prevention coalitions in Mexico to those in the United States. Measures of coalition context include community problems, community leadership style, and sense of community. Measures of coalition capacity include the existence of collaborative partnerships and coalition champions. The assessment was completed by 195 members of 9 coalitions in Mexico and 139 members of 7 coalitions in the United States. Psychometric analyses indicate the measures have moderate to strong internal consistency, along with good convergent and discriminant validity in both settings. Results indicate that members of Mexican coalitions perceive substantially more serious community problems, especially with respect to education, law enforcement, and access to alcohol and drugs. Compared to respondents in the United States, Mexican respondents perceive sense of community to be weaker and that prevention efforts are not as valued by the population where the coalitions are located. The Mexican coalitions appear to be operating in a substantially more challenging environment for the prevention of violence and substance use. Their ability to manage these challenges will likely play a large role in determining whether they are successful in their prevention efforts. The context and capacity assessment is a valuable tool that coalitions can use in order to identify and address initial barriers to success. © 2015 Society for Public Health Education.

Antibiotic stewardship through the EU project "ABS International".

PubMed

Allerberger, Franz; Frank, Annegret; Gareis, Roland

2008-01-01

The increasing problem of antimicrobial resistance requires implementation of antibiotic stewardship (ABS) programs. The project "ABS International--implementing antibiotic strategies for appropriate use of antibiotics in hospitals in member states of the European Union" was started in September 2006 in Austria, Belgium, the Czech Republic, Germany, Hungary, Italy, Poland, Slovenia and Slovakia. A training program for national ABS trainers was prepared and standard templates for ABS tools (antibiotic list, guides for antibiotic treatment and surgical prophylaxis, antibiotic-related organization) and valid process measures, as well as quality indicators for antibiotic use were developed. Specific ABS tools are being implemented in up to five healthcare facilities in each country. Although ABS International clearly focuses on healthcare institutions, future antimicrobial stewardship programs must also cover public education and antibiotic prescribing in primary care.

Second Wave of Biometric ID-documents in Europe: The Residence Permit for non-EU/EEA Nationals

NASA Astrophysics Data System (ADS)

Houdeau, Detlef

The first implementation of biometric documents, called biometric passports, based on a regulation is running, the second implementation since end of CY 2008 is coming to Europe. The focus is on persons staying for business, study or leisure for more than 3 months in Europe and coming from a state outside Europe and not being a member of the Visa-Waiver-Program of the EU. This second wave increases the demand for the security industry for certified security microcontroller chips, secure smart cards, readers and supporting infrastructure on top of the biometric Passport business. It underlines the continuing advance of contactless identification technology in the public sector. The article gives an overview on the application, the technology, the EU regulation, the EU roadmap and the implementations.

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

Gerald Hill; Kenneth Nemeth; Gary Garrett

The Southern States Energy Board's (SSEB) 'Regional Effort to Deploy Clean Coal Technologies' program began on June 1, 2003, and was completed on January 31, 2009. The project proved beneficial in providing state decision-makers with information that assisted them in removing barriers or implementing incentives to deploy clean coal technologies. This was accomplished through two specific tasks: (1) domestic energy security and diversity; and (2) the energy-water interface. Milestones accomplished during the project period are: (1) Presentations to Annual Meetings of SSEB Members, Associate Member Meetings, and the Gasification Technologies Council. (2) Energy: Water reports - (A) Regional Efforts tomore » Deploy Clean Coal Technologies: Impacts and Implications for Water Supply and Quality. June 2004. (B) Energy-Water Interface Challenges: Coal Bed Methane and Mine Pool Water Characterization in the Southern States Region. 2004. (C) Freshwater Availability and Constraints on Thermoelectric Power Generation in the Southeast U.S. June 2008. (3) Blackwater Interactive Tabletop Exercise - Decatur, Georgia April 2007. (4) Blackwater Report: Blackwater: Energy and Water Interdependency Issues: Best Practices and Lessons Learned. August 2007. (5) Blackwater Report: BLACKWATER: Energy Water Interdependency Issues REPORT SUMMARY. April 2008.« less

Individualized music for dementia: Evolution and application of evidence-based protocol.

PubMed

Gerdner, Linda A

2012-04-22

The theory-based intervention of individualized music has been evaluated clinically and empirically leading to advancement and refinement of an evidence-based protocol, currently in its 5th edition. An expanded version of the protocol was written for professional health care providers with a consumer version tailored for family caregivers. The underlying mid-range theory is presented along with a seminal study that was followed by further research in the United States, Canada, Great Britain, France, Sweden, Norway, Japan and Taiwan. Key studies are summarized. Given its efficacy when implemented by research staff, studies have advanced to testing the intervention under real-life conditions when implemented and evaluated by trained nursing assistants in long-term care facilities and visiting family members. In addition, one study evaluated the implementation of music by family members in the home setting. Initial research focused on agitation as the dependent variable with subsequent research indicating a more holistic response such as positive affect, expressed satisfaction, and meaningful interaction with others. The article advances by describing on-line programs designed to train health care professionals in the assessment, implementation and evaluation of individualized music. In addition, Gerdner has written a story for a picture book intended for children and their families (in press). The story models principles of individualized music to elicit positive memories, reduce anxiety and agitation, and promote communication. The article concludes with implications for future research.

Individualized music for dementia: Evolution and application of evidence-based protocol

PubMed Central

Gerdner, Linda A

2012-01-01

The theory-based intervention of individualized music has been evaluated clinically and empirically leading to advancement and refinement of an evidence-based protocol, currently in its 5th edition. An expanded version of the protocol was written for professional health care providers with a consumer version tailored for family caregivers. The underlying mid-range theory is presented along with a seminal study that was followed by further research in the United States, Canada, Great Britain, France, Sweden, Norway, Japan and Taiwan. Key studies are summarized. Given its efficacy when implemented by research staff, studies have advanced to testing the intervention under real-life conditions when implemented and evaluated by trained nursing assistants in long-term care facilities and visiting family members. In addition, one study evaluated the implementation of music by family members in the home setting. Initial research focused on agitation as the dependent variable with subsequent research indicating a more holistic response such as positive affect, expressed satisfaction, and meaningful interaction with others. The article advances by describing on-line programs designed to train health care professionals in the assessment, implementation and evaluation of individualized music. In addition, Gerdner has written a story for a picture book intended for children and their families (in press). The story models principles of individualized music to elicit positive memories, reduce anxiety and agitation, and promote communication. The article concludes with implications for future research. PMID:24175165

Compression member response of double steel angles on truss structure with member length variation

NASA Astrophysics Data System (ADS)

Hasibuan, Purwandy; Panjaitan, Arief; Haiqal, Muhammad

2018-05-01

One type of structures that implements steel angles as its members is truss system of telecommunication tower. For this structure, reinforcements on tower legs are also needed when antennas and microwaves installation placed on the peak of tower increases in quantity. One type of reinforcement methods commonly used is by increasing areas section capacity, where tower leg consisted of single angle section will be reinforced to be double angle sections. Regarding this case, this research discussed behavior two types of double angle steel section 2L 30.30.3 that were designed identically in area section but vary in length: 103 cm and 83 cm. At the first step, compression member together with tension member was formed to be a truss system, where compression and tension member were met at the joint plate. Schematic loading was implemented by giving tension loading on the joint plate, and this loading was terminated when each specimen reached its failure. Research findings showed that implementing shorter double angle (83 cm) sections, increased compression strength of steel angle section up to 13 %. Significant deformation occurring only on the flange for both of specimens indicated that implementing double angle is effective to prevent lateral-torsional buckling.

The SAGES Fundamental Use of Surgical Energy program (FUSE): history, development, and purpose.

PubMed

Fuchshuber, P; Schwaitzberg, S; Jones, D; Jones, S B; Feldman, L; Munro, M; Robinson, T; Purcell-Jackson, G; Mikami, D; Madani, A; Brunt, M; Dunkin, B; Gugliemi, C; Groah, L; Lim, R; Mischna, J; Voyles, C R

2018-06-01

Adverse events due to energy device use in surgical operating rooms are a daily occurrence. These occur at a rate of approximately 1-2 per 1000 operations. Hundreds of operating room fires occur each year in the United States, some causing severe injury and even mortality. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) therefore created the first comprehensive educational curriculum on the safe use of surgical energy devices, called Fundamental Use of Surgical Energy (FUSE). This paper describes the history, development, and purpose of this important training program for all members of the operating room team. The databases of SAGES and the FUSE committee as well as personal photographs and documents of members of the FUSE task force were used to establish a brief history of the FUSE program from its inception to its current status. The authors were able to detail all aspects of the history, development, and national as well as global implementation of the third SAGES Fundamentals Program FUSE. The written documentation of the making of FUSE is an important contribution to the history and mission of SAGES and allows the reader to understand the idea, concept, realization, and implementation of the only free online educational tool for physicians on energy devices available today. FUSE is the culmination of the SAGES efforts to recognize gaps in patient safety and develop state-of-the-art educational programs to address those gaps. It is the goal of the FUSE task force to ensure that general FUSE implementation becomes multinational, involving as many countries as possible.

Implementation of a Nurse-Led Family Meeting in a Neuroscience Intensive Care Unit.

PubMed

Wu, Huixin; Ren, Dianxu; Zinsmeister, Glenn R; Zewe, Gretchen E; Tuite, Patricia K

2016-01-01

The aims of this study were to develop, implement, and evaluate the impact of early intensive care unit (ICU) nurse-led family meetings on nurse-family communication, family decision making, and satisfaction of family members. Intensive care unit nurses are in an ideal position to meet family needs, and family members may cope better with the crisis of an ICU admission if consistent honest information is provided by nurses; however, there are no early ICU family meetings led by bedside nurses. This quality improvement project was implemented in a 10-bed neuroscience ICU over a 3-month period. A convenience sample of 23 nurses participated in the project. Following development of a communication protocol to facilitate nurse-led meetings, the nurses received education and then implemented the protocol. Thirty-one family members participated in the project. Family members were surveyed before and after the meetings. Mean meeting time was 26 (SD, 14) minutes. Following implementation of the meetings, findings demonstrated that families felt that communication improved (P = .02 and P = .008), they had appropriate information for decision making allowing them to feel in control (P = .002), and there was an increase in family satisfaction (P = .001). Early ICU nurse-led family meetings were feasible, improved communication between ICU nurses and family members, facilitated decision making in ICU families, and increased satisfaction of family members.

Health Care IT Collaboration in Massachusetts: The Experience of Creating Regional Connectivity

PubMed Central

Halamka, John; Aranow, Meg; Ascenzo, Carl; Bates, David; Debor, Greg; Glaser, John; Goroll, Allan; Stowe, Jim; Tripathi, Micky; Vineyard, Gordon

2005-01-01

The state of Massachusetts has significant early experience in planning for and implementing interoperability networks for exchange of clinical and financal data. Members of our evolving data-sharing organizations gained valuable experience that is of potential benefit to others regarding the governance, policies, and technologies underpinning regional health information organizations. We describe the history, roles, and evolution of organizations and their plans for and success with pilot projects. PMID:16049225

75 FR 70973 - Registration of Foreign Boards of Trade

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-19

...The Commodity Futures Trading Commission (Commission or CFTC) is proposing rules to implement new statutory provisions enacted by Title VII of the Dodd-Frank Wall Street Reform and Consumer Protection Act. These proposed rules establish a registration requirement that applies to foreign boards of trade (FBOT) that wish to provide their identified members or other participants located in the United States with direct access to their electronic trading and order matching systems.

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

PubMed

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

2017-10-01

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

Tri-focal Model of Care Implementation: Perspectives of Residents and Family.

PubMed

Hutchinson, Alison; Rawson, Helen; O'Connell, Beverly; Walker, Helen; Bucknall, Tracey; Forbes, Helen; Ostaszkiewicz, Joan; Ockerby, Cherene

2017-01-01

To explore residents' and family members' perceptions of partnership-centered long-term care (LTC) associated with implementation of the Tri-focal Model of Care. The Model promotes partnership-centered care, evidence-based practice, and a positive environment. Its implementation is supported by a specifically designed education program. The Model was implemented over approximately 12 months in seven LTC facilities in Victoria, Australia. A qualitative exploratory-descriptive approach was used. Data were collected using individual and focus group interviews with residents and family members prior to and following implementation of the Model. Data were analyzed thematically. Prior to implementation of the Model, residents described experiencing a sense of disempowerment, and emphasized the importance of communication, engagement, and being a partner in the staff-resident care relationship. Following implementation, residents reported experiencing improved partnership approaches to care, although there were factors that impacted on having a good experience. Family members described a desire to remain involved in the resident's life by establishing good communication and rapport with staff. They acknowledged this was important for partnership-centered care. Following implementation, they described experiencing a partnership with staff, giving them confidence to assist staff and be included in decisions about the resident. The Tri-focal Model of Care can enable residents, family members, and staff to be partners in resident care in LTC settings. With an ageing population, an increasing demand for complex, individualized LTC exists. Delivery of high-quality LTC requires a strategy to implement a partnership-centered approach, involving residents, family members, and staff. © 2016 The Authors. Journal of Nursing Scholarship published by Wiley Periodicals, Inc. on behalf of Society for Journal of Nursing Scholarship.

Extended producer responsibility: The impact of organizational dimensions on WEEE collection from households.

PubMed

Corsini, Filippo; Rizzi, Francesco; Frey, Marco

2017-01-01

Extended Producer Responsibility (EPR) has been the backbone of product life cycle management in Europe since the 2000s. Unfortunately, EPR implementation has multiple impacts on the supply chain and, thus, its consequences are not always easily manageable. Although several studies have explored various examples within the EU, the determinants of the effectiveness of EPR management are still not fully understood. This research seeks to bridge this gap by making use of quantitative analyses to investigate how key issues related to: WEEE Directive transposition and organizational settings adopted by each Member State, influenced the results achieved in those Member States in terms of collection from households. In details, a latent class analysis (LCA) has been used to analyse different EPR management strategies based on the policy set, the supply chain structure, and the performance of the household collection of electronic waste. Results highlight the strong connection between allocation of responsibility and organizational model adopted in Member States and performance related to small households equipment's. Conclusions shows the need for stronger coordination of EPR and waste policies in order to achieve adequate levels of Waste Electrical and Electronic Equipment (WEEE) collection, the need of a clear delineation of the responsibilities of each subject of the supply chain and also the importance of "clearing houses" in moderating the impacts of short-sighted competition between collective schemes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Tobacco control efforts in the Gulf Cooperation Council countries: achievements and challenges.

PubMed

Hassounah, S; Rawaf, D; Khoja, T; Rawaf, S; Hussein, M S; Qidwai, W; Majeed, A

2014-08-19

This paper reports a review into the current state of tobacco use, governance and national commitment for control, and current intervention frameworks in place to reduce the use of tobacco among the populations of the Gulf Cooperation Council (GCC) member states and Yemen. It further reviews structured policy-oriented interventions (in line with the MPOWER package of 6 evidence-based tobacco control measures) that represent government actions to strengthen, implement and manage tobacco control programmes and to address the growing epidemic of tobacco use. Our findings show that tobacco control in the GCC countries has witnessed real progress over the past decades. These are still early days but they indicate steps in the right direction. Future investment in implementation and enforcement of the Framework Convention on Tobacco Control, production of robust tobacco control legislation and the establishment of universally available tobacco cessation services are essential to sustain and strengthen tobacco control in the GCC region.

Strategic environmental noise mapping: methodological issues concerning the implementation of the EU Environmental Noise Directive and their policy implications.

PubMed

Murphy, E; King, E A

2010-04-01

This paper explores methodological issues and policy implications concerning the implementation of the EU Environmental Noise Directive (END) across Member States. Methodologically, the paper focuses on two key thematic issues relevant to the Directive: (1) calculation methods and (2) mapping methods. For (1), the paper focuses, in particular, on how differing calculation methods influence noise prediction results as well as the value of the EU noise indicator L(den) and its associated implications for comparability of noise data across EU states. With regard to (2), emphasis is placed on identifying the issues affecting strategic noise mapping, estimating population exposure, noise action planning and dissemination of noise mapping results to the general public. The implication of these issues for future environmental noise policy is also examined. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Coincidence of role expectations between staff and volunteer members of drug free community coalitions.

PubMed

Goldstein, Marc B; Sapere, Heather; Daviau, John

2017-08-01

Community coalitions have proliferated as a means of addressing a range of complex community problems. Such coalitions often consist of a small paid staff and volunteer members. The present study examines one likely contributor to coalition effectiveness: the degree of agreement on role expectations between paid staff and volunteer members. Role confusion occurs when paid staff and volunteers differ in their expectations of who is responsible for accomplishing specific tasks. Staff and volunteer members from 69 randomly selected Drug Free Coalitions in the United States as well as 21 Drug Free Coalitions in Connecticut were asked to respond to an online survey asking about 37 specific coalition tasks critical for effective coalition functioning and the degree to which paid staff and/or voluntary members should be responsible for accomplishing each. Our final sample consisted of 476 individuals from 35 coalitions. Using coalitions as the unit of analysis, we found significant differences between paid staff and volunteer coalition members on nine tasks reflecting four domains: meeting leadership and participation, (2) planning and implementation leadership, (3) publicity/media relations, and (4) logistical functions. Implications of these differences and ways that evaluators could help coalitions deal with differing role expectations were discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Case Analysis of an Elementary School's Implementation of Response to Intervention

ERIC Educational Resources Information Center

White, Richard B.; Polly, Drew; Audette, Robert H.

2012-01-01

The study provides an illustration of an elementary school's implementation of a model of Response to Intervention (RTI). The school was selected to be the pilot for RTI implementation within the district. The study employed interviews of all members of the school RTI Leadership Team and select members of the district-level RTI Leadership Team. An…

Latino sexual and gender identity minorities promoting sexual health within their social networks: Process evaluation findings from a lay health advisor intervention

PubMed Central

Sun, Christina J.; García, Manuel; Mann, Lilli; Alonzo, Jorge; Eng, Eugenia; Rhodes, Scott D.

2015-01-01

The HOLA intervention was a lay health advisor intervention designed to reduce the disproportionate HIV burden borne by Latino sexual and gender identity minorities (gay, bisexual, and other men who have sex with men, and transgender persons) living in the United States. Process evaluation data were collected for over a year of intervention implementation from 11 trained Latino male and transgender lay health advisors (Navegantes) to document the activities each Navegante conducted to promote condom use and HIV testing among his or her 8 social network members enrolled in the study. Over 13 months, the Navegantes reported conducting 1,820 activities. The most common activity was condom distribution. Navegantes had extensive reach beyond their enrolled social network members, and they engaged in health promotion activities beyond social network members enrolled in the study. There were significant differences between the types of activities conducted by Navegantes depending on who was present. Results suggest that lay health advisor interventions reach large number of at-risk community members and may benefit populations disproportionately impacted by HIV. PMID:25416309

National Differences in Requirements for Ethical and Competent Authority Approval for a Multinational Vaccine Trial under the EU Directive 2001/20/EC

PubMed Central

van Doorn, Eva; Hak, Eelko; Wilffert, Bob

2015-01-01

Obtaining approval for a multinational vaccine trial from an ethics committee and the national competent authority of different Member States of the European Union (EU) is challenging under clinical trial Directive 2001/20/EC because of the differences in the implementation of the directive in national laws of Member States. In this review the national differences in requirements for ethical and competent authority approval are illustrated. The national ethical and competent authority review procedures in Finland, Hungary, The Netherlands, Norway and Slovenia are described under the EU trial directive after discussing the provisions of the trial directive related to both review procedures. The review illustrates the differences between the countries in the documents that have to be submitted for the review procedures, the submission procedures and the language requirements of the documents, the organization of the ethics committees and the role of the competent authority in the approval procedure. PMID:26343188

National Differences in Requirements for Ethical and Competent Authority Approval for a Multinational Vaccine Trial under the EU Directive 2001/20/EC.

PubMed

van Doorn, Eva; Hak, Eelko; Wilffert, Bob

2015-04-14

Obtaining approval for a multinational vaccine trial from an ethics committee and the national competent authority of different Member States of the European Union (EU) is challenging under clinical trial Directive 2001/20/EC because of the differences in the implementation of the directive in national laws of Member States. In this review the national differences in requirements for ethical and competent authority approval are illustrated. The national ethical and competent authority review procedures in Finland, Hungary, The Netherlands, Norway and Slovenia are described under the EU trial directive after discussing the provisions of the trial directive related to both review procedures. The review illustrates the differences between the countries in the documents that have to be submitted for the review procedures, the submission procedures and the language requirements of the documents, the organization of the ethics committees and the role of the competent authority in the approval procedure.

New risk indicator approach for Operators, Workers, Bystanders and Residents for a sustainable use of plant protection products.

PubMed

Sacchettini, Gabriele; Calliera, Maura; Marchis, Alexandru; Glass, Richard; Ellis, Clare Butler; Machera, Kyriaki; Gerritsen-Ebben, Rianda; Spanoghe, Pieter; Capri, Ettore

2015-11-01

In 2009, the European Union adopted the Directive on Sustainable Use of pesticides (SUD, Directive 2009/128/EC) establishing a framework for achieving a sustainable use of Plant Protection Products (PPPs) through reducing the risks and impacts of PPP use on human health and the environment, promoting integrated pest management and stimulating effective non-chemical alternatives. The core idea of the SUD is that it is necessary to monitor the use of PPPs through the implementation of an appropriate set of risk indicators to monitor progress and trends in risk reduction within the Member States. To contribute to this direction, following a comprehensive analysis of the risk (including procedures of risk assessment and risk management) and involving stakeholders in the decision process, specific toolboxes of practical indirect risk indicators of exposure of Operators, Workers, Bystanders and Residents were developed and are now available to be used by Member States (MSs) based on their specific context.

Policy interventions related to medicines: Survey of measures taken in European countries during 2010-2015.

PubMed

Vogler, Sabine; Zimmermann, Nina; de Joncheere, Kees

2016-12-01

Policy-makers can use a menu of pharmaceutical policy options. This study aimed to survey these measures that were implemented in European countries between 2010 and 2015. We did bi-annual surveys with competent authorities of the Pharmaceutical Pricing and Reimbursement Information network. Additionally, we consulted posters produced by members of this network as well as further published literature. Information on 32 European countries (all European Union Member States excluding Luxembourg; Iceland, Norway, Serbia, Switzerland, Turkey) was included. 557 measures were reported between January 2010 and December 2015. The most frequently mentioned measure was price reductions and price freezes, followed by changes in patient co-payments, modifications related to the reimbursement lists and changes in distribution remuneration. Most policy measures were identified in Portugal, Greece, Belgium, France, the Czech Republic, Iceland, Spain and Germany. 22% of the measures surveyed could be classified as austerity. Countries that were strongly hit by the financial crisis implemented most policy changes, usually aiming to generate savings and briefly after the emergence of the crisis. Improvements in the economic situation tended to lead to an easing of austerity measures. Countries also implemented policies that aimed to enhance enforcement of existing measures and increase efficiency. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Family Engagement in Schoolwide Positive Behavioral Interventions and Supports: Barriers and Facilitators to Implementation.

PubMed

Garbacz, S Andrew; Hirano, Kara; McIntosh, Kent; Eagle, John W; Minch, Devon; Vatland, Christopher

2017-11-20

The purpose of this study was to identify barriers and facilitators to family engagement in schools implementing schoolwide positive behavioral interventions and supports (PBIS). Participants consisted of 1 representative member each from 204 school PBIS teams across 3 states. Qualitative analysis guided examination of responses to 1 question regarding barriers and 2 questions about facilitators to family engagement. Survey respondents identified key barriers to family engagement as a lack of resources, inconsistent communication, and reluctance of families and school staff to partner. Specified facilitators included communication, PBIS, shared decision-making, and strategies to build relationships with families. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Brazil and UN Security Council Resolution 1325: Progress and Challenges of the Implementation Process

DTIC Science & Technology

2016-03-01

political crises. As the UN and its member states increasingly recognize that peace and stability depend on inclusivity and gender equality, are troop...oversees the women, peace and security program . Mariana Lima is a researcher at the Pandiá Calógeras Institute, Brazilian Ministry of Defense, and...Cooperation Agency of the Ministry of External Relations signed a cooperation agreement with UN Women to promote gender equality in two programs : the

Translations on North Korea. Number 509

DTIC Science & Technology

1977-02-16

forward a Wise agricultural policy and guided all farming work one by one. Sin In-chol, a member of the "Chongmaek Association" and student in Seoul...same time, find out and ascertain as normal procedure the status of enforcing the party’s agricultural policy and the state of all farm work. They...must intensify party guidance and control so that the great leader’s instructions and the party’s agricultural policy are accurately implemented and

National quality improvement policies and strategies in European healthcare systems.

PubMed

Spencer, E; Walshe, K

2009-02-01

This survey provides an overview of the development of policies and strategies for quality improvement in European healthcare systems, by mapping quality improvement policies and strategies, progress in their implementation, and early indications of their impact. A survey of quality improvement policies and strategies in healthcare systems of the European Union was conducted in 2005 for the first phase of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The survey, completed by 68 key experts in quality improvement from 24 European Union member states, represents their views and accounts of quality improvement policies and strategies in their healthcare systems. There are substantial international and intra-national variations in the development of healthcare quality improvement. Legal requirements for quality improvement strategies are an important driver of progress, along with the activities of national governments and professional associations and societies. Patient and service user organisations appear to have less influence on quality improvement. Wide variation in voluntary and mandatory coverage of quality improvement policies and strategies across sectors can potentially lead to varying levels of progress in implementation. Many healthcare organisations lack basic infrastructure for quality improvement. Some convergence can be observed in policies on quality improvement in healthcare. Nevertheless, the growth of patient mobility across borders, along with the implications of free market provisions for the organisation and funding of healthcare systems in European Union member states, require policies for cooperation and learning transfer.

Design, implementation, and first-year outcomes of a value-based drug formulary.

PubMed

Sullivan, Sean D; Yeung, Kai; Vogeler, Carol; Ramsey, Scott D; Wong, Edward; Murphy, Chad O; Danielson, Dan; Veenstra, David L; Garrison, Louis P; Burke, Wylie; Watkins, John B

2015-04-01

Value-based insurance design attempts to align drug copayment tier with value rather than cost. Previous implementations of value-based insurance design have lowered copayments for drugs indicated for select "high value" conditions and have found modest improvements in medication adherence. However, these implementations have generally not resulted in cost savings to the health plan, suggesting a need for increased copayments for "low value" drugs. Further, previous implementations have assigned equal copayment reductions to all drugs within a therapeutic area without assessing the value of individual drugs. Aligning the individual drug's copayment to its specific value may yield greater clinical and economic benefits. In 2010, Premera Blue Cross, a large not-for-profit health plan in the Pacific Northwest, implemented a value-based drug formulary (VBF) that explicitly uses cost-effectiveness analyses after safety and efficacy reviews to estimate the value of each individual drug. Concurrently, Premera increased copayments for existing tiers. To describe and evaluate the design, implementation, and first-year outcomes of the VBF. We compared observed pharmacy cost per member per month in the year following the VBF implementation with 2 comparator groups: (1) observed pharmacy costs in the year prior to implementation, and (2) expected costs if no changes were made to the pharmacy benefits. Expected costs were generated by applying autoregressive integrated moving averages to pharmacy costs over the previous 36 months. We used an interrupted time series analysis to assess drug use and adherence among individuals with diabetes, hypertension, or dyslipidemia compared with a group of members in plans that did not implement a VBF.  Pharmacy costs decreased by 3% compared with the 12 months prior and 11% compared with expected costs. There was no significant decline in medication use or adherence to treatments for patients with diabetes, hypertension, or dyslipidemia. The VBF and copayment changes enabled pharmacy plan cost savings without negatively affecting utilization in key disease states.

Automation and robotics for COLUMBUS: An implementation concept for the free flying laboratory (MTFF)

NASA Technical Reports Server (NTRS)

Goelz, G.; Sommer, B.

1992-01-01

With nearly forty percent of the funding, Germany is the main contributor to the European COLUMBUS Programme, followed by Italy, France and further ESA member states. The COLUMBUS elements are the Attached Laboratory (APM) to be permanently attached to the Space Station FREEDOM, the polar platform (PPF) and the Man Tended Free Flyer (MTFF). The latter element is regarded to be of special interest for the German micro-g community. Until now the implementation of A&R Technologies has not been included as part of the system concept for the COLUMBUS laboratory modules. Yet especially for the Free Flyer, a high degree of A&R will be indispensible. An A&R system concept and implementation options for A&R are given to make the COLUMBUS labs 'intelligent' laboratories in orbit.

The Fight Against Piracy in Peer-to-Peer Networks: the Sword of Damocles Hanging over ISP's Head?

NASA Astrophysics Data System (ADS)

Werkers, Evi; Coudert, Fanny

During the past few years, copyright holders and holders of related rights have started to legally challenge peer-to-peer networks. Their latest strategy consists of trying to actively involve Internet service providers (ISPs) in this combat, e.g. through the implementation of filters. This development raises legal problems and questions both in terms of the liability of ISPs and the protection of privacy of their clients. This chapter discusses the difficult task of balancing copyright interests and fundamental rights which as the European Court of Justice clearly stated in the Promusicae case remains a matter of Member States.

75 FR 4911 - Food Stamp Program: Eligibility and Certification Provisions of the Farm Security and Rural...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-29

...This final rule implements 11 provisions of the Farm Security and Rural Investment Act of 2002 (FSRIA) that establish new eligibility and certification requirements for the receipt of food stamps. The provisions of the final rule will simplify program administration, allow States greater flexibility, and provide enhanced access to eligible populations. This rule will allow States, at their option, to treat legally obligated child support payments to a non-household member as an income exclusion rather than a deduction; allow a State option to exclude certain types of income and resources that are not counted under the State's Temporary Assistance for Needy Families (TANF) cash assistance or Medicaid programs; replace the current, fixed standard deduction with a deduction that varies according to household size and is adjusted annually for cost-of-living increases; allow States to simplify the Standard Utility Allowance (SUA) if the State elects to use the SUA rather than actual utility costs for all households; allow States to use a standard deduction from income of $143 per month for homeless households with some shelter expenses; allow States to disregard reported changes in deductions during certification periods (except for changes associated with new residence or earned income) until the next recertification; increase the resource limit for households with a disabled member from $2,000 to $3,000 consistent with the limit for households with an elderly member; allow States to extend simplified reporting of changes to all households; require State agencies that have a Web site to post applications on these sites in the same languages that the State uses for its written applications; allow States to extend from the current 3 months up to 5 months the period of time households may receive transitional food stamp benefits when they cease to receive TANF cash assistance; and restore food stamp eligibility to qualified aliens who are otherwise eligible and who are receiving disability benefits regardless of date of entry, are under 18 years of age regardless of date of entry, or have lived in the United States for 5 years as qualified aliens beginning on the date of entry.

Universal screening for Lynch syndrome among patients with colorectal cancer: Patient perspectives on screening and sharing results with at-risk relatives

PubMed Central

Hunter, Jessica Ezzell; Arnold, Kathleen A.; Cook, Jennifer E.; Zepp, Jamilyn; Gilmore, Marian J.; Rope, Alan F.; Davis, James V.; Bergen, Kellene M.; Esterberg, Elizabeth; Muessig, Kristin R.; Peterson, Susan K.; Syngal, Sapna; Acheson, Louise; Wiesner, Georgia; Reiss, Jacob; Goddard, Katrina A.B.

2018-01-01

Universal screening for Lynch syndrome (LS) among all cases of colorectal cancer (CRC) could increase the diagnosis of LS and reduce morbidity and mortality of LS-associated cancers. Given universal screening includes all patients, irrespective of high risk factors such early age at onset or family history of CRC, it is important to understand perspectives of all patients and not just those at high risk. As part of a study to assess the feasibility and implementation of universal screening, 189 patients newly diagnosed with CRC were surveyed about their interest in screening for LS and communication of results with at-risk family members. Overall, participants responded positively regarding screening for LS, with most wanting to know their genetic risks in general (86%) and risk of hereditary CRC (93%). Prior to receiving screening results, most participants stated they intended to share their screening results with parents (89%), siblings (96%), and children (96%). Of the 28 participants who received a positive LS screening result, 26 (93%) reported sharing their result with at least one first-degree family member. Interest in screening for LS and communication of screening results with family members was not associated with high risk factors. This study indicates that patients are interested in being screened for LS and that sharing information on the risk of LS with at-risk family members is not a significant barrier. These findings provide novel insight into patient perspectives about screening for LS and can guide successful implementation of universal screening programs. PMID:28176204

Family presence during resuscitation: A descriptive study with Iranian nurses and patients' family members.

PubMed

Zali, Mahnaz; Hassankhani, Hadi; Powers, Kelly A; Dadashzadeh, Abbas; Rajaei Ghafouri, Rouzbeh

2017-09-01

Family presence during resuscitation (FPDR) has advantages for the patients' family member to be present at the bedside. However, FPDR is not regularly practiced by nurses, especially in low to middle income countries. The purpose of this study was to determine Iranian nurses' and family members' attitudes towards FPDR. In a descriptive study, data was collected from the random sample of 178 nurses and 136 family members in four hospitals located in Iran. A 27-item questionnaire was used to collect data on attitudes towards FPDR, and descriptive and correlational analyses were conducted. Of family members, particularly the women, 57.2% (n=78) felt it is their right to experience FPDR and that it has many advantages for the family; including the ability to see that everything was done and worry less. However, 62.5% (n=111) of the nurses disagreed with an adult implementation of FPDR. Nurses perceived FPDR to have many disadvantages. Family members becoming distressed and interfering with the patient which may prolong the resuscitation effort. Nurses with prior education on FPDR were more willing to implement it. FPDR was desired by the majority of family members. To meet their needs, it is important to improve Iranian nurses' views about the advantages of the implementation of FPDR. Education on FPDR is recommended to improve Iranian nurses' views about the advantages of the implementation of FPDR. Copyright © 2017 Elsevier Ltd. All rights reserved.

State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within Secondary School Athletics

PubMed Central

Adams, William M.; Scarneo, Samantha E.; Casa, Douglas J.

2017-01-01

Background: Sudden death and catastrophic injuries during sport can be attenuated with the implementation of evidence-based health and safety policies. However, the extent of the implementation of these policies within secondary school athletics is unknown. Purpose: To provide an assessment of the implementation of health and safety policies pertaining to the leading causes of sudden death and catastrophic injuries in sport within secondary school athletics in the United States. Study Design: Descriptive epidemiology study. Methods: A rubric for evidence-based practices for preventing the leading causes of death and catastrophic injuries in sport was created. The rubric comprised 5 equally weighted sections for sudden cardiac arrest, head injuries, exertional heat stroke, appropriate medical coverage, and emergency preparedness. State high school athletic association (SHSAA) policies, enacted legislation, and Department of Education policies were extensively reviewed for all 50 states and the District of Columbia. States meeting the specific criteria in the rubric, which required policies to be mandated for all SHSAA member schools, were awarded credit; the weighted scores were tabulated to calculate an aggregate score. States were then ranked from 1 (best) to 51 (worst) based on the aggregate score achieved. Results: The median score on the rubric was 47.1% (range, 23.00%-78.75%). States ranked 1 through 10 (from 78.75% to 56.98%) were North Carolina, Kentucky, Massachusetts, New Jersey, South Dakota, Missouri, Washington, Hawaii, Wisconsin, and Georgia, respectively. States ranked 11 through 20 (from 56.03% to 50.55%) were Arkansas, New York, Mississippi, West Virginia, Oregon, Illinois, Tennessee, Arizona, Texas, and District of Columbia, respectively. States ranked 21 through 30 (from 49.40% to 44.00%) were Virginia, Pennsylvania, Florida, New Mexico, Alabama, Maine, Rhode Island, Indiana, Nevada, and Utah, respectively. States ranked 31 through 40 (from 43.93% to 39.80%) were Ohio, Delaware, Alaska, Vermont, Louisiana, Maryland, Oklahoma, Connecticut, Idaho, and South Carolina, respectively. States ranked 41 through 51 (from 38.73% to 23.00%) were Michigan, North Dakota, Nebraska, New Hampshire, Kansas, Wyoming, Minnesota, Montana, Iowa, California, and Colorado, respectively. Conclusion: State scores ranged from 23.00% to 78.75% for the implementation of evidence-based best practices for preventing the leading causes of sudden death and catastrophic injuries (sudden cardiac arrest, traumatic head injuries, exertional heat stroke, and exertional sickling) in sport. Continued advocacy for the development and implementation of policies at the secondary school level surrounding sudden death and catastrophic injuries is warranted to optimize the health and safety of these student athletes. PMID:28951881

State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within Secondary School Athletics.

PubMed

Adams, William M; Scarneo, Samantha E; Casa, Douglas J

2017-09-01

Sudden death and catastrophic injuries during sport can be attenuated with the implementation of evidence-based health and safety policies. However, the extent of the implementation of these policies within secondary school athletics is unknown. To provide an assessment of the implementation of health and safety policies pertaining to the leading causes of sudden death and catastrophic injuries in sport within secondary school athletics in the United States. Descriptive epidemiology study. A rubric for evidence-based practices for preventing the leading causes of death and catastrophic injuries in sport was created. The rubric comprised 5 equally weighted sections for sudden cardiac arrest, head injuries, exertional heat stroke, appropriate medical coverage, and emergency preparedness. State high school athletic association (SHSAA) policies, enacted legislation, and Department of Education policies were extensively reviewed for all 50 states and the District of Columbia. States meeting the specific criteria in the rubric, which required policies to be mandated for all SHSAA member schools, were awarded credit; the weighted scores were tabulated to calculate an aggregate score. States were then ranked from 1 (best) to 51 (worst) based on the aggregate score achieved. The median score on the rubric was 47.1% (range, 23.00%-78.75%). States ranked 1 through 10 (from 78.75% to 56.98%) were North Carolina, Kentucky, Massachusetts, New Jersey, South Dakota, Missouri, Washington, Hawaii, Wisconsin, and Georgia, respectively. States ranked 11 through 20 (from 56.03% to 50.55%) were Arkansas, New York, Mississippi, West Virginia, Oregon, Illinois, Tennessee, Arizona, Texas, and District of Columbia, respectively. States ranked 21 through 30 (from 49.40% to 44.00%) were Virginia, Pennsylvania, Florida, New Mexico, Alabama, Maine, Rhode Island, Indiana, Nevada, and Utah, respectively. States ranked 31 through 40 (from 43.93% to 39.80%) were Ohio, Delaware, Alaska, Vermont, Louisiana, Maryland, Oklahoma, Connecticut, Idaho, and South Carolina, respectively. States ranked 41 through 51 (from 38.73% to 23.00%) were Michigan, North Dakota, Nebraska, New Hampshire, Kansas, Wyoming, Minnesota, Montana, Iowa, California, and Colorado, respectively. State scores ranged from 23.00% to 78.75% for the implementation of evidence-based best practices for preventing the leading causes of sudden death and catastrophic injuries (sudden cardiac arrest, traumatic head injuries, exertional heat stroke, and exertional sickling) in sport. Continued advocacy for the development and implementation of policies at the secondary school level surrounding sudden death and catastrophic injuries is warranted to optimize the health and safety of these student athletes.

Use of social media to engage membership of a state health-system pharmacy organization.

PubMed

Sabato, Leah A; Barone, Caroline; McKinney, Kathryn

2017-01-01

The influence of targeted strategies implemented to increase member engagement on a social media page of a professional pharmacy organization was studied. The Ohio Society of Health-System Pharmacists (OSHP) implemented posting strategies to increase member engagement with its social media page in late 2013. Data were collected retrospectively for a nine-month period in 2013 (preimplementation) and a matching nine-month period in 2014 (postimplementation). The primary endpoint was reach (as provided by the social media website). Data regarding reach were reported to OSHP page administrators on a weekly basis. Posts during the study period were characterized by the day of week, time of day, type of post, and corresponding reach. Continuous variables were represented using means and standard deviations or medians and interquartile ranges (IQRs); categorical data were represented by percentages. The total reach of posts during the nine-month study period increased postimplementation, from 10,826 to 32,338. Further, the median reach per post on the OSHP Facebook page was higher postimplementation (214; IQR, 107-380) versus preimplementation (152; IQR, 89-224; p = 0.035). Evening posts had significantly greater reach compared with nonevening posts. The median reach for evening posts was 232 (IQR, 143-378) versus 131 (IQR, 77-200) for nonevening posts (p < 0.001). There was no significant difference in the median reach of weekday posts (179.5; IQR, 85.5-339.5) versus weekend posts (192; IQR, 113-252). Posts with photos or pictures had the highest reach of all post types. Implementation of targeted strategies resulted in an increase in the number of users reached by a state health-system pharmacy organization's social media page. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Randomised controlled trial of a web-based programme in sustaining best practice alcohol management practices at community sports clubs: a study protocol

PubMed Central

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

Health Care Reform: Understanding Individuals' Attitudes and Information Sources

PubMed Central

Shue, Carolyn K.; McGeary, Kerry Anne; Reid, Ian; Fan, Maoyong

2014-01-01

Since passage of the Affordable Care Act (ACA) was signed into law by President Barrack Obama, little is known about state-level perceptions of residents on the ACA. Perceptions about the act could potentially affect implementation of the law to the fullest extent. This 3-year survey study explored attitudes about the ACA, the types of information sources that individuals rely on when creating those attitudes, and the predictors of these attitudes among state of Indiana residents. The respondents were split between favorable and unfavorable views of the ACA, yet the majority of respondents strongly supported individual components of the act. National TV news, websites, family members, and individuals' own reading of the ACA legislation were identified as the most influential information sources. After controlling for potential confounders, the respondent's political affiliation, age, sex, and obtaining ACA information from watching national television news were the most important predictors of attitudes about the ACA and its components. These results mirror national-level findings. Implications for implementing health care reform at the state-level are discussed. PMID:25045705

LHC Inauguration and LHCFest

ScienceCinema

None

2018-06-26

The LHC official inauguration will take place from 14h00 to 18h00, at Point 18 of the Laboratory, in the presence of the highest representatives from the member states of CERN and representatives from the other communities and authorities of the countries participating in the LHC adventure. 300 members from the international press are also expected, giving a total of 1500 guests. The ceremony will be broadcast live in the Laboratory’s main conference rooms, via webcast and satellite TV (Eurovision). The LHC-fest will follow in the evening in the same place. Its purpose is to, "thank all the actors – physicists, engineers, technicians and administrators – who took part in the design, construction, implementation and commissioning of this great enterprise." For obvious logistical reasons, it has been necessary to limit the number of invited guests to 3000, to include all members of personnel (blue badge holders), representatives of the LHC experiments and other users, as well as representatives from retired staff and industrial support.

Food Safety Strategies in the Federal Republic of Germany

NASA Astrophysics Data System (ADS)

Gaus, Joachim

Food regulation is essentially harmonised in the European Community (EC). National provisions exist only where Community law leaves regulatory gaps or where national specifications are required for the implementation of Community law. Community and national legal provisions provide for a high and, at the same time, non-discriminatory level of protection in the area of food safety. Only safe food may be marketed, irrespective of whether it comes from Germany, an EC Member State or from abroad - a so-called third country.

Four Years of Practical Arrangements between IAEA and Moscow SIA 'Radon': Preliminary Results - 13061

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

Batyukhnova, O.G.; Karlina, O.K.; Neveikin, P.P.

The International Education Training Centre (IETC) at Moscow State Unitary Enterprise Scientific and Industrial Association 'Radon' (SIA 'Radon'), in co-operation with the International Atomic Energy Agency (IAEA), has developed expertise and provided training to waste management personnel for the last 15 years. Since 1997, the educational system of the enterprise with the support of the IAEA has acquired an international character: more than 470 experts from 35 countries- IAEA Member States completed the professional development. Training is conducted at various thematic courses or fellowships for individual programs and seminars on IAEA technical projects. In June 2008 a direct agreement (Practicalmore » Arrangements) was signed between SIA 'Radon' and the IAEA on cooperation in the field of development of new technologies, expert's advice to IAEA Member States, and, in particular, the training of personnel in the field of radioactive waste management (RWM), which opens up new perspectives for fruitful cooperation of industry professionals. The paper summarizes the current experience of the SIA 'Radon' in the organization and implementation of the IAEA sponsored training and others events and outlines some of strategic educational elements, which IETC will continue to pursue in the coming years. (authors)« less

Cell-Based Veterinary Pharmaceuticals – Basic Legal Parameters Set by the Veterinary Pharmaceutical Law and the Genetic Engineering Law of the European Union

PubMed Central

Faltus, Timo; Brehm, Walter

2016-01-01

Cell-based therapies have been in use in veterinary medicine for years. However, the legal requirement of manufacturing, placing on the market and use of cell-based veterinary pharmaceuticals are not as well developed as the respective requirements of chemical pharmaceuticals. Cell-based veterinary pharmaceuticals are medicinal products in the sense of the pharmaceutical law of the European Union (EU). For that reason, such medicinal products principally require official approval for their manufacture and an official marketing authorization for their placement on the market before being used by the veterinarian. The manufacture, placing on the market, and use of cell-based veterinary pharmaceuticals without manufacturing approval and marketing authorization is permitted only in certain exceptional cases determined by EU and individual Member State law. Violations of this requirement may have consequences for the respective veterinarian under criminal law and under the code of professional conduct in the respective Member State. The regular use of cell-based veterinary pharmaceuticals within the scope of a therapeutic emergency as well as the import of such veterinary pharmaceuticals from non-European countries for use in the EU are currently out of the question in the EU because of a lack of legal bases. Here, we review the general legal requirement of manufacturing, placing on the market, and use of cell-based veterinary pharmaceuticals within the EU and point out different implementations of EU law within the different Member States. PMID:27965965

Community prevention coalition context and capacity assessment: Comparing the United States and Mexico

PubMed Central

Brown, Louis D.; Chilenski, Sarah Meyer; Ramos, Rebeca; Gallegos, Nora; Feinberg, Mark E.

2015-01-01

Effective planning for community health partnerships requires understanding how initial readiness—that is, contextual factors and capacity-- influence implementation of activities and programs. This study compares the context and capacity of drug and violence prevention coalitions in Mexico to those in the United States. Measures of coalition context include community problems, community leadership style, and sense of community. Measures of coalition capacity include the existence of collaborative partnerships and coalition champions. The assessment was completed by 195 members of 9 coalitions in Mexico and 139 members of 7 coalitions in the United States. Psychometric analyses indicate the measures have moderate to strong internal consistency, along with good convergent and discriminant validity in both settings. Results indicate that members of Mexican coalitions perceive substantially more serious community problems, especially with respect to education, law enforcement, and access to alcohol and drugs. Compared to respondents in the U.S., Mexican respondents perceive sense of community to be weaker and that prevention efforts are not as valued by the population where the coalitions are located. The Mexican coalitions appear to be operating in a substantially more challenging environment for the prevention of violence and substance use. Their ability to manage these challenges will likely play a large role in determining whether they are successful in their prevention efforts. The context and capacity assessment is a valuable tool coalitions can use to identify and address initial barriers to success. PMID:26205249

Cell-Based Veterinary Pharmaceuticals - Basic Legal Parameters Set by the Veterinary Pharmaceutical Law and the Genetic Engineering Law of the European Union.

PubMed

Faltus, Timo; Brehm, Walter

2016-01-01

Cell-based therapies have been in use in veterinary medicine for years. However, the legal requirement of manufacturing, placing on the market and use of cell-based veterinary pharmaceuticals are not as well developed as the respective requirements of chemical pharmaceuticals. Cell-based veterinary pharmaceuticals are medicinal products in the sense of the pharmaceutical law of the European Union (EU). For that reason, such medicinal products principally require official approval for their manufacture and an official marketing authorization for their placement on the market before being used by the veterinarian. The manufacture, placing on the market, and use of cell-based veterinary pharmaceuticals without manufacturing approval and marketing authorization is permitted only in certain exceptional cases determined by EU and individual Member State law. Violations of this requirement may have consequences for the respective veterinarian under criminal law and under the code of professional conduct in the respective Member State. The regular use of cell-based veterinary pharmaceuticals within the scope of a therapeutic emergency as well as the import of such veterinary pharmaceuticals from non-European countries for use in the EU are currently out of the question in the EU because of a lack of legal bases. Here, we review the general legal requirement of manufacturing, placing on the market, and use of cell-based veterinary pharmaceuticals within the EU and point out different implementations of EU law within the different Member States.

77 FR 235 - Approval and Promulgation of Air Quality Implementation Plans; Colorado; Procedural Rules...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-04

... Promulgation of Air Quality Implementation Plans; Colorado; Procedural Rules; Conflicts of Interest AGENCY... its members of potential conflicts of interest. We are also reproposing approval of a portion of... federally mandate that Commission members disclose any potential conflicts of interest that arise during...

Introduction and Progress of APOSOS Project

NASA Astrophysics Data System (ADS)

Zhao, You; Gao, P. Q.; Shen, Ming; Chaudhry, Maqbool A.; Guo, Xiaozhong; Teng, D. P.; Yang, Datao; Yu, Huanhuan; Zhao, Zhe

Asia-Pacific Ground-Based Optical Satellite Observation System (APOSOS) project is based on members of Asia-Pacific Space Cooperation Organization (APSCO). Its aim is to develop a regional or even global satellite tracking network basically composed of optical trackers. The system will be used to track objects of interest or space-debris for the safety of spacecraft launch mission or the intactness of operational satellites. The system will benefit from the distribution of APSCO members and multi-national fund support or technical cooperation. Thus APOSOS will have a potential capability to observe all the satellites orbiting earth with high precision but relatively low cost. This paper will present the introduction, progress and current status of APOSOS project, including: System Requirements Definition, System Main Mission, System Goal, System design, Services and Clients, Organization Framework of Observation Center, Major Function of Observation Center, Establishment of Observation Plan, Format Standard for Exchanging Data, Data Policy, Implementation Schedule, etc.. APOSOS will build a unified surveillance network from observational facilities of member states involved, to utilize the wide geographical distribution advantage of multi-country. It will be operated under the coordination of APSCO observation mission management department. (1)APOSOS should conduct observation missions of specific satellites, space-debris or other space objects of interest, based on requirements of member states. APOSOS should fulfill the basic requirement for satellites observation and tracking missions. And it should also have the potential ability of small debris detection to support collision avoidance planning, which can protect the members high valued space assets. (2)In some particular application, APOSOS would be able to be used for long-term tracking of specific space object of interest, and have the ability of data processing and analysis, so as to provide conjunction assessment, collision probability calculation and avoidance planning for space assets. (3)APOSOS should have the capability of publishing information and sharing data among member states, with the ability to deal with user’s requests for data and mange the data in different levels. (4)APOSOS should have the capability of providing services such as technical consultation, training and science popularization.

Assisted outpatient treatment in New York: regional differences in New York's assisted outpatient treatment program.

PubMed

Robbins, Pamela Clark; Keator, Karli J; Steadman, Henry J; Swanson, Jeffrey W; Wilder, Christine M; Swartz, Marvin S

2010-10-01

This study sought to describe the implementation of "Kendra's Law" in New York State and examine regional differences in the application of the program. Between February 2007 and April 2008, interviews were conducted with 50 key informants across New York State. Key informants included assisted outpatient treatment (AOT) county coordinators, county directors of community services, judges, attorneys from the Mental Hygiene Legal Service (MHLS), psychiatrists, treatment providers, peer advocates, family members, and other referred individuals. Additional analyses were conducted using AOT program administrative and evaluation databases and client history data. From program inception in 1999 through 2007, a total of 8,752 initial AOT orders and 5,684 renewals were granted. Notable regional differences were found in the use of two distinct models of AOT: AOT First and Enhanced Voluntary Services First. Regional differences were also found in how the AOT program was implemented and administered. Other variations stemmed from the court proceedings themselves, the continuity and interest of the presiding judge, and the attitudes of the MHLS attorneys. Many regional adaptations of the AOT program were found. Many were the result of lack of guidance in implementing Kendra's Law. Policy makers may want to consider whether the law should change to allow for these differences or whether additional support from a central source is warranted to ensure more uniformity in the implementation of AOT and thus the fairness of its application across the state.

Impact of a Hurricane Shelter Viral Gastroenteritis Outbreak on a Responding Medical Team.

PubMed

Gaither, Joshua B; Page, Rianne; Prather, Caren; Paavola, Fred; Garrett, Andrew L

2015-08-01

Introduction In late October of 2012, Hurricane Sandy struck the northeast United States and shelters were established throughout the impacted region. Numerous cases of infectious viral gastroenteritis occurred in several of these shelters. Such outbreaks are common and have been well described in the past. Early monitoring for, and recognition of, the outbreak allowed for implementation of aggressive infection control measures. However, these measures required intensive medical response team involvement. Little is known about how such outbreaks affect the medical teams responding to the incident. Hypothesis/Problem Describe the impact of an infectious viral gastroenteritis outbreak within a single shelter on a responding medical team. The number of individuals staying in the single shelter each night (as determined by shelter staff) and the number of patients treated for symptoms of viral gastroenteritis were recorded each day. On return from deployment, members of a single responding medical team were surveyed to determine how many team members became ill during, or immediately following, their deployment. The shelter population peaked on November 5, 2012 with 811 individuals sleeping in the shelter. The first patients presented to the shelter clinic with symptoms of viral gastroenteritis on November 4, 2012, and the last case was seen on November 21, 2012. A total of 64 patients were treated for nausea, vomiting, or diarrhea over the 17-day period. A post-deployment survey was sent to 66 deployed medical team members and 45 completed the survey. Twelve (26.7%) of the team members who responded to the survey experienced symptoms of probable viral gastroenteritis. Team members reported onset of symptoms during deployment as well as after returning home. Symptoms started on days 4-8, 8-14, on the trip home, and after returning home in four, four, two, and two team members, respectively. Medical teams providing shelter care during viral gastroenteritis outbreaks are susceptible to contracting the virus while caring for patients. When responding to similar incidents in the future, teams should not only be ready to implement aggressive infectious control measures but also be prepared to care for team members who become ill.

Implementing SDG 15.3 on Land Degradation Neutrality in the EU and EU Member States

NASA Astrophysics Data System (ADS)

Wunder, Stephanie; Starke, Sue Martina; Frelih-Larsen, Ana; Kaphengst, Timo

2017-04-01

The continuing degradation of land and soils is a severe threat to the provision of ecosystem services and economic development. Sustainable use of land and soils are therefore an integral part of the "Agenda 2030" with its 17 Sustainable Development Goals (SDGs) and 169 targets adopted by the UNGeneral Assembly in September 2015. The SDGs provide new opportunities for an ambitious and integrated environmental policy worldwide and in the EU. Among the many relevant targets that directly or indirectly address soils (such as goals on zero hunger, well being, clean energy, climate change, water and sustainable cities), target 15.3 that aims to achieve "a land degradation-neutral world" by 2030 is the most relevant. The concept of "Land Degradation Neutrality" (LDN) is not only about halting the loss of healthy and fertile land, but also actively reversing degradation by restoring land in order to counterbal-ance losses that cannot be avoided. It is a very ambitious target but due to a lack of balancing mechanisms for degradation and restoration in most countries also a new concept. Land Degra-dation Neutrality therefore both needs a scientific conceptual framework as well as a political debate about its implementation and development of instruments. In the EU and its Member States, this debate can also serve as a catalyst to revive the discussion on a common soil policy in Europe after the withdrawal of the proposal for a soil framework directive in 2014. To analyze options for the implementation of target 15.3 in Germany and Europe the research project "Implementing the Sustainable Development Goals on Soils in Germany" (http://ecologic.eu/12876) is currently carried out by the Ecologic Institute on behalf of the Ger-man Environment Agency (UBA) and the German Federal Environment Ministry (BMUB). The project will run until spring 2017 and the session "European Environmental Policies and Sustainability" at the EGU will be an ideal opportunity to present the final outcomes of the project and give participants an overview of this very dynamic political process and its science policy interface. Specifically, the presentation can provide an overview about two key results of the project: A) Steps and guiding questions to implement LDN on a national level for policy makers (including a reflection about key definitions and concept) B) Appropriate indicators for LDN (with a special focus on Land Use Change) The results are based on a literature review, more than 50 international expert interviews and discussions within two German workshops and one international workshop (that brought together 15 EU Member State representatives, EEA, UNCCD and the European Commission) to discuss the political options to implement LDN. The results also build on the extensive work that the UNCCD and the global Target Setting Programme have conducted to further develop and define the concept of land degradation neutrality. The continuing degradation of land and soils is a severe threat to the provision of ecosystem services and economic development. Sustainable use of land and soils are therefore an integral part of the "Agenda 2030" with its 17 Sustainable Development Goals (SDGs) and 169 targets adopted by the UNGeneral Assembly in September 2015. The SDGs provide new opportunities for an ambitious and integrated environmental policy worldwide and in the EU. Among the many relevant targets that directly or indirectly address soils (such as goals on zero hunger, well being, clean energy, climate change, water and sustainable cities), target 15.3 that aims to achieve "a land degradation-neutral world" by 2030 is the most relevant. The concept of "Land Degradation Neutrality" (LDN) is not only about halting the loss of healthy and fertile land, but also actively reversing degradation by restoring land in order to counterbal-ance losses that cannot be avoided. It is a very ambitious target but due to a lack of balancing mechanisms for degradation and restoration in most countries also a new concept. Land Degra-dation Neutrality therefore both needs a scientific conceptual framework as well as a political debate about its implementation and development of instruments. In the EU and its Member States, this debate can also serve as a catalyst to revive the discussion on a common soil policy in Europe after the withdrawal of the proposal for a soil framework directive in 2014. To analyze options for the implementation of target 15.3 in Germany and Europe the research project "Implementing the Sustainable Development Goals on Soils in Germany" (http://ecologic.eu/12876) is currently carried out by the Ecologic Institute on behalf of the Ger-man Environment Agency (UBA) and the German Federal Environment Ministry (BMUB). The project runs until spring 2017 and the session "European Environmental Policies and Sustainability" at the EGU is an ideal opportunity to present the final outcomes of the project and give participants an overview of this very dynamic political process and its science policy interface. Specifically, the presentation can provide an overview about two key results of the project: A) Steps and guiding questions to implement LDN on a national level for policy makers (including a reflection about key definitions and concept) B) Appropriate indicators for LDN (with a special focus on Land Use Change) The results are based on a literature review, more than 50 international expert interviews and discussions within two German workshops and one international workshop (that brought together 15 EU Member State representatives, EEA, UNCCD and the European Commission) to discuss the political options to implement LDN. The results also build on the extensive work that the UNCCD and the global Target Setting Programme have conducted to further develop and define the concept of land degradation neutrality.

Software-In-the-Loop based Modeling and Simulation of Unmanned Semi-submersible Vehicle for Performance Verification of Autonomous Navigation

NASA Astrophysics Data System (ADS)

Lee, Kwangkook; Jeong, Mijin; Kim, Dong Hun

2017-12-01

Since an unmanned semi-submersible is mainly used for the purpose of carrying out dangerous missions in the sea, it is possible to work in a region where it is difficult to access due to safety reasons. In this study, an USV hull design was determined using Myring hull profile, and reinforcement work was performed by designing and implementing inner stiffener member for 3D printing. In order to simulate a sea state 5.0 or more at sea, which is difficult to implement in practice, a regular and irregular wave equation was implemented in Matlab / Simulink. We performed modeling and simulation of semi - submersible simulation based on DMWorks considering the rolling motion in wave. To verify and improve unpredicted errors, we implemented a numeric and physical simulation model of the USV based on software-in-the-loop (SIL) method. This simulation allows shipbuilders to participate in new value-added markets such as engineering, procurement, construction, installation, commissioning, operation, and maintenance for the USV.

Awareness, Facilitators, and Barriers to Policy Implementation Related to Obesity Prevention for Primary School Children in Malaysia.

PubMed

Chan, Camelina; Moy, Foong Ming; Lim, Jennifer N W; Dahlui, Maznah

2018-03-01

To assess the awareness, facilitators, and barriers to policy implementation related to obesity prevention for primary school children. A cross-sectional study administered using an online questionnaire. Conducted in 447 primary schools in a state in Malaysia. One school administrator from each school served as a participant. The questionnaires consisted of 32 items on awareness, policy implementation, and facilitators and barriers to policy implementation. Descriptive analysis was used to describe the awareness, facilitators, and barriers of policies implementation. Association between schools' characteristics and policy implementation was assessed using logistic regression. The majority (90%) of school administrators were aware of the policies. However, only 50% to 70% of schools had implemented the policies fully. Reported barriers were lack of equipment, insufficient training, and limited time to complete implementation. Facilitators of policy implementation were commitment from the schools, staff members, students, and canteen operators. Policy implementation was comparable in all school types and locality; except the policy on "Food and Drinks sold at the school canteens" was implemented by more rural schools compared to urban schools (odds ratio: 1.74, 95% confidence interval: 1.13-2.69). Majority of the school administrators were aware of the existing policies; however, the implementation was only satisfactory. The identified barriers to policy implementation were modifiable and thus, the stakeholders should consider restrategizing plans in overcoming them.

Implementation of the Single European Code in a Multi-Tissue Bank.

PubMed

Schroeter, Jan; Schulz, Tino; Schroeter, Bernard; Fleischhauer, Katrin; Pruß, Axel

2017-11-01

The traceability of tissue and cells transplants is important to ensure a high level of safety for the recipients. With the final introduction of the Single European Code (SEC) in April 2017 in the EU a consistent system among all member states became mandatory. The regulations for the SEC on EU and national level were evaluated. An overview on the different parts of the SEC with detailed explanations is given. Our own experiences with the implementation of the SEC in our multi-tissue bank are reported in addition. The implementation of the SEC in our multi-tissue bank could be successfully realized. However, it revealed a number of difficulties, especially the sterile labeling of certain tissue transplants and the complex update of the existing database. The introduction of the SEC has made a contribution to the safety of recipients of tissue and cells transplants through a system of comprehensive and transparent traceability.

Business continuity management in international organisations.

PubMed

Adamou, Christel

2014-01-01

In the area of business continuity management, a preliminary review of the literature reveals extensive knowledge, expertise and experience concerning organisations in the private and public sectors. It is interesting to note, however, that there is little literature about business continuity management in international organisations, although these entities are complex and particularly prone to threats. This apparent absence of literature suggests that business continuity management has not yet hit the agenda of international organisations. In recent years, member states have encouraged senior management to design and implement business continuity strategies to minimise the mishandling of an internal crisis and build organisational resilience, but very few of them have actually been able to design and implement comprehensive business continuity programmes. Based on actual experience working in international organisations, this paper outlines some of the challenges faced by international organisations in developing and implementing business continuity activities and attempts to make suggestions for further improvement.

European Patient Summary Guideline: Focus on Greece.

PubMed

Berler, Alexander; Tagaris, Anastassios; Chronaki, Catherine

2016-01-01

The European Patient Summary (PS) guideline specifies a minimal dataset of essential and important information for unplanned or emergency care initially defined in the epSOS project with aim to improve patients' safety and quality of Care. The eHealth Network of European Union (EU) Member State (MS) representatives established under Article 14 of the EU directive 2011/24 on patient rights to cross-border healthcare adopted PS guideline in November 2013 and since then the guideline has been part of MS strategic eHealth implementation plans, standardization efforts, and concrete regional, national, European and international projects. This paper reviews implementation efforts for the implementation of an operational patient summary service in Greece drawing on challenges and lessons learned for sustainable standards-based large scale eHealth deployment in Europe and abroad, as well as the reuse of best practices from international standards and integration profiles.

The implementation of the Directive on the Application of Patients' Rights in Cross-border Healthcare in the Netherlands.

PubMed

Bongers, L M H; Townend, D M R

2014-03-01

This article discusses the significance of the Directive 2011/24/EU on the application of patients' rights in cross-border healthcare for the protection of individual patients' rights in the Netherlands by describing how its provisions are implemented in Dutch health law. The responsible Dutch authorities take the view that most of the Directive's provisions and requirements are covered in existing Dutch law. Implementation of the Directive would only require adaptations to national legislation with regard to the establishment of a national contact point for cross-border healthcare and the recognition of medical prescriptions issued in another Member State. This article looks into the question of how far the Dutch law meets the requirements of the Directive in relation to the individual patients' rights addressed in this special issue of the European Journal of Health Law.

Optimization of Antibiotic Use in Hospitals – Antimicrobial Stewardship and the EU Project ABS International

PubMed Central

Allerberger, Franz; Lechner, Arno; Wechsler-Fördös, Agnes; Gareis, Roland

2008-01-01

Background The problem of antimicrobial resistance requires common strategies at the European level. Methods We report on an EU initiative fostering antibiotic (AB) stewardship (ABS) in hospitals. Results The project ‘ABS International: implementing antibiotic strategies for appropriate use of antibiotics in hospitals in member states of the EU’ started in September 2006 in Austria, Belgium, the Czech Republic, Germany, Hungary, Italy, Poland, Slovenia and Slovakia. A training program for national ABS trainers was prepared and standard templates for ABS tools (AB list, guidelines for AB treatment and surgical prophylaxis, and AB-related organization) and valid process measures as well as quality indicators for AB use were developed. Specific ABS tools are being implemented in up to five health care facilities per country. Conclusion ABS International is the first EU-funded initiative focusing on the implementation of structural measures in hospitals to promote the prudent use of ABs. PMID:18667815

REVIEW OF THE NEGOTIATION OF THE MODEL PROTOCOL ADDITIONAL TO THE AGREEMENT(S) BETWEEN STATE(S) AND THE INTERNATIONAL ATOMIC ENERGY AGENCY FOR THE APPLICATION OF SAFEGUARDS,INFCIRC/540 (Corrected) VOLUME I/III SETTING THE STAGE: 1991-1996.

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

Rosenthal, M.D.; Saum-Manning, L.; Houck, F.

Events in Iraq at the beginning of the 1990s demonstrated that the safeguards system of the International Atomic Energy Agency (IAEA) needed to be improved. It had failed, after all, to detect Iraq's clandestine nuclear weapon program even though some of Iraq's's activities had been pursued at inspected facilities in buildings adjacent to ones being inspected by the IAEA. Although there were aspects of the implementation of safeguards where the IAEA needed to improve, the primary limitations were considered to be part of the safeguards system itself. That system was based on the Nuclear Nonproliferation Treaty of 1970, to whichmore » Iraq was a party, and implemented on the basis of a model NPT safeguards agreement, published by the IAEA 1972 as INFCIRC/153 (corrected). The agreement calls for states to accept and for the IAEA to apply safeguards to all nuclear material in the state. Iraq was a party to such an agreement, but it violated the agreement by concealing nuclear material and other nuclear activities from the IAEA. Although the IAEA was inspecting in Iraq, it was hindered by aspects of the agreement that essentially limited its access to points in declared facilities and provided the IAEA with little information about nuclear activities anywhere else in Iraq. As a result, a major review of the NPT safeguards system was initiated by its Director General and Member States with the objective of finding the best means to enable the IAEA to detect both diversions from declared stocks and any undeclared nuclear material or activities in the state. Significant improvements that could be made within existing legal authority were taken quickly, most importantly a change in 1992 in how and when and what design information would be reported to the IAEA. During 1991-1996, the IAEA pursued intensive study, legal and technical analysis, and field trials and held numerous consultations with Member States. The Board of Governors discussed the issue of strengthening safeguards at almost all of its meeting.« less

Training Staff to Implement Brief Stimulus Preference Assessments

ERIC Educational Resources Information Center

Weldy, Christina R.; Rapp, John T.; Capocasa, Kelli

2014-01-01

We trained 9 behavioral staff members to conduct 2 brief preference assessments using 30-min video presentations that contained instructions and modeling. After training, we evaluated each staff member's implementation of the assessments in situ. Results indicated that 1 or 2 training sessions for each method were sufficient for teaching each…

Implementing HIPAA security in a membership organization.

PubMed

Hillabrant, L P; Gaignard, K E

2000-01-01

The upcoming HIPAA security regulations are forcing a change in business and operating procedures that many, if not most, healthcare organizations are ill-prepared to tackle. Of all healthcare organizational structures, membership organizations will most likely face the greatest number of obstacles in preparing for and implementing the HIPAA security regulations. This is because the membership organization as a whole must find a way to accommodate the disparate technologies, business and operating methodologies and processes, and available, limited resources of its individual member organizations, and integrate these into a uniform implementation plan. Compounding these obvious difficulties is the unique challenge of enforcement authority. The individual member organizations are autonomous business entities, whereas the membership organization as a whole merely acts as an advisor or consultant, and has only limited enforcement authority over any individual member organization. This article explores this unique situation in depth. We focus on PROMINA Health System, a nonprofit healthcare membership organization that consists of five disparate member healthcare organizations. We examine the challenges PROMINA has encountered in its quest to institute an organization-wide HIPAA security program and its methodology for accomplishing program implementation.

Latino sexual and gender identity minorities promoting sexual health within their social networks: process evaluation findings from a lay health advisor intervention.

PubMed

Sun, Christina J; García, Manuel; Mann, Lilli; Alonzo, Jorge; Eng, Eugenia; Rhodes, Scott D

2015-05-01

The HOLA intervention was a lay health advisor intervention designed to reduce the disproportionate HIV burden borne by Latino sexual and gender identity minorities (gay, bisexual, and other men who have sex with men, and transgender persons) living in the United States. Process evaluation data were collected for over a year of intervention implementation from 11 trained Latino male and transgender lay health advisors (Navegantes) to document the activities each Navegante conducted to promote condom use and HIV testing among his or her eight social network members enrolled in the study. Over 13 months, the Navegantes reported conducting 1,820 activities. The most common activity was condom distribution. Navegantes had extensive reach beyond their enrolled social network members, and they engaged in health promotion activities beyond social network members enrolled in the study. There were significant differences between the types of activities conducted by Navegantes depending on who was present. Results suggest that lay health advisor interventions reach large number of at-risk community members and may benefit populations disproportionately affected by HIV. © 2014 Society for Public Health Education.

ENGAGING THE COMMUNITY IN HEALTH RESEARCH IN INDIA

PubMed Central

Wells, Kristen J.; Preuss, Charles; Pathak, Yashwant; Kosambiya, J. K.; Kumar, Ambuj

2013-01-01

Community-engaged research approaches involve members of the community in various aspects of a research endeavor to improve the health of populations. Engaging the community in research is important in the development, dissemination, and evaluation of new interventions, technologies, and other medical advancements to improve population health globally. A review of published community-engaged research studies conducted in India was performed. Fifteen published studies were identified and reviewed to evaluate the state of community-engaged research in India. The review indicated that community-engaged research in India is limited. Most published community-engaged research focused on health promotion, especially in the prevention or management of HIV/AIDS and other STIs. Community members were involved in a variety of aspects of the research, but there was not one published article indicating that community members had defined the disease of focus. Community-engaged research often led to valuable insights into the views, experiences, and behaviors of community members and also led to increased community participation in health initiatives. It is anticipated that future community-engaged research will lead to improvements in global health through increased empowerment of communities and a better ability to implement new and innovative medical advances, technologies, and interventions. PMID:24353757

Incorporating the catering sector in nutrition policies of WHO European Region: is there a good recipe?

PubMed

Lachat, Carl; Roberfroid, Dominique; Huybregts, Lieven; Van Camp, John; Kolsteren, Patrick

2009-03-01

To review how countries of the WHO European Region address issues related to the catering sector in their nutrition policy plans. Documentary analysis of national nutrition policy documents from the policy database of the WHO Regional Office for Europe by a multidisciplinary research team. Recurring themes were identified and related information extracted in an analysis matrix. Case studies were performed for realistic evaluation. Fifty-three member states of the WHO European Region in September 2007. The catering sector is a formally acknowledged stakeholder in national nutrition policies in about two-thirds of countries of the European region. Strategies developed for the catering sector are directed mainly towards labelling of foods and prepared meals, training of health and catering staff, and advertising. Half of the countries reviewed propose dialogue structures with the catering sector for the implementation of the policy. However, important policy fields remain poorly developed, such as strategies for stimulating and monitoring actual implementation of policies. Others are simply lacking, such as strategies to ensure affordability of healthy out-of-home eating or to enhance accountability of stakeholders. It is also striking that strategies for the private sector are rarely developed. Important policy issues are still embryonic. As evidence is accumulating on the impact of out-of-home eating on the increase of overweight, member states are advised to urgently develop operational frameworks and instruments for participatory planning and evaluation of stakeholders in public health nutrition policy.

Presence, characteristics and equity of access to breast cancer screening programmes in 27 European countries in 2010 and 2014. Results from an international survey.

PubMed

Deandrea, S; Molina-Barceló, A; Uluturk, A; Moreno, J; Neamtiu, L; Peiró-Pérez, R; Saz-Parkinson, Z; Lopez-Alcalde, J; Lerda, D; Salas, D

2016-10-01

The European Union Council Recommendation of 2 December 2003 on cancer screening suggests the implementation of organised, population-based breast cancer screening programmes based on mammography every other year for women aged 50 to 69years, ensuring equal access to screening, taking into account potential needs for targeting particular socioeconomic groups. A European survey on coverage and participation, and key organisational and policy characteristics of the programmes, targeting years 2010 and 2014, was undertaken in 2014. Overall, 27 countries contributed to this survey, 26 of the 28 European Union member states (92.9%) plus Norway. In 2014, 25 countries reported an ongoing population-based programme, one country reported a pilot programme and another was planning a pilot. In eight countries, the target age range was broader than that proposed by the Council Recommendation, and in three countries the full range was not covered. Fifteen countries reported not reaching some vulnerable populations, such as immigrants, prisoners and people without health insurance, while 22 reported that participation was periodically monitored by socioeconomic variables (e.g. age and territory). Organised, population-based breast cancer screening programmes based on routine mammograms are in place in most EU member states. However, there are still differences in the way screening programmes are implemented, and participation by vulnerable populations should be encouraged. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

WHO-REMPAN for global health security and strengthening preparedness and response to radiation emergencies.

PubMed

Carr, Zhanat

2010-06-01

In response to the changing global environment and emerging new issues related to health security, the World Health Organization (WHO) is putting in place new tools for collective defense, such as the revised International Health Regulations (IHR) (2005). The new framework puts additional responsibilities on both Member States and WHO itself in order to effectively implement the IHR (2005) and react effectively in case of public health emergency events of any nature. Since its establishment in 1987, the Radiation Emergency Medical Preparedness and Assistance Network of WHO (WHO-REMPAN) has become an important asset for the organization's capacity to respond to radiation emergencies and to assist its Member States to strengthen their own response capacities. The paper describes in detail the framework for the WHO's role in preparedness and response to radiation emergencies, including Emergency Conventions and IHR (2005), and how the WHO-REMPAN, through its activities (i.e., technical guidelines development, training, education, research, and information sharing), provides a significant contribution to the organization's program of work towards achievement of the global health security goal.

[The Telehealth Network of the Americas and its role in primary health care].

PubMed

Bill, Guillermo; Crisci, Carlos D; Canet, Tomislav

2014-01-01

The need to guarantee equitable access to health regardless of geographic, economic, or technological barriers motivated the Member States of the Organization of American States to create the Telehealth Network of the Americas, coordinated by the Inter-American Telecommunication Committee. The Network focuses on the use of new information and communications technology applied to health, based on the values of respect, equity, and solidarity and mandated by the philosophy of primary health. Its members include government agencies, nongovernmental organizations, university forums, hospital federations, and telecommunications companies, and it has already extended its reach to other continents and to different fields in which telemedicine is being used. Among its first achievements, it has implemented an innovative tool to be used in cases of disaster or limited geographic access. This mobile telemedicine station is housed in a portable case that includes a computer, various digital devices (otoscope, ophthalmoscope, microscope, dermatoscope), a high-resolution digital camera, an X-ray film viewer, and a satellite antenna. With this tool, it is possible to provide specialized support for rural physicians and primary health care workers located far from large urban centers.

Advances in the development of common noise assessment methods in Europe: The CNOSSOS-EU framework for strategic environmental noise mapping.

PubMed

Kephalopoulos, Stylianos; Paviotti, Marco; Anfosso-Lédée, Fabienne; Van Maercke, Dirk; Shilton, Simon; Jones, Nigel

2014-06-01

The Environmental Noise Directive (2002/49/EC) requires EU Member States to determine the exposure to environmental noise through strategic noise mapping and to elaborate action plans in order to reduce noise pollution, where necessary. A common framework for noise assessment methods (CNOSSOS-EU) has been developed by the European Commission in co-operation with the EU Member States to be applied for strategic noise mapping as required by the Environment Noise Directive (2002/49/EC). CNOSSOS-EU represents a harmonised and coherent approach to assess noise levels from the main sources of noise (road traffic, railway traffic, aircraft and industrial) across Europe. This paper outlines the process behind the development of CNOSSOS-EU and the parts of the CNOSSOS-EU core methodological framework which were developed during phase A of the CNOSSOS-EU process (2010-2012), whilst focusing on the main scientific and technical issues that were addressed, and the implementation challenges that are being faced before it can become fully operational in the EU MS. Copyright © 2014. Published by Elsevier B.V.

Implementation of a School-wide Clinical Intervention Documentation System

PubMed Central

Stevenson, T. Lynn; Fox, Brent I.; Andrus, Miranda; Carroll, Dana

2011-01-01

Objective. To evaluate the effectiveness and impact of a customized Web-based software program implemented in 2006 for school-wide documentation of clinical interventions by pharmacy practice faculty members, pharmacy residents, and student pharmacists. Methods. The implementation process, directed by a committee of faculty members and school administrators, included preparation and refinement of the software, user training, development of forms and reports, and integration of the documentation process within the curriculum. Results. Use of the documentation tool consistently increased from May 2007 to December 2010. Over 187,000 interventions were documented with over $6.2 million in associated cost avoidance. Conclusions. Successful implementation of a school-wide documentation tool required considerable time from the oversight committee and a comprehensive training program for all users, with ongoing monitoring of data collection practices. Data collected proved to be useful to show the impact of faculty members, residents, and student pharmacists at affiliated training sites. PMID:21829264

Faculty and student perceptions of academic integrity at U.S. and Canadian dental schools.

PubMed

Andrews, Kenneth G; Smith, Linda A; Henzi, David; Demps, Elaine

2007-08-01

The issues of cheating and plagiarism in educational settings have received a large amount of attention in recent years. The purpose of this study was to assess the degree to which academic integrity issues currently exist in the dental schools throughout the United States and Canada. An online survey was developed to gather data pertaining to this topic from two key groups in dental education: faculty and students. Responses were obtained from 1,153 students and 423 faculty members. The results of the survey clearly reveal that cheating is a significant problem in dental schools and that significant differences exist between students' and faculty members' perceptions of academic integrity. The challenge for dental schools is to identify effective strategies to prevent cheating opportunities and to implement and enforce effective means of dealing with specific examples of cheating.

Evaluation of an Efficient Method for Training Staff to Implement Stimulus Preference Assessments

ERIC Educational Resources Information Center

Roscoe, Eileen M.; Fisher, Wayne W.

2008-01-01

We used a brief training procedure that incorporated feedback and role-play practice to train staff members to conduct stimulus preference assessments, and we used group-comparison methods to evaluate the effects of training. Staff members were trained to implement the multiple-stimulus-without-replacement assessment in a single session and the…

The Wildlife Habitat Education Program: Moving from Contest Participation to Implementation

ERIC Educational Resources Information Center

Allen, Kevin; Elmore, R. Dwayne; Harper, Craig

2013-01-01

Do members participating in the Wildlife Habitat Education Program (WHEP) apply knowledge gained by implementing wildlife management practices at the local level? 4-H members who participated in the National WHEP Contest from 2003-2005 and 2007-2011 completed an evaluation at the end of each contest. The evaluation asked participants if they…

Development and implementation of online National Board Dental Examination Review Courses.

PubMed

Gadbury-Amyot, Cynthia C; Austin, Kylie Siruta; Overman, Pamela R

2013-12-01

Failure on the National Board Dental Examination (NBDE) Parts I and II has troubling consequences for dental students, faculty members, and school administrators. Since the NBDE is a high-stakes exam for all involved, it is important to determine effective strategies to help students prepare. The purpose of this article is to describe the development and implementation of online NBDE Parts I and II Review Courses by the faculty and administration at the University of Missouri-Kansas City School of Dentistry. The courses are taught by faculty members who are content experts. By utilizing distance technology, students in any geographic location can review the material at the time, place, and pace that are most convenient. Early outcomes show that 592 students from thirty-two states have participated in the courses since they were first offered in 2010-11. In post-course evaluations, students report that participation in the courses encouraged them to spend more time preparing for the exam and that the associated PowerPoint slides/handouts provided structure for their review. The literature suggests that multiple modalities are most effective in preparing for the NBDE. These online review courses can serve as a beneficial component of a student's preparation regimen.

Practice Innovation, Health Care Utilization and Costs in a Network of Federally Qualified Health Centers and Hospitals for Medicaid Enrollees.

PubMed

Johnson, Tricia J; Jones, Art; Lulias, Cheryl; Perry, Anthony

2018-06-01

State Medicaid programs need cost-effective strategies to provide high-quality care that is accessible to individuals with low incomes and limited resources. Integrated delivery systems have been formed to provide care across the continuum, but creating a shared vision for improving community health can be challenging. Medical Home Network was created as a network of primary care providers and hospital systems providing care to Medicaid enrollees, guided by the principles of egalitarian governance, practice-level care coordination, real-time electronic alerts, and pay-for-performance incentives. This analysis of health care utilization and costs included 1,189,195 Medicaid enrollees. After implementation of Medical Home Network, a risk-adjusted increase of $9.07 or 4.3% per member per month was found over the 2 years of implementation compared with an increase of $17.25 or 9.3% per member per month, before accounting for the cost of care management fees and other financial incentives, for Medicaid enrollees within the same geographic area with a primary care provider outside of Medical Home Network. After accounting for care coordination fees paid to providers, the net risk-adjusted cost reduction was $11.0 million.

Opioid Use in the Twenty First Century: Similarities and Differences Across National Borders

PubMed Central

Vasilev, Georgi; Milcheva, Svetla; Vassileva, Jasmin

2016-01-01

Opinion Statement The global prevalence in the use of opiates and opioids has remained stable, though there were some unprecedented recent increases in opioid use and associated mortality and morbidity in the United States. Internationally, there is a strong tendency for consolidation of drug treatment strategies in favor of more systematic, structured and balanced approaches to regional and national drug policies. However, there are considerable differences in the scope, focus, and implementation of national drug policies and the political context is shaping drug prevention, treatment and rehabilitation efforts to an extent not typically observed in other public health domains. As a result, though in theory, there is a considerable multi-national agreement about the efficacy and effectiveness of different treatment modalities for opioid dependence, in practice, there are striking differences among different world regions and countries in the degree of implementation of these treatment modalities into clinical practice. Such discrepancies between theory and practice are observed even in high-income countries such as the United States and European Union member states, where evidence-based treatment modalities are still not well implemented into clinical practice. Despite the lack of evidence-based support for the role of detoxification as a stand-alone treatment for opioid use disorders, it appears to be the most widely used intervention for opioid use across the world. PMID:27493878

Healthy Amistad: improving the health of people with severe mental illness.

PubMed

Martin, Maurice Bud; Martin, Sarah L

2014-10-01

Here, we report evaluation results of implementing a health promotion program for individuals with serious mental illnesses. Healthy Amistad aimed to address four behaviors: physical inactivity, nutrition choices, smoking, and seeking access to health care. The evaluation employed a mixed-method study design to assess changes in the health of individuals in the program. Process measures assessed the implementation of the program. A pre-post examination was used to compare data associated with behaviors. Data sources included the 2008 and 2009 annual surveys, clinical data, interviews for staff, interviews with members, and an on-site observation. Participants were staff and members of Amistad. Those involved with the Peer Patient Navigator lost weight; new physically active activities were being offered. A new salad bar and healthier menu was offered in the Amistad cafeteria. Interviews revealed that 11 members lost a total of 150 pounds. The percentage reporting visits to an emergency room more than once in the last 6 months decreased from 58% to 37%, the percentage calling the crisis line less often increased from 75% to 86%, and the percentage reporting that they had become more satisfied with their life since joining Amistad improved from 76% to 88%. Individuals with serious mental illnesses are benefiting from programs that focus on the mitigation of disease states manifested from issues with physical inactivity, nutrition, smoking, and health access. Evaluation of the Healthy Amistad program has shown a positive influence.

Postdeployment military mental health training: cross-national evaluations.

PubMed

Foran, Heather M; Garber, Bryan G; Zamorski, Mark A; Wray, Mariane; Mulligan, Kathleen; Greenberg, Neil; Castro, Carl Andrew; Adler, Amy B

2013-05-01

Deployments increase risk for adjustment problems in service members. To mitigate this increased risk, mental health training programs have been developed and implemented in several nations. As part of a coordinated effort, three nations adapted a U.S. mental health training program that had been validated by a series of group randomized trials demonstrating improvement in postdeployment adjustment. Implementation of evidence-based programs in a new context is challenging: How much of the original program needs to remain intact in order to retain its utility? User satisfaction rates can provide essential data to assess how well a program is accepted. This article summarizes service member ratings of postdeployment mental health training and compares ratings from service members across four nations. The participating nations (Canada, New Zealand, United Kingdom, and the United States) administered mental health training to active duty military personnel in their respective nations. Following the training, military personnel completed an evaluation of the training. Overall, across the four nations, more than 70% of military personnel agreed or strongly agreed that they were satisfied with the mental health training. Although some differences in evaluations were observed across nations, components of training that were most important to overall satisfaction with the training were strikingly similar across nations. Fundamentally, it appears feasible that despite cultural and organizational differences, a mental health training program developed in one nation can be successfully adapted for use in other nations. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Scientific collaboration between 'old' and 'new' member states: Did joining the European Union make a difference?

PubMed

Makkonen, Teemu; Mitze, Timo

This paper provides new insights on the effects of the enlargement of the European Union (EU) and European integration by investigating the issue of scientific collaboration within the new EU member states vis - à - vis the old EU member states. The question addressed is whether the EU membership following the two enlargement waves 2004 and 2007 has significantly increased the co-publication intensity of the new member states with other member countries. The empirical results based on data collected from the Web of Science database and Difference-in-Difference estimations point towards a conclusion that joining the EU indeed has had an additional positive impact on the co-publication intensity between the new and old member states and, in particular, within the new member states themselves. These results give tentative support for the successfulness of the EU's science policies in achieving a common 'internal market' in research. We also find evidence for early anticipation effects of the consecutive EU accession.

Improving maternal and child healthcare programme using community-participatory interventions in Ebonyi State Nigeria.

PubMed

Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Ezeoha, Abel Abeh; Urochukwu, Henry Chukwuemeka; Ezeonu, Chinonyelum Thecla

2014-10-01

In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP). The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government's FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers' groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities' health.

Improving maternal and child healthcare programme using community-participatory interventions in Ebonyi State Nigeria

PubMed Central

Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Ezeoha, Abel Abeh; Urochukwu, Henry Chukwuemeka; Ezeonu, Chinonyelum Thecla

2014-01-01

In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP). The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government’s FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers’ groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities’ health. PMID:25337602

The global diffusion of organ transplantation: trends, drivers and policy implications

PubMed Central

Hirth, Richard; Mahíllo, Beatriz; Domínguez-Gil, Beatriz; Delmonico, Francis L; Noel, Luc; Chapman, Jeremy; Matesanz, Rafael; Carmona, Mar; Alvarez, Marina; Núñez, Jose R; Leichtman, Alan

2014-01-01

Abstract Rising incomes, the spread of personal insurance, lifestyle factors adding to the burden of illness, ageing populations, globalization and skills transfer within the medical community have increased worldwide demand for organ transplantation. The Global Observatory on Donation and Transplantation, which was built in response to World Health Assembly resolution WHA57.18, has conducted ongoing documentation of global transplantation activities since 2007. In this paper, we use the Global Observatory’s data to describe the current distribution of – and trends in – transplantation activities and to evaluate the role of health systems factors and macroeconomics in the diffusion of transplantation technology. We then consider the implications of our results for health policies relating to organ donation and transplantation. Of the World Health Organization’s Member States, most now engage in organ transplantation and more than a third performed deceased donor transplantation in 2011. In general, the Member States that engage in organ transplantation have greater access to physician services and greater total health spending per capita than the Member States where organ transplantation is not performed. The provision of deceased donor transplantation was closely associated with high levels of gross national income per capita. There are several ways in which governments can support the ethical development of organ donation and transplantation programmes. Specifically, they can ensure that appropriate legislation, regulation and oversight are in place, and monitor donation and transplantation activities, practices and outcomes. Moreover, they can allocate resources towards the training of specialist physicians, surgeons and transplant coordinators, and implement a professional donor-procurement network. PMID:25378744

The global diffusion of organ transplantation: trends, drivers and policy implications.

PubMed

White, Sarah L; Hirth, Richard; Mahíllo, Beatriz; Domínguez-Gil, Beatriz; Delmonico, Francis L; Noel, Luc; Chapman, Jeremy; Matesanz, Rafael; Carmona, Mar; Alvarez, Marina; Núñez, Jose R; Leichtman, Alan

2014-11-01

Rising incomes, the spread of personal insurance, lifestyle factors adding to the burden of illness, ageing populations, globalization and skills transfer within the medical community have increased worldwide demand for organ transplantation. The Global Observatory on Donation and Transplantation, which was built in response to World Health Assembly resolution WHA57.18, has conducted ongoing documentation of global transplantation activities since 2007. In this paper, we use the Global Observatory's data to describe the current distribution of - and trends in - transplantation activities and to evaluate the role of health systems factors and macroeconomics in the diffusion of transplantation technology. We then consider the implications of our results for health policies relating to organ donation and transplantation. Of the World Health Organization's Member States, most now engage in organ transplantation and more than a third performed deceased donor transplantation in 2011. In general, the Member States that engage in organ transplantation have greater access to physician services and greater total health spending per capita than the Member States where organ transplantation is not performed. The provision of deceased donor transplantation was closely associated with high levels of gross national income per capita. There are several ways in which governments can support the ethical development of organ donation and transplantation programmes. Specifically, they can ensure that appropriate legislation, regulation and oversight are in place, and monitor donation and transplantation activities, practices and outcomes. Moreover, they can allocate resources towards the training of specialist physicians, surgeons and transplant coordinators, and implement a professional donor-procurement network.

Analytical ultrasonics for structural materials

NASA Technical Reports Server (NTRS)

Kupperman, D. S.

1986-01-01

The application of ultrasonic velocity and attenuation measurements to characterize the microstructure of structural materials is discussed. Velocity measurements in cast stainless steel are correlated with microstructural variations ranging from equiaxed (elastically isotropic) to columnar (elastically anisotropic) grain structure. The effect of the anisotropic grain structure on the deviation of ultrasonic waves in cast stainless steel is also reported. Field-implementable techniques for distinguishing equiaxed from columnar grain structures in cast strainless steel structural members are presented. The application of ultrasonic velocity measurements to characterize structural ceramics in the green state is also discussed.

An independent investigation into the deployment of the federal communications commissions' rural health care pilot program.

PubMed

Whitten, Pamela; Holtz, Bree; Laplante, Carolyn; Alverson, Dale; Krupinski, Elizabeth

2010-12-01

the goal of this study was to provide an independent and objective evaluation of the implementation of the Federal Communications Commission's Rural Health Care Pilot Program. thirty-nine of the programs that were provided funding through this program were interviewed and asked about their project deployment, network planning, and the involvement of their state in implementation. RESULTS showed that programs recruited project team members from a variety of fields to fulfill different roles. Network partners were often chosen because they were stakeholders in the outcome of the project and because they had a past working relationship with the grant-receiving programs. In terms of deployment, many programs had made progress in filling out necessary paperwork and were tracking milestones, but had experienced changes since first receiving funding, such as losing participants. Additionally, many encountered challenges that inhibited deployment, such as coping with rule fluctuations. Many of the programs received support from their respective state governments in project development, often through matching funds, but few states were involved in the actual management of projects. as rural healthcare facilities often lack the information technology infrastructure compared with many urban facilities, it is important to understand the implementation process for programs such as the Rural Health Care Pilot Program and to examine what contributes to progress, stagnation, or disintegration. Although the programs reported some success, almost all had encountered challenges that inhibited implementation. A follow-up study is planned to further investigate deployment and determine the implications of Federal Communications Commission funding.

Exploring interpersonal behavior and team sensemaking during health information technology implementation.

PubMed

Kitzmiller, Rebecca R; McDaniel, Reuben R; Johnson, Constance M; Lind, E Allan; Anderson, Ruth A

2013-01-01

We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT) implementation project. Over the course of 18 months, we directly observed the interpersonal interactions of HIT implementation teams using a sensemaking lens. We identified three voice-promoting strategies enacted by team leaders that fostered team member voice and sensemaking; communicating a vision; connecting goals to team member values; and seeking team member input. However, infrequent leader expressions of anger quickly undermined team sensemaking, halting dialog essential to problem solving. By seeking team member opinions, team leaders overcame the negative effects of anger. Leaders must enact voice-promoting behaviors and use them throughout a team's engagement. Further, training teams in how to use conflict to achieve greater innovation may improve sensemaking essential to project risk mitigation. Health care work processes are complex; teams involved in implementing improvements must be prepared to deal with conflicting, contentious issues, which will arise during change. Therefore, team conflict training may be essential to sustaining sensemaking. Future research should seek to identify team interactions that foster sensemaking, especially when topics are difficult or unwelcome, then determine the association between staff sensemaking and the impact on HIT implementation outcomes. We are among the first to focus on project teams tasked with HIT implementation. This research extends our understanding of how leaders' behaviors might facilitate or impeded speaking up among project teams in health care settings.

Sepsis in Children: Global Implications of the World Health Assembly Resolution on Sepsis.

PubMed

Kissoon, Niranjan; Reinhart, Konrad; Daniels, Ron; Machado, Machado Flavia R; Schachter, Raymond D; Finfer, Simon

2017-12-01

Sepsis, worldwide the leading cause of death in children, has now been recognized as the global health emergency it is. On May 26, 2017, the World Health Assembly, the decision-making body of the World Health Organization, adopted a resolution proposed by the Global Sepsis Alliance to improve the prevention, diagnosis, and management of sepsis. To discuss the implications of this resolution for children worldwide. The resolution highlights sepsis as a global threat and urges the 194 United Nations member states to take specific actions and implement appropriate measures to reduce its human and health economic burden. The resolution is a major step toward achieving the targets outlined by the Sustainable Developmental Goals for decreasing mortality in infants and children, but implementing it will require a concerted global effort.

The Water Framework Directive: The Challenges of Testing and Validation of Guidance Documents

NASA Astrophysics Data System (ADS)

Barth, F.; Bidoglio, G.; Murray, C. N.; Zaldivar, J.; Bouraoui, F.

On the 23rd October 2000 the European Parliament and Council passed a Directive establishing a framework of community action in the field of water policy (Water Framework Directive- FWD). The Water Framework Directive (FWD) raises major challenges, these include an extremely demanding timetable, in particular in the nine preparatory years; the complexity of the text and the diversity of possible solutions to scientific, technical and practical questions. A further problem is that a common understanding and methodologies for the application of the different areas of the FWD do not necessarily exist. Member States have, historically, developed approaches to monitoring, impact assessment, economic analysis etc. that will need to be compared in order to be certain that they provide comparable level of results over the range of ecosystems covered in the European Union. Accession Countries will also have to start to adjust their environmental legislation to be compatible with EU Directives and standards. The Framework Water Directive imposes a series of deadlines for the reporting by Member States to the European Commission. In order to respond to this problem a Common Strategy on the Implementation of the Water Framework Directive is being developed by the European Commission and Member States. The aim of the development of this Common Strategy is to allow, as far as possible, a coherent and harmonious implementation of the Directive. Focus is on methodological questions related to a common understanding of the technical and scientific implications of the Directive. The aim is to clarify and develop, where appropriate, supporting technical and scientific information to assist in the practical implementation of the Directive. Guidance documents, advice for operational methods and other supporting documents will be developed for this purpose. A modular structure has been chosen for the overall strategy. The main modules are the key activities for the implementation process.. · Activity 1: Information sharing · Activity 2: Develop guidance on technical issues · Activity 3: Information and data management · Activity 4: Application, testing and validation The first three priorities have a more horizontal character. They are the key activities for developing a common understanding of the implementation of the Water Framework Directive. All these horizontal activities need to be integrated and made operational in the River Basin Management Plans. Activity 4 (Application, Testing and Validation) significantly contributes to this integration role by making these activities operational in the River Basin Management Plans. The integration step is crucial for the effective implementation of the WFD. The objective of Activity 4 is to ensure coherence amongst the different guidance documents and their cross applicability by testing the guidance documents in selected pilot river basins. To achieve these objectives a Network of pilot river basins and associated coastal zones (where applicable) will be identified, in close co- operation with WGs in Key Action 2, that are considered to represent a range of problems and conditions characteristic of those to be found in the application of the different guidelines. The Network of identified sites will used for testing and cross- validation of proposed WG guidelines. The Joint Research Centre is acting as the technical secretariat for the Scientific Coordination Committee who is responsible for Activity 4. The purpose of the present paper is to describe approach, methodology and timetable for integrated testing of guidance documents.

Forensic Memory Analysis for Apple OS X

DTIC Science & Technology

2012-06-14

x86. Table 5. Template interface fields. Variable Python Type Description template dict template implementing the C stuct interface MBR_NAME str ...dictionary key, variable name for a struct member template[MBR_NAME] tuple dictionary value, a struct member description MBR_TYPE str C type of the...named member OFFSET int offset in bytes for the member SIZE int size in bytes for the member type FIELD str lsof field represented by member

Influence network linkages across implementation strategy conditions in a randomized controlled trial of two strategies for scaling up evidence-based practices in public youth-serving systems.

PubMed

Palinkas, Lawrence A; Holloway, Ian W; Rice, Eric; Brown, C Hendricks; Valente, Thomas W; Chamberlain, Patricia

2013-11-14

Given the importance of influence networks in the implementation of evidence-based practices and interventions, it is unclear whether such networks continue to operate as sources of information and advice when they are segmented and disrupted by randomization to different implementation strategy conditions. The present study examines the linkages across implementation strategy conditions of social influence networks of leaders of youth-serving systems in 12 California counties participating in a randomized controlled trial of community development teams (CDTs) to scale up use of an evidence-based practice. Semi-structured interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welfare departments. A web-based survey collected additional quantitative data on information and advice networks of study participants. A mixed-methods approach to data analysis was used to create a sociometric data set (n = 176) to examine linkages between treatment and standard conditions. Of those network members who were affiliated with a county (n = 137), only 6 (4.4%) were directly connected to a member of the opposite implementation strategy condition; 19 (13.9%) were connected by two steps or fewer to a member of the opposite implementation strategy condition; 64 (46.7%) were connected by three or fewer steps to a member of the opposite implementation strategy condition. Most of the indirect steps between individuals who were in different implementation strategy conditions were connections involving a third non-county organizational entity that had an important role in the trial in keeping the implementation strategy conditions separate. When these entities were excluded, the CDT network exhibited fewer components and significantly higher betweenness centralization than did the standard condition network. Although the integrity of the RCT in this instance was not compromised by study participant influence networks, RCT designs should consider how influence networks may extend beyond boundaries established by the randomization process in implementation studies. NCT00880126.

Implementation Evaluation Study: Flipped Classroom Professional Development with Faculty Members to Enhance Students' Engagement in Higher Education

ERIC Educational Resources Information Center

Alebrahim, Fatimah Hussain

2016-01-01

The purpose of this qualitative study was to explore student engagement in higher education by evaluating training provided by experienced faculty members for those faculty desiring to implement a flipped classroom. A case study was utilized; data were collected in the form of online observation, in-class observation, student focus group…

12 CFR 723.20 - How can a state supervisory authority develop and enforce a member business loan regulation?

Code of Federal Regulations, 2010 CFR

2010-01-01

... state regulation minimizes the risk and accomplishes the overall objectives of NCUA's member business... and enforce a member business loan regulation? 723.20 Section 723.20 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS MEMBER BUSINESS LOANS § 723.20 How can a state...

Project-based faculty development for e-learning.

PubMed

Vyas, Rashmi; Faith, Minnie; Selvakumar, Dhayakani; Pulimood, Anna; Lee, Mary

2016-12-01

The Christian Medical College, Vellore, in collaboration with Tufts University, Boston, conducted an advanced workshop in e-learning for medical faculty members in India. E-learning can enhance educational reforms for today's computer-literate generation, and keep faculty members up to speed in a rapidly changing world. The purpose of this paper is to report on the design and evaluation of a project-based faculty member development programme focused on developing faculty members as educators and as peer trainers who can use e-learning for educational reforms. During a 2-day workshop, 29 participants in groups of two or three developed 13 e-learning projects for implementation in their institutions. Evaluation of the workshop was through written feedback from the participants at the end of the workshop and by telephone interview with one participant from each project group at the end of one year. Content analysis of qualitative data was perfomed. The participants reported that they were motivated to implement e-learning projects and recognised the need for and usefulness of e-learning. The majority of projects (10 out of 13) that were implemented 'to some extent' or 'to a great extent' faced challenges with a lack of resources and administrative support, but faculty members were able to overcome them. E-learning can enhance educational reforms for today's computer-literate generation IMPLICATIONS: Designing feasible e-learning projects in small groups and obtaining hands-on experience with e-learning tools enhance the effectiveness of subsequent implementation. To successfully incorporate e-learning when designing educational reforms, faculty member training, continuing support and infrastructure facilities are essential. © 2016 John Wiley & Sons Ltd.

Reciprocal Relations between Coalition Functioning and the Provision of Implementation Support

PubMed Central

Brown, Louis D.; Feinberg, Mark E.; Shapiro, Valerie B.; Greenberg, Mark T.

2014-01-01

Community coalitions have been promoted as a strategy to help overcome challenges to the dissemination and implementation of evidence-based prevention programs. This paper explores the characteristics of coalitions that enable the provision of implementation support for prevention programs in general, and for the implementation of evidence-based prevention programs with fidelity. Longitudinal cross-lagged panel models were used to study 74 Communities That Care (CTC) coalitions in Pennsylvania. These analyses provide evidence of a unidirectional influence of coalition functioning on the provision of implementation support. Coalition member knowledge of the CTC model best predicted the coalition’s provision of support for evidence-based program implementation with fidelity. Implications for developing and testing innovative methods for delivering training and technical assistance to enhance coalition member knowledge are discussed. PMID:24323363

Recommendations for Adopting the International Code of Marketing of Breast-milk Substitutes Into U.S. Policy.

PubMed

Soldavini, Jessica; Taillie, Lindsey Smith

2017-08-01

In 1981, the World Health Organization adopted the International Code of Marketing of Breast-milk Substitutes ( International Code), with subsequent resolutions adopted since then. The International Code contributes to the safe and adequate provision of nutrition for infants by protecting and promoting breastfeeding and ensuring that human milk substitutes, when necessary, are used properly through adequate information and appropriate marketing and distribution. Despite the World Health Organization recommendations for all member nations to implement the International Code in its entirety, the United States has yet to take action to translate it into any national measures. In 2012, only 22.3% of infants in the United States met the American Academy of Pediatrics recommendation of at least 6 months of exclusive breastfeeding. Countries adopting legislation reflecting the provisions of the International Code have seen increases in breastfeeding rates. This article discusses recommendations for translating the International Code into U.S. policy. Adopting legislation that implements, monitors, and enforces the International Code in its entirety has the potential to contribute to increased rates of breastfeeding in the United States, which can lead to improved health outcomes in both infants and breastfeeding mothers.

Statement to the Commission on the Status of Women -- March 1997.

PubMed

1997-01-01

Although the Economic and Social Commission for Western Asia (ESCWA) has achieved some social progress in recent years, several factors negatively affected the overall economic and social development of ESCWA member States. These factors include the state of political relations within the region, the extent and nature of regional cooperation in various socioeconomic fields, general trends in the oil sector, economic sanctions on Iraq, investment climate at the regional and national levels, and the Middle East peace process. Social problems are associated mainly with the inequality in income distribution, which results in disparities in standards of living and emergence of poverty. These problems prompted ESCWA to redirect the focus of its activities in order to respond better to the emerging challenges and to expand its role as a forum for regional policy coordination and program implementation. A compilation of textual database on national policies and measures was initiated by ESCWA to provide materials for comparative analysis of policies, identification of gaps, formulation of policies, and provision of technical assistance to member States for capacity building. To address the overall theme of poverty eradication, ESCWA is involved in identifying the extent of feminization of poverty in the ESCWA region through the use of already tested methodologies.

Use of evidence-based interventions in state health departments: a qualitative assessment of barriers and solutions.

PubMed

Dodson, Elizabeth A; Baker, Elizabeth A; Brownson, Ross C

2010-01-01

Existing knowledge on chronic disease prevention is not systematically disseminated and applied. State-level public health practitioners are in positions to implement programs and services related to chronic disease control. To advance dissemination science, this study sought to evaluate how and why evidence-based decision making (EBDM) is occurring. Specifically, it identified barriers to using EBDM commonly faced by state-level chronic disease practitioners and solutions for increasing the use of EBDM. Descriptive research using online survey methods. State health departments. Members of the National Association of Chronic Disease Directors. Barriers to using EBDM and solutions to increase the use of EBDM. In total, 469 people completed the survey (64% response rate). More than 60% of respondents described their position as project managers or coordinators. Nearly 80% of respondents were women, and 39% reported at least a master's degree as their highest degree. The survey elicited responses from every US state and the District of Columbia. Commonly-cited barriers to using EBDM included lack of time, resources, funding, and data. Participants noted that promising solutions to increase the use of EBDM include improved leadership, training, and collaboration. These results identify several modifiable barriers to EBDM among state-level public health practitioners. This information may improve state health departments' abilities to facilitate and encourage EBDM. In turn, this may assist chronic disease practitioners in implementing chronic disease interventions that have been proven effective. The use of such interventions will improve public health through the prevention of chronic diseases.

The American Society of Clinical Oncology's Efforts to Support Global Cancer Medicine

PubMed Central

El-Saghir, Nagi S.; Cufer, Tanja; Cazap, Eduardo; de Guzman, Roselle; Othieno-Abinya, Nicholas Anthony; Sanchez, Jose Angel; Pyle, Doug

2016-01-01

Despite much progress in the management of malignant diseases, the number of new cases and cancer-related deaths continues to rise around the world. More than half of new cases occur in economically developing countries, where more than two thirds of cancer deaths are expected. However, implementation of all necessary steps to accomplish the dissemination of state-of-the-art prevention, diagnosis, and management will require increased allocation of resources, and, more importantly, harmonization of the efforts of hundreds of national and international public health agencies, policy-setting bodies, governments, pharmaceutical companies, and philanthropic organizations. More than 30% of the members of the American Society of Clinical Oncology (ASCO) reside and practice outside US borders, and more than half of attendees at all of the scientific congresses and symposia organized by ASCO are international. As cancer has become an increasingly global disease, ASCO has evolved as a global organization. The ASCO Board of Directors currently includes members from France, Brazil, and Canada. In 2013, the ASCO Board of Directors identified a number of strategic priorities for the future. Recognizing the importance of non-US members to the society, their first strategic priority was improving the society's service to non-US members and defining these members' identity in the international oncology community. This article reviews current ASCO activities in the international arena and its future plans in global oncology. PMID:26578614

End-Member Formulation of Solid Solutions and Reactive Transport

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

Lichtner, Peter C.

2015-09-01

A model for incorporating solid solutions into reactive transport equations is presented based on an end-member representation. Reactive transport equations are solved directly for the composition and bulk concentration of the solid solution. Reactions of a solid solution with an aqueous solution are formulated in terms of an overall stoichiometric reaction corresponding to a time-varying composition and exchange reactions, equivalent to reaction end-members. Reaction rates are treated kinetically using a transition state rate law for the overall reaction and a pseudo-kinetic rate law for exchange reactions. The composition of the solid solution at the onset of precipitation is assumed tomore » correspond to the least soluble composition, equivalent to the composition at equilibrium. The stoichiometric saturation determines if the solid solution is super-saturated with respect to the aqueous solution. The method is implemented for a simple prototype batch reactor using Mathematica for a binary solid solution. Finally, the sensitivity of the results on the kinetic rate constant for a binary solid solution is investigated for reaction of an initially stoichiometric solid phase with an undersaturated aqueous solution.« less

Implicit Total Variation Diminishing (TVD) schemes for steady-state calculations

NASA Technical Reports Server (NTRS)

Yee, H. C.; Warming, R. F.; Harten, A.

1983-01-01

The application of a new implicit unconditionally stable high resolution total variation diminishing (TVD) scheme to steady state calculations. It is a member of a one parameter family of explicit and implicit second order accurate schemes developed by Harten for the computation of weak solutions of hyperbolic conservation laws. This scheme is guaranteed not to generate spurious oscillations for a nonlinear scalar equation and a constant coefficient system. Numerical experiments show that this scheme not only has a rapid convergence rate, but also generates a highly resolved approximation to the steady state solution. A detailed implementation of the implicit scheme for the one and two dimensional compressible inviscid equations of gas dynamics is presented. Some numerical computations of one and two dimensional fluid flows containing shocks demonstrate the efficiency and accuracy of this new scheme.

Survey of Local School Council Members, 1992: A Report on the Findings.

ERIC Educational Resources Information Center

Mueller, Siegfried G.

This report is based on a survey of local school council (LSC) members in Chicago (Illinois) that was conducted in 1992 to determine and share the thoughts of LSC members on planning for school improvements and educational change, implementing policies, training, and fulfilling responsibilities and duties. Nearly 850 council members responded.…

Implementing Non-violent Resistance, a Method to Cope with Aggression in Child and Adolescent Residential Care: Exploration of Staff Members Experiences.

PubMed

van Gink, Kirsten; Visser, Katharina; Popma, Arne; Vermeiren, Robert R J M; van Domburgh, Lieke; van der Stegen, Ber; Jansen, Lucres M C

2018-06-01

Staff members in residential care for youth are frequently confronted with aggressive behaviour, which has adverse effects on their stress levels and work satisfaction. This paper describes a qualitative evaluation to find out how staff members benefit from Non-violent Resistance (NVR), a method to create an aggression mitigating residential climate. Staff members were positive about NVR and reported feeling more relaxed. Most valued aspects of this method were the focus on being a team, delayed response and giving up the illusion of control. However, training and the intention to use NVR isn't enough, high quality implementation and maintenance are crucial. Copyright © 2017 Elsevier Inc. All rights reserved.

Systems and Methods for Implementing Bulk Metallic Glass-Based Macroscale Compliant Mechanisms

NASA Technical Reports Server (NTRS)

Hofmann, Douglas C. (Inventor); Agnes, Gregory (Inventor)

2017-01-01

Systems and methods in accordance with embodiments of the invention implement bulk metallic glass-based macroscale compliant mechanisms. In one embodiment, a bulk metallic glass-based macroscale compliant mechanism includes: a flexible member that is strained during the normal operation of the compliant mechanism; where the flexible member has a thickness of 0.5 mm; where the flexible member comprises a bulk metallic glass-based material; and where the bulk metallic glass-based material can survive a fatigue test that includes 1000 cycles under a bending loading mode at an applied stress to ultimate strength ratio of 0.25.

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Reserve Select for certain members of the selected reserve; Transitional Assistance Management Program; early eligibility for TRICARE for certain reserve component members. Interim final rule with comment period.

PubMed

2005-03-16

This interim final rule establishes requirements and procedures for implementation of TRICARE Reserve Select. It also revises requirements and procedures for the Transitional Assistance Management Program. In addition, it establishes requirements and procedures for implementation of the earlier TRICARE eligibility for certain reserve component members. The rule is being published as an interim final rule with comment period in order to comply with statutory effective dates.

Implementing a fax referral program for quitline smoking cessation services in urban health centers: a qualitative study.

PubMed

Cantrell, Jennifer; Shelley, Donna

2009-12-17

Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax referral program in primary care. The study involved implementation of a fax referral system paired with a chart stamp prompting providers to identify smoking patients, provide advice to quit and refer interested smokers to a state-based fax quitline. Three focus groups (n = 26) and eight key informant interviews were conducted with staff and physicians at two clinics after the intervention. We used the Chronic Care Model as a framework to analyze the data, examining how well the systems changes were implemented and the impact of these changes on care processes, and to develop recommendations for improvement. Physicians and staff described numerous benefits of the fax referral program for providers and patients but pointed out significant barriers to full implementation, including the time-consuming process of referring patients to the Quitline, substantial patient resistance, and limitations in information and care delivery systems for referring and tracking smokers. Respondents identified several strategies for improving integration, including simplification of the referral form, enhanced teamwork, formal assignment of responsibility for referrals, ongoing staff training and patient education. Improvements in Quitline feedback were needed to compensate for clinics' limited internal information systems for tracking smokers. Establishing sustainable linkages to quitline services in clinical sites requires knowledge of existing patterns of care and tailored organizational changes to ensure new systems are prioritized, easily integrated into current office routines, formally assigned to specific staff members, and supported by internal systems that ensure adequate tracking and follow up of smokers. Ongoing staff training and patient self-management techniques are also needed to ease the introduction of new programs and increase their acceptability to smokers.

The Influence of Standards on the College Fraternity Man: An Evaluative Study on the Impact of the 2004 Implementation of the North American Interfraternity Conference Standards for Member Organizations

ERIC Educational Resources Information Center

Godwin, Kimberly A.

2011-01-01

This dissertation sought to examine the effects that the implementation of standard nine by the North American Interfraternity Conference had upon member behaviors with respect to academic achievement, alcohol consumption, career preparation, civic engagement, hazing, leadership development, sexual assault awareness/prevention, and values and…

Using a Consensus Conference to Characterize Regulatory Concerns Regarding Bioremediation of Radionuclides and Heavy Metals in Mixed Waste at DOE Sites

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

Denise Lach; Stephanie Sanford

2006-09-01

A consensus workshop was developed and convened with ten state regulators to characterize concerns regarding emerging bioremediation technology to be used to clean-up radionuclides and heavy metals in mixed wastes at US DOE sites. Two questions were explored: integrated questions: (1) What impact does participation in a consensus workshop have on the knowledge, attitudes, and practices of state regulators regarding bioremediation technology? (2) How effective is a consensus workshop as a strategy for eliciting and articulating regulators’ concerns regarding the use of bioremediation to clean up radionuclides and heavy metals in mixed wastes at U.S. Department of Energy Sites aroundmore » the county? State regulators met together for five days over two months to learn about bioremediation technology and develop a consensus report of their recommendations regarding state regulatory concerns. In summary we found that panel members: - quickly grasped the science related to bioremediation and were able to effectively interact with scientists working on complicated issues related to the development and implementation of the technology; - are generally accepting of in situ bioremediation, but concerned about costs, implementation (e.g., institutional controls), and long-term effectiveness of the technology; - are concerned equally about technological and implementation issues; and - believed that the consensus workshop approach to learning about bioremediation was appropriate and useful. Finally, regulators wanted decision makers at US DOE to know they are willing to work with DOE regarding innovative approaches to clean-up at their sites, and consider a strong relationship between states and the DOE as critical to any effective clean-up. They do not want perceive themselves to be and do not want others to perceive them as barriers to successful clean-up at their sites.« less

76 FR 35219 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... service environment in which the evaluation is implemented and the opportunities for control group members to access the same or similar services as the treatment group members. Respondents: Individuals enrolled in ISIS demonstration interventions, control group members, ISIS program operators (BIF and SAQ...

TRIPS, the Doha declaration and paragraph 6 decision: what are the remaining steps for protecting access to medicines?

PubMed Central

Kerry, Vanessa Bradford; Lee, Kelley

2007-01-01

Background The World Trade Organisation's Declaration on the TRIPS Agreement and Public Health (known as the Doha Declaration) of 2001, and subsequent Decision on the Interpretation of Paragraph 6 reached in 2003, affirmed the flexibilities available under the Agreement on Trade Related Property Rights (TRIPS) to member states seeking to protect public health. Despite these important clarifications, the actual implementation of these measures to improve access to medicines remains uncertain. There are also concerns that so-called TRIPS-plus measures within many regional and bilateral trade agreements are further undermining the capacity of the poor to access affordable medicines. Methods The paper reviews policy debates among governments, nongovernmental organisations and international organisations from 1995, and notably since 2003, surrounding access to medicines and trade agreements. The provisions for protecting public health provided by the Doha Declaration and Paragraph 6 Decision are reviewed in terms of challenges for implementation, along with measures to protect intellectual property rights (IPRs) under selected regional and bilateral trade agreements. Results While provisions, in principle, were affirmed for member states under the TRIPS agreement to protect public health, numerous challenges remain. Implementation of the flexibilities has been hindered by lack of capacity in many LMICs. More intransigent have been stark inequalities in power and influence among trading nations, leaving LMICs vulnerable to pressures to permit the globalization of IPRs in order to protect broader trade and economic interests. Such inequalities are apparent in proposals or adopted TRIPS-plus measures which re-establish the primacy of trade over public health goals. Conclusion Despite being hailed as a "watershed in international trade", the Doha Declaration and Paragraph 6 decision have not resolved the problem of access to affordable medicines. The way forward must begin with a simplification of their content, to enable actual implementation. More fundamentally, once agreed, public health protections under TRIPS must be recognised as taking precedent over measures subsequently adopted under other trade agreements. This requires, above all, setting aside such protections as a basic need and shared goal from trade negotiations at all levels. PMID:17524147

Birds of a Feather - Developments towards shared, regional geological disposal in the EU?

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

Codee, H.D.K.; Verhoef, E.V.; McCombie, Ch.

2008-07-01

Geological disposal is an essential component of the long-term management of spent fuel, high level and other long-lived radioactive waste. In the EU, all 25 member states generate radioactive waste. Of course, there are large differences in type and quantity between the member states, but all of them need a long-term solution. Even a country with only lightning rods with radium will need a long-term solution for the disposal. The 1600 year half-life of radium does not fit in a solution with a span of control of just a few hundred years. Implementation of a suitable deep repository may, however,more » be difficult or impossible for countries with small volumes of waste, because of the high costs involved. Will economy of scale force these birds of a feather to wait to flock together and share a repository? Implementing a small repository and operating it for very long times is very costly. There are past and current examples of countries being prepared to accept radioactive waste from others if a better environmental solution is thus achieved and if the arrangements are fair for all parties involved. The need for supranational surveillance also points to shared solutions. Although the European Parliament and the Commission have both supported the concept of shared regional repositories in Europe, (national) political and societal constraints have hampered the realization of such facilities up to now. The first step in this staged process was the EC funded project, SAPIERR I. The project (2003 to 2005) studied the feasibility of shared regional storage facilities and geological repositories, for use by European countries. It showed that, if shared regional repositories are to be implemented even some decades ahead, efforts must already be increased now. The next step in the process is to develop a practical implementation strategy and organizational structures to work on shared EU radioactive waste storage and disposal activities. This is addressed in the EC funded project SAPIERR II (2006-2008). The paper gives an update of the SAPIERR II project and describes the progress achieved. (authors)« less

Walking the Walk in Team-Based Education: The Crimson Care Collaborative Clinic in Family Medicine.

PubMed

Meisinger, Kirsten; Wohler, Diana

2016-09-01

Effective implementation of robust team-based care in the United States requires significant training for all team members. This education is integral to creating a culture of collaboration and respect among interprofessional members of the health care team. The lack of interprofessional clinical educational experiences contributes to a "hidden curriculum" that reinforces the problematic view that medicine is at the top of a hierarchy among health professions. However, learners themselves have started resisting this view by integrating cross-disciplinary team-based training into their own education. One example of learner-based leadership in interprofessional team care is the Crimson Care Collaborative at Cambridge Health Alliance, a student-faculty collaborative family medicine clinic. This successful clinic demonstrates that high-quality interprofessional clinical education can be accomplished through partnerships between educational institutions and existing patient-centered medical homes. © 2016 American Medical Association. All Rights Reserved.

Mechanism Design and Testing of a Self-Deploying Structure Using Flexible Composite Tape Springs

NASA Technical Reports Server (NTRS)

Footdale, Joseph N.; Murphey, Thomas W.

2014-01-01

The detailed mechanical design of a novel deployable support structure that positions and tensions a membrane optic for space imagining applications is presented. This is a complex three-dimensional deployment using freely deploying rollable composite tape spring booms that become load bearing structural members at full deployment. The deployment tests successfully demonstrate a new architecture based on rolled and freely deployed composite tape spring members that achieve simultaneous deployment without mechanical synchronization. Proper design of the flexible component mounting interface and constraint systems, which were critical in achieving a functioning unit, are described. These flexible composite components have much potential for advancing the state of the art in deployable structures, but have yet to be widely adopted. This paper demonstrates the feasibility and advantages of implementing flexible composite components, including the design details on how to integrate with required traditional mechanisms.

TA Beliefs in a SCALE-UP Style Classroom

NASA Astrophysics Data System (ADS)

DeBeck, George; Settelmeyer, Sam; Li, Sissi; Demaree, Dedra

2010-10-01

In Spring 2010, the Oregon State University physics department instituted a SCALE-UP (Student-Centered Active Learning Environment for Undergraduate Programs) style studio classroom in the introductory, calculus-based physics series. In our initial implementation, comprised of two hours lecture, two hours of studio, and two hours lab work, the studio session was lead by a faculty member and either 2 GTAs or 1 GTA and 1 LA. We plan to move to a model where senior GTAs can lead studio sections after co-teaching with the faculty member. It is critical that we know how to prepare and support the instructional team in facilitating student learning in this setting. We examine GTA and LA pedagogical beliefs through reflective journaling, interviews, and personal experience of the authors. In particular, we examine how these beliefs changed over their first quarter of instruction, as well as the resources used to adapt to the new classroom environment.

Testing the extended biotic index in Slovakia: consistency, advantages, and limitations versus the saprobic assessment method of water quality.

PubMed

Pennelli, Bruno; Nagel, Karl-Otto; Crivellaro, Giuseppe; Fabiani, Claudio; Vancova, Alexandra; Mancini, Laura

2006-04-01

The European Union Water Framework Directive requires the achievement of environmental objectives for the ecological quality of water bodies. A comparable implementation of the Directive throughout member countries of the European Union is necessary to verify equal protection of surface waters. The Directive specifies that member states determine ecological quality by means of biological indices. To improve comparability of water quality assessment, this research carried out an intercalibration trial between the Slovak Saprobic Index and the Italian protocol of the Extended Biotic Index, as part of a cooperative program between Italy and the Slovak Republic. When assessing streams with no or low pollution, statistics showed similar results for both methods. In contrast, the comparison of indices was not accurate in the case of severely affected waters. Reliable conversion formulas are feasible to transform the Italian Extended Biotic Index into the Slovak Saprobic Index, and not vice versa.

An historical overview of the activities in the field of exposure and risk assessment of non-ionizing radiation in Bulgaria.

PubMed

Israel, Michel

2015-09-01

The exposure and risk evaluation process in Bulgaria concerning non-ionizing radiation health and safety started in the early 1970s. Then, the first research laboratory "Electromagnetic fields in the working environment" was founded in the framework of the Centre of Hygiene, belonging to the Medical Academy, Sofia. The main activities were connected with developing legislation, new equipment for measurement of electromagnetic fields, new methods for measurement and exposure assessment, in vivo and human studies for developing methods, studying the effect of non-ionizing radiation on human body, developing exposure limits. Most of the occupations as metal industry, plastic welding, energetics, physiotherapy, broadcasting, telephone stations, computer industry, etc., have been covered by epidemiological investigations and risk evaluation. In 1986, the ANSI standard for safe use of lasers has been implemented as national legislation that gave the start for studies in the field of risk assessment concerning the use of lasers in industry and medicine. The environmental exposure studies started in 1991 following the very fast implementation of the telecommunication technologies. Now, funds for research are very insignificant, and studies in the field of risk assessment are very few. Nevertheless, Bulgaria has been an active member of the WHO International EMF Project, since 1997, and that gives good opportunity for collaboration with other Member states, and for implementation of new approach in the EMF policy for workers and people's protection against non-ionizing radiation exposure.

One WEEE, many species: lessons from the European experience.

PubMed

Deepali Sinha Khetriwal; Widmer, Rolf; Kuehr, Ruediger; Huisman, Jaco

2011-09-01

Electrical and electronic equipment (EEE) pervades modern lifestyles, but its quick obsolescence is resulting in huge quantities of EEE to be disposed of. This fast-growing waste stream has been recognized for its hazard potential. The European Union's (EU) Waste Electrical and Electronic Equipment (WEEE) Directive was essentially in response to the toxicity of e-waste - to ensure that it was collected and treated in an environmentally sound manner. Since then, the WEEE Directive has expanded its aims to include recovery of valuable resources as a means to reduce raw material extraction. With these objectives in mind, the Directive sets a common minimum legislative framework for all EU member states. However, the transposition of the Directive into national legislations has meant many differences in actual implementation models. There are 27 national transpositions of the Directive with different definitions, provisions and agreements. Each legislation reflects national situations, whether they are geographical considerations, legislative history, the influence of lobby groups and other national priorities. Although this diversity in legislations has meant massive problems in compliance and enforcement, it provides an opportunity to get an insight into the possible operational models of e-waste legislation. Building on the study by the United Nations University commissioned by the European Commission as part of its 2008 Review of the WEEE Directive, the paper identifies some key features of the Directive as well as legislative and operational differences in transposition and implementation in the various members states. The paper discusses the successes and challenges of the Directive and concludes with lessons learnt from the European experience.

Antimicrobial resistance in South East Asia: time to ask the right questions.

PubMed

Kakkar, Manish; Chatterjee, Pranab; Chauhan, Abhimanyu Singh; Grace, Delia; Lindahl, Johanna; Beeche, Arlyne; Jing, Fang; Chotinan, Suwit

2018-01-01

Antimicrobial resistance (AMR) has emerged as a major public health concern, around which the international leadership has come together to form strategic partnerships and action plans. The main driving force behind the emergence of AMR is selection pressure created due to consumption of antibiotics. Consumption of antibiotics in human as well as animal sectors are driven by a complex interplay of determinants, many of which are typical to the local settings. Several sensitive and essential realities are tied with antibiotic consumption - food security, livelihoods, poverty alleviation, healthcare access and national economies, to name a few. That makes one-size-fits-all policies, framed with the developed country context in mind, inappropriate for developing countries. Many countries in the South East Asian Region have some policy structures in place to deal with AMR, but most of them lack detailed implementation plans or monitoring structures. In this current debates piece, the authors argue that the principles driving the AMR agenda in the South East Asian countries need to be dealt with using locally relevant policy structures. Strategies, which have successfully reduced the burden of AMR in the developed countries, should be evaluated in the developing country contexts instead of ad hoc implementation. The Global Action Plan on AMR encourages member states to develop locally relevant National Action Plans on AMR. This policy position should be leveraged to develop and deploy locally relevant strategies, which are based on a situation analysis of the local systems, and are likely to meet the needs of the individual member states.

World Health Organization Guidelines for Containment of Poliovirus Following Type-Specific Polio Eradication - Worldwide, 2015.

PubMed

Previsani, Nicoletta; Tangermann, Rudolph H; Tallis, Graham; Jafari, Hamid S

2015-08-28

In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate polio worldwide. Among the three wild poliovirus (WPV) types (type 1, type 2, and type 3), WPV type 2 (WPV2) has been eliminated in the wild since 1999, and WPV type 3 (WPV3) has not been reported since 2012. In 2015, only Afghanistan and Pakistan have reported WPV transmission. On May 25, 2015, all WHO Member States endorsed World Health Assembly resolution 68.3 on full implementation of the Polio Eradication and Endgame Strategic Plan 2013-2018 (the Endgame Plan), and with it, the third Global Action Plan to minimize poliovirus facility-associated risk (GAPIII). All WHO Member States have committed to implementing appropriate containment of WPV2 in essential laboratory and vaccine production facilities* by the end of 2015 and of type 2 oral poliovirus vaccine (OPV2) within 3 months of global withdrawal of OPV2, which is planned for April 2016. This report summarizes critical steps for essential laboratory and vaccine production facilities that intend to retain materials confirmed to contain or potentially containing type-specific WPV, vaccine-derived poliovirus (VDPV), or OPV/Sabin viruses, and steps for nonessential facilities† that process specimens that contain or might contain polioviruses. National authorities will need to certify that the essential facilities they host meet the containment requirements described in GAPIII. After certification of WPV eradication, the use of all OPV will cease; final containment of all polioviruses after polio eradication and OPV cessation will minimize the risk for reintroduction of poliovirus into a polio-free world.

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

PubMed

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

2016-12-01

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

WASP (Write a Scientific Paper): The right to privacy.

PubMed

Mallia, Pierre

2018-05-09

The data protection directive of the EU was set up to allow the freedom of movement of people between member states. This has the consequence of allowing the freedom of transfer of data between member states in research. The paper discusses three cases discussed during the project to see whether RECs can refuse research based on concern for data protection in some member states. Since the directive is not, as commonly thought, intended to protect the rights and freedoms of individuals - something which is the function of the Data Protection Acts of individual states, Member States do not have a right to prohibit research based on data laws. One must express concerns directly to Brussels. Conversely it is debated whether some research considered unlawful in one particular member state can be refused by this same state. Copyright © 2018. Published by Elsevier B.V.

Abstinence from drugs of abuse in community-based members of Narcotics Anonymous.

PubMed

Galanter, Marc; Dermatis, Helen; Post, Stephen; Santucci, Courtney

2013-03-01

Narcotics Anonymous (NA) is an abstinence-based fellowship with more than 58,000 groups worldwide. There has, however, been little research reported on its members. This study was designed to clarify the nature of the participants in NA who are primarily abstinent, long-term members. A protocol was implemented to survey members at 10 NA group meetings in three different states, through the cooperation of the NA World Service Office. A 51-item self-administered questionnaire, addressing key aspects of substance use and recovery, was anonymously completed by 396 respondents. Respondents were 71.5% male; the mean age was 38.1 years; 68.2% were White; and the principal drug problems comprised cocaine (28.5%), heroin (27.5%), other opiates (13.4%), methamphetamine (12.9%), alcohol (8.6%), marijuana (6.6%), and other stimulants (2.5%). Eighty-seven percent had prior treatment for a substance use disorder. On average respondents had first encountered NA at age 26.9, they had been abstinent an average of 5.7 years at the time they filled out the questionnaire, and 47.5% had served as sponsors. Ninety-four percent designated themselves as spiritual, and only 29.6% designated themselves as religious. NA offers support for long-term abstinence from diverse misuse of drugs among users of different backgrounds.

The evolving practice of nuclear cardiology: results from the 2011 ASNC member survey.

PubMed

Tilkemeier, Peter; Green, Jacqueline; Einstein, Andrew J; Fazel, Reza; Reames, Patricia; Shaw, Leslee J

2012-12-01

Today's imaging laboratories face challenges including reimbursement, prior authorization, and accreditation standards. The impact on the practice of nuclear cardiology in the United States is unknown. We conducted a survey of ASNC members to provide a snapshot of nuclear cardiology imaging laboratories in 2011. The survey identified practice patterns including personnel, volumes, protocols used, and laboratory characteristics. We employed random sampling methodology stratified geographically. The response rate was 19.5% (73/374 laboratories). A non-random survey conducted in 2001 of 25 laboratories served as a comparator. A total of 73 laboratories, representing 202 physicians and 177 technologists responded. The reported median procedural volume was 1,225 studies annually; 88.9% of laboratories were accredited. Compared with 2001, dual isotope imaging protocol use dropped from 72% to 15.6%. Five markers of quality were surveyed. Half of laboratories use the American College of Cardiology's Appropriate Use Criteria, 61% used segmental scoring, and 32% provided guidance on post-test therapeutic management. 89% perform catheterization correlations while only 33% implemented radiation dose tracking. This survey of ASNC members provides critical information on nuclear cardiology practice to better target and service our members' needs. These data can prove invaluable to target educational needs and inform healthcare policy of contemporary nuclear cardiology practice.

12 CFR 208.75 - What happens if the state member bank or any of its insured depository institution affiliates...

Code of Federal Regulations, 2010 CFR

2010-01-01

... MEMBERSHIP OF STATE BANKING INSTITUTIONS IN THE FEDERAL RESERVE SYSTEM (REGULATION H) Financial Subsidiaries... financial subsidiaries and expansion of existing financial subsidiaries. If a state member bank, or any... of any financial subsidiary; and (2) Any financial subsidiary controlled by the state member bank may...

Implementation of the Single European Code in a Multi-Tissue Bank

PubMed Central

Schroeter, Jan; Schulz, Tino; Schroeter, Bernard; Fleischhauer, Katrin; Pruß, Axel

2017-01-01

Introduction The traceability of tissue and cells transplants is important to ensure a high level of safety for the recipients. With the final introduction of the Single European Code (SEC) in April 2017 in the EU a consistent system among all member states became mandatory. Methods The regulations for the SEC on EU and national level were evaluated. An overview on the different parts of the SEC with detailed explanations is given. Our own experiences with the implementation of the SEC in our multi-tissue bank are reported in addition. Results The implementation of the SEC in our multi-tissue bank could be successfully realized. However, it revealed a number of difficulties, especially the sterile labeling of certain tissue transplants and the complex update of the existing database. Conclusion The introduction of the SEC has made a contribution to the safety of recipients of tissue and cells transplants through a system of comprehensive and transparent traceability. PMID:29344015

Implementing a video-based intervention to empower staff members in an autism care organization: a qualitative study.

PubMed

Hall, Alex; Finch, Tracy; Kolehmainen, Niina; James, Deborah

2016-10-21

Implementing good-quality health and social care requires empowerment of staff members within organizations delivering care. Video Interaction Guidance (VIG) is an intervention using positive video feedback to empower staff through reflection on practice. This qualitative study explored the implementation of VIG within an autism care organization in England, from the perspective of staff members undergoing training to deliver VIG. Semi-structured interviews were conducted with a purposive sample of 7 participants working within the organization (5 staff undergoing training to deliver VIG; 2 senior managers influencing co-ordination of training). Participants were asked about their views of VIG and its implementation. The topic guide was informed by Normalization Process Theory (NPT). Data were analysed inductively and emerging issues were related to NPT. Five broad themes were identified: (1) participants reported that they and other staff did not understand VIG until they became involved, initially believing it would highlight negative rather than positive practice; (2) enthusiastic feedback from staff who had been involved seemed to encourage other staff to become involved; (3) key implementation challenges included demands of daily work and securing managers' support; (4) ideas for future practice arising from empowerment through VIG seemed difficult to realise within an organizational culture reportedly unreceptive to creative ideas from staff; (5) individuals' emotional responses to implementation seemed beyond the reach of NPT, which focused more upon collective processes. Implementation of VIG may require recognition that it is not a 'quick fix'. Peer advocacy may be a fruitful implementation strategy. Senior managers may need to experience VIG to develop their understanding so that they can provide appropriate implementation support. NPT may lack specificity to explain how individual agency weaves with collective processes and social systems to embed innovation in routine practice. This exploratory study has provided broad insights into facilitators and barriers to the implementation of an intervention to empower staff within an autism care organization. Further research is needed into similar interventions, including a focus upon staff members' emotional responses and resources, and how such interventions may relate to the culture of the organization in which implementation occurs.

Advocacy coalitions involved in California's menu labeling policy debate: Exploring coalition structure, policy beliefs, resources, and strategies.

PubMed

Payán, Denise D; Lewis, LaVonna B; Cousineau, Michael R; Nichol, Michael B

2017-03-01

Advocacy coalitions often play an important role in the state health policymaking process, yet little is known about their structure, composition, and behavior. In 2008, California became the first state to enact a menu labeling law. Using the advocacy coalition framework, we examine different facets of the coalitions involved in California's menu labeling policy debate. We use a qualitative research approach to identify coalition members and explore their expressed beliefs and policy arguments, resources, and strategies by analyzing legislative documents (n = 87) and newspaper articles (n = 78) produced between 1999 and 2009. Between 2003 and 2008, six menu labeling bills were introduced in the state's legislature. We found the issue received increasing media attention during this period. We identified two advocacy coalitions involved in the debate-a public health (PH) coalition and an industry coalition. State organizations acted as coalition leaders and participated for a longer duration than elected officials. The structure and composition of each coalition varied. PH coalition leadership and membership notably increased compared to the industry coalition. The PH coalition, led by nonprofit PH and health organizations, promoted a clear and consistent message around informed decision making. The industry coalition, led by a state restaurant association, responded with cost and implementation arguments. Each coalition used various resources and strategies to advance desired outcomes. PH coalition leaders were particularly effective at using resources and employing advocacy strategies, which included engaging state legislators as coalition members, using public opinion polls and information, and leveraging media resources to garner support. Policy precedence and a local policy push emerged as important policymaking strategies. Areas for future research on the state health policymaking process are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adoption Factors of the Electronic Health Record: A Systematic Review

PubMed Central

2016-01-01

Background The Health Information Technology for Economic and Clinical Health (HITECH) was a significant piece of legislation in America that served as a catalyst for the adoption of health information technology. Following implementation of the HITECH Act, Health Information Technology (HIT) experienced broad adoption of Electronic Health Records (EHR), despite skepticism exhibited by many providers for the transition to an electronic system. A thorough review of EHR adoption facilitator and barriers provides ongoing support for the continuation of EHR implementation across various health care structures, possibly leading to a reduction in associated economic expenditures. Objective The purpose of this review is to compile a current and comprehensive list of facilitators and barriers to the adoption of the EHR in the United States. Methods Authors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE, 01/01/2012–09/01/2015, core clinical/academic journals, MEDLINE full text, and evaluated only articles germane to our research objective. Team members selected a final list of articles through consensus meetings (n=31). Multiple research team members thoroughly read each article to confirm applicability and study conclusions, thereby increasing validity. Results Group members identified common facilitators and barriers associated with the EHR adoption process. In total, 25 adoption facilitators were identified in the literature occurring 109 times; the majority of which were efficiency, hospital size, quality, access to data, perceived value, and ability to transfer information. A total of 23 barriers to adoption were identified in the literature, appearing 95 times; the majority of which were cost, time consuming, perception of uselessness, transition of data, facility location, and implementation issues. Conclusions The 25 facilitators and 23 barriers to the adoption of the EHR continue to reveal a preoccupation on cost, despite incentives in the HITECH Act. Limited financial backing and outdated technology were also common barriers frequently mentioned during data review. Future public policy should include incentives commensurate with those in the HITECH Act to maintain strong adoption rates. PMID:27251559

Conflict-of-interest disclosure at medical journals in Japan: a nationwide survey of the practices of journal secretariats

PubMed Central

Kojima, Takako; Green, Joseph; Barron, J Patrick

2015-01-01

Objectives Medical journals in Japan generally have appropriate policies regarding disclosure of conflicts of interest (COI). However, COI management depends on the staff members of each journal's editorial secretariat. This study's objectives were to find out (A) whether COI disclosure and the journal's role in it are clearly understood by the journal’s secretariat staff, (B) how much experience the editorial secretariat has in actually handling issues related to disclosure and (C) what kind of help or support they need. Setting and design In January 2014, questionnaires were sent to the editorial secretariats of journal-publishing societies belonging to the Japanese Association of Medical Sciences (JAMS). Participants The response rate was 100%, and the respondents represented 121 journals published by the 118 JAMS member societies (at the time of the survey). Primary and secondary outcome measures Information was collected on the history of COI policies and on how those policies were implemented. At the end of the questionnaire, there was an open-ended call for comments. Results Compulsory COI disclosure began between 2010 and 2013 for 60.3% of the journals (73/121). Handling of COI issues was not uniform: 17.4% (21/121) of respondents do not pursue cases of dubious disclosure, and 47.9% (58/121) do not require COI disclosures from editorial board members. Very few of the editorial secretariats had clearly-stated consequences for violations of COI-disclosure policy (33/121, 27.3%), and only 28.9% offered COI education (35/121). Respondents’ comments indicated that uniform, easily-searchable guidance regarding COI policies and implementation would be welcome. Conclusions Although commitment is widespread, policy implementation is inconsistent and COI experience is lacking. Clear, easy-to-use guidelines are desired by many societies. The JAMS is to be commended for supporting this country-wide investigation; other countries and regions are encouraged to perform similar investigations to respond to needs regarding COI management. PMID:26310399

76 FR 20435 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... points in the European Community and the Member States of the European Union, and a point or points in... States and the European Community and the Member States of the European Union. Specifically Calima... any point or points behind any Member State of the European Community via any point or points in any...

Huddle up!: The adoption and use of structured team communication for VA medical home implementation.

PubMed

Rodriguez, Hector P; Meredith, Lisa S; Hamilton, Alison B; Yano, Elizabeth M; Rubenstein, Lisa V

2015-01-01

Daily clinical team meetings (i.e., "huddles") may be helpful in implementing new roles and responsibilities for patient care because they provide a regular opportunity for member learning and feedback. We examined how huddles were implemented in the context of the VA patient-centered medical home (PCMH) transformation, including assessing barriers and facilitators to regular huddling among small teams ("teamlets"). We assessed the extent to which teamlet members that huddled had higher self-efficacy for PCMH changes, reported better teamwork experiences, and perceived more supportive practice environments. We used a convergent mixed-methods approach to analyze 79 teamlet member interviews from six VA primary care practices and 418 clinician and staff PCMH survey responses from the six interviewed practices and 13 additional practices in the same region. Most members reported participating in teamlet huddles when asked in surveys (85%). A minority of interview participants, however, described routine huddling focused on previsit planning that included all members. When members reported routine teamlet huddling, activities included (a) previsit planning, (b) strategizing treatment plans for patients with special or complex needs, (c) addressing daily workflow and communication issues through collective problem solving, and (d) ensuring awareness of what team members do and what actions are happening on the teamlet and in the practice. Primary care providers (PCPs) were least likely to report routine huddling. PCP huddlers reported greater self-efficacy for implementing PCMH changes. All huddlers, irrespective of role, reported better teamwork and more supportive practice climates. The most common barriers to teamlet huddling were limited time and operational constraints. In order to improve the impact of huddles on patient care, practice leaders should clearly communicate the goals, requirements, and benefits of huddling and provide adequate time and resources to ensure that frontline teams use huddle time to improve patient care.

Participatory Action Research as a Model for Conducting Family Research.

ERIC Educational Resources Information Center

Turnbull, Ann P.; Friesen, Barbara J.; Ramirez, Carmen

1998-01-01

This article discusses a participatory action research (PAR) approach to conducting family research. It proposes a model of PAR implementation level including the options of family members as research leaders and researchers as ongoing advisors, researchers and family members as coresearchers, and researches as leaders, and family members as…

34 CFR 602.14 - Purpose and organization.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) At least one member of the agency's decision-making body is a representative of the public, and at... and implemented guide lines for each member of the decision-making body to avoid conflicts of interest... this section, the term separate and independent means that— (1) The members of the agency's decision...

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

Dear, Jody

DOE grant DE-SC0005904 was allocated to fund the faculty development, curriculum development and travel to support the four institutions of the Connecticut State University System’s (CSUS) Initiative for Nanotechnology-related Equipment, Faculty Development and Curriculum Development. DOE grant DE-SC0005072 was also awarded for this program. In 2010, CSUS had identified the establishment of nanotechnology programs and infrastructure as a priority. At that time, the system set the goal of establishing an academic initiative in nanotechnology for the CSUS, beginning with the development of a series of courses at the graduate level. Implementation was planned via a collaborative effort including faculty frommore » all four of the CSUS campuses. The CSUS Nanotechnology Working Group [CSUS NWG] was established to accomplish this goal. A faculty member from the Physics Department at Southern Connecticut State University [SCSU] was assigned the task of organizing and coordinating the work of the CSUS NWG. Representatives from each of the four CSUS campuses were appointed to join the CSUS NWG with the following initial representation: SCSU [Physics and Biology], Western Connecticut State University (WCSU) [Chemistry], Eastern Connecticut State University (ECSU) [Chemistry] and Central Connecticut State University (CCSU) [Chemistry. As a further outcome it was determined that this collaborative effort would lead to the establishment of a formal nanotechnology center, serving as the nucleus of CSUS student and faculty learning and research. This CSUS Nanotechnology Center [CSUS-NC] was to be located at Southern Connecticut State University (SCSU). The goal of this grant was to provide funding for curriculum and faculty development necessary to facilitate the development and implementation of a collaborative Graduate Certificate in Nanotechnology for the Connecticut State University System. This outcome has been successfully achieved. The courses and structure of the Graduate Certificate program have been developed and approved and the program will be completely implemented in the fall of 2013. The Nanotechnology Center will be recognized as the CSCU Center for Nanotechnology and will thus impact both the CSUS and Connecticut Community College Systems.« less

Meat inspection for Trichinella in pork, horsemeat and game within the EU: available technology and its present implementation.

PubMed

Webster, P; Maddox-Hyttel, C; Nöckler, K; Malakauskas, A; van der Giessen, J; Pozio, E; Boireau, P; Kapel, C M O

2006-01-01

A new EU directive relating to meat inspection for Trichinella, expected to come into force in 2006, imposes important modifications to current legislation. Nevertheless, several issues need more attention. Optimisation of methods, especially concerning sensitivity and digestibility of the meat to be inspected, along with further simplification of the legislation with regard to the number of techniques accepted, is recommended to guarantee that all member states of the EU will be given tools to perform inspection of consumer meat at the same high level. Additionally, there is a need for guidelines and protocols regarding optimal proficiency testing procedures. This paper presents an overview of the current methods for Trichinella meat inspection and their implementation in the EU, listing advantages and disadvantages for each method, including some suggestions for specific points of improvement.

Community Member and Stakeholder Perspectives on a Healthy Environment Initiative in North Carolina.

PubMed

Carter-Edwards, Lori; Lowe-Wilson, Abby; Mouw, Mary Sherwyn; Jeon, Janet Yewon; Baber, Ceola Ross; Vu, Maihan B; Bethell, Monique

2015-08-13

The North Carolina Community Transformation Grant Project (NC-CTG) aimed to implement policy, system, and environmental strategies to promote healthy eating, active living, tobacco-free living, and clinical and community preventive services to advance health equity and reduce health disparities for the state's most vulnerable communities. This article presents findings from the Health Equity Collaborative Evaluation and Implementation Project, which assessed community and stakeholder perceptions of health equity for 3 NC-CTG strategies: farmers markets, shared use, and smoke-free multiunit housing. In a triangulated qualitative evaluation, 6 photo elicitation (PE) sessions among 45 community members in 1 urban and 3 rural counties and key informant interviews among 22 stakeholders were conducted. Nine participants from the PE sessions and key informant interviews in the urban county subsequently participated in a stakeholder power analysis and mapping session (SPA) to discuss and identify people and organizations in their community perceived to be influential in addressing health equity-related issues. Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies. The SPA identified specific community- and faith-based organizations, health care organizations, and local government agencies as key stakeholders for future efforts. Both community fit and access are essential constructs for promoting health equity. Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies.

[The implementation of Individual Placement and Support in the Netherlands].

PubMed

Giesen, F; van Erp, N; van Weeghel, J; Michon, H; Kroon, H

2007-01-01

Individual Placement and Support is a vocational rehabilitation programme for people with severe mental illness, which was implemented during the period 2003-2005 at four locations in the Netherlands. To investigate the degree of compliance with the Individual Placement and Support programme, the factors that hindered or facilitated its implementation, and the results. The degree of compliance was assessed using the Individual Placement and Support fidelity scale. Data regarding the factors that hindered or facilitated the implementation were collected via interviews and monitoring. In addition, data were collected on patient characteristics, the support provided and the jobs found. None of the locations achieved the highest level of compliance, although two locations came close. Eighteen per cent of the 316 patients were helped to find a regular job. The most important obstacles to implementation were loss of vocational team members, project leaders' lack of time, lack of finance, and insufficient cooperation between the organisations involved. The most important facilitating factors were the skills and commitment of the vocational team member(s) and the integration of the vocational teammember(s) and the mental health team. It is not easy to implement Individual Placement and Support. However, if more attention is given to good project management, Individual Placement and Support can succeed in the Netherlands.

Legal frameworks and key concepts regulating diversion and treatment of mentally disordered offenders in European Union member states.

PubMed

Dressing, Harald; Salize, Hans Joachim; Gordon, Harvey

2007-10-01

There is only limited research on the various legal regulations governing assessment, placement and treatment of mentally ill offenders in European Union member states (EU-member states). To provide a structured description and cross-boundary comparison of legal frameworks regulating diversion and treatment of mentally disordered offenders in EU-member states before the extension in May 2004. A special focus is on the concept of criminal responsibility. Information on legislation and practice concerning the assessment, placement and treatment of mentally ill offenders was gathered by means of a detailed, structured questionnaire which was filled in by national experts. The legal regulations relevant for forensic psychiatry in EU-member states are outlined. Definitions of mental disorders given within these acts are introduced and compared with ICD-10 diagnoses. Finally the application of the concept of criminal responsibility by the law and in routine practice is presented. Legal frameworks for the processing and placement of mentally disordered offenders varied markedly across EU-member states. Since May 2004 the European Union has expanded to 25 member states and in January 2007 it will reach 27. With increasing mobility across Europe, the need for increasing trans-national co-operation is becoming apparent in which great variation in legal tradition pertains.

Training Needs of School Board Members in the State of Missouri

ERIC Educational Resources Information Center

Rossmiller, Susan; O'Brien, Melody F.

2013-01-01

This project examined the training needs of school board members in the state of Missouri. Of the 520 school districts in Missouri, 382 are members of the Missouri School Boards Association (MSBA). The school board members of the MSBA schools were surveyed in this project. Data was gathered relating to the training needs of board members with 1 to…

Correlates of self-reported exposure to advertising of tobacco products and electronic cigarettes across 28 European Union member states

PubMed Central

Filippidis, Filippos T; Laverty, Anthony A; Fernandez, Esteve; Mons, Ute; Tigova, Olena; Vardavas, Constantine I

2017-01-01

Background Despite advertising bans in most European Union (EU) member states, outlets for promotion of tobacco products and especially e-cigarettes still exist. This study aimed to assess the correlates of self-reported exposure to tobacco products and e-cigarettee advertising in the EU. Methods We analysed data from wave 82.4 of the Eurobarometer survey (November–December 2014), collected through interviews in 28 EU member states (n=27 801 aged ≥15 years) and data on bans of tobacco advertising extracted from the Tobacco Control Scale (TCS, 2013). We used multilevel logistic regression to assess sociodemographic correlates of self-reported exposure to any tobacco and e-cigarette advertisements. Results 40% and 41.5% of the respondents reported having seen any e-cigarette and tobacco product advertisement respectively within the past year. Current smokers, males, younger respondents, those with financial difficulties, people who had tried e-cigarettes and daily internet users were more likely to report having seen an e-cigarette and a tobacco product advertisement. Respondents in countries with more comprehensive advertising bans were less likely to self-report exposure to any tobacco advertisements (OR 0.87; 95% CI 0.79 to 0.96 for one-unit increase in TCS advertising score), but not e-cigarette advertisements (OR 1.08; 95% CI 0.95 to 1.22). Conclusion Ten years after ratification of the Framework Convention for Tobacco Control, self-reported exposure to tobacco and e-cigarette advertising in the EU is higher in e-cigarette and tobacco users, as well as those with internet access. The implementation of the Tobacco Products Directive may result in significant changes in e-cigarette advertising, therefore improved monitoring of advertising exposure is required in the coming years. PMID:28607098

Regulations applicable to plant food supplements and related products in the European Union.

PubMed

Silano, Vittorio; Coppens, Patrick; Larrañaga-Guetaria, Ainhoa; Minghetti, Paola; Roth-Ehrang, René

2011-12-01

This paper deals with the current regulatory and legal settings of traditional plant food supplements and herbal medicinal products in the European Union (EU). Marketing of botanicals in foods and food supplements in the EU is subject to several provisions of food law, which cover aspects of safety, production, labelling and product composition, including the use of additives and maximum levels of contaminants and residues. However, due to limited harmonization at the EU level, specific national regulations adopted at a Member State level also apply and mutual recognition is the mechanism through which such products can be marketed in EU countries other than those of origin. Unlike food supplements, marketing of traditional herbal medicinal products is regulated by an ad hoc Directive (i.e. Directive 2004/24/EC) covering in detail all the relevant aspects of these products, including a facilitated registration procedure at national level. However, by distinguishing traditional herbal medicinal products from plant food supplements and establishing selective marketing modalities for these two product categories, the EU has been confronted with implementation difficulties for traditional herbal medicinal products and a lack of homogeneity in the regulatory approaches adopted in different EU Member States. In fact, currently the nature of the commercial botanical products made available to consumers as traditional medicinal products or food supplements, depends largely on the EU Member State under consideration as a consequence of how competent National Authorities and manufacturing companies interpret and apply current regulations rather than on the intrinsic properties of the botanical products and their constituents. When the EU approach is compared with approaches adopted in some non-European countries to regulate these product categories, major differences become evident.

Agricultural policy, food policy, and communicable disease policy.

PubMed

Grant, Wyn

2012-12-01

Food and agricultural policy is an essential element of a communicable disease policy. The European Union has developed a more systematic and broadly based interest in questions of food safety and animal health and welfare linked to modernization of the Common Agricultural Policy, reflected in a new treaty obligation on animal welfare. Following the bovine spongiform encephalopathy crisis, moves were made to create a European competency, but implementation and enforcement resources reside with the member states. The European Animal Health Strategy is meant to lead to an EU animal health law, but this has already been constrained by fiscal austerity. The development of such a law may lead to a lowest common denominator formula that does little to enhance consumer protection or improve animal welfare. This is an inherent risk with top-down forms of Europeanization; more attention should be paid to lessons to be learned from bottom-up initiatives of the type used to counteract the bovine diarrhea virus. There will always be a tension among what is good policy for reducing the incidence of communicable disease, policy that is popular with EU citizens, and policy that is acceptable to member states.

Elaboration of a global strategy for containing microbial drug resistance.

PubMed

Zabicki, W

2001-01-01

The World Health Organization is engaged in developing the Global Strategy for Containment of Antimicrobial Resistance. The preliminary document WHO/CDC/CSR/DRS/2000.I Draft has already been distributed, and remarks have been solicited.
The World Health Assembly Resolution of 1998 urged Member States to encourage the appropriate and cost-effective use of antimicrobials. Member States were requested to implement effective systems of microbial resistance surveillance and to monitor volumes and patterns of antimicrobial drug use.
The phenomenon of antimicrobial resistance is rising rapidly and causing growing international concern. Many countries have undertaken their own national plans to address the problem.
The overall aim of the strategy being developed is to find the most effective forms and to prevent the spread of antimicrobial resistance and resistant microbes. The strategy covers the following topics: patients and general community, prescribers, hospitals, veterinarians, manufacturers and drug dispensers, and international aspects.
The strategy is being developed on the basis of expert opinions, published reports, reviews of specific topics specially commissioned by various international and national bodies, and a large body of literature with a list of publications containing over 100 items.

Identifying components for programmatic latent tuberculosis infection control in the European Union

PubMed Central

Sandgren, Andreas; Vonk Noordegraaf-Schouten, Jannigje M; Oordt-Speets, Anouk M; van Kessel, Gerarda B; de Vlas, Sake J; van der Werf, Marieke J

2016-01-01

Individuals with latent tuberculosis infection (LTBI) are the reservoir of Mycobacterium tuberculosis in a population and as long as this reservoir exists, elimination of tuberculosis (TB) will not be feasible. In 2013, the European Centre for Disease Prevention and Control (ECDC) started an assessment of benefits and risks of introducing programmatic LTBI control, with the aim of providing guidance on how to incorporate LTBI control into national TB strategies in European Union/European Economic Area (EU/EEA) Member States and candidate countries. In a first step, experts from the Member States, candidate countries, and international and national organisations were consulted on the components of programmatic LTBI control that should be considered and evaluated in literature reviews, mathematical models and cost-effectiveness studies. This was done through a questionnaire and two interactive discussion rounds. The main components identified were identification and targeting of risk groups, determinants of LTBI and progression to active TB, optimal diagnostic tests for LTBI, effective preventive treatment regimens, and to explore the potential for combining LTBI control with other health programmes. Political commitment, a solid healthcare infrastructure, and favourable economic situation in specific countries were identified as essential to facilitate the implementation of programmatic LTBI control. PMID:27589214

[The eradication of the poliomyelitis in the European Region of the World Health Organization].

PubMed

Limia Sánchez, Aurora

2013-01-01

Poliomyelitis was considered an important event for the public health since the end of XIX century when this disease became epidemic. As soon as vaccines were available member states of the World Health Organization (WHO) in the European Region started to implement vaccination programmes against polio with an important impact in the incidence in this disease. In May 1988, the World Health Assembly resolution for the global eradication of poliomyelitis was adopted and the mechanisms to oversee the progress in the different WHO Regions were established. This article briefly reviews the history of polio in the WHO European Region, the process for certification and maintenance, the strategies for eradication and the current situation in the European Region and globally. The European Region was certified polio-free in 2002. Nevertheless, there are still three endemic countries in the world, some others use live attenuated vaccines as well as countries in the Horn of Africa are recently suffering the reintroduction of wild poliovirus. Considering these circumstances, the risk of reintroduction of poliovirus and the generation of outbreaks in the European Region exists, therefore high vaccination coverage against polio and good quality surveillance systems are needed to be guaranteed in every member state.

A viewpoint on the approval context of strategic environmental assessments

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

Kontic, Branko; Kontic, Davor, E-mail: davor.kontic@ijs.si

A reflection on the last report from the Commission to the Council, the European Parliament, the European Economic and Social Committee and the Committee of the Regions on the application and effectiveness of the Directive on Strategic Environmental Assessment (SEA) is provided. It covers the inadequacies of the approval/permitting context of SEA, which appears to be increasingly applied by a significant number of Member States in recent years. A viewpoint is provided on the main deficiencies of such praxis. As a practical defence of the planning context of SEA, the authors propose that the EC should consider a clear recommendationmore » to Member States to cease performing SEA in the approval/permitting context until proper amendments to the SEA Directive are made and implemented. - Highlights: Black-Right-Pointing-Pointer Administrative and permitting context of SEA, has ousted the primary environmental impact assessment goal. Black-Right-Pointing-Pointer The approval context moves from the environmental protection to the area of political power and economy. Black-Right-Pointing-Pointer SEA and EIA are misused. Black-Right-Pointing-Pointer Environmental evaluations should be used for improving the projects/plans/programmes and not for permitting them.« less

Preferences of Current and Potential Patients and Family Members Regarding Implementation of Electronic Communication Portals in Intensive Care Units.

PubMed

Brown, Samuel M; Bell, Sigall K; Roche, Stephanie D; Dente, Erica; Mueller, Ariel; Kim, Tae-Eun; O'Reilly, Kristin; Lee, Barbara Sarnoff; Sands, Ken; Talmor, Daniel

2016-03-01

The quality of communication with patients and family members in intensive care units (ICUs) is a focus of current interest for clinical care improvement. Electronic communication portals are commonly used in other healthcare settings to improve communication. We do not know whether patients and family members desire such portals in ICUs, and if so, what functionality they should provide. To define interest in and desired elements of an electronic communication portal among current and potential ICU patients and their family members. We surveyed, via an Internet panel, 1,050 English-speaking adults residing in the United States with a personal or family history of an ICU admission within 10 years (cohort A) and 1,050 individuals without a history of such admission (cohort B). We also administered a survey instrument in person to 105 family members of patients currently admitted to ICUs at an academic medical center in Boston (cohort C). Respondents, especially current ICU family members, supported an electronic communication portal, including access via an electronic tablet. They wanted at least daily updates, one-paragraph summaries of family meetings including a list of key decisions made, and knowledge of the role and experience of treating clinicians. Overall, they preferred detailed rather than "big picture" information. Respondents were generally comfortable sharing information with their family members. Preferences regarding a communication portal varied significantly by age, sex, ethnicity, and prior experience with ICU hospitalization. Electronic communication portals appear welcome in contemporary ICUs. Frequent updates, knowledge about the professional qualifications of clinicians, detailed medical information, and documentation of family meetings are particularly desired.

Perspectives of Family Members of People with an Intellectual Disability to a Major Reconfiguration of Living Arrangements for People with Intellectual Disability in Ireland

ERIC Educational Resources Information Center

O'Doherty, Siobhain; Linehan, Christine; Tatlow-Golden, Mimi; Craig, Sarah; Kerr, Mike; Lynch, Christy; Staines, Anthony

2016-01-01

Aim: To document the views of family members of people with an intellectual disability regarding implementation of a personalized model of social support in Ireland. Method: Forty family members participated in six focus groups. Data were thematically analysed. Results: Family members' preference for particular types of living arrangements were…

Expansion of Nature Conservation Areas: Problems with Natura 2000 Implementation in Poland?

PubMed Central

Cent, Joanna

2010-01-01

In spite of widespread support from most member countries’ societies for European Union policy, including support for the sustainable development idea, in many EU countries the levels of acceptance of new environmental protection programmes have been and, in particular in new member states, still are considerably low. The experience of the countries which were the first to implement union directives show that they cannot be effectively applied without widespread public participation. The goal of this study was, using the example of Poland, to assess public acceptance of the expansion of nature conservation in the context of sustainable development principles and to discover whether existing nature governance should be modified when establishing new protected areas. The increase in protected areas in Poland has become a hotbed of numerous conflicts. In spite of the generally favourable attitudes to nature which Polish people generally have, Natura 2000 is perceived as an unnecessary additional conservation tool. Both local authorities and communities residing in the Natura areas think that the programme is a hindrance, rather than a help in the economic development of municipalities or regions, as was initially supposed. This lack of acceptance results from many factors, mainly social, historic and economic. The implications of these findings for current approach to the nature governance in Poland are discussed. PMID:21107836

Vernal Pool Conservation in Connecticut: An Assessment and Recommendations

NASA Astrophysics Data System (ADS)

Preisser, Evan L.; Kefer, Jennifer Yelin; Lawrence, Jessica D.; Clark, Tim W.

2000-11-01

Vernal pools, a variety of ephemeral wetlands, are threatened in many areas of the United States. As habitat fragmentation and degradation increase, some vernal pool amphibian species are declining in numbers. Uneven implementation of state regulations further hampers effective conservation. To prevent further species decline and vernal pool loss, we evaluated alternatives for improving vernal pool conservation. We used transcripts from a recent vernal pool conference, interviews with members of relevant interest groups, and a literature review to determine opportunities for and constraints on improving vernal pool conservation policy. Participants from different interest groups had very diverse views about appropriate protection strategies. We have examined these different perspectives and alternatives and offer policy recommendations on both the state and local level. These recommendations can foster awareness of vernal pools as unique habitats, increase protection of these areas, and expand citizen participation in the vernal pool regulatory process.

Disseminating Innovations in Teaching Value-Based Care Through an Online Learning Network.

PubMed

Gupta, Reshma; Shah, Neel T; Moriates, Christopher; Wallingford, September; Arora, Vineet M

2017-08-01

A national imperative to provide value-based care requires new strategies to teach clinicians about high-value care. We developed a virtual online learning network aimed at disseminating emerging strategies in teaching value-based care. The online Teaching Value in Health Care Learning Network includes monthly webinars that feature selected innovators, online discussion forums, and a repository for sharing tools. The learning network comprises clinician-educators and health system leaders across North America. We conducted a cross-sectional online survey of all webinar presenters and the active members of the network, and we assessed program feasibility. Six months after the program launched, there were 277 learning community members in 22 US states. Of the 74 active members, 50 (68%) completed the evaluation. Active members represented independently practicing physicians and trainees in 7 specialties, nurses, educators, and health system leaders. Nearly all speakers reported that the learning network provided them with a unique opportunity to connect with a different audience and achieve greater recognition for their work. Of the members who were active in the learning network, most reported that strategies gleaned from the network were helpful, and some adopted or adapted these innovations at their home institutions. One year after the program launched, the learning network had grown to 364 total members. The learning network helped participants share and implement innovations to promote high-value care. The model can help disseminate innovations in emerging areas of health care transformation, and is sustainable without ongoing support after a period of start-up funding.

Implementing a mission-based reporting system at an academic health center: a method for mission enhancement.

PubMed

Howell, Lydia Pleotis; Hogarth, Michael A; Anders, Thomas F

2003-06-01

To describe the utility of school-wide use of mission-based reporting (MBR) for medical school deans and department chairs. All faculty members in the University of California, Davis, School of Medicine reported their clinical, creative, teaching, and service activities for 2000-2001 to the MBR system. The authors report on school-wide and department MBR profiles, and profiles by rank and academic series. They validate MBR by comparing individual results with actual merit actions reviewed independently by the school's academic personnel committee. A total of 419 faculty members (85%) completed their MBR reports. The average faculty member spent considerably more than 50 hours per week fulfilling the missions of the school, and full professors and faculty members in academic series supported by state funds were the most productive in investigative and creative work. The teaching load was shared equally by all the academic ranks, although the clinician-scholars taught more than did faculty members in the other series. There was an inverse relationship between clinical load and academic rank, with the majority of the clinical work performed by junior faculty members. MBR results compared favorably with the merit review process, although MBR is not expected to replace the traditional peer review system. The creation of these graphic profiles and summaries is a valuable feature of MBR that would not have been possible without such quantitative data. The profiles allow monitoring to ensure that workload conforms to established objectives for individuals, departments, academic ranks and series. Finally, the authors discuss future directions for their MBR system.

Legal Background of Aviation Medicine in Europe and its future development

PubMed Central

Siedenburg, J

2008-01-01

European aviation is moving into an exciting phase now, the administrative structure is changing. Aviation rules and aviation medicine will get a new structure as well. The nature of air traffic required an international scope in rulemaking – especially in such a confined continent as Europe with 41 countries, about 380 Million inhabitants and 317 billion person kilometres flown each year. For economic reasons it became necessary to develop common standards for certification of aircraft in the beginning of the 1970ies, maintenance followed later on. The Cyprus arrangement of 01 July 1990 created the JAA (Joint Aviation Authorities). Joint Aviation Requirements were drafted to replace existing national provisions and have been implemented from the end of the 1990ies. The areas of air operations and pilot licensing have been covered as well. The latter comprises of aviation medicine as well. The implementation of JAR-FCL 3, which covers the medical requirements for pilots, started from 1999 on in the several JAA member states. A detailed overview about development and structure of JAA, tools for harmonisation, rulemaking and amendment of requirements, medical standards, review procedures for contentious or marginal cases is described. Shortcomings were the fact that implementation was left to the discretion of the member states and that JAA had no executive power. This resulted in differences in safety and the EU commission concluded that aviation safety had to be regulated by the EU commission. After adoption of EU regulation 1592/2002 in 2002 common and binding requirements were to be drafted and a European aviation agency to be founded. EASA (European Aviation Safety Agency) started its work in September 2003. Finally it will take over the role of JAA completely. Whereas Certification and Maintenance were in the focus first, Flight Operations and Licensing are going to be covered as well in the near future. Essential Requirements have been drafted, outlining – inter alia – the scope of Licensing and of aeromedical aspects. However, the legislative process will most probably last at least until the end of 2007. Implementing Rules - being based on existing JAR-FCLs will be drafted soon and are going to be implemented as soon as EASA is operative for Licensing. JAR-FCL 3 will be the basis for the Implementing Rules concerning aeromedical fitness. An overview about the structure of the Agency, rulemaking procedures, philosophy of medical provisions and the transition from JAA to EASA is described. PMID:19048095

Influence network linkages across implementation strategy conditions in a randomized controlled trial of two strategies for scaling up evidence-based practices in public youth-serving systems

PubMed Central

2013-01-01

Background Given the importance of influence networks in the implementation of evidence-based practices and interventions, it is unclear whether such networks continue to operate as sources of information and advice when they are segmented and disrupted by randomization to different implementation strategy conditions. The present study examines the linkages across implementation strategy conditions of social influence networks of leaders of youth-serving systems in 12 California counties participating in a randomized controlled trial of community development teams (CDTs) to scale up use of an evidence-based practice. Methods Semi-structured interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welfare departments. A web-based survey collected additional quantitative data on information and advice networks of study participants. A mixed-methods approach to data analysis was used to create a sociometric data set (n = 176) to examine linkages between treatment and standard conditions. Results Of those network members who were affiliated with a county (n = 137), only 6 (4.4%) were directly connected to a member of the opposite implementation strategy condition; 19 (13.9%) were connected by two steps or fewer to a member of the opposite implementation strategy condition; 64 (46.7%) were connected by three or fewer steps to a member of the opposite implementation strategy condition. Most of the indirect steps between individuals who were in different implementation strategy conditions were connections involving a third non-county organizational entity that had an important role in the trial in keeping the implementation strategy conditions separate. When these entities were excluded, the CDT network exhibited fewer components and significantly higher betweenness centralization than did the standard condition network. Conclusion Although the integrity of the RCT in this instance was not compromised by study participant influence networks, RCT designs should consider how influence networks may extend beyond boundaries established by the randomization process in implementation studies. Trial registration NCT00880126 PMID:24229373

Effects of C5-substituent group on the hydrogen peroxide-mediated tautomerisation of protonated cytosine: a theoretical perspective

NASA Astrophysics Data System (ADS)

Jin, Lingxia; Shi, Shengnan; Zhao, Yang; Luo, Liyang; Zhao, Caibin; Lu, Jiufu; Jiang, Min

2018-02-01

The direct tautomerism (path A) and H2O2 as a catalyst (path B) have been studied in conversion of Cyt2t+ into CytN3+ isomer. The protonated 5-carboxycytosine (5-caCyt) is represented and has been further explored in the presence of H2O2 (path C). In going from a four-membered-ring transition state in the case of the direct tautomerism to the six-membered ring for H2O2, the H2O2 significantly contributes to decreasing the free energy barrier of tautomerisation. Although the carboxylic substituent of 5-carboxycytosine has certain affected on the electron distribution of the pyrimidine ring, the six-membered-ring transition state has not changed. This result illustrates that the C5-carboxylation has no significant effect on the H2O2-mediated isomerisation of Cyt2t+ to CytN3+ isomer. Meanwhile, these paths A-C have been further explored in the presence of two water molecules. Use of implicit solvent models (PCM) does not significantly alter the energetics of water-mediated paths A-C compared to those in gas phase. Furthermore, the rate constant with Wigner tunnelling correction of path A is obviously smaller than those of paths B and C. Finally, the lifetime τ99.9% of paths B and C is 10-5 s, which is implemented by the mechanism of the concerted synchronous double proton transfer.

[Inventive activity of the Departments of Protein Structure and Function, and Molecular Immunology of the Palladin Institute of Biochemistry of NAS of Ukraine. Part II. National breakthrough in the study and diagnostics of human hemostasis system].

PubMed

Lugovska, N E

2016-01-01

The scientists of Protein Structure and Function, and Molecular Immunology Departments of the Palladin Institute of Biochemistry (NAS of Ukraine) under the supervision of member of NASU and NAMSU, prof. S. V. Komisarenko and corresponding member of NASU prof. E. V. Lugovskoy have made the real breakthrough in the field of research of the mechanisms of fibrin polymerization and formation of fibrin framework of thrombi. The immunodiagnostic test-systems for the evaluation of the risk of thrombus formation were developed for the first time. Researches have obtained the monoclonal antibodies to fibrinogen, fibrin, D-dimer and their fragments. These monoclonal antibodies were used as molecular probes for the localization of newly detected fibrin polymerization sites. Obtained antibodies with high affinity interact with fibrinogen, D-dimer and soluble fibrin – main markers of the risk of thrombus formation. They were used for the development of the immunodiagnostic test-systems to quantify these markers in human blood plasma for the evaluation of the state of haemostasis system, detection of prethrombotic states, disseminated intravascular coagulation, detection of thrombosis and monitoring of antithrombotic and fibrinolytic therapy. The successful trial of developed test-systems was carried out in clinics of Ukraine, and the State registration was obtained for the implementation of them into the clinical practice. Presented works were awarded State prize of Ukraine in Science and technology.

Training activities at FSUE 'RADON' and Lomonosov's Moscow state university under practical arrangements with IAEA

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

Batyukhnova, O.G.; Karlina, O.K.; Neveykin, P.P.

The International Education Training Centre (IETC) at Moscow Federal State Unitary Enterprise (FSUE) 'Radon', in co-operation with the International Atomic Energy Agency (IAEA), has developed expertise and provided training to waste management personnel for the last 15 years. Since 1997, the educational system of the enterprise with the support of the IAEA has acquired an international character: more than 470 experts from 35 countries - IAEA Member States completed the professional development. Training is conducted at various thematic courses or fellowships for individual programs and seminars on IAEA technical projects. In June 2008 a direct agreement (Practical Arrangements) has beenmore » signed between FSUE 'Radon' and the IAEA on cooperation in the field of development of new technologies, expert's advice to IAEA Member States, and, in particular, the training of personnel in the field of radioactive waste management (RWM), which opens up new perspectives for fruitful cooperation of industry professionals. A similar agreement - Practical Arrangements - has been signed between Lomonosov's MSU and the IAEA in 2012. In October 2012 a new IAEA two-weeks training course started at Lomonosov's MSU and FSUE 'Radon' in the framework of the Practical Agreements signed. Pre-disposal management of waste was the main topic of the courses. The paper summarizes the current experience of the FSUE 'Radon' in the organization and implementation of the IAEA sponsored training and others events and outlines some of strategic educational elements, which IETC will continue to pursue in the coming years. (authors)« less

12 CFR Appendix B to Part 208 - Capital Adequacy Guidelines for State Member Banks: Tier 1 Leverage Measure

Code of Federal Regulations, 2014 CFR

2014-01-01

... Banks: Tier 1 Leverage Measure B Appendix B to Part 208 Banks and Banking FEDERAL RESERVE SYSTEM BOARD... RESERVE SYSTEM (REGULATION H) Pt. 208, App. B Appendix B to Part 208—Capital Adequacy Guidelines for State... state member banks are outlined in Appendix A to this part. b. The guidelines apply to all state member...

A randomized wait-list controlled analysis of the implementation integrity of team-initiated problem solving processes.

PubMed

Newton, J Stephen; Horner, Robert H; Algozzine, Bob; Todd, Anne W; Algozzine, Kate

2012-08-01

Members of Positive Behavior Interventions and Supports (PBIS) teams from 34 elementary schools participated in a Team-Initiated Problem Solving (TIPS) Workshop and follow-up technical assistance. Within the context of a randomized wait-list controlled trial, team members who were the first recipients of the TIPS intervention demonstrated greater implementation integrity in using the problem-solving processes during their team meetings than did members of PBIS Teams in the Wait-List Control group. The success of TIPS at improving implementation integrity of the problem-solving processes is encouraging and suggests the value of conducting additional research focused on determining whether there is a functional relation between use of these problem-solving processes and actual resolution of targeted student academic and social problems. Copyright © 2012 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

National Enhanced Elevation Assessment at a glance

USGS Publications Warehouse

Snyder, Gregory I.

2012-01-01

Elevation data are essential for hazards mitigation, conservation, infrastructure development, national security, and many other applications. Under the leadership of the U.S. Geological Survey and the member States of the National Digital Elevation Program (NDEP), Federal agencies, State agencies, and others work together to acquire high-quality elevation data for the United States and its territories. New elevation data are acquired using modern technology to replace elevation data that are, on average, more than 30 years old. Through the efforts of the NDEP, a project-by-project data acquisition approach resulted in improved, publicly available data for 28 percent of the conterminous United States and 15 percent of Alaska over the past 15 years. Although the program operates efficiently, the rate of data collection and the typical project specifications are currently insufficient to address the needs of government, the private sector, and other organizations. The National Enhanced Elevation Assessment was conducted to (1) document national-level requirements for improved elevation data, (2) estimate the benefits and costs of meeting those requirements, and (3) evaluate multiple national-level program-implementation scenarios. The assessment was sponsored by the NDEP's member agencies. The study participants came from 34 Federal agencies, agencies from all 50 States, selected local government and Tribal offices, and private and not-for-profit organizations. A total of 602 mission-critical activities were identified that need significantly more accurate data than are currently available. The results of the assessment indicate that a national-level enhanced-elevation-data program has the potential to generate from $1.2 billion to $13 billion in new benefits annually.

32 CFR 144.4 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF THE ARMED FORCES ON STATE AND LOCAL JURIES § 144.4 Policy. It is DoD policy to permit members of... duties. For Service members stationed in the United States, serving on a State or local jury is one such civic obligation. Service members are exempt from jury duty, when it unreasonably would interfere with...

The meaning and measurement of implementation climate

PubMed Central

2011-01-01

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

Towards local implementation of Dutch health policy guidelines: a concept-mapping approach.

PubMed

Kuunders, Theo J M; van Bon-Martens, Marja J H; van de Goor, Ien A M; Paulussen, Theo G W M; van Oers, Hans A M

2017-02-22

To develop a targeted implementation strategy for a municipal health policy guideline, implementation targets of two guideline users [Regional Health Services (RHSs)] and guideline developers of leading national health institutes were made explicit. Therefore, characteristics of successful implementation of the guideline were identified. Differences and similarities in perceptions of these characteristics between RHSs and developers were explored. Separate concept mapping procedures were executed in two RHSs, one with representatives from partner local health organizations and municipalities, the second with RHS members only. A third map was conducted with the developers of the guideline. All mapping procedures followed the same design of generating statements up to interpretation of results with participants. Concept mapping, as a practical implementation tool, will be discussed in the context of international research literature on guideline implementation in public health. Guideline developers consider implementation successful when substantive components (health issues) of the guidelines, content are visible in local policy practice. RHSs, local organizations and municipalities view the implementation process itself within and between organizations as more relevant, and state that usability of the guideline for municipal policy and commitment by officials and municipal managers are critical targets for successful implementation. Between the RHSs, differences in implementation targets were smaller than between RHSs and guideline developers. For successful implementation, RHSs tend to focus on process targets while developers focus more on the thematic contents of the guideline. Implications of these different orientations for implementation strategies are dealt with in the discussion. © The Author 2017. Published by Oxford University Press.

Maintenance of certification: current attitudes of members of the American Society of Neuroradiology.

PubMed

Yousem, D M

2008-02-01

The maintenance of certification (MOC) process has begun in radiology, and many physicians will be affected by it. We sought to assess the compliance with and knowledge of the MOC steps by American Society of Neuroradiology (ASNR) members. An on-line survey was distributed via e-mail to the members of the ASNR for whom e-mail addresses were available. The survey addressed 3 components of the MOC currently implemented: 1) MOC cognitive examinations, 2) self-assessment modules (SAMs), and 3) continuing medical education (CME) credits. The response rate was 1020/2662 (38.3%). Of those responding, 11% stated that they either do not support the MOC examination (8%) or were unaware of it (3%), 21.4% of respondents have completed an SAM module, but >30% were unaware that they had to complete SAMs or did not know where they were offered. Many members will receive most of their 25 required CME hours for 2007 from sources besides the ASNR annual meeting. Of the small proportion of respondents who made comments (247/1020, 24.2%), those about the MOC process were favorable in 6.1% (15/247), unfavorable in 46.6% (115/247), and neutral in 47.4% (117/247). The MOC process remains poorly understood, with limited compliance. The radiology societies should spend additional effort publicizing the requirements and offering support and products aimed at allowing their members to achieve compliance in a reasonable cost-effective fashion.

Planning intensive care unit design using computer simulation modeling: optimizing integration of clinical, operational, and architectural requirements.

PubMed

OʼHara, Susan

2014-01-01

Nurses have increasingly been regarded as critical members of the planning team as architects recognize their knowledge and value. But the nurses' role as knowledge experts can be expanded to leading efforts to integrate the clinical, operational, and architectural expertise through simulation modeling. Simulation modeling allows for the optimal merge of multifactorial data to understand the current state of the intensive care unit and predict future states. Nurses can champion the simulation modeling process and reap the benefits of a cost-effective way to test new designs, processes, staffing models, and future programming trends prior to implementation. Simulation modeling is an evidence-based planning approach, a standard, for integrating the sciences with real client data, to offer solutions for improving patient care.

[Project design and implementation of the fourth national survey Chinese matiera medica resources].

PubMed

Huang, Lu-Qi; Lu, Jian-Wei; Guo, Lan-Ping; Zhang, Xiao-Bo; Zhao, Run-Huai; Zhang, Ben-Gang; Li, Yu; Su, Gang-Qiang; Li, Da-Ning

2013-03-01

The planning of the fourth national survey on Chinese materia medica resources shall follow the requirement of "carrying out the national survey on Chinese materia medica resources, strengthening the construction of Chinese materia medica resources monitoring and information network" which is according to the document issued by the State Council. Based on the responsibilities of State Administration of Traditional Chinese Medicine which is "organizing the survey, promoting the resource-protection, keeping development and rational utilization", combined with the key problems that need to be solved in current medicinal industry, the related instructions issued by central leadership and the recommendations from NPC delegates, CPPCC members and experts, the planning shall make overall plans and top-level design for the new round of national survey on Chinese materia medica resources.

Facebook as a tool for communication, collaboration, and informal knowledge exchange among members of a multisite family health team.

PubMed

Lofters, Aisha K; Slater, Morgan B; Nicholas Angl, Emily; Leung, Fok-Han

2016-01-01

To implement and evaluate a private Facebook group for members of a large Ontario multisite Family Health Team (FHT) to facilitate improved communication and collaboration. Program implementation and subsequent survey of team members. A large multisite FHT in Toronto, Ontario. Health professionals of the FHT. Usage patterns and self-reported perceptions of the Facebook group by team members. At the time of the evaluation survey, the Facebook group had 43 members (37.4% of all FHT members). Activity in the group was never high, and posts by team members who were not among the researchers were infrequent throughout the study period. The content of posts fell into two broad categories: 1) information that might be useful to various team members and 2) questions posed by team members that others might be able to answer. Of the 26 team members (22.6%) who completed the evaluation survey, many reported that they never logged into the Facebook page (16 respondents), and never used it to communicate with team members outside of their own site of practice (19 respondents). Only six respondents reported no concerns with using Facebook as a professional communication tool; the most frequent concerns were regarding personal and patient privacy. The use of social media by health care practitioners is becoming ubiquitous. However, the issues of privacy concerns and determining how to use social media without adding to provider workload must be addressed to make it a useful tool in health care.

Development, implementation, and evaluation of an integrated multidisciplinary Objective Structured Clinical Examination (OSCE) in primary health care settings within limited resources.

PubMed

Abdelaziz, Adel; Hany, Mohamed; Atwa, Hani; Talaat, Wagdy; Hosny, Somaya

2016-01-01

In ordinary circumstances, objective structured clinical examination (OSCE) is a resource-intensive assessment method. In case of developing and implementing multidisciplinary OSCE, there is no doubt that the cost will be greater. Through this study a research project was conducted to develop, implement and evaluate a multidisciplinary OSCE model within limited resources. This research project went through the steps of blueprinting, station writing, resources reallocation, implementation and finally evaluation. The developed model was implemented in the Primary Health Care (PHC) program which is one of the pillars of the Community-Based undergraduate curriculum of the Faculty of Medicine, Suez Canal University (FOM-SCU). Data for evaluation of the implemented OSCE model were derived from two resources. First, feedback of the students and assessors through self-administered questionnaires was obtained. Second, evaluation of the OSCE psychometrics was done. The deliverables of this research project included a set of validated integrated multi-disciplinary and low cost OSCE stations with an estimated reliability index of 0.6. After having this experience, we have a critical mass of faculty members trained on blueprinting and station writing and a group of trained assessors, facilitators and role players. Also there is a state of awareness among students on how to proceed in this type of OSCE which renders future implementation more feasible.

7 CFR 1466.24 - EQIP payments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... members of the legal entity and joint operation and associated embedded entities, along with the members... production, a participant will develop and implement an organic system plan as defined in § 1466.3. (8...

7 CFR 1466.24 - EQIP payments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... members of the legal entity and joint operation and associated embedded entities, along with the members... production, a participant will develop and implement an organic system plan as defined in § 1466.3. (8...

7 CFR 1466.24 - EQIP payments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... members of the legal entity and joint operation and associated embedded entities, along with the members... production, a participant will develop and implement an organic system plan as defined in § 1466.3. (8...

7 CFR 1466.24 - EQIP payments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... members of the legal entity and joint operation and associated embedded entities, along with the members... production, a participant will develop and implement an organic system plan as defined in § 1466.3. (8...

Impacts on industry of Europe's emerging chemicals policy REACh.

PubMed

Angerer, Gerhard; Nordbeck, Ralf; Sartorius, Christian

2008-03-01

For Europe, a new regime in chemicals regulation is about to start. After the proposal of the European Commission concerning the Registration, Evaluation and Authorization of Chemicals (REACh) passed its readings in the European Parliament and some differences with the European Council of Ministers were resolved, the regulation will come into force in June 2007. This paper is focused on the question how serious the cost burdens for industry induced by REACh will be, and whether the New European Member States (NMS) which joined the European Union in May 2004 will be able to cope with the regulation. This evaluation has been done by assessing the legislative, administrative and economic framework in New Member States and by analysing real business cases in companies. The empirical showcase business impact studies are at the same time of interest for companies of EU-15 states, other European countries who may implement the regulation, and even for exporters of raw materials and chemicals outside Europe, who will also have to comply with REACh if they market in the European Community. The results give no indications that REACh adoption will bring significant drawbacks to companies in the NMS. The emerging regulation will bring challenges for individual companies, especially for small and medium-sized ones, but for the European chemical industry as a whole, there is no question that it will be able to cope with REACh burdens without losing its global competitiveness.

Correlates of self-reported exposure to advertising of tobacco products and electronic cigarettes across 28 European Union member states.

PubMed

Filippidis, Filippos T; Laverty, Anthony A; Fernandez, Esteve; Mons, Ute; Tigova, Olena; Vardavas, Constantine I

2017-12-01

Despite advertising bans in most European Union (EU) member states, outlets for promotion of tobacco products and especially e-cigarettes still exist. This study aimed to assess the correlates of self-reported exposure to tobacco products and e-cigarettee advertising in the EU. We analysed data from wave 82.4 of the Eurobarometer survey (November-December 2014), collected through interviews in 28 EU member states (n=27 801 aged ≥15 years) and data on bans of tobacco advertising extracted from the Tobacco Control Scale (TCS, 2013). We used multilevel logistic regression to assess sociodemographic correlates of self-reported exposure to any tobacco and e-cigarette advertisements. 40% and 41.5% of the respondents reported having seen any e-cigarette and tobacco product advertisement respectively within the past year. Current smokers, males, younger respondents, those with financial difficulties, people who had tried e-cigarettes and daily internet users were more likely to report having seen an e-cigarette and a tobacco product advertisement. Respondents in countries with more comprehensive advertising bans were less likely to self-report exposure to any tobacco advertisements (OR 0.87; 95% CI 0.79 to 0.96 for one-unit increase in TCS advertising score), but not e-cigarette advertisements (OR 1.08; 95% CI 0.95 to 1.22). Ten years after ratification of the Framework Convention for Tobacco Control, self-reported exposure to tobacco and e-cigarette advertising in the EU is higher in e-cigarette and tobacco users, as well as those with internet access. The implementation of the Tobacco Products Directive may result in significant changes in e-cigarette advertising, therefore improved monitoring of advertising exposure is required in the coming years. © 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.

Advocacy Coalitions involved in California’s Menu Labeling Policy Debate: Exploring Coalition Structure, Policy Beliefs, Resources, and Strategies

PubMed Central

Payán, Denise D.; Lewis, LaVonna B.; Cousineau, Michael R.; Nichol, Michael B.

2017-01-01

Advocacy coalitions often play an important role in the state health policymaking process, yet little is known about their structure, composition, and behavior. In 2008, California became the first state to enact a menu labeling law. Using the advocacy coalition framework, we examine different facets of the coalitions involved in California’s menu labeling policy debate. We use a qualitative research approach to identify coalition members and explore their expressed beliefs and policy arguments, resources, and strategies by analyzing legislative documents (n=87) and newspaper articles (n=78) produced between 1999 and 2009. Between 2003 and 2008, six menu labeling bills were introduced in the state’s legislature. We found the issue received increasing media attention during this period. We identified two advocacy coalitions involved in the debate—a public health (PH) coalition and an industry coalition. State organizations acted as coalition leaders and participated for a longer duration than elected officials. The structure and composition of each coalition varied. PH coalition leadership and membership notably increased compared to the industry coalition. The PH coalition, led by nonprofit PH and health organizations, promoted a clear and consistent message around informed decision making. The industry coalition, led by a state restaurant association, responded with cost and implementation arguments. Each coalition used various resources and strategies to advance desired outcomes. PH coalition leaders were particularly effective at using resources and employing advocacy strategies, which included engaging state legislators as coalition members, using public opinion polls and information, and leveraging media resources to garner support. Policy precedence and a local policy push emerged as important policymaking strategies. Areas for future research on the state health policymaking process are discussed. PMID:28161674

32 CFR 884.15 - Procedures involving a request by Federal or state authorities for custody of an overseas...

Code of Federal Regulations, 2013 CFR

2013-07-01

... state authorities for custody of an overseas civilian employee or a command-sponsored family member. 884... or a command-sponsored family member. (a) The procedures of this section apply to civilian employees..., and to command-sponsored family members residing outside the United States. (b) This section applies...

32 CFR 884.15 - Procedures involving a request by Federal or state authorities for custody of an overseas...

Code of Federal Regulations, 2012 CFR

2012-07-01

... state authorities for custody of an overseas civilian employee or a command-sponsored family member. 884... or a command-sponsored family member. (a) The procedures of this section apply to civilian employees..., and to command-sponsored family members residing outside the United States. (b) This section applies...

32 CFR 884.15 - Procedures involving a request by Federal or state authorities for custody of an overseas...

Code of Federal Regulations, 2014 CFR

2014-07-01

... state authorities for custody of an overseas civilian employee or a command-sponsored family member. 884... or a command-sponsored family member. (a) The procedures of this section apply to civilian employees..., and to command-sponsored family members residing outside the United States. (b) This section applies...

32 CFR 884.15 - Procedures involving a request by Federal or state authorities for custody of an overseas...

Code of Federal Regulations, 2011 CFR

2011-07-01

... state authorities for custody of an overseas civilian employee or a command-sponsored family member. 884... or a command-sponsored family member. (a) The procedures of this section apply to civilian employees..., and to command-sponsored family members residing outside the United States. (b) This section applies...

32 CFR 884.15 - Procedures involving a request by Federal or state authorities for custody of an overseas...

Code of Federal Regulations, 2010 CFR

2010-07-01

... state authorities for custody of an overseas civilian employee or a command-sponsored family member. 884... or a command-sponsored family member. (a) The procedures of this section apply to civilian employees..., and to command-sponsored family members residing outside the United States. (b) This section applies...

EU Rural Development Policy in the New Member States: Promoting Multifunctionality?

ERIC Educational Resources Information Center

Ramniceanu, Irina; Ackrill, Robert

2007-01-01

European Union (EU) enlargement has seen 10 new member states (NMS) adopt the full range of EU policies. Within this, the rural development arm of the Common Agricultural Policy offers particular points of interest. Member states chose from an extensive list of policy measures developed within the EU15 and intended, in particular, to…

77 FR 9723 - Department of State Performance Review Board Members

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-17

... DEPARTMENT OF STATE [Public Notice: 7802] Department of State Performance Review Board Members In accordance with section 4314(c)(4) of 5 United States Code, the Department of State has appointed the following individuals to the Department of State Performance Review Board for Senior [[Page 9724

76 FR 62893 - Department of State Performance Review Board Members

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

... DEPARTMENT OF STATE [Public Notice: 7639] Department of State Performance Review Board Members In accordance with section 4314(c)(4) of 5 United States Code, the Department of State has appointed the following individuals to the Department of State Performance Review Board for Senior Executive Service...

Feasibility and Outcomes of Implementing a Portfolio Assessment System Alongside a Traditional Grading System.

PubMed

O'Brien, Celia Laird; Sanguino, Sandra M; Thomas, John X; Green, Marianne M

2016-11-01

Portfolios are a powerful tool to collect and evaluate evidence of medical students' competence across time. However, comprehensive portfolio assessment systems that are implemented alongside traditional graded curricula at medical schools in the United States have not been described in the literature. This study describes the development and implementation of a longitudinal competency-based electronic portfolio system alongside a graded curriculum at a relatively large U.S. medical school. In 2009, the authors developed a portfolio system that served as a repository for all student assessments organized by competency domain. Five competencies were selected for a preclerkship summative portfolio review. Students submitted reflections on their performance. In 2014, four clinical faculty members participated in standard-setting activities and used expert judgment and holistic review to rate students' competency achievement as "progressing toward competence," "progressing toward competence with some concern," or "progressing toward competence pending remediation." Follow-up surveys measured students' and faculty members' perceptions of the process. Faculty evaluated 156 portfolios and showed high levels of agreement in their ratings. The majority of students achieved the "progressing toward competence" benchmark in all competency areas. However, 31 students received at least one concerning rating, which was not reflected in their course grades. Students' perceptions of the system's ability to foster self-assessment were mixed. The portfolio review process allowed faculty to identify students with a concerning rating in a behavioral competency who would not have been identified in a traditional grading system. Identification of these students allows for intervention and early remediation.

Management of Energy Consumption on Cluster Based Routing Protocol for MANET

NASA Astrophysics Data System (ADS)

Hosseini-Seno, Seyed-Amin; Wan, Tat-Chee; Budiarto, Rahmat; Yamada, Masashi

The usage of light-weight mobile devices is increasing rapidly, leading to demand for more telecommunication services. Consequently, mobile ad hoc networks and their applications have become feasible with the proliferation of light-weight mobile devices. Many protocols have been developed to handle service discovery and routing in ad hoc networks. However, the majority of them did not consider one critical aspect of this type of network, which is the limited of available energy in each node. Cluster Based Routing Protocol (CBRP) is a robust/scalable routing protocol for Mobile Ad hoc Networks (MANETs) and superior to existing protocols such as Ad hoc On-demand Distance Vector (AODV) in terms of throughput and overhead. Therefore, based on this strength, methods to increase the efficiency of energy usage are incorporated into CBRP in this work. In order to increase the stability (in term of life-time) of the network and to decrease the energy consumption of inter-cluster gateway nodes, an Enhanced Gateway Cluster Based Routing Protocol (EGCBRP) is proposed. Three methods have been introduced by EGCBRP as enhancements to the CBRP: improving the election of cluster Heads (CHs) in CBRP which is based on the maximum available energy level, implementing load balancing for inter-cluster traffic using multiple gateways, and implementing sleep state for gateway nodes to further save the energy. Furthermore, we propose an Energy Efficient Cluster Based Routing Protocol (EECBRP) which extends the EGCBRP sleep state concept into all idle member nodes, excluding the active nodes in all clusters. The experiment results show that the EGCBRP decreases the overall energy consumption of the gateway nodes up to 10% and the EECBRP reduces the energy consumption of the member nodes up to 60%, both of which in turn contribute to stabilizing the network.

Soil Erosion map of Europe based on high resolution input datasets

NASA Astrophysics Data System (ADS)

Panagos, Panos; Borrelli, Pasquale; Meusburger, Katrin; Ballabio, Cristiano; Alewell, Christine

2015-04-01

Modelling soil erosion in European Union is of major importance for agro-environmental policies. Soil erosion estimates are important inputs for the Common Agricultural Policy (CAP) and the implementation of the Soil Thematic Strategy. Using the findings of a recent pan-European data collection through the EIONET network, it was concluded that most Member States are applying the empirical Revised Universal Soil Loss Equation (RUSLE) for the modelling soil erosion at National level. This model was chosen for the pan-European soil erosion risk assessment and it is based on 6 input factors. Compared to past approaches, each of the factors is modelled using the latest pan-European datasets, expertise and data from Member states and high resolution remote sensing data. The soil erodibility (K-factor) is modelled using the recently published LUCAS topsoil database with 20,000 point measurements and incorporating the surface stone cover which can reduce K-factor by 15%. The rainfall erosivity dataset (R-factor) has been implemented using high temporal resolution rainfall data from more than 1,500 precipitation stations well distributed in Europe. The cover-management (C-factor) incorporates crop statistics and management practices such as cover crops, tillage practices and plant residuals. The slope length and steepness (combined LS-factor) is based on the first ever 25m Digital Elevation Model (DEM) of Europe. Finally, the support practices (P-factor) is modelled for first time at this scale taking into account the 270,000 LUCAS earth observations and the Good Agricultural and Environmental Condition (GAEC) that farmers have to follow in Europe. The high resolution input layers produce the final soil erosion risk map at 100m resolution and allow policy makers to run future land use, management and climate change scenarios.

Bovine tuberculosis surveillance in cattle and free-ranging wildlife in EU Member States in 2013: a survey-based review.

PubMed

Rivière, J; Carabin, K; Le Strat, Y; Hendrikx, P; Dufour, B

2014-10-10

Bovine tuberculosis (TB) is a common disease in cattle and wildlife, with animal health, zoonotic and economic impacts. Most of the TB data for the European Union (EU) concern the epidemiological situation, but comprehensive descriptions of the way in which surveillance is conducted in each country are rare, despite being essential for cross-Europe comparisons. A European survey was conducted in the 28 Member States and in three other neighboring countries (Norway, Macedonia and Switzerland), to review TB surveillance in cattle and wildlife. EU legislation currently requires TB surveillance solely in cattle. Considerable differences between the surveillance systems of the 26 responding countries were observed, according to the official TB-freedom status of the country and the local prevalence of TB. These differences related principally to the combination of surveillance components (routine screening test in herd and/or movement testing and/or slaughterhouse surveillance), the tests used and their interpretation, and the definition of an infected herd or animal. For wildlife TB surveillance, only 8 on 21 respondent countries have declared to have implemented passive and/or active surveillance, with marked differences concerning the species and the geographical scale of the surveillance. The choice of the combination of surveillance components depends on the national or regional epidemiological situation, the species involved in TB epidemiology and epidemiological risk factors, although various surveillance systems have been recorded for countries with similar epidemiological status. Assessments of the cost-effectiveness of each surveillance system would be useful, to confirm the advantages of implementing one or more components. Copyright © 2014 Elsevier B.V. All rights reserved.

Strengthening radiopharmacy practice in IAEA Member States.

PubMed

Duatti, Adriano; Bhonsle, Uday

2013-05-01

Radiopharmaceuticals are essential components of nuclear medicine procedures. Without radiopharmaceuticals nuclear medicine procedures cannot be performed. Therefore it could be said that 'No radiopharmaceutical-no nuclear medicine.' A good radiopharmacy practice supports nuclear medicine activities by producing radiopharmaceuticals that are safe and are of the required quality in a consistent way. As with any medicinal product, radiopharmaceuticals are required to be produced under carefully controlled conditions and are tested for their quality, prior to the administration to patients, using validated standard operating procedures. These procedures are based on the principles of Good Manufacturing Practice (GMP). The GMP principles are based on scientific knowledge and applicable regulatory requirements and guidance related to radiopharmaceutical productions and use. The International Atomic Energy Agency (IAEA) is committed to promote, in the Member States (MS), a rational and practical approach for the implementation of GMP for compounding or manufacturing of diagnostic or therapeutic radiopharmaceuticals. To pursue this goal the IAEA has developed various mechanisms and collaborations with individual experts in the field and with relevant national and international institutions or organizations. IAEA's activities in promoting radiopharmaceutical science include commissioning expert advice in the form of publications on radiopharmaceutical production, quality control and usage, producing technical guidance on production and regulatory aspects related to new radiopharmaceuticals, creating guidance documentation for self or internal audits of radiopharmaceutical production facilities, producing guidance on implementation of Quality Management System and GMP in radiopharmacy, assisting in creation of specific radiopharmaceutical monographs for the International Pharmacopoeia, and developing radiopharmacy-related human resource capabilities in MS through individual and regional training courses and education programs. IAEA strongly supports development of clinical nuclear medicine services by assisting MS in setting up reliable Radiopharmaceutical production facilities for single photon emission computed tomography, positron emission tomography, and for therapeutic applications. Copyright © 2013 Elsevier Inc. All rights reserved.

[Implementation and results of the EU-wide baseline studies on the prevalence of Salmonella spp. in slaughter and breeding pigs in Austria].

PubMed

Kostenzer, Klaus; Much, Peter; Kornschober, Christian; Lassnig, Heimo; Köfer, Josef

2014-01-01

The Member States of the European Union are following a common strategy on the control of Salmonella and other foodborne pathogens (Anonym, 2003). Within that framework baseline studies on the most relevant animal populations have been carried out. This paper describes the implementation and the results of the baseline studies on Salmonella spp. in slaughter and breeding pigs in Austria. A total of 647 slaughter pigs were sampled in 28 slaughterhouses between October 2006 and September 2007. Samples were taken from the ileocaecal lymphnodes to detect infection in pigs and from the surface of the carcasses to detect contamination. Out of the 617 datasets included in the final analysis, Salmonella prevalences of 2% in lymphnodes and 1.1% on the carcass surface were observed. S. Derby, S. Enteritidis and S. Typhimurium were the three most frequently identified serovars. In an additional study, a total of 252 holdings with breeding pigs has been sampled between January and December combined multiplier herds. Respectively prevalences of 5, 8, 5, 3 and 9.1% were obtained, with S. Typhimurium being the most frequently isolated serovar. Overall, compared to neighbouring Member States a rather low prevalence of Salmonella spp. in pigs was documented for Austria, in particular in slaughter pigs.The serovar distribution seemed to be similar throughout the pig populations, some also being represented in Austrian human isolates. Contamination of feed seems to play a minor role considering the overall low prevalence, but nevertheless has to be taken into account in any future control or monitoring strategy for Salmonella spp. in pigs.

Tobacco industry strategies for influencing European Community tobacco advertising legislation.

PubMed

Neuman, Mark; Bitton, Asaf; Glantz, Stanton

2002-04-13

Restrictions on tobacco company advertising and sponsorship are effective parts of tobacco control programmes worldwide. Through Council Directive 98/43/EC, the European Community (EC) sought to end all tobacco advertising and sponsorship in EC member states by 2006. Initially proposed in 1989, the directive was adopted in 1998, and was annulled by the European Court of Justice in 2000 following a protracted lobbying campaign against the directive by a number of interested organisations including European tobacco companies. A new advertising directive was proposed in May, 2001. We reviewed online collections of tobacco industry documents from US tobacco companies made public under the US Master Settlement Agreement of 1998. Documents reviewed dated from 1978 to 1994 and came from Philip Morris, R J Reynolds, and Brown and Williamson (British American Tobacco) collections. We also obtained approximately 15,000 pages of paper records related to British American Tobacco from its documents' depository in Guildford, UK. This information was supplemented with information in the published literature and consultations with European tobacco control experts. The tobacco industry lobbied against Directive 98/43/EC at the level of EC member state governments as well as on a pan-European level. The industry sought to prevent passage of the directive within the EC legislature, to substitute industry-authored proposals in place of the original directive, and if necessary to use litigation to prevent implementation of the directive after its passage. The tobacco industry sought to delay, and eventually defeat, the EC directive on tobacco advertising and sponsorship by seeking to enlist the aid of figures at the highest levels of European politics while at times attempting to conceal the industry's role. An understanding of these proposed strategies can help European health advocates to pass and implement effective future tobacco control legislation.

An evaluation of public participation in UK river basin management planning

NASA Astrophysics Data System (ADS)

Schmid, M.; Benson, D.

2012-04-01

The EU Water Framework Directive is reshaping multi-level environmental governance structures in many Member States. One area where re-structuring should be highly visible is in regards to public participation in water management. The Directive legally mandates that implementing agencies should make information publicly available relating to river basin management planning, include the public in the planning process and encourage the active involvement of 'interested parties' both during and after the planning stage. Yet critical questions arise over the extent to which these requirements have actually been met in Member States and the outcomes of participatory processes on the ground. In this study, public participation was evaluated in England and Wales by conducting: a) a broad based quantitative survey of the implementation strategy undertaken across all 11 River Basin Districts (RBDs); and, b) an in-depth analysis of the Anglian RBD drawing on theoretical notions of social learning; a critical measure of participatory processes. Results from the survey showed all RBDs complied with the minimum regulatory requirements on public access to information and written consultation, and even went further with provisions for oral consultation and stakeholder engagement. But the focus was clearly on stakeholder groups with little public involvement beyond minimal legally mandated requirements. Analysis of case study data provided some evidence of social learning at every level (instrumental, communicative and transformative) and beyond the individual scale (wider community and organisational learning). Learning was however significantly limited by participant's high level of expertise and environmental awareness. Also apparent was the influence of other factors, operating at various institutional scales, in shaping learning. The paper then speculates on the implications of the findings for both future research and policy, particularly in light of the European Commission's upcoming review of EU water policy.

Changes in dentist and dental hygienist numbers in the European Union and economic area.

PubMed

Widström, E; Eaton, K A; Luciak-Donsberger, C

2010-08-01

To investigate the extent to which changes in the numbers of dental hygienists and dentists have occurred in the Member States of the European Union and Economic Area (EU/EEA) during the last ten years and discuss the changes in relation to the possibilities of sharing tasks between the two groups. Numbers for active dentists, registered hygienists and EU/EEA member state populations in 2007 were taken from the website of the Council of European Chief Dental Officers (CECDO) (www.cecdo.org) and from CECDO records for the EU/EEA member states in 1998 and for the new EU member states (who joined in 2004 and 2007) in 2000. From these data, population: active dentists, population: registered dental hygienist and active dentists: registered dental hygienist ratios were calculated together with percentage changes in the number of dentists and dental hygienists by member state, between 1998 and 2007 for the old and between 2000 and 2007 for the new EU member states. In 2007, there were a total of 343,922 active dentists and 30,963 registered dental hygienists in the 30 EU/EEA member states plus Switzerland. The mean population to dentist ratio was about 1500:1 and the mean population to dental hygienist ratio (in the 25 states where dental hygienists were registered) was 13,454:1. During the study period, the population of the EU/EEA plus Switzerland increased by less that 3%, the number of dentists increased by 13% and the number dental hygienists by 42%. The overall ratio of active dentists: dental hygienists changed from 18:1 to 11:1. In six of the 30 member states plus Switzerland the population to dental hygienist ratio was between 2000:1 and 6000:1 and the dentist: dental hygienist ratio less than 1:3. Although, most member states educate dental hygienists and their numbers in the EU/EEA during the last 10 years have risen more than the dentist numbers, there are still only a handful countries where the hygienist numbers are great enough to make a significant difference to the delivery of oral health care.

77 FR 23298 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... Organizations Report to the Order Audit Trail System Information Barriers Put Into Place by the Member... Amex Equities Rule 5320 to require that member organizations report to the Order Audit Trail System... Amex Equities Rule 5320 provides that if a member organization implements and uses an effective system...

The Use of Collaboration, Authentic Learning, Linking Material to Personal Knowledge, and Technology in the Constructivist Classroom: Interviews with Community College Faculty Members

ERIC Educational Resources Information Center

Zielinski, Dianne E.

2017-01-01

This study explored how faculty members implemented constructivist teaching methods after training. The student-centered teaching methods were interactions and collaborations, authentic learning and real-world experiences, linking material to previously learned information, and using technology in the classroom. Seven faculty members trained in…

Clinical Practice Informs Secure Messaging Benefits and Best Practices.

PubMed

Haun, Jolie N; Hathaway, Wendy; Chavez, Margeaux; Antinori, Nicole; Vetter, Brian; Miller, Brian K; Martin, Tracey L; Kendziora, Lisa; Nazi, Kim M; Melillo, Christine

2017-10-01

Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustained use by VA clinical care team members and veterans. Objectives A collaborative project solicited input from VA clinical care teams about their local practices using SM to provide access to proactive patient-centered care for veterans and enhance workflow. Methods This project implemented a single-item cross-sectional qualitative electronic survey via internal e-mail to local coordinators in all 23 Veterans Integrated Service Networks (VISNs). Content analysis was used to manage descriptive data responses. Descriptive statistics described sample characteristics. Results VA clinical care team members across 15 of 23 VISNs responded to the questionnaire. Content analysis of 171 responses produced two global domains: (1) benefits of SM and (2) SM best practices. Benefits of SM use emphasize enhanced and efficient communication and increased access to care. Care team members incorporate SM into their daily clinical practices, using it to provide services before, during, and after clinical encounters as a best practice. SM users suggest improvements in veteran care, clinical team workflow, and efficient use of health resources. Clinical team members invested in the successful implementation of SM integrate SM into their daily practices to provide meaningful and useful veteran-centered care and improve workflow. Conclusion VA clinical care team members can use SM proactively to create an integrated SM culture. With adequate knowledge and motivation to proactively use this technology, all clinical team members within the VA system can replicate best practices shared by other clinical care teams to generate meaningful and useful interactions with SM to enrich veterans' health care experience.

76 FR 42762 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... authorized by the United States-European Union Air Transport Agreement (``U.S.-E.U. Agreement''), including... from any point(s) behind any Member State(s) of the European Community, via any point(s) in any Member... and any point(s) in any member of the European Common Aviation Area; (iii) other charters pursuant to...

Quality in Higher Education: Perspectives from Front-Line Faculty in the United States

ERIC Educational Resources Information Center

Hall, Molly Reas

2015-01-01

The purpose of this study was to explore perceptions of front-line faculty members in the United States related to quality and quality management in higher education. The study's three research questions were: (1) How do front-line faculty members in the United States define quality in higher education? (2) How do front-line faculty members in the…

77 FR 30508 - Open Meeting To Obtain Input for 2013 DoD 10 Key State Issues Impacting Service Members and Their...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-23

... State Issues Impacting Service Members and Their Families AGENCY: Department of Defense. ACTION: Notice. SUMMARY: The public is invited to attend an open session to consider issues impacting Service members and their families that can best be resolved by state governments. Additionally, the public is invited to...

Transposition and implementation of EU rare disease policy in Eastern Europe.

PubMed

Pejcic, Ana V; Iskrov, Georgi; Raycheva, Ralitsa; Stefanov, Rumen; Jakovljevic, Mihajlo Michael

2017-12-01

А series of European Union (EU) political decisions have made rare diseases one of the cornerstones of the common European health policy. Adopted in 2009, Council Recommendation on an action in the field of rare diseases aimed to serve as a policy-making guideline. However, the implementation report, which followed it, neither performed detailed cross-country comparison, nor assessed the impact of the policies. Areas covered: A 10-indicator set was elaborated to structure the review and to describe rare disease activities in 14 Eastern European countries. Expert commentary: Taking into account all indicators, EU member states outperform candidate and potential candidate countries in terms of rare disease policy planning and implementation. Hungary is the top performer, followed by Bulgaria and Czech Republic. Non-EU countries form the bottom tier, with Serbia being the best ranked among them. While EU adhesion is a major facilitator for planning and adopting rare disease policies, local stakeholders are the triggering factor for their successful implementation. European reference networks are likely to be the future of rare disease activities in the EU. They need to synchronize and closely collaborate with all important EU projects in the field of rare diseases if they are to achieve their objectives.

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

PubMed

Forsyth, Stewart

2013-06-01

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

Setting Housing Standards to Improve Global Health

PubMed Central

Howden-Chapman, Philippa; Roebbel, Nathalie

2017-01-01

Developing World Health Organization international guidelines is a highly formal process. Yet the resulting guidelines, which Member States are encouraged, but not required to adopt, are a powerful way of developing rigorous policy and fostering implementation. Using the example of the housing and health guidelines, which are currently being finalised, this paper outlines the process for developing WHO guidelines. This includes: forming a Guidelines Review Group that represents all regions of the world, and ensures gender balance and technical expertise; identifying key health outcomes of interest; commissioning systematic reviews of the evidence; assessing the evidence; and formulating recommendations. The strength of each recommendation is assessed based on the quality of the evidence, along with consideration of issues such as equity, acceptability, and feasibility of the implementation of the recommendation. The proposed housing guidelines will address: cold and hot indoor temperatures, home injuries, household crowding, accessibility and access to active travel infrastructure. PMID:29232827

Marine spatial planning in Cyprus

NASA Astrophysics Data System (ADS)

Hadjimitsis, Diofantos; Agapiou, Athos; Mettas, Christodoulos; Themistocleous, Kyriacos; Evagorou, Evagoras; Cuca, Branka; Papoutsa, Christiana; Nisantzi, Argyro; Mamouri, Rodanthi-Elisavet; Soulis, George; Xagoraris, Zafiris; Lysandrou, Vasiliki; Aliouris, Kyriacos; Ioannou, Nicolas; Pavlogeorgatos, Gerasimos

2015-06-01

Marine Spatial Planning (MSP), which is in concept similar to land-use planning, is a public process by which the relevant Member State's authorities analyse and organise human activities in marine areas to achieve ecological, economic and social objectives. MSP aims to promote sustainable growth of maritime economies, sustainable development of marine areas and sustainable use of marine resources. This paper highlights the importance of MSP and provides basic outcomes of the main European marine development. The already successful MSP plans can provide useful feedback and guidelines for other countries that are in the process of implementation of an integrated MSP, such as Cyprus. This paper presents part of the MSP project, of which 80% funded by the European Regional Development Fund (ERDF) and 20% from national contribution. An overview of the project is presented, including data acquisition, methodology and preliminary results for the implementation of MSP in Cyprus.

Implementing the European Marine Strategy Framework Directive: Scientific challenges and opportunities

NASA Astrophysics Data System (ADS)

Newton, Alice; Borja, Angel; Solidoro, Cosimo; Grégoire, Marilaure

2015-10-01

The Marine Strategy Framework Directive (MSFD; EC, 2008) is an ambitious European policy instrument that aims to achieve Good Environmental Status (GES) in the 5,720,000 km2 of European seas by 2020, using an Ecosystem Approach. GES is to be assessed using 11 descriptors and up to 56 indicators (European Commission, 2010), and the goal is for clean, healthy and productive seas that are the basis for marine-based development, known as Blue-Growth. The MSFD is one of many policy instruments, such as the Water Framework Directive, the Common Fisheries Policy and the Habitats Directive that, together, should result in "Healthy Oceans and Productive Ecosystems - HOPE". Researchers working together with stakeholders such as the Member States environmental agencies, the European Environmental Agency, and the Regional Sea Conventions, are to provide the scientific knowledge basis for the implementation of the MSFD. This represents both a fascinating challenge and a stimulating opportunity.

Achieving the Framework Convention on Tobacco Control's potential by investing in national capacity.

PubMed

Wipfli, H; Stillman, F; Tamplin, S; da Costa e Silva, V Luiza; Yach, D; Samet, J

2004-12-01

May 2003 marked a critical achievement in efforts to stem the global tobacco epidemic, as the member states of the World Health Organization unanimously endorsed the Framework Convention on Tobacco Control (FCTC). However, the adoption of the FCTC signifies only the end of the beginning of effective global action to control tobacco. Over the next several years the utility of the FCTC process and the treaty itself will be tested as individual countries seek to ratify and implement the treaty's obligations. Significant barriers to the treaty's long term success exist in many countries. It is crucial that the international tobacco control community now refocuses its efforts on national capacity building and ensures that individual countries have the knowledge, tools, data, people, and organisations needed to implement the convention and develop sustained tobacco control programmes. This paper provides a model of national tobacco control capacity and offers a prioritised agenda for action.

Measurement invariance of an instrument assessing sustainability of school-based universal behavior practices.

PubMed

Mercer, Sterett H; McIntosh, Kent; Strickland-Cohen, M Kathleen; Horner, Robert H

2014-06-01

The purpose of the study was to examine the extent to which the School-Wide Universal Behavior Sustainability Index: School Teams (SUBSIST; McIntosh, Doolittle, Vincent, Horner, & Ervin, 2009), a measure of school and district contextual factors that promote the sustainability of school practices, demonstrated measurement invariance across groups of schools that differed in length of time implementing school-wide Positive Behavioral Interventions and Supports (PBIS; Sugai & Horner, 2009), student ethnic composition, and student socioeconomic status (SES). School PBIS team members and district coaches representing 860 schools in 14 U.S. states completed the SUBSIST. Findings supported strong measurement invariance, for all items except 1, of a model with two school-level factors (School Priority and Team Use of Data) and 2 district-level factors (District Priority and Capacity Building) across groups of schools at initial implementation, institutionalization, and sustainability phases of PBIS implementation. Schools in the sustainability phase were rated significantly higher on School Priority and Team Use of Data than schools in initial implementation. Strong measurement invariance held across groups of schools that differed in student ethnicity and SES. The findings regarding measurement invariance are important for future longitudinal investigations of factors that may promote the sustained implementation of school practices. PsycINFO Database Record (c) 2014 APA, all rights reserved.

[The implementation of legislation acts regarding prevention of occupational exposure to bloodborne pathogens from perspective of Poland as the ue country].

PubMed

Szczeniowski, Adam; Gańczak, Maria

2011-01-01

The paper presents the history of implementation of legislation related to prevention of occupational exposure to blood-borne pathogens in the U.S.A. and EU, including a detailed description of existing regulations. The pioneering role of American legislation in establishing relevant legal acts to prevent employees from sharp injuries is also stressed. In this context the European road towards safer work in the healthcare sector is discussed. The legal acts, currently functioning in the EU, including Council Directive 2010/32/EU of 10 May 2010, are described. The Directive implements the Framework Agreement on prevention from sharp injuries in the hospital and healthcare sector concluded by the European Hospital and Healthcare Employers' Association (HOSPEEM) and the European Federation of Public Service Unions (EPSU). The arguments for the universal implementation of legal acts, protecting medical staff in all EU Member States, are pointed out. As far as Poland is concerned, a great need for an urgent action mobilising all social partners (i.e., nurses, doctors, other employees at potential risk of acquiring an occupational infection, employers, professional organisations and scientific bodies) to develop relevant regulations and to assure sufficient funds for their broad implementation is underlined.

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

PubMed

Brooks, Steven C; Morrison, Laurie J

2008-06-01

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

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

Sequis, Julietta E.; Cain, Ronald A.; Burbank, Roberta L.

The Philippines entered into force the International Atomic Energy Agency (IAEA) Additional Protocol (AP) in February 2010. The Philippine Nuclear Research Institute (PNRI) is the government agency responsible for implementing the AP. In June 2010 the IAEA invited the U.S. Department of Energy (DOE) to help conduct a joint national training seminar on the AP. DOE presented to PNRI its AP international technical assistance program, administered by the International Nuclear Safeguards and Engagement Program (INSEP), which helps partner countries implement the AP. In coordination with the IAEA, DOE established this program in 2008 to complement IAEA AP seminars with long-termmore » country-specific cooperation from the perspective of a Member State. The US version of the AP is the same version as that of non-nuclear weapon states except for the addition of a national security exclusion. Due to this, DOE cooperation with other countries enables the sharing of valuable lessons learned in implementing the AP. DOE/INSEP described to PNRI the various areas of cooperation it offers to interested countries, whether they are preparing for entry into force or already implementing the AP. Even countries that have entered the AP into force are sometimes not fully prepared to implement it well, and welcome cooperation to improve their implementation process. PNRI and DOE/INSEP subsequently agreed to cooperate in several areas to enhance the efficiency and effectiveness of the Philippines AP implementation. These areas include providing working-level training to PNRI staff and preparing an information document that details that training for future reference, assisting with the development of an outreach program and procedures for AP reporting and complementary access, and identifying Annex II equipment and non-nuclear materials whose export must be reported under the AP. DOE laboratory representatives, funded by INSEP, met again with PNRI in February 2011 to provide training for PNRI AP staff and investigate specific ways to improve implementation. Another meeting in July 2011 focused on preparations for outreach to industry and universities. In this paper PNRI describes current implementation of the AP in the Philippines, and both DOE/INSEP and PNRI provide their perspectives on their cooperation to enhance that implementation.« less

Promoting public health through state cancer control plans: a review of capacity and sustainability.

PubMed

Ory, Marcia G; Sanner, Brigid; Vollmer Dahlke, Deborah; Melvin, Cathy L

2015-01-01

The Centers for Disease Prevention and Control's National Comprehensive Cancer Control (CCC) Program oversee CCC programs designed to develop and implement CCC plans via CCC coalitions, alliances, or consortia of program stakeholders. We reviewed 40 up-to-date plans for states and the District of Columbia in order to assess how capacity building and sustainability, two evidence-based practices necessary for organizational readiness, positive growth, and maintenance are addressed. We employed an electronic key word search, supplemented by full text reviews of each plan to complete a content analysis of the CCC plans. Capacity is explicitly addressed in just over half of the plans (53%), generally from a conceptual point of view, with few specifics as to how capacity will be developed or enhanced. Roles and responsibilities, timelines for action, and measurements for evaluation of capacity building are infrequently mentioned. Almost all (92%) of the 40 up-to-date plans address sustainability on at least a cursory level, through efforts aimed at funding or seeking funding, policy initiatives, and/or partnership development. However, few details as to how these strategies will be implemented are found in the plans. We present the Texas plan as a case study offering detailed insight into how one plan incorporated capacity building and sustainability into its development and implementation. Training, technical assistance, templates, and tools may help CCC coalition members address capacity and sustainability in future planning efforts and assure the inclusion of capacity building and sustainability approaches in CCC plans at the state, tribal, territorial, and jurisdiction levels.

Commandant's international technical series. Volume 9. International regulations on the prevention of pollution from ships carrying hazardous chemicals in bulk. Final report

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

Not Available

1985-12-01

MARPOL was developed to minimize accidental and operational pollution from ships carrying noxious liquid substances in bulk. Accidental pollution could result from a collision, a grounding, or an overflow of a cargo tank. Operational pollution results from the disposal of cargo tank washings. Major amendments were made to the original Annex II by the International Maritime Organization. The United States and other States party to MARPOL will implement Annex II, as amended, on April 7, 1987. Implementation will affect seagoing ships transporting noxious liquid substances to and from such ships. The attached documents contain internationally agreed requirements, interpretations, and guidelinesmore » necessary for the implementation of Annex II. The documents attached include: (1) MARPOL Annex II as amended by amendments adopted by the twenty-second session of the IMO Marine Environment Protection Committee; (2) Unified Interpretations of Annex II; (3) Standards for the Procedures and Arrangements for the Discharge of Noxious Liquid Substances; (4) Ammendments to the Bulk Chemical Code and the International Bulk Chemical Code to include marine pollution concerns; (5) Guidelines on the Provision of Adequate Reception Facilities in Ports, Part II (Noxious Liquid Substances). The contents of these documents are being placed in regulations. The purpose of this document is to give members of the interested public advance notification of impending regulations.« less

One common way - The strategic and methodological influence on environmental planning across Europe

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

Jiricka, Alexandra, E-mail: alexandra.jiricka@boku.ac.a; Proebstl, Ulrike, E-mail: ulrike.proebstl@boku.ac.a

In the last decades the European Union exerted influence on precautionary environmental planning by the establishment of several Directives. The most relevant were the Habitat-Directive, the EIA-Directive, the SEA-Directive and the Water Framework Directive. Comparing these EU policies in the area of environmental precaution it becomes obvious that there is a lot of common ground. Thus, the conclusion seems likely that the European Union, in doing so, has intended to establish general planning concepts through introducing several methodological steps indicated by the regulations. The goal of this article is firstly to point out, which are the common planning principles, convertedmore » by methodological elements and secondly examine the consideration of these planning concepts by the implementation and application in the member states. In this context it is analysed whether the connections and divergences between the directives lead to significant differences in the implementation process. To this aim the directives are shortly introduced and significant steps of the processes regulated by them are outlined. In the second steps the national legal implementation in the Alpine states and its consequences for the practical application are discussed. The results show a heterogeneous application of the EU principles. Within the comparative view on the four directives influence and causalities between the national implementation and the practical application were identified, which can be simplified as four types. Since a coherent strategic and methodological concept for improving environmental precaution planning from part of the EU is noticeable, more unity and comparability within the implementation is desirable, particularly in areas with comparable habitats such as the alpine space. Beyond this the trade-off between the directives poses an important task for the future.« less

Exploring faculty perceptions towards electronic health records for nursing education.

PubMed

Kowitlawakul, Y; Chan, S W C; Wang, L; Wang, W

2014-12-01

The use of electronic health records in nursing education is rapidly increasing worldwide. The successful implementation of electronic health records for nursing education software program relies on students as well as nursing faculty members. This study aimed to explore the experiences and perceptions of nursing faculty members using electronic health records for nursing education software program, and to identify the influential factors for successful implementation of this technology. This exploratory qualitative study was conducted using in-depth individual interviews at a university in Singapore. Seven faculty members participated in the study. The data were gathered and analysed at the end of the semester in the 2012/2013 academic year. The participants' perceptions of the software program were organized into three main categories: innovation, transition and integration. The participants perceived this technology as innovative, with both values and challenges for the users. In addition, using the new software program was perceived as transitional process. The integration of this technology required time from faculty members and students, as well as support from administrators. The software program had only been implemented for 2-3 months at the time of the interviews. Consequently, the participants might have lacked the necessary skill and competence and confidence to implement it successfully. In addition, the unequal exposure to the software program might have had an impact on participants' perceptions. The findings show that the integration of electronic health records into nursing education curricula is dependent on the faculty members' experiences with the new technology, as well as their perceptions of it. Hence, cultivating a positive attitude towards the use of new technologies is important. Electronic health records are significant applications of health information technology. Health informatics competency should be included as a required competency component in faculty professional development policy and programmes. © 2014 International Council of Nurses.

Family Presence During Resuscitation (FPDR): Observational case studies of emergency personnel in Victoria, Australia.

PubMed

Porter, Joanne E; Miller, Nareeda; Giannis, Anita; Coombs, Nicole

2017-07-01

Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR. One rural and one metropolitan emergency department in the state of Victoria, Australia were observed and data was collected on FPDR events. The participants consisted of resuscitation team members, including; emergency trained nurses, senior medical officers, general nurses and doctors. The participants were not told that the data would be recorded around interactions with family members or team discussions regarding family involvement in the resuscitation, following ethical approval involving limited disclosure of the aims of the study. Seventeen adult presentations (Metro n=9, Rural n=8) were included in this study and will be presented as resuscitation case studies. The key themes identified included ambiguity around resuscitation status, keeping the family informed, family isolation and inter-professional communication. During 17 adult resuscitation cases, staff were witnessed communicating with family, which was often limited and isolation resulted. Family were often uninformed or separated from their family member, however when a family liaison person was available it was found to be beneficial. This research indicated that staff could benefit from a designated family liaison role, formal policy and further education. Copyright © 2016 Elsevier Ltd. All rights reserved.

75 FR 62176 - Department of State Performance Review Board Members

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-07

... accordance with section 4314(c)(4) of 5 United States Code, the Department of State has appointed the... members: James H. Thessin, Chairperson, Deputy Legal Adviser, Office of the Legal Adviser, Department of State; Tracy H. Mahaffey, Executive Director, Bureau of Diplomatic Security, Department of State; Joseph...

Geographic and Age-Based Variations in Medicare Reimbursement Among ASSH Members.

PubMed

Gaspar, Michael P; Kane, Patrick M; Honik, Grace B; Shin, Eon K; Jacoby, Sidney M; Osterman, A Lee

2016-09-01

Background: The purpose of this study was to investigate how American Society for Surgery of the Hand (ASSH) members' Medicare reimbursement depends on their geographical location and number of years in practice. Methods: Demographic data for surgeons who were active members of the ASSH in 2012 were obtained using information publicly available through the US Centers for Medicare and Medicaid Services (CMS). "Hand-surgeons-per-capita" and average reimbursement per surgeon were calculated for each state. Regression analysis was performed to determine a relationship between (1) each state's average reimbursement versus the number of ASSH members in that state, (2) average reimbursement versus number of hand surgeons per capita, and (3) total reimbursement from Medicare versus number of years in practice. Analysis of variance (ANOVA) was used to detect a difference in reimbursement based on categorical range of years as an ASSH member. Results: A total of 1667 ASSH members satisfied inclusion in this study. Although there was significant variation among states' average reimbursement, reimbursement was not significantly correlated with the state's hand surgeons per capita or total number of hand surgeons in that given state. Correlation between years as an ASSH member and average reimbursement was significant but non-linear; the highest reimbursements were seen in surgeons who had been ASSH members from 8 to 20 years. Conclusions: Peak reimbursement from Medicare for ASSH members appears to be related to the time of surgeons' peak operative volume, rather than any age-based bias for or against treating Medicare beneficiaries. In addition, though geographic variation in reimbursement does exist, this does not appear to correlate with density or availability of hand surgeons.

75 FR 79070 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... transportation of persons, property and mail from any point or points behind any Member State of the European Union via any point or points in any Member State and via intermediate points to any point or points in... between any point or points in the United States and any point or points in any member of the European...

75 FR 16226 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-31

... transportation of persons, property and mail from any point or points behind any Member State of the European Union, via any point or points in any Member State and via intermediate points to any point or points in... between any point or points in the United States and any point or points in any member of the European...

Multilevel Governance and Shared Sovereignty: European Union, Member States, and the FCTC

PubMed Central

MAMUDU, HADII M.; STUDLAR, DONLEY T.

2010-01-01

The Westphalian idea of sovereignty in international relations has undergone recent transformation. “Shared sovereignty” through multilevel governance describes the responsibility of the European Union (EU) and its Member States in tobacco control policy. We examine how this has occurred on the EU level through directives and recommendations, accession rules for new members, tobacco control campaigns, and financial support for antitobacco nongovernmental organizations. In particular, the negotiation and ratification of the Framework Convention on Tobacco Control (FCTC) and the participation in the FCTC Conference of the Parties illustrates shared sovereignty. The EU Commission was the lead negotiator for Member States on issues over which it had jurisdiction, while individual Member States, through the EU presidency, could negotiate on issues on which authority was divided or remained with them. Shared sovereignty through multilevel governance has become the norm in the tobacco control policy area for EU members, including having one international organization negotiate within the context of another. PMID:20622934

Interpreting medium ring canonical conformers by a triangular plane tessellation of the macrocycle

NASA Astrophysics Data System (ADS)

Khalili, Pegah; Barnett, Christopher B.; Naidoo, Kevin J.

2013-05-01

Cyclic conformational coordinates are essential for the distinction of molecular ring conformers as the use of Cremer-Pople coordinates have illustrated for five- and six-membered rings. Here, by tessellating medium rings into triangular planes and using the relative angles made between triangular planes we are able to assign macrocyclic pucker conformations into canonical pucker conformers such as chairs, boats, etc. We show that the definition is straightforward compared with other methods popularly used for small rings and that it is computationally simple to implement for complex macrocyclic rings. These cyclic conformational coordinates directly couple to the motion of individual nodes of a ring. Therefore, they are useful for correlating the physical properties of macrocycles with their ring pucker and measuring the dynamic ring conformational behavior. We illustrate the triangular tessellation, assignment, and pucker analysis on 7- and 8-membered rings. Sets of canonical states are given for cycloheptane and cyclooctane that have been previously experimentally analysed.

The Oregon migrant farmworker community: an evolving model for participatory research.

PubMed Central

McCauley, L A; Beltran, M; Phillips, J; Lasarev, M; Sticker, D

2001-01-01

Migrant farmworker communities present distinct challenges that require new approaches for community participation in research. In the State of Oregon an agency that advocates for the migrant farmworker community has collaborated successfully with university researchers to implement a research program directed to reducing pesticide exposures among the children of migrant farmworkers. The research process has included both qualitative research methods with members of the community and quantitative approaches to measure pesticide dust residues in homes, biomarkers of pesticide exposure, and effects on health. A committee of university and community stakeholders advises the research. Evaluative processes have been initiated to assess the effectiveness of the participatory model used in this project. The components of the preliminary process evaluation and results are presented. Evaluative data show that researchers and community members differ on perceptions of community involvement and the extent to which communication problems have been resolved between the two groups. Suggestions for improved community involvement and communication are given. PMID:11427395

34 CFR 403.188 - What is a State's responsibility for the cost of services and activities for members of special...

Code of Federal Regulations, 2012 CFR

2012-07-01

... services and activities for members of special populations? 403.188 Section 403.188 Education Regulations... activities for members of special populations? A State is not required to use non-Federal funds to pay the cost of services and activities that it provides to members of special populations pursuant to § 403.32...

34 CFR 403.188 - What is a State's responsibility for the cost of services and activities for members of special...

Code of Federal Regulations, 2013 CFR

2013-07-01

... services and activities for members of special populations? 403.188 Section 403.188 Education Regulations... activities for members of special populations? A State is not required to use non-Federal funds to pay the cost of services and activities that it provides to members of special populations pursuant to § 403.32...

34 CFR 403.188 - What is a State's responsibility for the cost of services and activities for members of special...

Code of Federal Regulations, 2011 CFR

2011-07-01

... services and activities for members of special populations? 403.188 Section 403.188 Education Regulations... activities for members of special populations? A State is not required to use non-Federal funds to pay the cost of services and activities that it provides to members of special populations pursuant to § 403.32...

34 CFR 403.188 - What is a State's responsibility for the cost of services and activities for members of special...

Code of Federal Regulations, 2014 CFR

2014-07-01

... services and activities for members of special populations? 403.188 Section 403.188 Education Regulations... activities for members of special populations? A State is not required to use non-Federal funds to pay the cost of services and activities that it provides to members of special populations pursuant to § 403.32...

Team-Based Learning in US Colleges and Schools of Pharmacy

PubMed Central

Copeland, Jeffrey; Franks, Andrea S.; Karimi, Reza; McCollum, Marianne; Riese, David J.; Lin, Anne Y.F.

2013-01-01

Objective. To characterize the use of team-based learning (TBL) in US colleges and schools of pharmacy, including factors that may affect implementation and perceptions of faculty members regarding the impact of TBL on educational outcomes. Methods. Respondents identified factors that inhibit or enable TBL use and its impact on student learning. Results were stratified by type of institution (public/private), class size, and TBL experience. Results. Sixty-nine of 100 faculty members (69%) representing 43 (86%) institutions responded. Major factors considered to enable TBL implementation included a single campus and student and administration buy-in. Inhibiting factors included distant campuses, faculty resistance, and lack of training. Compared with traditional lectures, TBL is perceived to enhance student engagement, improve students’ preparation for class, and promote achievement of course outcomes. In addition, TBL is perceived to be more effective than lectures at fostering learning in all 6 domains of Bloom’s Taxonomy. Conclusions. Despite potential implementation challenges, faculty members perceive that TBL improves student engagement and learning. PMID:23966718

Regional Cooperation to Strengthen Safeguards

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

Minnini, Margot; Elkhamri, Oksana O.

2016-06-06

President Obama’s decision over four years ago to ”pivot” toward Asia represented an important strategic shift in American foreign policy and a rebalancing of U.S. economic and security engagement in the Asia-Pacific countries. The United States has since supported a variety of regional initiatives aimed at promoting nuclear security and safeguards. When a new regional organization, the Asia-Pacific Safeguards Network (APSN) was established in 2010, DOE/NNSA became an early member and enthusiastic advocate. Launched on the initiative of Australia, Japan, Republic of Korea, and Indonesia, the APSN aims to strengthen the quality and effectiveness of safeguards implementation in the Asia-Pacificmore » region.« less

The net fiscal impact of a chronic disease management program: Indiana Medicaid.

PubMed

Holmes, Ann M; Ackermann, Ronald D; Zillich, Alan J; Katz, Barry P; Downs, Stephen M; Inui, Thomas S

2008-01-01

In 2003 the Indiana Office of Medicaid Policy and Planning implemented the Indiana Chronic Disease Management Program (ICDMP). This paper reports on the fiscal impact of the ICDMP from the state's perspective, as estimated from the outcomes of a randomized trial. Medicaid members with congestive heart failure (CHF) or diabetes, or both, were randomly assigned by practice site to chronic disease management services or standard care. The effect of the ICDMP varied by disease group and risk class: while cost savings were achieved in the CHF subgroup, disease management targeted to patients with only diabetes resulted in no significant fiscal impact.

The NASA L3 Study

NASA Technical Reports Server (NTRS)

Stebbins, Robin

2016-01-01

The Astrophysics Implementation Plan calls for a minority role in L3, planned for launch in 2034. L3 The third large mission in ESAs Cosmic Visions 2015-2025 Programme NASA and ESA have been discussing a collaboration for 2 years Gravitational Observatory Advisory Team (GOAT) ESA study evaluating and recommend scientific performance tradeoffs, detection technologies, technology development activities, data analysis capabilities, schedule and cost US representatives: Guido Mueller, Mark Kasevich, Bill Klipstein, RTS Started in October 2014, concluding with a final report in late Marchor early April 2016. ESA solicited interest from ESA Member States in November 2015 NASA is continuing technology development support. ESA is restarting technology development activities.

Beyond the One-Hour Outreach Talk: Introducing a Reading and Writing Program into a High School Science Class

NASA Astrophysics Data System (ADS)

Ratay, Douglas L.; Schairer, Ashley; Garland, Catherine A.; Gomez-Martin, Cynthia

We present a discussion of a newly implemented one-year program that brings high-level science reading and writing into a remedial high school science class. In the program, articles from publications such as Scientific American and Astronomy magazines are used to teach current science topics and to reinforce reading and writing skills. These skills are critical for general knowledge, literacy, and for passing state standardized tests. Members of the astronomy community act as "writing coaches" to help guide the students through the reading and writing process. This program illustrates one way that astronomers can become involved with underserved populations.

Civil Commitment for Opioid and Other Substance Use Disorders: Does It Work?

PubMed

Jain, Abhishek; Christopher, Paul; Appelbaum, Paul S

2018-04-01

Many states are turning to civil commitment for substance use disorders as a potential solution to address rising rates of overdose deaths. Civil commitment allows family members or others to seek court-ordered involuntary treatment for a substance-abusing person. In contrast to mandatory treatment ordered by drug courts, civil commitment does not require involvement with the criminal justice system. Although these laws are understandably appealing, statutes and their implementation are highly variable, ethical concerns about deprivation of liberty continue to be raised, and outcome data are limited and often not generalizable. Above all, more studies are needed to determine effectiveness.

Non-hospital based registered nurses and the risk of bloodborne pathogen exposure.

PubMed

Gershon, Robyn R M; Qureshi, Kristine A; Pogorzelska, Monika; Rosen, Jonathan; Gebbie, Kristine M; Brandt-Rauf, Paul W; Sherman, Martin F

2007-10-01

The aim of this study was to assess the risk of blood and body fluid exposure among non-hospital based registered nurses (RNs) employed in New York State. The study population was mainly unionized public sector workers, employed in state institutions. A self-administered questionnaire was completed by a random stratified sample of members of the New York State Nurses Association and registered nurse members of the New York State Public Employees Federation. Results were reviewed by participatory action research (PAR) teams to identify opportunities for improvement. Nine percent of respondents reported at least one needlestick injury in the 12-month period prior to the study. The percutaneous injury (PI) rate was 13.8 per 100 person years. Under-reporting was common; 49% of all PIs were never formally reported and 70% never received any post-exposure care. Primary reasons for not reporting included: time constraints, fear, and lack of information on reporting. Significant correlates of needlestick injuries included tenure, patient load, hours worked, lack of compliance with standard precautions, handling needles and other sharps, poor safety climate, and inadequate training and availability of safety devices (p<0.05). PAR teams identified several risk reduction strategies, with an emphasis on safety devices. Non-hospital based RNs are at risk for bloodborne exposure at rates comparable to hospital based RNs; underreporting is an important obstacle to infection prevention, and primary and secondary risk management strategies appeared to be poorly implemented. Intervention research is warranted to evaluate improved risk reduction practices tailored to this population of RNs.

Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologists.

PubMed

Cannesson, Maxime; Pestel, Gunther; Ricks, Cameron; Hoeft, Andreas; Perel, Azriel

2011-08-15

Several studies have demonstrated that perioperative hemodynamic optimization has the ability to improve postoperative outcome in high-risk surgical patients. All of these studies aimed at optimizing cardiac output and/or oxygen delivery in the perioperative period. We conducted a survey with the American Society of Anesthesiologists (ASA) and the European Society of Anaesthesiology (ESA) to assess current hemodynamic management practices in patients undergoing high-risk surgery in Europe and in the United States. A survey including 33 specific questions was emailed to 2,500 randomly selected active members of the ASA and to active ESA members. Overall, 368 questionnaires were completed, 57.1% from ASA and 42.9% from ESA members. Cardiac output is monitored by only 34% of ASA and ESA respondents (P = 0.49) while central venous pressure is monitored by 73% of ASA respondents and 84% of ESA respondents (P < 0.01). Specifically, the pulmonary artery catheter is being used much more frequently in the US than in Europe in the setup of high-risk surgery (85.1% vs. 55.3% respectively, P < 0.001). Clinical experience, blood pressure, central venous pressure, and urine output are the most widely indicators of volume expansion. Finally, 86.5% of ASA respondents and 98.1% of ESA respondents believe that their current hemodynamic management could be improved. In conclusion, these results point to a considerable gap between the accumulating evidence about the benefits of perioperative hemodynamic optimization and the available technologies that may facilitate its clinical implementation, and clinical practices in both Europe and the United States.

Participation in modified sports programs: a longitudinal study of children's transition to club sport competition.

PubMed

Eime, Rochelle M; Casey, Meghan M; Harvey, Jack T; Charity, Melanie J; Young, Janet A; Payne, Warren R

2015-07-14

Many children are not physically active enough for a health benefit. One avenue of physical activity is modified sport programs, designed as an introduction to sport for young children. This longitudinal study identified trends in participation among children aged 4-12 years. Outcomes included continuation in the modified sports program, withdrawal from the program or transition to club sport competition. De-identified data on participant membership registrations in three popular sports in the Australian state of Victoria were obtained from each sport's state governing body over a 4-year period (2009-2012 for Sport A and 2010-2013 for Sports B and C). From the membership registrations, those who were enrolled in a modified sports program in the first year were tracked over the subsequent three years and classified as one of: transition (member transitioned from a modified sport program to a club competition); continue (member continued participation in a modified sport program; or withdraw (member discontinued a modified program and did not transition to club competition). Many modified sports participants were very young, especially males aged 4-6 years. More children withdrew from their modified sport program rather than transitioning. There were age differences between when boys and girls started, withdrew and transitioned from the modified sports programs. If we can retain children in sport it is likely to be beneficial for their health. This study highlights considerations for the development and implementation of sport policies and programming to ensure lifelong participation is encouraged for both males and females.

School Gardens: A Qualitative Study on Implementation Practices.

PubMed

Huys, Nele; De Cocker, Katrien; De Craemer, Marieke; Roesbeke, Marleen; Cardon, Greet; De Lepeleere, Sara

2017-11-25

School gardens have beneficial effects on children's dietary behaviors but information on its implementation is scarce. The current study aimed to gain insight in implementation practices of school gardens and in perceptions of key members and children towards a school garden. We conducted twelve interviews involving 14 key members and five focus groups with 38 children from fifth to sixth grade (10-13 years old) in four primary schools in Ghent (Flanders, Belgium). We analyzed the interviews and focus groups in NVivo, using thematic analysis. School gardens were mainly initiated to involve children in nature, not to improve vegetable consumption. Participants were positive about having a school garden, experienced facilitating factors (e.g., adaptability of the garden, having a person responsible for the garden), but also various barriers (e.g., difficulties with startup, maintenance during summer holidays and integration in the school curriculum) and suggested some solutions (e.g., involving external organizations and parents, expanding the garden) and motivating factors for children (e.g., colorful plants, use of gloves). In order to improve implementation and to contribute to children's health, future school gardening projects should take the recommendations of key members and children into account.

School Gardens: A Qualitative Study on Implementation Practices

PubMed Central

De Cocker, Katrien; Roesbeke, Marleen; De Lepeleere, Sara

2017-01-01

School gardens have beneficial effects on children’s dietary behaviors but information on its implementation is scarce. The current study aimed to gain insight in implementation practices of school gardens and in perceptions of key members and children towards a school garden. We conducted twelve interviews involving 14 key members and five focus groups with 38 children from fifth to sixth grade (10–13 years old) in four primary schools in Ghent (Flanders, Belgium). We analyzed the interviews and focus groups in NVivo, using thematic analysis. School gardens were mainly initiated to involve children in nature, not to improve vegetable consumption. Participants were positive about having a school garden, experienced facilitating factors (e.g., adaptability of the garden, having a person responsible for the garden), but also various barriers (e.g., difficulties with startup, maintenance during summer holidays and integration in the school curriculum) and suggested some solutions (e.g., involving external organizations and parents, expanding the garden) and motivating factors for children (e.g., colorful plants, use of gloves). In order to improve implementation and to contribute to children’s health, future school gardening projects should take the recommendations of key members and children into account. PMID:29186835

Understanding the emergence of state goal orientation in organizational work groups: the role of leadership and multilevel climate perceptions.

PubMed

Dragoni, Lisa

2005-11-01

This article attends to a broad range of practically significant employee motivations and provides insight into how to enhance individual-level performance by examining individual-level state goal orientation emergence in organizational work groups. Leadership and multilevel climate processes are theorized to parallel each dimension of state goal orientation to cue and ultimately induce the corresponding achievement focus among individual work group members. It is argued that the patterns of leader behavior, which elucidate the leader's achievement priority, shape group members' psychological and work group climate to embody this priority. Resulting multilevel climate perceptions signal and compel group members to adopt the ascribed form of state goal orientation. The quality of the leader-member exchange relationship is viewed as a means to clarify leader messages in the formation of group members' psychological climate and internalize these cues in the emergence of state goal orientation. Considerations for future research and practice are discussed. ((c) 2005 APA, all rights reserved).

34 CFR 403.205 - What are the State's responsibilities for members of special populations?

Code of Federal Regulations, 2013 CFR

2013-07-01

... APPLIED TECHNOLOGY EDUCATION PROGRAM What Are the Administrative Responsibilities of a State Under the State Vocational and Applied Technology Education Program? § 403.205 What are the State's... 34 Education 3 2013-07-01 2013-07-01 false What are the State's responsibilities for members of...

34 CFR 403.205 - What are the State's responsibilities for members of special populations?

Code of Federal Regulations, 2011 CFR

2011-07-01

... APPLIED TECHNOLOGY EDUCATION PROGRAM What Are the Administrative Responsibilities of a State Under the State Vocational and Applied Technology Education Program? § 403.205 What are the State's... 34 Education 3 2011-07-01 2011-07-01 false What are the State's responsibilities for members of...

34 CFR 403.205 - What are the State's responsibilities for members of special populations?

Code of Federal Regulations, 2012 CFR

2012-07-01

... APPLIED TECHNOLOGY EDUCATION PROGRAM What Are the Administrative Responsibilities of a State Under the State Vocational and Applied Technology Education Program? § 403.205 What are the State's... 34 Education 3 2012-07-01 2012-07-01 false What are the State's responsibilities for members of...

34 CFR 403.205 - What are the State's responsibilities for members of special populations?

Code of Federal Regulations, 2014 CFR

2014-07-01

... APPLIED TECHNOLOGY EDUCATION PROGRAM What Are the Administrative Responsibilities of a State Under the State Vocational and Applied Technology Education Program? § 403.205 What are the State's... 34 Education 3 2014-07-01 2014-07-01 false What are the State's responsibilities for members of...

Awareness and implementation of the regional animal welfare strategy for the Americas: a questionnaire.

PubMed

Glass, E; Kahn, S; Arroyo Kuribreha, M

2015-12-01

The World Organisation for Animal Health (OIE) is the global standard-setting organisation for animal health and these standards are references for the World Trade Organization legal framework. In 2002, noting the relationship between animal health and welfare, the OIE accepted the mandate to develop animal welfare standards. These standards were subsequently adopted by Member Countries and have been included in the TerrestrialAnimal Health Code and the Aquatic Animal Health Code. The implementation of the OIE standards by Member Countries is continually promoted. National OIE Delegates are encouraged to nominate National Focal Points for key topics, including animal welfare. In 2012, the OIE Regional Commission of the Americas adopted a Regional Animal Welfare Strategy (Regional Strategy) to promote a coordinated approach to the implementation of the OIE animal welfare standards by the 29 Member Countries in the region. In February 2015, the OIE Regional Representation for the Americas distributed a questionnaire to determine the level of awareness and implementation of the Regional Strategy. This paper presents the results of the questionnaire. With a few exceptions, veterinary officials and stakeholders are only just becoming aware of the strategy and implementation is at an early stage. To promote the implementation of the Regional Strategy, it will be.necessary to continue building the capacity of the national Veterinary Services, strengthening public-private partnerships, modernising legislation and promoting veterinary involvement in animal welfare. Through the implementation of the Regional Strategy, the OIE will provide support to countries in establishing animal welfare standards, in line with government priorities and consumer concerns.

Protecting Animals and Enabling Research in the European Union: An Overview of Development and Implementation of Directive 2010/63/EU.

PubMed

Olsson, I Anna S; Silva, Sandra Pinto da; Townend, David; Sandøe, Peter

2016-05-01

In 1986, European Directive 86/609/EEC, regulating the use of animals in research, was one of the first examples of common legislation to set standards for animal protection across the Member States of the former European Economic Community, now the European Union, with the aim of securing a level European playing field. Starting in 2002, a process of revising European animal experimentation legislation was undertaken, with one of its key aims being to ensure high standards of welfare for laboratory animals across Europe. This resulted in Directive 2010/63/EU, which has regulated this activity in Europe since 2013. Since this is a European Union Directive, transposition into national legislation is a necessary and important part of the implementation of the new legislation. This paper gives an overview of the transposition process followed by an analysis of the potential to reach the different objectives of the directive, particularly with a focus on securing the same high standards of animal protection across member countries. The analysis focuses on three separate issues: (1) minimum standards for laboratory animal housing and care, (2) restrictions on the use of certain animal species, and (3) project review and authorization. © The Author 2016. Published by Oxford University Press on behalf of the Institute for Laboratory Animal Research. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Michigan's Physician Group Incentive Program offers a regional model for incremental 'fee for value' payment reform.

PubMed

Share, David A; Mason, Margaret H

2012-09-01

Blue Cross Blue Shield of Michigan partnered with providers across the state to create an innovative, "fee for value" physician incentive program that would deliver high-quality, efficient care. The Physician Group Incentive Program rewards physician organizations-formal groups of physicians and practices that can accept incentive payments on behalf of their members-based on the number of quality and utilization measures they adopt, such as generic drug dispensing rates, and on their performance on these measures across their patient populations. Physicians also receive payments for implementing a range of patient-centered medical home capabilities, such as patient registries, and they receive higher fees for office visits for incorporating these capabilities into routine practice while also improving performance. Taken together, the incentive dollars, fee increases, and care management payments amount to a potential increase in reimbursement of 40 percent or more from Blue Cross Blue Shield of Michigan for practices designated as high-performing patient-centered medical homes. At the same time, we estimate that implementing the patient-centered medical home capabilities was associated with $155 million in lower medical costs in program year 2011 for Blue Cross Blue Shield of Michigan members. We intend to devote a higher percentage of reimbursement over time to communities of caregivers that offer high-value, system-based care, and a lower percentage of reimbursement to individual physicians on a service-specific basis.

The Potential to Promote Resilience: Piloting a Minority Stress-Informed, GSA-Based, Mental Health Promotion Program for LGBTQ Youth

PubMed Central

Heck, Nicholas C.

2015-01-01

This article describes the results of a pilot study to determine the feasibility and acceptability of a mental health promotion program that was developed to address minority stressors and promote coping skills among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. It was hypothesized that the program would be feasible to implement within the context of a gay-straight alliance (GSA) and that GSA members would find the program acceptable (e.g., educational, enjoyable, helpful, and relevant). Participants included ten members of a high school GSA in the northeastern United States. The program sessions were delivered during GSA meetings. The first session emphasized the identification of minority and general stressors, which was followed by a discussion of coping strategies. The remaining sessions emphasized the development of cognitive coping, affect regulation, and problem-solving skills. After each session, participants completed a 13-item feedback form. Ten items assessed acceptability and three open-ended items allowed participants to provide constructive feedback. Although the program was feasible to implement within the GSA setting, attendance at the sessions was variable. Those who attended the sessions reported them to be enjoyable, informative, relevant to their lives, and potentially helpful for other LGBTQ students. After revising the program, future research is needed to investigate its dissemination potential and determine whether the program can disrupt the minority stress-psychiatric distress relationship. PMID:26366425

The Potential to Promote Resilience: Piloting a Minority Stress-Informed, GSA-Based, Mental Health Promotion Program for LGBTQ Youth.

PubMed

Heck, Nicholas C

2015-09-01

This article describes the results of a pilot study to determine the feasibility and acceptability of a mental health promotion program that was developed to address minority stressors and promote coping skills among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. It was hypothesized that the program would be feasible to implement within the context of a gay-straight alliance (GSA) and that GSA members would find the program acceptable (e.g., educational, enjoyable, helpful, and relevant). Participants included ten members of a high school GSA in the northeastern United States. The program sessions were delivered during GSA meetings. The first session emphasized the identification of minority and general stressors, which was followed by a discussion of coping strategies. The remaining sessions emphasized the development of cognitive coping, affect regulation, and problem-solving skills. After each session, participants completed a 13-item feedback form. Ten items assessed acceptability and three open-ended items allowed participants to provide constructive feedback. Although the program was feasible to implement within the GSA setting, attendance at the sessions was variable. Those who attended the sessions reported them to be enjoyable, informative, relevant to their lives, and potentially helpful for other LGBTQ students. After revising the program, future research is needed to investigate its dissemination potential and determine whether the program can disrupt the minority stress-psychiatric distress relationship.

Integrating Population Health Data on Violence Into the Emergency Department: A Feasibility and Implementation Study.

PubMed

Levas, Michael N; Hernandez-Meier, Jennifer L; Kohlbeck, Sara; Piotrowski, Nancy; Hargarten, Stephen

Geocoded emergency department (ED) data have allowed for the development and evaluation of novel interventions for the prevention of violence in cities outside of the United States. First implemented in Cardiff, United Kingdom, collection of these data provides public health agencies, community organizations, and law enforcement with place-based information on assaults. The purpose of this study was to assess the feasibility of translating this model within the electronic medical record (EMR) in the United States. A new EMR module based on the Cardiff Model was developed and integrated into the existing ED EMR. Data were collected for all patients reporting an assaultive injury upon arrival to the ED. Emergency department nurses were subsequently recruited to participate in 2 surveys and a focus group to evaluate the implementation and to provide qualitative feedback to enhance integration. Nurses completed EMR questions in 98.2% of patients reporting to the ED over the study period. More than 90% of survey respondents were satisfied with their participation, and most felt that the questions were useful for clinical care (79/70%), were integrated well into workflow (89/90%), and were congruent with the ED and hospital goals and mission (93/98%). Focus group themes centered on ED culture, external factors, and internal workflow. It is feasible to implement place-based, assault-related injury-specific questions into the EMR with minimal disruption of workflow and triage times. Nurses, as key members of the ED team, are receptive to participating in the collection of population health data that may inform community violence prevention activities.

Awareness of the 2010 guidelines implemented by the New York State Education Department for respiratory therapists in their role as clinical preceptors.

PubMed

Smith, Stephen G; Brittelli, John; Scott, Lisa Benz

2014-12-01

In 1993, the New York State (NYS) legislature and governor signed into law the Respiratory Therapy Guide to Practice Education Law to guide and regulate the profession of respiratory care under the auspices of the New York State Education Department. New guidelines were implemented by the New York State Education Department for respiratory therapists (RTs) in 2010 to provide the opportunity for RTs to receive continuing education units (CEUs) when participating as clinical preceptors. This study was conducted in June 2012 to determine the extent to which the NYS RTs are aware of the new licensing guidelines and amendments. In June 2012, a web-based survey was e-mailed to 2,503 NYS members of the New York State Society for Respiratory Care, 14% of which (n= 360) completed the survey. The survey included 21 items to assess RTs' awareness of the licensing guidelines that were implemented in 2010, and these respondents were analyzed using basic descriptive statistics. The study showed that 50% of the respondents were not aware of eligibility to earn CEUs as a clinical preceptor in NYS. Twenty-eight percent responded correctly that licensed RTs were eligible to earn CEUs as a clinical preceptor in NYS. In addition, 67% of those who responded were unaware of how many CEUs could be earned for each renewal period for clinical precepting. Finally, 70% of the respondents indicated that they would be inclined to seek employment at a facility that has a clinical affiliation with a university or college respiratory care program. The findings indicate that more education is needed in NYS to make licensed RTs aware of the 2010 guidelines. Practitioners may require incentives to become actively involved in the clinical education of respiratory care students as their clinical preceptors. Copyright © 2014 by Daedalus Enterprises.

Development and Implementation of a Novel Prehospital Care System in the State of Kerala, India.

PubMed

Brown, Heather A; Douglass, Katherine A; Ejas, Shafi; Poovathumparambil, Venugopalan

2016-12-01

Most low- and middle-income countries (LMICs) have struggled to find a system for prehospital care that can provide adequate patient care and geographical coverage while maintaining a feasible price tag. The emergency medical systems of the Western world are not necessarily relevant in developing economic systems, given the lack of strict legislation, the scarcity of resources, and the limited number of trained personnel. Meanwhile, most efforts to provide prehospital care in India have taken the form of adapting Western models to the Indian context with limited success. Described here is a novel approach to prehospital care designed for and implemented in the State of Kerala, India. The Active Network Group of Emergency Life Savers (ANGELS) was launched in 2011 in Calicut City, the third largest city in the Indian State of Kerala. The ANGELS integrated an existing fleet of private and state-owned ambulances into a single network utilizing Global Positioning System (GPS) technology and a single statewide call number. A total of 85 volunteer emergency medical certified technicians (EMCTs) were trained in basic first aid and trauma care principles. Public awareness campaigns accompanied all activities to raise awareness amongst community members. Funding was provided via public-private partnership, aimed to minimize costs to patients for service utilization. Over a two-year period from March 2011 to April 2013, 8,336 calls were recorded, of which 54.8% (4,569) were converted into actual ambulance run sheets. The majority of calls were for medical emergencies and most patients were transported to Medical College Hospital in Calicut. This unique public-private partnership has been responsive to the needs of the population while sustaining low operational costs. This system may provide a relevant template for Emergency Medical Services (EMS) development in other resource-limited settings. Brown HA , Douglass KA , Ejas S , Poovathumparambil V . Development and implementation of a novel prehospital care system in the State of Kerala, India. Prehosp Disaster Med. 2016;31(6):663-666.

Quantifying the negative impact of brain drain on the integration of European science.

PubMed

Doria Arrieta, Omar A; Pammolli, Fabio; Petersen, Alexander M

2017-04-01

The 2004/2007 European Union (EU) enlargement by 12 member states offers a unique opportunity to quantify the impact of EU efforts to expand and integrate the scientific competitiveness of the European Research Area (ERA). We apply two causal estimation schemes to cross-border collaboration data extracted from millions of academic publications from 1996 to 2012, which are disaggregated across 14 subject areas and 32 European countries. Our results illustrate the unintended consequences following the 2004/2007 enlargement, namely, its negative impact on cross-border collaboration in science. First, we use the synthetic control method to show that levels of European cross-border collaboration would have been higher without EU enlargement, despite the 2004/2007 EU entrants gaining access to EU resources incentivizing cross-border integration. Second, we implement a difference-in-difference panel regression, incorporating official intra-European high-skilled mobility statistics, to identify migration imbalance-principally from entrant to incumbent EU member states-as a major factor underlying the divergence in cross-border integration between Western and Eastern Europe. These results challenge central tenets underlying ERA integration policies that unifying labor markets will increase the international competitiveness of the ERA, thereby calling attention to the need for effective home-return incentives and policies.

Perceived benefits and challenges of interprofessional education based on a multidisciplinary faculty member survey.

PubMed

Lash, David Benjamin; Barnett, Mitchell J; Parekh, Nirali; Shieh, Anita; Louie, Maggie C; Tang, Terrill T-L

2014-12-15

To identify differences among faculty members in various health professional training programs in perceived benefits and challenges of implementing interprofessional education (IPE). A 19-item survey using a 5-point Likert scale was administered to faculty members across different health disciplines at a west coast, multicollege university with osteopathic medicine, pharmacy, and physician assistant programs. Sixty-two of 103 surveys (60.2%) were included in the study. Faculty members generally agreed that there were benefits of IPE on patient outcomes and that implementing IPE was feasible. However, group differences existed in belief that IPE improves care efficiency (p=0.001) and promotes team-based learning (p=0.001). Program divergence was also seen in frequency of stressing importance of IPE (p=0.009), preference for more IPE opportunities (p=0.041), and support (p=0.002) within respective college for IPE. Despite consensus among faculty members from 3 disciplines that IPE is invaluable to their curricula and training of health care students, important program level differences existed that would likely need to be addressed in advance IPE initiatives.

Dissemination and implementation sciences in pharmacy: A call to action for professional organizations.

PubMed

Seaton, Terry L

There is a substantial gap between the generation of new knowledge and its widespread incorporation into routine clinical practice, including the medication use process. Principles of dissemination and implementation sciences, if fully embraced by clinicians and researchers, have the potential of improving healthcare effectiveness, efficiency, quality, and safety. This commentary is a call to action for member-driven professional organizations in pharmacy to serve their members and the profession by proactively and strategically leading efforts to develop pharmacist's abilities to incorporate principles of dissemination and implementation sciences into their practice. Additionally, these organizations should provide meaningful support for dissemination and implementation research that hastens the adoption, promotes intervention fidelity, and demonstrates the scaling and sustaining of evidence-based practices to optimize patient care delivery and medication therapy outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

78 FR 65030 - Department of State Performance Review Board Members

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... State; and Teddy Taylor, Diplomat in Residence, Bureau of Human Resources, Department of State. Dated: October 21, 2013. Hans Klemm, Acting Director General of the Foreign Service and Director of Human... members: Robert Goldberg, Chairperson, Director, Office of the United States Foreign Assistance Resources...

76 FR 69320 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... to and from the United States to the full extent authorized by the United States-European Union Air... States of America and the European Union and its Member States and Iceland and Norway. lcelandair also... the European Community, via any point(s) in any Member State(s) and via intermediate points to any...

Implementing care programmes for frail older people: a project management perspective.

PubMed

Bindels, Jill; Cox, Karen; Abma, Tineke A; van Schayck, Onno C P; Widdershoven, Guy

2015-01-01

To examine the issues that influenced the implementation of programmes designed to identify and support frail older people in the community in the Netherlands. Qualitative research methods were used to investigate the perspectives of project leaders, project members and members of the steering committee responsible for the implementation of the programmes. Interviews were conducted in 2009 (n = 10) and in 2012 (n = 13) and a focus group was organised in 2012 (n = 5). The interviews revealed that the implementation was influenced by the extent and quality of collaboration between organisations, adaptation to existing structures, future funding for the programmes and project leadership. A good relationship between participating organisations and professionals is required for successful implementation. A lack of clear project leadership and structural funding hampers the implementation of complex programmes in primary care settings. The findings of this study are useful for organisations and professionals who are planning to implement complex programmes. Identifying barriers concerning institutional collaboration, adaptation to existing structures, leadership and continuation of financial support at an early stage of the implementation process can support practitioners in overcoming them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Staff perceptions of a Productive Community Services implementation: A qualitative interview study.

PubMed

Bradley, Dominique Kim Frances; Griffin, Murray

2015-06-01

The Productive Series is a collection of change programmes designed by the English National Health Service (NHS) Institute for Innovation and Improvement to help frontline healthcare staff improve quality and reduce wasted time, so that this time can be reinvested into time spent with patients. The programmes have been implemented in at least 14 countries around the world. This study examines an implementation of the Productive Community Services programme that took place in a Community healthcare organisation in England from July 2010 to March 2012. To explore staff members' perceptions of a Productive Community Services implementation. Cross-sectional interview. Community Healthcare Organisation in East Anglia, England. 45 participants were recruited using purposive, snowballing and opportunistic sampling methods to represent five main types of staff group in the organisation; clinical team members, administrative team members, service managers/team leaders, senior managers and software support staff. Team members were recruited on the basis that they had submitted data for at least one Productive Community Services module. Semi-structured individual and group interviews were carried out after the programme concluded and analysed using thematic analysis. This report focuses on six of the themes identified. The analysis found that communication was not always effective, and there was a lack of awareness, knowledge and understanding of the programme. Many staff did not find the Productive Community Services work relevant, and although certain improvements were sustained, suboptimal practices crept back. Although negative outcomes were reported, such as the programme taking time away from patients initially, many benefits were described including improved stock control and work environments, and better use of the Electronic Patient Record system. One of the themes identified highlighted the positive perceptions of the programme, however a focus on five other themes indicate that important aspects of the implementation could have been improved. The innovation and implementation literature already addresses the issues identified, which suggests a gap between theory and practice for implementation teams. A lack of perceived relevance also suggests that similar programmes need to be made more easily adaptable for the varied specialisms found in Community Services. Further research on Productive Community Services implementations and knowledge transfer is required, and publication of studies focusing on the less positive aspects of implementations may accelerate this process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Mutatis Mutandis? The Court of Justice of the European Union Rules that Member States May Be Allowed to Impose Non-Resident Student Quotas

ERIC Educational Resources Information Center

Observatory on Borderless Higher Education, 2010

2010-01-01

Earlier this month, the Court of Justice of the European Union (the Court), ruled that European Union (EU) member states can impose non-resident student quotas in certain circumstances. The Court, whose job is to ensure that all EU member states interpret and apply EU legislation in the same way, recently made the ruling in response to a…

26 CFR 1.692-1 - Abatement of income taxes of certain members of the Armed Forces of the United States upon death.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the Armed Forces of the United States upon death. 1.692-1 Section 1.692-1 Internal Revenue INTERNAL...) Income in Respect of Decedents § 1.692-1 Abatement of income taxes of certain members of the Armed Forces... active service as a member of the Armed Forces of the United States, and (ii) His death occurs while he...

26 CFR 1.692-1 - Abatement of income taxes of certain members of the Armed Forces of the United States upon death.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the Armed Forces of the United States upon death. 1.692-1 Section 1.692-1 Internal Revenue INTERNAL... Respect of Decedents § 1.692-1 Abatement of income taxes of certain members of the Armed Forces of the... as a member of the Armed Forces of the United States, and (ii) His death occurs while he is serving...

School Board Member Practices in Governance, Teamwork and Board Development, and Their Sense of Effectiveness in High and Low Math Academic Achievement Districts of New York State

ERIC Educational Resources Information Center

Siegel, Kyrie

2009-01-01

The purpose of this study was to examine the relationships among New York State school board member attitudes toward components of school board governance and their sense of effectiveness in high and low math academic achievement districts in New York State. The study examined board members' perceptions of their actual practices in policy…

Faculty Internationalization Priorities

ERIC Educational Resources Information Center

Criswell, John R., II; Zhu, Hao

2015-01-01

The internationalization of higher education has been the subject of a substantial body of research. However, few studies have examined how faculty members, significant implementers of internationalization, think about internationalization priorities. This article presents the results of a questionnaire which was sent to faculty members at three…

32 CFR 153.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Department of Defense OFFICE OF THE SECRETARY OF DEFENSE REGULATIONS PERTAINING TO MILITARY JUSTICE CRIMINAL... SERVICE MEMBERS, AND FORMER SERVICE MEMBERS § 153.1 Purpose. This part: (a) Implements policies and...,” October 28, 2004 (hereinafter referred to as “the Act”) for exercising extraterritorial criminal...

Model reduction in a subset of the original states

NASA Technical Reports Server (NTRS)

Yae, K. H.; Inman, D. J.

1992-01-01

A model reduction method is investigated to provide a smaller structural dynamic model for subsequent structural control design. A structural dynamic model is assumed to be derived from finite element analysis. It is first converted into the state space form, and is further reduced by the internal balancing method. Through the co-ordinate transformation derived from the states that are deleted during reduction, the reduced model is finally expressed with the states that are members of the original states. Therefore, the states in the final reduced model represent the degrees of freedom of the nodes that are selected by the designer. The procedure provides a more practical implementation of model reduction for applications in which specific nodes, such as sensor and/or actuator attachment points, are to be retained in the reduced model. Thus, it ensures that the reduced model is under the same input and output condition as the original physical model. The procedure is applied to two simple examples and comparisons are made between the full and reduced order models. The method can be applied to a linear, continuous and time-invariant model of structural dynamics with nonproportional viscous damping.

Value-based cost sharing in the United States and elsewhere can increase patients' use of high-value goods and services.

PubMed

Thomson, Sarah; Schang, Laura; Chernew, Michael E

2013-04-01

This article reviews efforts in the United States and several other member countries of the Organization for Economic Cooperation and Development to encourage patients, through cost sharing, to use goods such as medications, services, and providers that offer better value than other options--an approach known as value-based cost sharing. Among the countries we reviewed, we found that value-based approaches were most commonly applied to drug cost sharing. A few countries, including the United States, employed financial incentives, such as lower copayments, to encourage use of preferred providers or preventive services. Evidence suggests that these efforts can increase patients' use of high-value services--although they may also be associated with high administrative costs and could exacerbate health inequalities among various groups. With careful design, implementation, and evaluation, value-based cost sharing can be an important tool for aligning patient and provider incentives to pursue high-value care.

Modeling Insights into Haemophilus influenzae Type b Disease, Transmission, and Vaccine Programs

PubMed Central

Rose, Charles E.; Cohn, Amanda; Coronado, Fatima; Clark, Thomas A.; Wenger, Jay D.; Bulkow, Lisa; Bruce, Michael G.; Messonnier, Nancy E.; Hennessy, Thomas W.

2012-01-01

In response to the 2007–2009 Haemophilus influenzae type b (Hib) vaccine shortage in the United States, we developed a flexible model of Hib transmission and disease for optimizing Hib vaccine programs in diverse populations and situations. The model classifies population members by age, colonization/disease status, and antibody levels, with movement across categories defined by differential equations. We implemented the model for the United States as a whole, England and Wales, and the Alaska Native population. This model accurately simulated Hib incidence in all 3 populations, including the increased incidence in England/Wales beginning in 1999 and the change in Hib incidence in Alaska Natives after switching Hib vaccines in 1996. The model suggests that a vaccine shortage requiring deferral of the booster dose could last 3 years in the United States before loss of herd immunity would result in increasing rates of invasive Hib disease in children <5 years of age. PMID:22257582

Compression member response of steel angle on truss structure with variation of single and double sections

NASA Astrophysics Data System (ADS)

Panjaitan, Arief; Hasibuan, Purwandy

2018-05-01

Implementation of an axial compression load on the steel angle can be found at the various structure such as truss system on telecommunication tower. For telecommunication tower, steel angle section can be suggested as an alternative solution due to its assembling easiness as well as its strength. But, antennas and microwaves installation that keep increases every time on this structure demand reinforcement on each leg of the tower structure. One solution suggested is reinforcement with increasing areas section capacity, where tower leg consisted of single angle section will be reinforced to be double angle section. Regarding this case, this research discussed the behavior of two types of steel angle section: single angle of L.30.30.3 and double angles of 2L.30.30.3. These two sections were designed identically in length (103 cm) and tested by axial compression load. At the first step, compression member together with tension member was formed to be a truss system, where compression and tension member were met at a joint plate. Schematic loading was implemented by giving tension loading on the joint plate until failure of specimens. Experimental work findings showed that implementing double angle sections (103 cm) significantly increased compression capacity of steel angle section up to 118 %.

Ohio hospital PR pros collaborate on crisis communications plan.

PubMed

Rees, Tom

2002-01-01

Two member hospitals of the Akron Regional Hospital Association (ARHA), Ohio, experienced crisis situations which severely strained their public relations resources. These events were the genesis for the development of a comprehensive plan for sharing public relations resources among 11 member hospitals. The plan details procedures for sharing help in the event of a crisis or specific hospital media event. It identifies three potential situations in which it can be implemented: internal disaster, external disaster, or a specific incident unique to one of the hospitals. No occasion has yet arisen to implement the plan.

A national action plan for promoting preconception health and health care in the United States (2012-2014).

PubMed

Floyd, R Louise; Johnson, Kay A; Owens, Jasmine R; Verbiest, Sarah; Moore, Cynthia A; Boyle, Coleen

2013-10-01

Preconception health and health care (PCHHC) has gained increasing popularity as a key prevention strategy for improving outcomes for women and infants, both domestically and internationally. The Action Plan for the National Initiative on Preconception Health and Health Care: A Report of the PCHHC Steering Committee (2012-2014) provides a model that states, communities, public, and private organizations can use to help guide strategic planning for promoting preconception care projects. Since 2005, a national public-private PCHHC initiative has worked to create and implement recommendations on this topic. Leadership and funding from the Centers for Disease Control and Prevention combined with the commitment of maternal and child health leaders across the country brought together key partners from the public and private sector to provide expertise and technical assistance to develop an updated national action plan for the PCHHC Initiative. Key activities for this process included the identification of goals, objectives, strategies, actions, and anticipated timelines for the five workgroups that were established as part of the original PCHHC Initiative. These are further described in the action plan. To assist other groups doing similar work, this article discusses the approach members of the PCHHC Initiative took to convene local, state, and national leaders to enhance the implementation of preconception care nationally through accomplishments, lessons learned, and projections for future directions.

Conflict-of-interest disclosure at medical journals in Japan: a nationwide survey of the practices of journal secretariats.

PubMed

Kojima, Takako; Green, Joseph; Barron, J Patrick

2015-08-26

Medical journals in Japan generally have appropriate policies regarding disclosure of conflicts of interest (COI). However, COI management depends on the staff members of each journal's editorial secretariat. This study's objectives were to find out (A) whether COI disclosure and the journal's role in it are clearly understood by the journal's secretariat staff, (B) how much experience the editorial secretariat has in actually handling issues related to disclosure and (C) what kind of help or support they need. In January 2014, questionnaires were sent to the editorial secretariats of journal-publishing societies belonging to the Japanese Association of Medical Sciences (JAMS). The response rate was 100%, and the respondents represented 121 journals published by the 118 JAMS member societies (at the time of the survey). Information was collected on the history of COI policies and on how those policies were implemented. At the end of the questionnaire, there was an open-ended call for comments. Compulsory COI disclosure began between 2010 and 2013 for 60.3% of the journals (73/121). Handling of COI issues was not uniform: 17.4% (21/121) of respondents do not pursue cases of dubious disclosure, and 47.9% (58/121) do not require COI disclosures from editorial board members. Very few of the editorial secretariats had clearly-stated consequences for violations of COI-disclosure policy (33/121, 27.3%), and only 28.9% offered COI education (35/121). Respondents' comments indicated that uniform, easily-searchable guidance regarding COI policies and implementation would be welcome. Although commitment is widespread, policy implementation is inconsistent and COI experience is lacking. Clear, easy-to-use guidelines are desired by many societies. The JAMS is to be commended for supporting this country-wide investigation; other countries and regions are encouraged to perform similar investigations to respond to needs regarding COI management. 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.

Evaluation of the childhood obesity prevention program Kids--'Go for your life'.

PubMed

de Silva-Sanigorski, Andrea; Prosser, Lauren; Carpenter, Lauren; Honisett, Suzy; Gibbs, Lisa; Moodie, Marj; Sheppard, Lauren; Swinburn, Boyd; Waters, Elizabeth

2010-05-28

Kids--'Go for your life' (K-GFYL) is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children's care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services are centrally supported to undertake the health promotion (intervention) activities. Once the K-GFYL program 'criteria' are reached the school/service is assessed and 'awarded'. This paper describes the design of the evaluation of the statewide K-GFYL intervention program. The evaluation is mixed method and cross sectional and aims to: 1) Determine if K-GFYL award status is associated with more health promoting environments in schools/services compared to those who are members only; 2) Determine if children attending K-GFYL award schools/services have higher levels of healthy eating and physical activity-related behaviors compared to those who are members only; 3) Examine the barriers to implementing and achieving the K-GFYL award; and 4) Determine the economic cost of implementing K-GFYL in primary schools. Parent surveys will capture information about the home environment and child dietary and physical activity-related behaviors. Environmental questionnaires in early childhood settings and schools will capture information on the physical activity and nutrition environment and current health promotion activities. Lunchbox surveys and a set of open-ended questions for kindergarten parents will provide additional data. Resource use associated with the intervention activities will be collected from primary schools for cost analysis. The K-GFYL award program is a community-wide intervention that requires a comprehensive, multi-level evaluation. The evaluation design is constrained by the lack of a non-K-GFYL control group, short time frames and delayed funding of this large scale evaluation across all intervention settings. However, despite this, the evaluation will generate valuable evidence about the utility of a community-wide environmental approach to preventing childhood obesity which will inform future public health policies and health promotion programs internationally. ACTRN12609001075279.

User experience with a health insurance coverage and benefit-package access: implications for policy implementation towards expansion in Nigeria.

PubMed

Mohammed, Shafiu; Aji, Budi; Bermejo, Justo Lorenzo; Souares, Aurelia; Dong, Hengjin; Sauerborn, Rainer

2016-04-01

Developing countries are devising strategies and mechanisms to expand coverage and benefit-package access for their citizens through national health insurance schemes (NHIS). In Nigeria, the scheme aims to provide affordable healthcare services to insured-persons and their dependants. However, inclusion of dependants is restricted to four biological children and a spouse per user. This study assesses the progress of implementation of the NHIS in Nigeria, relating to coverage and benefit-package access, and examines individual factors associated with the implementation, according to users' perspectives. A retrospective, cross-sectional survey was done between October 2010 and March 2011 in Kaduna state and 796 users were randomly interviewed. Questions regarding coverage of immediate-family members and access to benefit-package for treatment were analysed. Indicators of coverage and benefit-package access were each further aggregated and assessed by unit-weighted composite. The additive-ordinary least square regression model was used to identify user factors that may influence coverage and benefit-package access. With respect to coverage, immediate-dependants were included for 62.3% of the users, and 49.6 rated this inclusion 'good' (49.6%). In contrast, 60.2% supported the abolishment of the policy restriction for non-inclusion of enrolees' additional children and spouses. With respect to benefit-package access, 82.7% of users had received full treatments, and 77.6% of them rated this as 'good'. Also, 14.4% of users had been refused treatments because they could not afford them. The coverage of immediate-dependants was associated with age, sex, educational status, children and enrolment duration. The benefit-package access was associated with types of providers, marital status and duration of enrolment. This study revealed that coverage of family members was relatively poor, while benefit-package access was more adequate. Non-inclusion of family members could hinder effective coverage by the scheme. Potential policy implications towards effective coverage and benefit-package access are discussed. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Researching routine immunization-do we know what we don't know?

PubMed

Clements, C John; Watkins, Margaret; de Quadros, Ciro; Biellik, Robin; Hadler, James; McFarland, Deborah; Steinglass, Robert; Luman, Elizabeth; Hennessey, Karen; Dietz, Vance

2011-11-03

The Expanded Programme on Immunization (EPI), launched in 1974, has developed and implemented a range of strategies and practices over the last three decades to ensure that children and adults receive the vaccines they need to help protect them against vaccine-preventable diseases. Many of these strategies have been implemented, resulting in immunization coverage exceeding 80% among children one year of age in many countries. Yet millions of infants remain under-immunized or unimmunized, particularly in poorer countries. In November 2009, a panel of external experts met at the United States Centers for Disease Control and Prevention (CDC) to review and identify areas of research required to strengthen routine service delivery in developing countries. Research opportunities were identified utilizing presentations emphasizing existing research, gaps in knowledge and key questions. Panel members prioritized the topics, as did other meeting participants. Several hundred research topics covering a wide range were identified by the panel members and participants. However there were relatively few topics for which there was a consensus that immediate investment in research is warranted. The panel identified 28 topics as priorities. 18 topics were identified as priorities by at least 50% of non-panel participants; of these, five were also identified as priorities by the panel. Research needs included identifying the best ways to increase coverage with existing vaccines and introduce new vaccines, integrate other services with immunizations, and finance immunization programmes. There is an enormous range of research that could be undertaken to support routine immunization. However, implementation of strategic plans, rather than additional research will have the greatest impact on raising immunization coverage and preventing disease, disability, and death from vaccine-preventable diseases. The panel emphasized the importance of tying operational research to programmatic needs, with a focus on efforts to scale up proven best practices in each country, facilitating the full implementation of immunization strategies. Copyright © 2011. Published by Elsevier Ltd.. All rights reserved.

Recent developments in family psychoeducation as an evidence-based practice.

PubMed

Lucksted, Alicia; McFarlane, William; Downing, Donna; Dixon, Lisa

2012-01-01

Among potential resources for people with serious mental illnesses (SMI) and their families, professionally delivered family psychoeducation (FPE) is designed to engage, inform, and educate family members, so that they can assist the person with SMI in managing their illness. In this article, we review research regarding FPE outcomes and implementation since 2001, updating the previous review in this journal (McFarlane, Dixon, Lukens, & Lucksted, Journal of Marital and Family Therapy 2003; 29, 223). Research on a range of FPE variations continues to return mostly positive effects for adults with schizophrenia and increasingly, bipolar disorder. More recent studies include functional outcomes as well as the more common relapse and hospitalization. FPE research involving adults with other diagnoses is increasing, as is FPE research outside the United States In both cases, uneven methodologies and multiple FPE variations make drawing conclusions difficult, although the core utility of access to information, skill building, problem solving, and social support often shines though. Since the previous review, several FPE programs for parents of children or youth with mood disorders have also been developed, with limited research showing more positive than null results. Similarly, we review the developing inquiry into early intervention and FPE, short-form FPE, and cost studies involving FPE. The second half of the article updates the paradox of FPE's evidence base versus its persistently low use, via recent implementation efforts. Multiple challenges and facilitating factors across healthcare systems and financing, individual programs and providers, family members, and consumers shape this issue, and we conclude with discussion of the need for empirical evaluation of implementation strategies and models. © 2011 American Association for Marriage and Family Therapy.

Improving the implementation of responsible alcohol management practices by community sporting clubs: A randomised controlled trial.

PubMed

Kingsland, Melanie; Wolfenden, Luke; Tindall, Jennifer; Rowland, Bosco; Sidey, Maree; McElduff, Patrick; Wiggers, John H

2015-07-01

Despite an increased prevalence of risky alcohol consumption and alcohol-related harm among members of sporting groups and at sporting venues, sporting clubs frequently fail to implement alcohol management practices consistent with liquor legislation and best practice guidelines. The aim of this study was to assess the impact of a multi-strategy intervention in improving the implementation of responsible alcohol management practices by sports clubs. A randomised controlled trial was conducted with 87 football clubs, with half randomised to receive a multi-strategy intervention to support clubs to implement responsible alcohol management practices. The 2-year intervention, which was based on implementation and capacity building theory and frameworks, included project officer support, funding, accreditation rewards, printed resources, observational audit feedback, newsletters, training and support from state sporting organisations. Interviews were undertaken with club presidents at baseline and post-intervention to assess alcohol management practice implementation. Post-intervention, 88% of intervention clubs reported implementing '13 or more' of 16 responsible alcohol management practices, which was significantly greater than the proportion of control groups reporting this level of implementation (65%) [odds ratio: 3.7 (95% confidence interval: 1.1-13.2); P = 0.04]. All intervention components were considered highly useful and three-quarters or more of clubs rated the amount of implementation support to be sufficient. The multi-strategy intervention was successful in improving alcohol management practices in community sports clubs. Further research is required to better understand implementation barriers and to assess the long-term sustainability of the change in club alcohol management practices. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Synthesis of a Stereochemically Diverse Library of Medium-Sized Lactams and Sultams via SNAr Cycloetherification

PubMed Central

Gerard, Baudouin; Duvall, Jeremy R.; Lowe, Jason T.; Murillo, Tiffanie; Wei, Jingqiang; Akella, Lakshmi B.; Marcaurelle, Lisa A.

2011-01-01

We have implemented an aldol-based ‘build/couple/pair’ (B/C/P) strategy for the synthesis of stereochemically diverse 8-membered lactam and sultam scaffolds via SNAr cycloetherification. Each scaffold contains two handles, an amine and aryl bromide, for solid-phase diversification via N-capping and Pd-mediated cross coupling. A sparse matrix design strategy that achieves the dual objective of controlling physicochemical properties and selecting diverse library members was implemented. The production of two 8000-membered libraries is discussed including a full analysis of library purity and property distribution. Library diversity was evaluated in comparison to the Molecular Library Small Molecule Repository (MLSMR) through the use of a multi-fusion similarity (MFS) map and principal component analysis (PCA). PMID:21526820

Narratives of family members on the suicide of older adults in an Amazonian metropolis.

PubMed

Costa, André Luis Sales da; Souza, Maximiliano Loiola Ponte de

2017-12-11

To analyze the narratives of family members on the suicide of older adults in Manaus, State of Amazonas, Brazil. This is a qualitative study of the narratives of eight older adults, who committed suicide in the period of 2001-2012. In the analytic-interpretative process, we have tried to perform the hermeneutic double exercise: to interpret the interpretation of narrators. We have used as theoretical references authors who have investigated suicide from the perspective of gender and its correlations with the sociofamiliar context and with mental disorders. The family members would conceive the suicide of the older adults as related to losses, which would occur in a strained sociofamiliar scenario, leading to the appearance of psychopathological situations that, if not properly followed, would result in death. There would also be something inexorable in this sequence of events. The older adults, by the very time of their life, would tend to accumulate losses of different aspects in their trajectory. Their rigor and other relational limitations would simultaneously stress family relationships, favoring conflicts, and hinder adherence to treatment. This model of understanding, which has a wide support in the hegemonic medical-psychological discourse, in a sense minimizes possible self- or heteroaccusations directed at family members. Special attention should be given to identify the older adults who present losses, family conflicts, and signs of psychopathology and who do not follow-up psychosocial care services. Strategies to help older adults handle family conflicts and losses, empowering them, should be developed and made available by intersectoral actions. The adequate treatment of psychopathological conditions should be implanted in a context in which active search mechanisms also existed for older adults who abandoned follow-up. The implementation of these actions is a challenge to be faced in Manaus, State of Amazonas, Brazil, where there is a low availability of psychosocial care services, which are not articulated with specialized care services in tertiary medical conditions, and there is still low coverage by the basic care.

Enhancing the use of research in health-promoting, anti-racism policy.

PubMed

Ferdinand, Angeline S; Paradies, Yin; Kelaher, Margaret

2017-07-11

The Localities Embracing and Accepting Diversity (LEAD) programme was established to improve the health of ethnic minority communities through the reduction of racial discrimination. Local governments in the state of Victoria, Australia, were at the forefront of LEAD implementation in collaboration with leading state and national organisations. Key aims included expanding the available evidence regarding effective anti-racism interventions and facilitating the uptake of this evidence in organisational policies and practices. One rural and one metropolitan local government areas were selected to participate in LEAD. Key informant interviews and discussions were conducted with individuals who had participated in LEAD implementation and members of LEAD governance structures. Data were also collected on programme processes and implementation, partnership formation and organisational assessments. The LEAD model demonstrated both strengths and weaknesses in terms of facilitating the use of evidence in a complex, community-based health promotion initiative. Representation of implementing, funding and advisory bodies at different levels of governance enabled the input of technical advice and guidance alongside design and implementation. The representation structure assisted in ensuring the development of a programme that was acceptable to all partners and informed by the best available evidence. Simultaneous evaluation also enhanced perceived validity of the intervention, allowed for strategy correction when necessary and supported the process of double-loop organisational learning. However, due to the model's demand for simultaneous and intensive effort by various organisations, when particular elements of the intervention were not functional, there was a considerable loss of time and resources across the partner organisations. The complexity of the model also presented a challenge in ensuring clarity regarding roles, functions and the direction of the programme. The example of LEAD provides guidance on mechanisms to strengthen the entry of evidence into complex community-based health promotion programmes. The paper highlights some of the strengths and weaknesses of the LEAD model and implications for practical collaboration between policymakers, implementers and researchers.

Using a linked data approach to aid development of a metadata portal to support Marine Strategy Framework Directive (MSFD) implementation

NASA Astrophysics Data System (ADS)

Wood, Chris

2016-04-01

Under the Marine Strategy Framework Directive (MSFD), EU Member States are mandated to achieve or maintain 'Good Environmental Status' (GES) in their marine areas by 2020, through a series of Programme of Measures (PoMs). The Celtic Seas Partnership (CSP), an EU LIFE+ project, aims to support policy makers, special-interest groups, users of the marine environment, and other interested stakeholders on MSFD implementation in the Celtic Seas geographical area. As part of this support, a metadata portal has been built to provide a signposting service to datasets that are relevant to MSFD within the Celtic Seas. To ensure that the metadata has the widest possible reach, a linked data approach was employed to construct the database. Although the metadata are stored in a traditional RDBS, the metadata are exposed as linked data via the D2RQ platform, allowing virtual RDF graphs to be generated. SPARQL queries can be executed against the end-point allowing any user to manipulate the metadata. D2RQ's mapping language, based on turtle, was used to map a wide range of relevant ontologies to the metadata (e.g. The Provenance Ontology (prov-o), Ocean Data Ontology (odo), Dublin Core Elements and Terms (dc & dcterms), Friend of a Friend (foaf), and Geospatial ontologies (geo)) allowing users to browse the metadata, either via SPARQL queries or by using D2RQ's HTML interface. The metadata were further enhanced by mapping relevant parameters to the NERC Vocabulary Server, itself built on a SPARQL endpoint. Additionally, a custom web front-end was built to enable users to browse the metadata and express queries through an intuitive graphical user interface that requires no prior knowledge of SPARQL. As well as providing means to browse the data via MSFD-related parameters (Descriptor, Criteria, and Indicator), the metadata records include the dataset's country of origin, the list of organisations involved in the management of the data, and links to any relevant INSPIRE-compliant services relating to the dataset. The web front-end therefore enables users to effectively filter, sort, or search the metadata. As the MSFD timeline requires Member States to review their progress on achieving or maintaining GES every six years, the timely development of this metadata portal will not only aid interested stakeholders in understanding how member states are meeting their targets, but also shows how linked data can be used effectively to support policy makers and associated legislative bodies.

Achieving compliance with the International Health Regulations by overseas territories of the United Kingdom of Great Britain and Northern Ireland.

PubMed

Hamblion, Esther L; Salter, Mark; Jones, Jane

2014-11-01

The 2005 International Health Regulations (IHR) came into force for all Member States of the World Health Organization (WHO) in June 2007 and the deadline for achieving compliance was June 2012. The purpose of the IHR is to prevent, protect against, control - and provide a public health response to - international spread of disease. The territory of the United Kingdom of Great Britain and Northern Ireland and that of several other Member States, such as China, Denmark, France, the Netherlands and the United States of America, include overseas territories, which cover a total population of approximately 15 million people. Member States have a responsibility to ensure that all parts of their territory comply with the IHR. Since WHO has not provided specific guidance on compliance in the special circumstances of the overseas territories of Member States, compliance by these territories is an issue for self-assessment by Member States themselves. To date, no reports have been published on the assessment of IHR compliance in countries with overseas territories. We describe a gap analysis done in the United Kingdom to assess IHR compliance of its overseas territories. The findings and conclusions are broadly applicable to other countries with overseas territories which may have yet to assess their compliance with the IHR. Such assessments are needed to ensure compliance across all parts of a Member States' territory and to increase global health security.

12 CFR 208.6 - Establishment and maintenance of branches.

Code of Federal Regulations, 2010 CFR

2010-01-01

... member bank wishing to establish a branch in the United States or its territories must file an... possessions of those nations and of the United States, and in the Commonwealth of Puerto Rico, are subject to... publication. A State member bank wishing to establish a branch in the United States or its territories must...

Rapid assessment procedures in environmental sanitation research: a case study from the northern border of Mexico.

PubMed

Cifuentes, Enrique; Alamo, Urinda; Kendall, Tamil; Brunkard, Joan; Scrimshaw, Susan

2006-01-01

There is a need to enhance the quality and sustainability of environmental health programs in Mexico. What socio-cultural factors influenced the adoption or rejection of Clean Water in Homes programs in this population? We applied rapid appraisal procedures (RAP) to evaluate these community-based programs. Qualitative study conducted in communities along Mexico's northern border. We conducted informal dialogues, semi-structured interviews, field notes and observations. Home visits used a checklist to observe: sources of water, handwashing, as well as human waste and garbage disposal patterns. Data analysis was conducted using ATLAS.ti, which facilitated comparison and illustration of discrepancies, the elaboration of emerging issues and relationships between them. Community members perceived that the Clean Water program was a top-down intervention. Water is perceived as a political issue and a matter of corruption. Inequity also limits solidarity activities involved in environmental sanitation. Migration to the United States of America (US) contributes to community fragmentation, which in turn dilutes communal efforts to improve water and sanitation infrastructure. While targeting women as program "recipients", the Clean Water program did not take gendered spheres of decision-making into account. Community members and authorities discussed the main results in "assemblies", particularly addressing the needs of excluded groups. The oversight of not exploring community members' needs and priorities prior to program implementation resulted in interventions that did not address the structural (economic, infrastructure) and socio-cultural barriers faced by community members to undertake the health-promoting behaviour change, and provoked resentment.

Disclosure of Cancer Information in Iran: a Perspective of Patients, Family Members, and Health Professionals.

PubMed

Beyraghi, N; Mottaghipour, Y; Mehraban, A; Eslamian, E; Esfahani, F

2011-01-01

In the last decades cancer has become one of the important causes of death in Iran .This study examined perspective of a group of Iranian health professionals, patients and patients' family members regarding their view on disclosure of cancer information at a university hospital in Tehran, Iran. The method of study was qualitative semi-structured focused group content analysis. Two group leaders (psychologist and psychiatrist) run the focus groups. Oncologists, nurses, patients and family members participated in separate focus groups. Five group sessions were held to sum up the participants views in four major topics related to disclosure of cancer information to patients and families. Most of physicians and nurses believed that disclosure of cancer diagnosis is a mistake. Family members think that it should be delivered gradually during stages of therapy based on patient's psychological state, but most of the patients consider truth telling as a patient right. All physicians, most of nurses and all the patients see the physician as a person responsible to break the diagnostic disclosure. All patients wanted the physicians to take the total control of decision-making process for their treatment. Iranian physicians and nurses hesitate to disclose cancer diagnosis compared to patients, who want to know the truth. Patients, nurses and physicians consider the physician to be the person responsible for delivering the information of cancer diagnosis .Development and implementation of a protocol based on Iranian culture is a necessity.

Community-based participatory research in complex settings: clean mind–dirty hands

PubMed Central

Makhoul, Jihad; Nakkash, Rima; Harpham, Trudy; Qutteina, Yara

2014-01-01

Despite the abundance of the literature which discusses factors supporting or inhibiting effective participation of community members in community-based research, there is a paucity of publications analysing challenges to participation in complex settings. This manuscript describes an intervention built on researcher–community partnership amid complex social conditions which challenged participation of community members at different stages of the research process. The research took place in a Palestinian refugee camp in Beirut, Lebanon and 1 of 12 in Lebanon which suffer from deteriorating social, economic and physical conditions perpetuated by state-imposed restrictions. The research team developed a community coalition which was involved in all stages of planning, designing, implementation and dissemination. In all those stages the aim was to maintain rigorous research, to follow a ‘clean mind’ approach to research, but maintain principles of community participation which necessitate ‘a dirty hand’. Despite commitment to the principles of community-based participatory research, participation of community members (including youth, parents and teachers) was affected to a great extent by the social, physical and structural conditions of the community context. Characteristics of the context where research is conducted and how it affects community members should not be overlooked since multiple factors beyond the researchers' control could interfere with the rigour of scientific research. Researchers need to develop a plan for participation with the community from the beginning with an understanding of the community forces that affect meaningful participation and address possible deterrence. PMID:23872385

Examining the Multi-level Fit between Work and Technology in a Secure Messaging Implementation.

PubMed

Ozkaynak, Mustafa; Johnson, Sharon; Shimada, Stephanie; Petrakis, Beth Ann; Tulu, Bengisu; Archambeault, Cliona; Fix, Gemmae; Schwartz, Erin; Woods, Susan

2014-01-01

Secure messaging (SM) allows patients to communicate with their providers for non-urgent health issues. Like other health information technologies, the design and implementation of SM should account for workflow to avoid suboptimal outcomes. SM may present unique workflow challenges because patients add a layer of complexity, as they are also direct users of the system. This study explores SM implementation at two Veterans Health Administration facilities. We interviewed twenty-nine members of eight primary care teams using semi-structured interviews. Questions addressed staff opinions about the integration of SM with daily practice, and team members' attitudes and experiences with SM. We describe the clinical workflow for SM, examining complexity and variability. We identified eight workflow issues directly related to efficiency and patient satisfaction, based on an exploration of the technology fit with multilevel factors. These findings inform organizational interventions that will accommodate SM implementation and lead to more patient-centered care.

Capacity building of midwifery faculty to implement a 3-years midwifery diploma curriculum in Bangladesh: A process evaluation of a mentorship programme.

PubMed

Erlandsson, Kerstin; Doraiswamy, Sathyanarayanan; Wallin, Lars; Bogren, Malin

2018-03-01

When a midwifery diploma-level programme was introduced in 2010 in Bangladesh, only a few nursing faculty staff members had received midwifery diploma-level. The consequences were an inconsistency in interpretation and implementation of the midwifery curriculum in the midwifery programme. To ensure that midwifery faculty staff members were adequately prepared to deliver the national midwifery curriculum, a mentorship programme was developed. The aim of this study was to examine feasibility and adherence to a mentorship programme among 19 midwifery faculty staff members who were lecturing the three years midwifery diploma-level programme at ten institutes/colleges in Bangladesh. The mentorship programme was evaluated using a process evaluation framework: (implementation, context, mechanisms of impact and outcomes). An online and face-to-face blended mentorship programme delivered by Swedish midwifery faculty staff members was found to be feasible, and it motivated the faculty staff members in Bangladesh both to deliver the national midwifery diploma curriculum as well as to carry out supportive supervision for midwifery students in clinical placement. First, the Swedish midwifery faculty staff members visited Bangladesh and provided a two-days on-site visit prior to the initiation of the online part of the mentorship programme. The second on-site visit was five-days long and took place at the end of the programme, that being six to eight months from the first visit. Building on the faculty staff members' response to feasibility and adherence to the mentorship programme, the findings indicate opportunities for future scale-up to all institutes/collages providing midwifery education in Bangladesh. It has been proposed that a blended online and face-to-face mentorship programme may be a means to improving national midwifery programmes in countries where midwifery has only recently been introduced. Copyright © 2018. Published by Elsevier Ltd.

Marathon Kids UK: study design and protocol for a mixed methods evaluation of a school-based running programme.

PubMed

Chalkley, Anna E; Routen, Ash C; Harris, Jo P; Cale, Lorraine A; Gorely, Trish; Sherar, Lauren B

2018-05-14

Schools are promising settings for physical activity promotion; however, they are complex and adaptive systems that can influence the quality of programme implementation. This paper presents an evaluation of a school-based running programme (Marathon Kids). The aims of this study are (1) to identify the processes by which schools implement the programme, (2) identify and explain the contextual factors affecting implementation and explications of effectiveness and (3) examine the relationship between the level of implementation and perceived outcomes. Using a realist evaluation framework, a mixed method single-group before-and-after design, strengthened by multiple interim measurements, will be used. Year 5 (9-10 years old) pupils and their teachers will be recruited from six state-funded primary schools in Leicestershire, UK.Data will be collected once prior to implementation, at five discrete time points during implementation and twice following implementation. A weekly implementation log will also be used. At time point 1 (TP1) (September 2016), data on school environment, teacher and pupil characteristics will be collected. At TP1 and TP6 (July 2017), accelerometry, pupil self-reported physical activity and psychosocial data (eg, social support and intention to be active) will be collected. At TP2, TP3 and TP5 (January, March and June 2017), observations will be conducted. At TP2 and TP5, there will be teacher interviews and pupil focus groups. Follow-up teacher interviews will be conducted at TP7 and TP8 (October 2017 and March 2018) and pupil focus group at TP8. In addition, synthesised member checking will be conducted (June 2018) with a mixed sample of schools. Ethical approval for this study was obtained through Loughborough University Human Participants Ethics Subcommittee (R16-P032 & R16-P116). Findings will be disseminated via print, online media and dissemination events as well as practitioner and/or research journals. © 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.

ISO 9001 certification for hospitals in Bulgaria: does it help service?

PubMed

Stoimenova, Assena; Stoilova, Ani; Petrova, Guenka

2014-03-04

The aim of our study is to review the published literature on establishment and implementation of ISO 9001 QMS in European hospitals, to study the availability of International Organization for Standardization (ISO) quality management systems (QMS) in Bulgarian hospitals and to outline the main advantages of ISO implementation in the hospitals in Bulgaria. The information on availability of ISO QMS in the hospitals in Bulgaria was gathered via Bulgarian certification register, the registries of various quality associations, websites of hospitals and certification companies presented in Bulgaria. A total number of 312 hospitals in Bulgaria were screened for the availability of QMS certified against the ISO 9001 requirements. The experience of European hospitals that implemented QMS is positive and the used approaches to improve the processes and the demonstrated effects from ISO implementation are analysed by the researchers. Unlike other European Union member states, the establishment of quality management systems in Bulgaria is not compulsory. However, our study revealed that 14.42% of the hospitals in Bulgaria have implemented and have certified quality systems against the requirements of ISO 9001. Our study confirmed that a quality management system using the ISO 9001 standard is useful for the hospitals as it can help to increase the operational efficiencies, to reduce errors, improve patient safety and produce a more preventive approach instead of a reactive environment.

Organizational attributes and screening and brief intervention in primary care.

PubMed

Nemeth, Lynne S; Miller, Peter M; Nietert, Paul J; Ornstein, Steven M; Wessell, Andrea M; Jenkins, Ruth G

2013-11-01

Overconsumption of alcohol is well known to lead to numerous health and social problems. Prevalence studies of United States adults found that 20% of patients meet criteria for an alcohol use disorder. Routine screening for alcohol use is recommended in primary care settings, yet little is known about the organizational factors that are related to successful implementation of screening and brief intervention (SBI) and treatment in these settings. The purpose of this study was to evaluate organizational attributes in primary care practices that were included in a practice-based research network trial to implement alcohol SBI. The Survey of Organizational Attributes in Primary Care (SOAPC) has reliably measured four factors: communication, decision-making, stress/chaos and history of change. This 21-item instrument was administered to 178 practice members at the baseline of this trial, to evaluate for relationship of organizational attributes to the implementation of alcohol SBI and treatment. No significant relationships were found correlating alcohol screening, identification of high-risk drinkers and brief intervention, to the factors measured in the SOAPC instrument. These results highlight the challenges related to the use of organizational survey instruments in explaining or predicting variations in clinical improvement. Comprehensive mixed methods approaches may be more effective in evaluations of the implementation of SBI and treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Developing, evaluating and implementing alcohol brief interventions in Europe.

PubMed

Heather, Nick

2011-03-01

This article traces the history of research on the development, evaluation and implementation of alcohol brief intervention (BI) in Europe. Narrative and historical review. BI originated in Europe and, following a definition of opportunistic BI, early pioneering studies are summarised. The role of European scientists in the series of studies making up the WHO Collaborative Project on Detection and Management of Alcohol-related Problems in Primary Health Care (1982-2006) is then described, followed by a short account of a current EU-funded project (Primary Health European Project on Alcohol) with the aim of achieving a widespread, routine and enduring implementation of BI in EU member states. In addition to involvement in these two major projects, a great deal of research on BI has been carried out in a range of European countries and some of this research is noted. Several European governments are now taking the rolling out of BI in routine services very seriously as a policy measure. There is no necessary conflict between widely available BI and alcohol control measures. While much remains to be done regarding practical implementation, the mood of those interested in the promotion of BI as a means of reducing alcohol-related harm, in Europe as elsewhere, is cautiously optimistic. © 2011 Australasian Professional Society on Alcohol and other Drugs.

78 FR 20372 - Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... Member State of the European Union, via any point or points in any Member State and via intermediate... made available to European Union carriers in the future. Docket Number: DOT-OST-2013-0057. Date Filed... member of the European Common Aviation Area; (c) foreign charter air transportation of cargo between any...

78 FR 39435 - Applications for Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

... Member State of the European Union via any point or points in any Member State and via intermediate... rights made available to European Union carriers in the future. Barbara J. Hairston, Acting Program... any member of the European Common Aviation Area; (c) foreign charter cargo air transportation between...

78 FR 68134 - Certificates of Public Convenience and Necessity and Foreign Air Carrier Permits

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... behind any Member State of the European Union, via any point or points in any EU Member State and via... available to European Union carriers in the future. Barbara J. Hairston, Supervisory Dockets Officer, Docket... points in any member of the European Common Aviation Area; (iii) foreign charter air transportation of...

77 FR 37732 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... any Member State of the European Union via any point or points in any Member State and via... points in any member of the European Common Aviation Area; (iii) other charters; and (iv) transportation authorized by any additional route rights made available to European Community carriers in the future. HLE...

77 FR 32172 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-31

... Member State of the European Union via any point or points in any Member State and via intermediate... points in any member of the European Common Aviation Area; (c) foreign scheduled and charter all-cargo... (d) transportation authorized by any additional route rights made available to European Community...

76 FR 38265 - Notice of Applications for Certificates of Public Convenience and Necessity and Foreign Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... Member State of the European Union via any point or points in any Member State and via intermediate... points in any member of the European Common Aviation Area (``ECAA''); (c) other charters pursuant to the... available to European Community carriers in the future. Renee V. Wright, Program Manager, Docket Operations...

19 CFR 148.90 - Foreign military personnel.

Code of Federal Regulations, 2011 CFR

2011-04-01

... baggage and effects of persons on duty in the United States as members of the armed forces of any foreign... member of the armed forces of any foreign country on duty in the United States, for his personal use or... consumption for the official use of members of the armed forces of any foreign country on duty in the United...

19 CFR 148.90 - Foreign military personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

... baggage and effects of persons on duty in the United States as members of the armed forces of any foreign... member of the armed forces of any foreign country on duty in the United States, for his personal use or... consumption for the official use of members of the armed forces of any foreign country on duty in the United...

Forensic DNA databases in Western Balkan region: retrospectives, perspectives, and initiatives

PubMed Central

Marjanović, Damir; Konjhodžić, Rijad; Butorac, Sara Sanela; Drobnič, Katja; Merkaš, Siniša; Lauc, Gordan; Primorac, Damir; Anđelinović, Šimun; Milosavljević, Mladen; Karan, Željko; Vidović, Stojko; Stojković, Oliver; Panić, Bojana; Vučetić Dragović, Anđelka; Kovačević, Sandra; Jakovski, Zlatko; Asplen, Chris; Primorac, Dragan

2011-01-01

The European Network of Forensic Science Institutes (ENFSI) recommended the establishment of forensic DNA databases and specific implementation and management legislations for all EU/ENFSI members. Therefore, forensic institutions from Bosnia and Herzegovina, Serbia, Montenegro, and Macedonia launched a wide set of activities to support these recommendations. To assess the current state, a regional expert team completed detailed screening and investigation of the existing forensic DNA data repositories and associated legislation in these countries. The scope also included relevant concurrent projects and a wide spectrum of different activities in relation to forensics DNA use. The state of forensic DNA analysis was also determined in the neighboring Slovenia and Croatia, which already have functional national DNA databases. There is a need for a ‘regional supplement’ to the current documentation and standards pertaining to forensic application of DNA databases, which should include regional-specific preliminary aims and recommendations. PMID:21674821

Computational materials science and engineering education: A survey of trends and needs

NASA Astrophysics Data System (ADS)

Thornton, K.; Nola, Samanthule; Edwin Garcia, R.; Asta, Mark; Olson, G. B.

2009-10-01

Results from a recent reassessment of the state of computational materials science and engineering (CMSE) education are reported. Surveys were distributed to the chairs and heads of materials programs, faculty members engaged in computational research, and employers of materials scientists and engineers, mainly in the United States. The data was compiled to assess current course offerings related to CMSE, the general climate for introducing computational methods in MSE curricula, and the requirements from the employers’ viewpoint. Furthermore, the available educational resources and their utilization by the community are examined. The surveys show a general support for integrating computational content into MSE education. However, they also reflect remaining issues with implementation, as well as a gap between the tools being taught in courses and those that are used by employers. Overall, the results suggest the necessity for a comprehensively developed vision and plans to further the integration of computational methods into MSE curricula.

European Union pharmacovigilance capabilities: potential for the new legislation

PubMed Central

Tanti, Amy; Kouvelas, Dimitrios; Lungu, Calin; Pirozynski, Michal; Serracino-Inglott, Anthony; Aislaitner, George

2015-01-01

European Directives and Regulations introduced between late 2010 and 2012 have substantially overhauled pharmacovigilance processes across the European Union (EU). In this review, the implementation of the pharmacovigilance legislative framework by EU regulators is examined with the aim of mapping Directive 2010/84/EU and Regulation EC No. 1235/2010 against their aspired objectives of strengthening and rationalizing pharmacovigilance in the EU. A comprehensive review of the current state of affairs of the progress made by EU regulators is presented in this paper. Our review shows that intense efforts by regulators and industry to fulfil legislative obligations have resulted in major positive shifts in pharmacovigilance. Harmonized decision making, transparency in decision processes with patient involvement, information accessibility to the public, patient adverse drug reaction reporting, efforts in communication and enhanced cooperation between member states to maximize resource utilization and minimize duplication of efforts are observed. PMID:26301067

Housing Archetype Analysis for Home Energy-Efficient Retrofit in the Great Lakes Region

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

Kim, S. -K.; Mrozowski, T.; Harrell-Seyburn, A.

This project report details activities and results of the "Market Characterization" project undertaken by the Cost Effective Energy Retrofit (CEER) team targeted toward the DOE goal of achieving 30%-50% reduction in existing building energy use. CEER consists of members from the Dow Chemical Company, Michigan State University, Ferris State University, and Habitat for Humanity Kent County. The purpose of this market characterization project was to identify housing archetypes which are dominant within the Great Lakes region and therefore offer significant potential for energy-efficient retrofit research and implementation due to the substantial number of homes possessing similar characteristics. Understanding the characteristicsmore » of housing groups referred to as "archetypes" by vintage, style, and construction characteristics can allow research teams to focus their retrofit research and develop prescriptive solutions for those structure types which are prevalent and offer high potential uptake within a region or market.« less

Forensic DNA databases in Western Balkan region: retrospectives, perspectives, and initiatives.

PubMed

Marjanović, Damir; Konjhodzić, Rijad; Butorac, Sara Sanela; Drobnic, Katja; Merkas, Sinisa; Lauc, Gordan; Primorac, Damir; Andjelinović, Simun; Milosavljević, Mladen; Karan, Zeljko; Vidović, Stojko; Stojković, Oliver; Panić, Bojana; Vucetić Dragović, Andjelka; Kovacević, Sandra; Jakovski, Zlatko; Asplen, Chris; Primorac, Dragan

2011-06-01

The European Network of Forensic Science Institutes (ENFSI) recommended the establishment of forensic DNA databases and specific implementation and management legislations for all EU/ENFSI members. Therefore, forensic institutions from Bosnia and Herzegovina, Serbia, Montenegro, and Macedonia launched a wide set of activities to support these recommendations. To assess the current state, a regional expert team completed detailed screening and investigation of the existing forensic DNA data repositories and associated legislation in these countries. The scope also included relevant concurrent projects and a wide spectrum of different activities in relation to forensics DNA use. The state of forensic DNA analysis was also determined in the neighboring Slovenia and Croatia, which already have functional national DNA databases. There is a need for a 'regional supplement' to the current documentation and standards pertaining to forensic application of DNA databases, which should include regional-specific preliminary aims and recommendations.

Using Hourly Time-Outs and a Standardized Tool to Promote Team Communication, Medical Record Documentation, and Patient Satisfaction During Second-Stage Labor.

PubMed

Wood, Jessica; Stevenson, Eleanor

2018-04-12

During labor, effective communication and collaboration among the healthcare team is critical for patient safety; however, there is currently no standard for communication and documentation of the plan of care as agreed upon by healthcare team members and the woman in labor. The goal of this project was to increase consistency in communication and collaboration between clinicians and laboring women during secondstage labor. An hourly "time-out" meeting of all healthcare team members was initiated for all women during second-stage labor. A documentation tool was implemented to ensure regular and clear communication between the clinical team and laboring women. Data were collected via medical review of cases of second-stage labor lasting more than 2 hours (n = 21 in the pre-implementation group; n = 39 for 3 months postimplementation; and n = 468 patients for 2 years post-implementation). Surveys were conducted of the clinical team (n = 40) and patients (n = 28). Following implementation, documented agreement of the plan of care increased from 14.3% before the project to 82.1% 3 months after implementation and remained at 81.6% 2 years after implementation. All nurses who participated in the survey reported a clear understanding of how and when to complete necessary medical record documentation during secondstage labor. The providers viewed the project favorably. Most women (92.9%) reported satisfaction with their experience. This project enhanced collaborative communication between members of the clinical team and laboring women and improved patient satisfaction. The improvements were sustainable over a 2-year period.

Leadership, Innovation Climate, and Attitudes toward Evidence-Based Practice during a Statewide Implementation

PubMed Central

Aarons, Gregory A.; Sommerfeld, David H.

2013-01-01

Objective Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader member exchange (i.e., the relationship between a supervisor and their direct service providers) on team innovation climate (i.e., openness to new innovations) and provider attitudes toward adopting evidence-based practice (EBP) during a statewide evidence-based practice implementation (EBPI) of an intervention to reduce child neglect. Methods Participants were 140 case-managers in 30 teams providing home-based services to families in a statewide child-welfare system. Teams were assigned by region to EBPI or services as usual (SAU) conditions. Multiple group path analysis was used to examine associations of transformational leadership and leader member exchange with innovation climate and attitudes toward adoption and use of EBP. Results Transformational leadership predicted higher innovation climate during implementation while leader member exchange predicted higher innovation climate during SAU. Innovation climate was, in turn, associated with more positive attitudes toward EBP for the EBPI group. Conclusions Strategies designed to enhance supervisor transformational leadership have the potential to facilitate implementation efforts by promoting a strong climate for EBPI and positive provider attitudes toward adoption and use of EBP. PMID:22449648

Extra-team connections for knowledge transfer between staff teams

PubMed Central

Ramanadhan, Shoba; Wiecha, Jean L.; Emmons, Karen M.; Gortmaker, Steven L.; Viswanath, Kasisomayajula

2009-01-01

As organizations implement novel health promotion programs across multiple sites, they face great challenges related to knowledge management. Staff social networks may be a useful medium for transferring program-related knowledge in multi-site implementation efforts. To study this potential, we focused on the role of extra-team connections (ties between staff members based in different site teams) as potential channels for knowledge sharing. Data come from a cross-sectional study of afterschool childcare staff implementing a health promotion program at 20 urban sites of the Young Men's Christian Association of Greater Boston. We conducted a sociometric social network analysis and attempted a census of 91 program staff members. We surveyed 80 individuals, and included 73 coordinators and general staff, who lead and support implementation, respectively, in this study. A multiple linear regression model demonstrated a positive relationship between extra-team connections (β = 3.41, P < 0.0001) and skill receipt, a measure of knowledge transfer. We also found that intra-team connections (within-team ties between staff members) were also positively related to skill receipt. Connections between teams appear to support knowledge transfer in this network, but likely require greater active facilitation, perhaps via organizational changes. Further research on extra-team connections and knowledge transfer in low-resource, high turnover environments is needed. PMID:19528313

Leadership & Technology: What School Board Members Need To Know.

ERIC Educational Resources Information Center

Bailey, Gerald D.; And Others

Board members' role in technology implementation ranges from prompting development of technology plans to gathering community support for funding technology initiatives; they need substantial knowledge to enable them to ask the right questions, absorb new information, make good decisions, set appropriate policies, and lead confidently as…

Internal V-Band Clamp

DOEpatents

Vaughn, Mark R.; Hafenrichter, Everett S.; Chapa, Agapito C.; Harris, Steven M.; Martinez, Marcus J.; Baty, Roy S.

2006-02-28

A system for clamping two tubular members together in an end-to-end relationship uses a split ring with a V-shaped outer rim that can engage a clamping surface on each member. The split ring has a relaxed closed state where the ends of the ring are adjacent and the outside diameter of the split ring is less than the minimum inside diameter of the members at their ends. The members are clamped when the split ring is spread into an elastically stretched position where the ring rim is pressed tightly against the interior surfaces of the members. Mechanisms are provided for removing the spreader so the split ring will return to the relaxed state, releasing the clamped members.

Promoting Employee Health Through an American Cancer Society Program, The CEOs Challenge, Washington State, 2013-2015.

PubMed

Harris, Jeffrey R; Parrish, Amanda T; Kohn, Marlana; Hammerback, Kristen; McMillan, Becca; Hannon, Peggy A

2015-12-17

Evidence-based practices in the workplace can increase levels of healthy eating, cancer screening, physical activity, and tobacco cessation but are underused, even in large workplaces. This report summarizes an evaluation of the first year of The CEOs Challenge, a program developed by the American Cancer Society to promote implementation and maintenance of health-promoting, evidence-based workplace practices by large companies. Use of 17 evidence-based practices by 17 companies in the Washington State Chapter of the American Cancer Society's CEOs Against Cancer network was assessed via survey and scored from 0 to 100. Companies received a written report of their baseline performance, followed by at least quarterly consultations with American Cancer Society staff members trained to assist in implementation of these practices. Follow-up performance was measured at 1 year. At baseline, implementation scores were 54.8 for cancer screening, 46.5 for healthy eating, 59.8 for physical activity, and 68.2 for tobacco cessation. At follow-up, scores increased by 19.6 for cancer screening, 19.4 for healthy eating, 16.0 for physical activity, and 9.4 points for tobacco cessation. The CEOs Challenge is a promising approach to chronic disease prevention via the workplace. It brings together one of the nation's largest health-promoting voluntary agencies with the nation's largest employers to promote evidence-based practices targeted at the most common causes of disease and death. The program increased the adoption of these practices and was well-accepted.

Implementation of a pharmacy residency in a Veterans Affairs community-based outpatient clinic.

PubMed

Phillips, Beth Bryles; Williams, Kim C

2012-05-15

The implementation of an innovative ambulatory care pharmacy residency program at a Veterans Affairs (VA) outpatient clinic is described. Community-based outpatient clinics (CBOCs) are a largely underutilized resource for pharmacy residency training. Through a collaboration of the University of Georgia College of Pharmacy in Athens and Charlie Norwood VA Medical Center in Augusta, a postgraduate year 2 (PGY2) pharmacy residency program was established at the CBOC in Athens. The program graduated its first resident in 2009; components of training included (1) disease state management at an anticoagulation clinic and a newly created disease state-focused pharmacotherapy clinic, (2) participation in the planning and implementation of a new lipid management service, (3) a variety of didactic, laboratory, and experiential teaching activities at the college of pharmacy, and (4) management experiences such as completing requests for nonformulary medications, management of drug shortages, adverse drug reaction reporting, and participation in meetings of local and regional VA pharmacy and therapeutics committees. The demonstrated value of the ongoing program led to position upgrades for two CBOC clinical pharmacists and the addition of a clinical faculty member, enabling the program to offer additional learning experiences and preceptorship opportunities. A PGY2 ambulatory care residency program established in a CBOC provided a novel practice setting for the resident, helped improve patient care and pharmacy student education, and assisted in the professional development of preceptors and providers at the training site.

78 FR 32698 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

... --Partnerships for progress --Voluntary IMO Member State Audit Scheme --Integration of women in the maritime... Member State Audit Scheme --Consideration of the report of the Maritime Safety Committee --Consideration...

7 CFR 63.100 - Establishment and membership.

Code of Federal Regulations, 2011 CFR

2011-01-01

...: (a) Voting members. (1) Four members shall be active producers of sheep or goats in the United States... expertise in lamb, wool, goat, or goat product marketing. (b) Non-voting members. (1) One member shall be...

Next steps in addressing the prevention, screening, and treatment of substance use disorder in active duty and veteran Operation Enduring Freedom and Operation Iraqi Freedom populations.

PubMed

Tollison, Sean J; Henderson, Ryan C; Baer, Johns S; Saxon, Andrew J

2012-08-01

The two articles presented previously in this volume provide state-of-the-art reviews of the etiology, epidemiology, screening and treatment of substance use disorder (SUD). This article identifies next steps in research and development for understanding and treating SUD in Operation Enduring Freedom/Operation Iraqi Freedom service members and veterans. Four promising areas are reviewed: advances in psychopharmacological treatment of SUD, innovations in behavioral treatments, the use of technological advances for the screening and treatment of SUD, and integration of treatment services. Future directions are explored and suggestions for research, development and implementation of each of these trends are discussed.

Stroke Telemedicine

PubMed Central

Demaerschalk, Bart M.; Miley, Madeline L.; Kiernan, Terri-Ellen J.; Bobrow, Bentley J.; Corday, Doren A.; Wellik, Kay E.; Aguilar, Maria I.; Ingall, Timothy J.; Dodick, David W.; Brazdys, Karina; Koch, Tiffany C.; Ward, Michael P.; Richemont, Phillip C.

2009-01-01

Stroke telemedicine is a consultative modality that facilitates care of patients with acute stroke at underserviced hospitals by specialists at stroke centers. The design and implementation of a hub-and-spoke telestroke network are complex. This review describes the technology that makes stroke telemedicine possible, the members that should be included in a telestroke team, the hub-and-spoke characteristics of a telestroke network, and the format of a typical consultation. Common obstacles to the practice of telestroke medicine are explored, such as medicolegal, economic, and market issues. An example of a state-based telestroke network is thoroughly described, and established international telestroke networks are presented and compared. The opportunities for future advances in telestroke practice, research, and education are considered. PMID:19121244

Violence, health, and the 2030 agenda: Merging evidence and implementation.

PubMed

Lee, Bandy X; Donnelly, Peter D; Cohen, Larry; Garg, Shikha

2016-09-01

The Guest Editors introduce the Special Issue for the Journal of Public Health Policy on violence, health, and the 2030 Agenda. Emphasizing the importance of collaboration between scholars and practitioners, they outline the process of jointly imagining and designing the next generation of violence prevention strategies. They include representative works of members of the World Health Organization (WHO) Violence Prevention Alliance (VPA), including the World Bank, the United States Centers for Disease Control and Prevention, Prevention Institute, the Danish Institute Against Torture, the University of Cambridge Institute of Criminology, the London School of Hygiene and Tropical Medicine Gender Violence and Health Centre, and the Yale University Law and Psychiatry Division, among others.

Complementary and Integrative Healthcare in a Long-term Care Facility: A Pilot Project.

PubMed

Evans, Roni; Vihstadt, Corrie; Westrom, Kristine; Baldwin, Lori

2015-01-01

The world's population is aging quickly, leading to increased challenges of how to care for individuals who can no longer independently care for themselves. With global social and economic pressures leading to declines in family support, increased reliance is being placed on community- and government-based facilities to provide long-term care (LTC) for many of society's older citizens. Complementary and integrative healthcare (CIH) is commonly used by older adults and may offer an opportunity to enhance LTC residents' wellbeing. Little work has been done, however, rigorously examining the safety and effectiveness of CIH for LTC residents. The goal of this work is to describe a pilot project to develop and evaluate one model of CIH in an LTC facility in the Midwestern United States. A prospective, mixed-methods pilot project was conducted in two main phases: (1) preparation and (2) implementation and evaluation. The preparation phase entailed assessment, CIH model design and development, and training. A CIH model including acupuncture, chiropractic, and massage therapy, guided by principles of collaborative integration, evidence informed practice, and sustainability, was applied in the implementation and evaluation phase. CIH services were provided for 16 months in the LTC facility. Quantitative data collection included pain, quality of life, and adverse events. Qualitative interviews of LTC residents, their family members, and LTC staff members queried perceptions of CIH services. A total of 46 LTC residents received CIH care, most commonly for musculoskeletal pain (61%). Participants were predominantly female (85%) and over the age of 80 years (67%). The median number of CIH treatments was 13, with a range of 1 to 92. Residents who were able to provide self-report data demonstrated, on average, a 15% decline in pain and a 4% improvement in quality of life. No serious adverse events related to treatment were documented; the most common mild and expected side effect was increased pain (63 reports over 859 treatments). Qualitative interviews revealed most residents, family members and LTC staff members felt CIH services were worthwhile due to perceived benefits including pain relief and enhanced psychological and social wellbeing. This project demonstrated that with extensive attention to preparation, one patient-centered model of CIH in LTC was feasible on several levels. Quantitative and qualitative data suggest that CIH can be safely implemented and might provide relief and enhanced wellbeing for residents. However, some aspects of model delivery and data collection were challenging, resulting in limitations, and should be addressed in future efforts.

Split WHO in two: strengthening political decision-making and securing independent scientific advice.

PubMed

Hoffman, Steven J; Røttingen, John-Arne

2014-02-01

The World Health Organization (WHO) has never fulfilled its original mission of simultaneously serving as the world's pre-eminent public health authority and intergovernmental platform for global health negotiations. While WHO's secretariat works hard to fulfill both functions, it is undermined by an institutional design that mixes technical and political mandates. This forces staff to walk uncomfortably along many fine lines: advising but never directing; guiding but never governing; leading but never advocating; evaluating but never judging. The result is mediocrity on both fronts. Instead, WHO should be split in two, separating its technical and political stewardship functions into separate entities, with collaboration in areas of overlap. The Executive Board and secretariat would be bifurcated, with technical units reporting to a Technical Board and political units reporting to a Political Board. Both boards would report to the World Health Assembly where all member states would continue to provide ultimate oversight. Such bold changes can be implemented either by revising WHO's constitution or through simpler mechanisms. Either way, structural governance reforms would need to be accompanied by complementary changes in culture that support strengthened political decision-making and scientific independence. States' inability to act on WHO's institutional design challenges will only lead them and non-state actors to continue bypassing the organization through the creation of new entities as they have done over the last 15 years. The key will be to mobilize those advocates and decision-makers who have the audacity to demand more from WHO and convince member states to elevate their ambitions in current WHO reform efforts. Continued progress in global health depends on it. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

An overview of Compassionate Use Programs in the European Union member states.

PubMed

Balasubramanian, Gayathri; Morampudi, Suman; Chhabra, Pankdeep; Gowda, Arun; Zomorodi, Behsad

2016-11-01

The past decade witnessed rapid development of novel drugs and therapeutic biological agents. The marketing authorization for novel therapies is often time consuming and distressing for patients. Earlier clinical trials were the only way to access new drugs under development. However, not every patient meets the enrolment criteria, and participation is difficult for patients with life-threatening, long-lasting or seriously debilitating diseases like rare diseases. Early access programs like "Compassionate Use Program (CUP)" have generated alternative channels for such patients. The European Medical Agency provides regulations and recommendations for compassionate use, upon which every European Union (EU) member state has developed its own rules and regulations. Despite previous reviews and studies, the available information is limited and gaps exist. This literature review explores CUP in 28 EU member states. Data was collected through literature review and use of country-specific search terms from the healthcare domain. Data sources were not limited to databases and articles published in journals, but also included grey literature. The results implied that CUP was present in 20 EU member states (71%). Of 28 EU states, 18 (∼64%) had nationalized regulations and processes were well-defined. Overall, this review identified CUP and its current status and legislation in 28 EU member states. The established legislation for CUP in the EU member states suggest their willingness to adopt processes that facilitate earlier and better access to new medicines. Further research and periodic reviews are warranted to understand the contemporary and future regulatory trends in early access programs.

The Relationship between Implementation of the American School Counselor Association National Model and Secondary School Counselor Burnout

ERIC Educational Resources Information Center

Camelford, Kellie Giorgio; Ebrahim, Christine H.; Herlihy, Barbara

2017-01-01

The purpose of this study was to examine the relationships between the implementation of the American School Counselor Association (ASCA) National Model and burnout in secondary school counselors who were ASCA members (n = 494). An inverse relationship was discovered between implementation and burnout based on survey results. Results indicated…