Knowledge and perceptions of national and provincial tuberculosis control programme managers in Pakistan about the WHO Stop TB strategy: a qualitative study

PubMed Central

Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz

2016-01-01

Objective To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. Design A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). Participants National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). Setting National and provincial tuberculosis programmes in Pakistan Main outcome measures 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. Results The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. Conclusion This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB strategy over others due to external influences and 3. Limitations in the overall health system. To improve the tuberculosis control programme in the country political commitment needs to be enhanced and public -private partnerships increased. This can be done through government prioritisation of TB control at both national and provincial levels; donor-funded components should not receive undue attention; and partnerships with the private health sector, health institutions not yet covered by DOTS services, non-governmental organisations and patient coalitions should be increased. PMID:28203383

The National Evaluation of NASA's Science, Engineering, Mathematics and Aerospace Academy (SEMAA) Program

ERIC Educational Resources Information Center

Martinez, Alina; Cosentino de Cohen, Clemencia

2010-01-01

This report presents findings from a NASA requested evaluation in 2008, which contains both implementation and impact modules. The implementation study investigated how sites implement Science, Engineering, Mathematics, and Aerospace Academy (SEMAA) and the contextual factors important in this implementation. The implementation study used data…

Protecting breastfeeding in West and Central Africa: over 25 years of implementation of the International Code of Marketing of Breastmilk Substitutes.

PubMed

Sokol, Ellen; Clark, David; Aguayo, Victor M

2008-09-01

In 1981 the World Health Assembly (WHA) adopted the International Code of Marketing of Breastmilk Substitutes out of concern that inappropriate marketing of breastmilk substitutes was contributing to the alarming decline in breastfeeding worldwide and the increase in child malnutrition and mortality, particularly in developing countries. To document progress, challenges, and lessons learned in the implementation of the International Code in West and Central Africa. Data were obtained by literature review and interviews with key informants. Twelve of the 24 countries have laws, decrees, or regulations that implement all or most of the provisions of the Code, 6 countries have a draft law or decree that is awaiting government approval or have a government committee that is studying how best to implement the Code, 3 countries have a legal instrument that enacts a few provisions of the Code, and 3 countries have not taken any action to implement the Code. International declarations and initiatives for child nutrition and survival have provided impetus for national implementation of the Code. National action to regulate the marketing of breastmilk substitutes needs to be linked to national priorities for nutrition and child survival. A clearly defined scope is essential for effective implementation of national legislation. Leadership and support by health professionals is essential to endorse and enforce national legislation. Training on Code implementation is instrumental for national action; national implementation of the Code requires provisions and capacity to monitor and enforce the legislative framework and needs to be part of a multipronged strategy to advance national child nutrition and survival goals. Nations in West and Central Africa have made important progress in implementing the International Code. More than 25 years after its adoption by the WHA, the Code remains as important as ever for child survival and development in West and Central Africa.

The Impact and Implementation of National Qualifications Frameworks: A Comparison of 16 Countries

ERIC Educational Resources Information Center

Allais, Stephanie M.

2011-01-01

This article provides some of the key findings of a comparative study commissioned by the International Labour Organization (ILO), which attempted to understand more about the impact and implementation of national qualifications frameworks (NQFs). Sixteen case studies were produced, on qualifications frameworks in Australia; Bangladesh; Botswana;…

The international implications of national and local coordination on building energy codes: Case studies in six cities

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

Evans, Meredydd; Yu, Sha; Staniszewski, Aaron

Building energy efficiency is an important strategy for reducing greenhouse gas emissions globally. In fact, 55 countries have included building energy efficiency in their Nationally Determined Contributions (NDCs) under the Paris Agreement. This research uses building energy code implementation in six cities across different continents as case studies to assess what it may take for countries to implement the ambitions of their energy efficiency goals. Specifically, we look at the cases of Bogota, Colombia; Da Nang, Vietnam; Eskisehir, Turkey; Mexico City, Mexico; Rajkot, India; and Tshwane, South Africa, all of which are “deep dive” cities under the Sustainable Energy formore » All's Building Efficiency Accelerator. The research focuses on understanding the baseline with existing gaps in implementation and coordination. The methodology used a combination of surveys on code status and interviews with stakeholders at the local and national level, as well as review of published documents. We looked at code development, implementation, and evaluation. The cities are all working to improve implementation, however, the challenges they currently face include gaps in resources, capacity, tools, and institutions to check for compliance. Better coordination between national and local governments could help improve implementation, but that coordination is not yet well established. For example, all six of the cities reported that there was little to no involvement of local stakeholders in development of the national code; only one city reported that it had access to national funding to support code implementation. More robust coordination could better link cities with capacity building and funding for compliance, and ensure that the code reflects local priorities. By understanding gaps in implementation, it can also help in designing more targeted interventions to scale up energy savings.« less

The international implications of national and local coordination on building energy codes: Case studies in six cities

DOE PAGES

Evans, Meredydd; Yu, Sha; Staniszewski, Aaron; ...

2018-04-17

Building energy efficiency is an important strategy for reducing greenhouse gas emissions globally. In fact, 55 countries have included building energy efficiency in their Nationally Determined Contributions (NDCs) under the Paris Agreement. This research uses building energy code implementation in six cities across different continents as case studies to assess what it may take for countries to implement the ambitions of their energy efficiency goals. Specifically, we look at the cases of Bogota, Colombia; Da Nang, Vietnam; Eskisehir, Turkey; Mexico City, Mexico; Rajkot, India; and Tshwane, South Africa, all of which are “deep dive” cities under the Sustainable Energy formore » All's Building Efficiency Accelerator. The research focuses on understanding the baseline with existing gaps in implementation and coordination. The methodology used a combination of surveys on code status and interviews with stakeholders at the local and national level, as well as review of published documents. We looked at code development, implementation, and evaluation. The cities are all working to improve implementation, however, the challenges they currently face include gaps in resources, capacity, tools, and institutions to check for compliance. Better coordination between national and local governments could help improve implementation, but that coordination is not yet well established. For example, all six of the cities reported that there was little to no involvement of local stakeholders in development of the national code; only one city reported that it had access to national funding to support code implementation. More robust coordination could better link cities with capacity building and funding for compliance, and ensure that the code reflects local priorities. By understanding gaps in implementation, it can also help in designing more targeted interventions to scale up energy savings.« less

Standardized patient walkthroughs in the National Drug Abuse Treatment Clinical Trials Network: common challenges to protocol implementation.

PubMed

Fussell, Holly E; Kunkel, Lynn E; McCarty, Dennis; Lewy, Colleen S

2011-09-01

Training research staff to implement clinical trials occurring in community-based addiction treatment programs presents unique challenges. Standardized patient walkthroughs of study procedures may enhance training and protocol implementation. Examine and discuss cross-site and cross-study challenges of participant screening and data collection procedures identified during standardized patient walkthroughs of multi-site clinical trials. Actors portrayed clients and "walked through" study procedures with protocol research staff. The study completed 57 walkthroughs during implementation of 4 clinical trials. Observers and walkthrough participants identified three areas of concern (consent procedures, screening and assessment processes, and protocol implementation) and made suggestions for resolving the concerns. Standardized patient walkthroughs capture issues with study procedures previously unidentified with didactic training or unscripted rehearsals. Clinical trials within the National Drug Abuse Treatment Clinical Trials Network are conducted in addiction treatment centers that vary on multiple dimensions. Based on walkthrough observations, the national protocol team and local site leadership modify standardized operating procedures and resolve cross-site problems prior to recruiting study participants. The standardized patient walkthrough improves consistency across study sites and reduces potential site variation in study outcomes.

Lessons learned and insights from the implementation of a food and physical activity policy to prevent obesity in Mexican schools: An analysis of nationally representative survey results.

PubMed

Théodore, Florence L; Moreno-Saracho, Jessica E; Bonvecchio, Anabelle; Morales-Ruán, María Del Carmen; Tolentino-Mayo, Lizbeth; López-Olmedo, Nancy; Shamah-Levy, Teresa; Rivera, Juan A

2018-01-01

Obesity is a serious problem among children in Mexico. In 2010, the government implemented a national food and physical activity policy in elementary schools, to prevent obesity. The goal of this study is to assess the implementation of this policy, using the logic model from a descriptive survey with national representativeness at the elementary school level and based on a stratified cluster design. We used a systematic random sampling of schools (n = 122), stratified into public and private. We administered questionnaires to 116 principals, 165 members of the Food and Physical Activity Committees, 132 food school food vendors, 119 teachers, 348 parents. This study evidences a significant deviation in implementation from what had been planned. Our lessons learned are the importance to: base the design/implementation of the policy on a theoretical framework, make programs appealing to stakeholders, select concrete and measurable objective or goals, and support stakeholders during the implementation process.

Integrating the Poor through e-Governance: A Case Study of the National e-Governance Plan in India

ERIC Educational Resources Information Center

Dasgupta, Shib Shankar

2010-01-01

This dissertation examines the adoption and implementation mechanism of the national e-Governance plan in the regional state of West Bengal in India. The questions that this dissertation seek to illuminate are (i) the various potentials and challenges in integrating the ordinary citizens in the implementation of the national e-Governance plan in…

Building capacity for implementation of the framework convention for tobacco control in Vietnam: lessons for developing countries

PubMed Central

Stillman, Frances A.; David, Annette M.; Kibria, Naseeb; Phan, Hai Thi

2014-01-01

Effective implementation of the WHO international Framework Convention on Tobacco Control (FCTC) is the key to controlling the tobacco epidemic. Within countries, strong national tobacco control capacity is the primary determinant for successful implementation of the FCTC. This case study of tobacco control policy describes the experience of building national tobacco control capacity in Vietnam under the Reduce Smoking in Vietnam Partnership project within a national capacity-building framework. In the Vietnam experience, four components of tobacco control capacity emerged as especially important to achieve ‘quality’ outputs and measurable outcomes at the implementation level: (i) organizational structure/infrastructure; (ii) leadership and expertise; (iii) partnerships and networks and (iv) data and evidence from research. The experience gained in this project helps in adapting our tobacco control capacity-building model, and the lessons that emerged from this country case study can provide guidance to global funders, tobacco control technical assistance providers and nations as governments endeavor to meet their commitment to the FCTC. PMID:23411160

The constraints of good governance practice in national solid waste management policy (NSWMP) implementation: A case study of Malaysia

NASA Astrophysics Data System (ADS)

Wee, Seow Ta; Abas, Muhamad Azahar; Chen, Goh Kai; Mohamed, Sulzakimin

2017-10-01

Nowadays, international donors have emphasised on the adoption of good governance practices in solid waste management which include policy implementation. In Malaysia, the National Solid Waste Management Policy (NSWMP) was introduced as the main guideline for its solid waste management and the Malaysian government has adopted good governance practice in the NSMWP implementation. However, the good governance practices implemented by the Malaysian government encountered several challenges. This study was conducted to explore the good governance constraints experienced by stakeholders in the NSWMP implementation. An exploratory research approach is applied in this study through in-depth interviews with several government agencies and concessionaires that involved in the NSWMP implementation in Malaysia. A total of six respondents took part in this study. The findings revealed three main good governance constraints in the NSWMP implementation, namely inadequate fund, poor staff's competency, and ambiguity of policy implementation system. Moreover, this study also disclosed that the main constraint influenced the other constraints. Hence, it is crucial to identify the main constraint in order to minimise its impact on the other constraints.

Implementation of Algebra I in Eighth Grade: An "Ex-Post Facto" Study on Student Achievement

ERIC Educational Resources Information Center

Realdine, Dorothy S.

2010-01-01

Only recently have school districts across the nation begun to offer Algebra I to all eighth grade students. Currently, most eighth grade Algebra I curriculum does not have a national consistent focus of topics or level of rigor. A key issue of implementing Algebra I in eighth grade is defining national Algebra I concepts and skills that students…

A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.

PubMed

Cohen, Deborah J; Balasubramanian, Bijal A; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I; Crabtree, Benjamin F; Stange, Kurt C; Davis, Melinda; Miller, William L; Damschroder, Laura J; McConnell, K John; Creswell, John

2016-06-29

The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic). Examples of external support include practice facilitation, expert consultation, performance feedback, and educational materials and activities. This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). This prospective observational study will examine the portfolio of EvidenceNOW Cooperatives using both qualitative and quantitative data. Qualitative data include: online implementation diaries, observation and interviews at Cooperatives and practices, and systematic assessment of context from the perspective of Cooperative team members. Quantitative data include: practice-level performance on clinical quality measures (aspirin prescribing, blood pressure and cholesterol control, and smoking cessation; ABCS) collected by Cooperatives from electronic health records (EHRs); practice and practice member surveys to assess practice capacity and other organizational and structural characteristics; and systematic tracking of intervention delivery. Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness. ESCALATES is a national evaluation of an ambitious large-scale dissemination and implementation effort focused on transforming smaller primary care practices. Insights will help to inform the design of national health care practice extension systems aimed at supporting practice transformation efforts in the USA. NCT02560428 (09/21/15).

Needs and Contradictions of a Changing Field: Evidence from a National Response to Intervention Implementation Study

ERIC Educational Resources Information Center

Patrikakou, Eva; Ockerman, Melissa S.; Hollenbeck, Amy Feiker

2016-01-01

As a result of the Response to Intervention (RTI) mandate in schools across many states, school counselors are well-positioned to take a leadership role. The present research study examines how school counselors across the nation perceived their training and knowledge of RTI, as well as their confidence in its implementation. Results indicate that…

An Evaluation of the Implementation of National Core Curricula in Australia. Summary Report.

ERIC Educational Resources Information Center

Parkinson, Kevin J.; Broderick, John S.

As part of a study of the development and implementation of the National Core Curricula (NCC) in Australia, a historical background was prepared from a number of data sources and views on NCC were sought from senior Technical and Further Education (TAFE) officers in Australia. More specific information was sought in three case studies, the project…

Favorite Lesson Plans: Powerful Standards-Based Activities.

ERIC Educational Resources Information Center

Wilen, William W., Ed.

This collection of lesson plans helps social studies teachers and teacher educators implement the various national and state standards in their classrooms. The collection illustrates how classroom implementation can be achieved through the application of the powerful teaching and learning principles devised by National Council for the Social…

Girls' and Women's Education: Policies and Implementation Mechanisms. Synthesis of Five Case Studies.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

The national policies and implementation mechanisms for girls' primary and women's basic education in the following Asian countries were examined: Lao People's Democratic Republic; Nepal, Thailand; Indonesia; and India. The analysis focused on the following issues: (1) goals and progress; (2) national policies; (3) strategies (strengthening…

Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care (CLAHRC) programme nationally and in North West London.

PubMed

Caldwell, Sarah E M; Mays, Nicholas

2012-10-15

The publication of Best research for best health in 2006 and the "ring-fencing" of health research funding in England marked the start of a period of change for health research governance and the structure of research funding in England. One response to bridging the 'second translational gap' between research knowledge and clinical practice was the establishment of nine Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The goal of this paper is to assess how national-level understanding of the aims and objectives of the CLAHRCs translated into local implementation and practice in North West London. This study uses a variation of Goffman's frame analysis to trace the development of the initial national CLAHRC policy to its implementation at three levels. Data collection and analysis were qualitative through interviews, document analysis and embedded research. Analysis at the macro (national policy), meso (national programme) and micro (North West London) levels shows a significant common understanding of the aims and objectives of the policy and programme. Local level implementation in North West London was also consistent with these. The macro-meso-micro frame analysis is a useful way of studying the transition of a policy from high-level idea to programme in action. It could be used to identify differences at a local (micro) level in the implementation of multi-site programmes that would help understand differences in programme effectiveness.

Implementation of the Xpert MTB/RIF assay for tuberculosis in Mongolia: a qualitative exploration of barriers and enablers.

PubMed

Rendell, Nicole L; Bekhbat, Solongo; Ganbaatar, Gantungalag; Dorjravdan, Munkhjargal; Pai, Madhukar; Dobler, Claudia C

2017-01-01

The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia's National Tuberculosis Program. Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia's capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software. Eight laboratory staff (five from the National Tuberculosis Reference Laboratory in Ulaanbaatar and three from provincial laboratories) and sixteen tuberculosis physicians (five from the Mongolian National Center for Communicable Diseases in Ulaanbaatar, four from district tuberculosis clinics in Ulaanbaatar and seven from provincial tuberculosis clinics) were interviewed. Major barriers to Xpert MTB/RIF implementation identified were: lack of awareness of program guidelines; inadequate staffing arrangements; problems with cartridge supply management; lack of local repair options for the Xpert machines; lack of regular formal training; paper based system; delayed treatment initiation due to consensus meeting and poor sample quality. Enablers to Xpert MTB/RIF implementation included availability of guidelines in the local language; provision of extra laboratory staff, shift working arrangements and additional modules; capacity for troubleshooting internally; access to experts; opportunities for peer learning; common understanding of diagnostic algorithms and decentralised testing. Our study identified a number of barriers and enablers to implementation of Xpert MTB/RIF in the Mongolian National Tuberculosis Program. Lessons learned from this study can help to facilitate implementation of Xpert MTB/RIF in other Mongolian locations as well as other low-and middle-income countries.

77 FR 14530 - National Institute of Child Health and Human Development; New Proposed Collection; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... methodological studies conducted during the Vanguard phase will inform the implementation and analysis plan for... Research Methodology Studies for the National Children's Study SUMMARY: In compliance with the requirement... Collection: Title: Environmental Science Formative Research Methodology Studies for the National Children's...

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

PubMed

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

2018-04-01

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

Research lessons from implementing a national nursing workforce study.

PubMed

Brzostek, T; Brzyski, P; Kózka, M; Squires, A; Przewoźniak, L; Cisek, M; Gajda, K; Gabryś, T; Ogarek, M

2015-09-01

National nursing workforce studies are important for evidence-based policymaking to improve nursing human resources globally. Survey instrument translation and contextual adaptation along with level of experience of the research team are key factors that will influence study implementation and results in countries new to health workforce studies. This study's aim was to describe the pre-data collection instrument adaptation challenges when designing the first national nursing workforce study in Poland while participating in the Nurse Forecasting: Human Resources Planning in Nursing project. A descriptive analysis of the pre-data collection phase of the study. Instrument adaptation was conducted through a two-phase content validity indexing process and pilot testing from 2009 to September 2010 in preparation for primary study implementation in December 2010. Means of both content validation phases were compared with pilot study results to assess for significant patterns in the data. The initial review demonstrated that the instrument had poor level of cross-cultural relevance and multiple translation issues. After revising the translation and re-evaluating using the same process, instrument scores improved significantly. Pilot study results showed floor and ceiling effects on relevance score correlations in each phase of the study. The cross-cultural adaptation process was developed specifically for this study and is, therefore, new. It may require additional replication to further enhance the method. The approach used by the Polish team helped identify potential problems early in the study. The critical step improved the rigour of the results and improved comparability for between countries analyses, conserving both money and resources. This approach is advised for cross-cultural adaptation of instruments to be used in national nursing workforce studies. Countries seeking to conduct national nursing workforce surveys to improve nursing human resources policies may find the insights provided by this paper useful to guide national level nursing workforce study implementation. © 2015 International Council of Nurses.

National Assessments for Student Teachers: Documenting Teaching Readiness to the Tipping Point

ERIC Educational Resources Information Center

Margolis, Jason; Doring, Anne

2013-01-01

To evaluate the impact of the emergent national teacher performance assessment (TPA) on student teachers, this study examined a pilot implementation at one university in Washington State during Spring 2011. The qualitative research focused on the lived experience of those directly affected by TPA implementation: student teachers, mentor teachers,…

Civic Education Policies: Their Effect on University Students' Spirit of Nationalism and Patriotism

ERIC Educational Resources Information Center

Nurdin, Encep Syarief

2017-01-01

This study aims to describe the effect of implementing Civic Education policies in a university on the development of students' sense of nationalism and patriotism; this is analysed from the perspective of Edward III's public policy implementation dimension and employs a quantitative approach based on the descriptive verification method. The…

GIS Education in Taiwanese Senior High Schools: A National Survey among Geography Teachers

ERIC Educational Resources Information Center

Wang, Yao-Hui; Chen, Che-Ming

2013-01-01

Following the integration of GIS into the national curriculum standards of senior high school geography, Taiwan has systematically implemented GIS education for over a decade. However, the effectiveness of this implementation is currently unclear. Therefore, this study investigates the status of GIS education in Taiwanese senior high schools. A…

Theoretical and Practical Issues of the Implementation of International Norms on Human Rights to the National Legislation (the Example of the Republic of Azerbaijan)

ERIC Educational Resources Information Center

Aliyev, Subhan F.

2016-01-01

The purpose of the study is to analyze the features of the implementation of international norms on human rights to the national law system of the Republic of Azerbaijan. Using the method of the critical analysis of national legislative framework on human rights, the authors argue that there are some certain problems connected with the application…

Building capacity for implementation of the framework convention for tobacco control in Vietnam: lessons for developing countries.

PubMed

Stillman, Frances A; David, Annette M; Kibria, Naseeb; Phan, Hai Thi

2014-09-01

Effective implementation of the WHO international Framework Convention on Tobacco Control (FCTC) is the key to controlling the tobacco epidemic. Within countries, strong national tobacco control capacity is the primary determinant for successful implementation of the FCTC. This case study of tobacco control policy describes the experience of building national tobacco control capacity in Vietnam under the Reduce Smoking in Vietnam Partnership project within a national capacity-building framework. In the Vietnam experience, four components of tobacco control capacity emerged as especially important to achieve 'quality' outputs and measurable outcomes at the implementation level: (i) organizational structure/infrastructure; (ii) leadership and expertise; (iii) partnerships and networks and (iv) data and evidence from research. The experience gained in this project helps in adapting our tobacco control capacity-building model, and the lessons that emerged from this country case study can provide guidance to global funders, tobacco control technical assistance providers and nations as governments endeavor to meet their commitment to the FCTC. © The Author (2013). Published by Oxford University Press.

The Battle for Vocational Education: An Evaluation of the Study Plan for the National Assessment (NAVE) and Its First Year Implementation.

ERIC Educational Resources Information Center

Merkel-Keller, Claudia

This paper examines the study plan for the National Assessment of Vocational Education (NAVE) and outlines some of the preliminary results that have been determined to date. According to the paper, the NAVE has identified five broad areas in which to conduct research: (1) implementation of the Carl D. Perkins Vocational Education Act; (2)…

78 FR 34034 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-06

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... purpose of the Committee is to provide advice and recommendations on the implementation of the National...

THE NATIONAL CHILDREN'S STUDY: BEGINNING THE IMPLEMENTATION OF A NATIONAL-PROBABILITY SAMPLE

EPA Science Inventory

Introduction: The National Children's Study (NCS) is a longitudinal cohort study that will follow a sample of approximately 100,000 children born in the United States from before birth until 21 years of age. The NCS will investigate the separate and combined effects of environmen...

Implementation of Policy, Systems, and Environmental Community-Based Interventions for Cardiovascular Health Through a National Not-for-Profit: A Multiple Case Study.

PubMed

Garney, Whitney R; Szucs, Leigh E; Primm, Kristin; King Hahn, Laura; Garcia, Kristen M; Martin, Emily; McLeroy, Kenneth

2018-05-01

In 2014, the Centers for Disease Control and Prevention funded the American Heart Association to implement policy, systems, and environment-focused strategies targeting access to healthy food and beverages, physical activity, and smoke-free environments. To understand factors affecting implementation and variations in success across sites, evaluators conducted a multiple case study. Based on past literature, community sites were categorized as capacity-building or implementation-ready, for comparison. A sample of six communities were selected using a systematic selection tool. Through site visits, evaluators conducted interviews with program staff and community partners and assessed action plans. Evaluators identified important implications for nationally coordinated community-based prevention programming. Differences in implementation varied by the communities' readiness, with the most notable differences in how they planned activities and defined success. Existing partner relationships (or lack thereof) played a significant role, regardless of the American Heart Association's existing presence within the communities, in the progression of initiatives and the differences observed among phases. Last, goals in capacity-building sites were tied to organizational goals while goals in implementation-ready sites were more incremental with increased community influence and buy-in. Using national organizations as a mechanism to carry out large-scale community-based prevention work is a viable option that provides coordinated, wide-scale implementation without sacrificing a community's priorities or input. In funding future initiatives, the presence of relationships and the time needed to cultivate such relationships should be accounted for in the planning and implementation processes, as well as both local and national expectations.

Accessibility and implementation in UK services of an effective depression relapse prevention programme – mindfulness-based cognitive therapy (MBCT): ASPIRE study protocol

PubMed Central

2014-01-01

Background Mindfulness-based cognitive therapy (MBCT) is a cost-effective psychosocial prevention programme that helps people with recurrent depression stay well in the long term. It was singled out in the 2009 National Institute for Health and Clinical Excellence (NICE) Depression Guideline as a key priority for implementation. Despite good evidence and guideline recommendations, its roll-out and accessibility across the UK appears to be limited and inequitably distributed. The study aims to describe the current state of MBCT accessibility and implementation across the UK, develop an explanatory framework of what is hindering and facilitating its progress in different areas, and develop an Implementation Plan and related resources to promote better and more equitable availability and use of MBCT within the UK National Health Service. Methods/Design This project is a two-phase qualitative, exploratory and explanatory research study, using an interview survey and in-depth case studies theoretically underpinned by the Promoting Action on Implementation in Health Services (PARIHS) framework. Interviews will be conducted with stakeholders involved in commissioning, managing and implementing MBCT services in each of the four UK countries, and will include areas where MBCT services are being implemented successfully and where implementation is not working well. In-depth case studies will be undertaken on a range of MBCT services to develop a detailed understanding of the barriers and facilitators to implementation. Guided by the study’s conceptual framework, data will be synthesized across Phase 1 and Phase 2 to develop a fit for purpose implementation plan. Discussion Promoting the uptake of evidence-based treatments into routine practice and understanding what influences these processes has the potential to support the adoption and spread of nationally recommended interventions like MBCT. This study could inform a larger scale implementation trial and feed into future implementation of MBCT with other long-term conditions and associated co-morbidities. It could also inform the implementation of interventions that are acceptable and effective, but are not widely accessible or implemented. PMID:24884603

Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care (CLAHRC) programme nationally and in North West London

PubMed Central

2012-01-01

Background The publication of Best research for best health in 2006 and the “ring-fencing” of health research funding in England marked the start of a period of change for health research governance and the structure of research funding in England. One response to bridging the ‘second translational gap’ between research knowledge and clinical practice was the establishment of nine Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The goal of this paper is to assess how national-level understanding of the aims and objectives of the CLAHRCs translated into local implementation and practice in North West London. Methods This study uses a variation of Goffman’s frame analysis to trace the development of the initial national CLAHRC policy to its implementation at three levels. Data collection and analysis were qualitative through interviews, document analysis and embedded research. Results Analysis at the macro (national policy), meso (national programme) and micro (North West London) levels shows a significant common understanding of the aims and objectives of the policy and programme. Local level implementation in North West London was also consistent with these. Conclusions The macro-meso-micro frame analysis is a useful way of studying the transition of a policy from high-level idea to programme in action. It could be used to identify differences at a local (micro) level in the implementation of multi-site programmes that would help understand differences in programme effectiveness. PMID:23067208

77 FR 50985 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... implementation of the National Forest System Land Management Rule. The meeting is open to the public. The purpose...

Dilemmas of Leading National Curriculum Reform in a Global Era: A Chinese Perspective

ERIC Educational Resources Information Center

Yin, Hongbiao; Lee, John Chi-Kin; Wang, Wenlan

2014-01-01

Since the mid-1980s, a global resurgence of large-scale reform in the field of education has been witnessed. Implementing these reforms has created many dilemmas for change leaders. Following a three-year qualitative research project, the present study explores the dilemmas leaders faced during the implementation of the national curriculum reform…

Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

ERIC Educational Resources Information Center

Naradko, Anthony M.

2017-01-01

The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

Teachers' Perceptions of Preparedness Related to National Common Core State Standards for Mathematics

ERIC Educational Resources Information Center

Brown, Tykier

2016-01-01

With the adoption of the National Common Core State Standards in Mathematics (CCSSM) in many states and the lack of understanding and strategies to implement the new standards by classroom teachers, implementing effective professional development is vital. The focus of this qualitative case study was to provide insight into elementary school…

[Study on the overall implementation status of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

PubMed

Li, J J; Li, J L; Zhang, J; Jin, R R; Ma, S; Deng, G J; Su, X W; Bian, F; Qu, Y M; Hu, L L; Jiang, Y

2018-04-10

Objective: To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: According to the scheme design of the questionnaires, all the National Demonstration Areas were involved in this study. For each National Demonstration Areas, eight departments were selected to complete a total of 12 questionnaires. Results: Scores related to the implementation of the National Demonstration Areas accounted for 71.8% of the total 170 points. Based on the scores gathered from this study, the 23-items-index-system that represented the status of project implementation was classified into seven categories. Categories with higher percentile scores would include: monitoring (88.0%), safeguard measures (75.0%), health education and health promotion (75.0%). Categories with lower percentile scores would include: the national health lifestyle actions (67.7%), community diagnosis (66.7%), discovery and intervention of high-risk groups (64.7%), and patient management (60.9%). There were significant differences noticed among the eastern, central and western areas on items as safeguard measures, health education/promotion, discovery and intervention of high-risk groups. In all, the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions. As for the 23 items, five of the highest scores appeared on policy support, mortality surveillance, tumor registration, reporting system on cardiovascular/cerebrovascular events, and on tobacco control, respectively. However, the lowest five scores fell on healthy diet, patient self-management program, oral hygiene, setting up the demonstration units and promotion on basic public health services, respectively. The overall scores in the eastern region was higher than that in the central or the western regions. The scores in the central and western regions showed basically the same. Conclusions: The overall status of implementation on the National Demonstration Areas was satisfactory. Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups, which also presented the lowest scores, in this survey.

Cross-sectional study on factors hampering implementation of measles pre- and postexposure measures in Dutch hospitals during the 2013-2014 measles outbreak.

PubMed

Fievez, L C R; Wong, A; Ruijs, W L M; Meerstadt-Rombach, F S; Timen, A

2017-07-01

This study examined adherence to national recommendations on measles pre- and postexposure measures, including immunization of health care workers (HCWs) in Dutch hospitals, during a national outbreak of measles in The Netherlands. This study also investigated which hospital characteristics and organizational issues hamper implementation. This was a cross-sectional survey among all general and academic hospitals in The Netherlands. An online structured questionnaire (48 questions) was administered. Analysis was performed using descriptive statistics and logistic regression. Of 88 hospitals, 70 (79.5%) were included. Of 68 hospitals, 48 (70.6%) assessed susceptibility to measles in HCWs. Of 70 hospitals, 61 (87.1%) offered vaccination to susceptible HCWs. Of 63 hospitals, 42 (66.7%) had postexposure policies consistent with national recommendations. Of 62 hospitals, 30 (48.4%) implemented all these measures, which is the minimum set of measures considered necessary to adequately prevent measles in HCWs. Logistic regression suggests that hospitals with several locations, hospitals with more employees, and hospitals where infectious disease experts designed infection prevention policies while occupational health experts implemented the policy less often implemented this minimum set of measures (P < .001, P < .01, and P < .001, respectively). During a national measles outbreak, most hospitals took measures to prevent measles in HCWs, but less than half implemented the minimum set of measures required. Implementation strategies in hospitals need to be improved, especially in large-sized hospitals and hospitals with several locations, and with respect to the assignment of responsibilities for infection prevention policies. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Implementation of the Xpert MTB/RIF assay for tuberculosis in Mongolia: a qualitative exploration of barriers and enablers

PubMed Central

Bekhbat, Solongo; Ganbaatar, Gantungalag; Dorjravdan, Munkhjargal; Pai, Madhukar; Dobler, Claudia C.

2017-01-01

Objective The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia’s National Tuberculosis Program. Methods Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia’s capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software. Results Eight laboratory staff (five from the National Tuberculosis Reference Laboratory in Ulaanbaatar and three from provincial laboratories) and sixteen tuberculosis physicians (five from the Mongolian National Center for Communicable Diseases in Ulaanbaatar, four from district tuberculosis clinics in Ulaanbaatar and seven from provincial tuberculosis clinics) were interviewed. Major barriers to Xpert MTB/RIF implementation identified were: lack of awareness of program guidelines; inadequate staffing arrangements; problems with cartridge supply management; lack of local repair options for the Xpert machines; lack of regular formal training; paper based system; delayed treatment initiation due to consensus meeting and poor sample quality. Enablers to Xpert MTB/RIF implementation included availability of guidelines in the local language; provision of extra laboratory staff, shift working arrangements and additional modules; capacity for troubleshooting internally; access to experts; opportunities for peer learning; common understanding of diagnostic algorithms and decentralised testing. Conclusion Our study identified a number of barriers and enablers to implementation of Xpert MTB/RIF in the Mongolian National Tuberculosis Program. Lessons learned from this study can help to facilitate implementation of Xpert MTB/RIF in other Mongolian locations as well as other low-and middle-income countries. PMID:28717600

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

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

76 FR 81911 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... National Forest System Land Management Planning Rule AGENCY: USDA Forest Service. ACTION: Notice of intent... intends to establish the National Advisory Committee for Implementation of the National Forest System Land... (FACA), the Committee is being established to provide advice and recommendations on the implementation...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

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

Marine Corps Installations National Capital RegionRegional Contracting Office Generally Implemented Recommendations

DTIC Science & Technology

2016-07-29

Corps Installations National Capital Region–Regional Contracting Office Generally Implemented Recommendations J U LY 2 9 , 2 0 1 6 Report No...Installations National Capital Region–Regional Contracting Office Generally Implemented Recommendations Objective We determined whether the Marine...Corps Regional Contracting Office–National Capital Region implemented the recommendations in Report No. DODIG-2015-095, “Small Business Contracting

Teachers' Value Internalization and Commitment to Implementation of National Junior Secondary School Home Economics Curriculum in South-Western States of Nigeria

ERIC Educational Resources Information Center

Badmus, Medinat

2007-01-01

This study investigated the level of degree to which the home Economics teachers developed value internalization and commitment for the implementation of the National Junior Secondary School Home Economics Curriculum (NJSSHEC). It also determined the state and qualification influence on the level of degree of value internalization and commitment…

Implementing non-invasive prenatal testing for aneuploidy in a national healthcare system: global challenges and national solutions.

PubMed

van Schendel, Rachèl V; van El, Carla G; Pajkrt, Eva; Henneman, Lidewij; Cornel, Martina C

2017-09-19

Since the introduction of non-invasive prenatal testing (NIPT) in 2011, mainly by commercial companies, a growing demand for NIPT from the public and healthcare professionals has been putting pressure on the healthcare systems of various countries. This study identifies the challenges of establishing a responsible implementation of NIPT for aneuploidy in prenatal healthcare, by looking at the Netherlands. A mixed methods approach involving 13 stakeholder interviews, document analysis and (participatory) observations of the Dutch NIPT Consortium meetings were used. The Diffusion of Innovation Theory and a Network of Actors model were used to interpret the findings. Implementation of NIPT was facilitated by several factors. The set-up of a national NIPT Consortium enabled discussion and collaboration between stakeholders. Moreover, it led to the plan to offer NIPT through a nationwide research setting (TRIDENT studies), which created a learning phase for careful implementation. The Dutch legal context was perceived as a delaying factor, but eventually gave room for the parties involved to organise themselves and their practices. This study shows that implementing advanced technologies with profound effects on prenatal care benefit from a learning phase that allows time to carefully evaluate the technical performance and women's experiences and to enable public debate. Such a coordinated learning phase, involving all stakeholders, will stimulate the process of responsible and sustainable implementation.

77 FR 47862 - National Environmental Policy Act: Implementing Procedures; Addition to Categorical Exclusions...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... DEPARTMENT OF THE INTERIOR Office of the Secretary National Environmental Policy Act: Implementing... Interior. ACTION: Notice of Final National Environmental Policy Act Implementing Procedures. SUMMARY: This notice announces the addition of a new categorical exclusion under the National Environmental Policy Act...

Anything but engaged: user involvement in the context of a national electronic health record implementation.

PubMed

Cresswell, Kathrin; Morrison, Zoe; Crowe, Sarah; Robertson, Ann; Sheikh, Aziz

2011-01-01

The absence of meaningful end user engagement has repeatedly been highlighted as a key factor contributing to 'failed' implementations of electronic health records (EHRs), but achieving this is particularly challenging in the context of national scale initiatives. In 2002, the National Health Service (NHS) embarked on a so-called 'top-down' national implementation strategy aimed at introducing commercial, centrally procured, EHRs into hospitals throughout England. We aimed to examine approaches to, and experiences of, user engagement in the context of a large-scale EHR implementation across purposefully selected hospital care providers implementing early versions of nationally procured software. We conducted a qualitative, case-study based, socio-technically informed, longitudinal investigation, purposefully sampling and collecting data from four hospitals. Our data comprised a total of 123 semi-structured interviews with users and managers, 15 interviews with additional stakeholders, 43 hours of non-participant observations of meetings and system use, and relevant organisation-specific documents from each case study site. Analysis was thematic, building on an existing model of user engagement that was originally developed in the context of studying the implementation of relatively simple technologies in commercial settings. NVivo8 software was used to facilitate coding. Despite an enduring commitment to the vision of shared EHRs and an appreciation of their potential benefits, meaningful end user engagement was never achieved. Hospital staff were not consulted in systems choice, leading to frustration; they were then further alienated by the implementation of systems that they perceived as inadequately customised. Various efforts to achieve local engagement were attempted, but these were in effect risk mitigation strategies. We found the role of clinical champions to be important in these engagement efforts, but progress was hampered by the hierarchical structures within healthcare teams. As a result, engagement efforts focused mainly on clinical staff with inadequate consideration of management and administrative staff. This work has allowed us to further develop an existing model of user engagement from the commercial sector and adapt it to inform user engagement in the context of large-scale eHealth implementations. By identifying key points of possible engagement, disengagement and re-engagement, this model will we hope both help those planning similar large-scale EHR implementation efforts and act as a much needed catalyst to further research in this neglected field of enquiry.

A Descriptive Study of Response to Intervention (RTI) Implementation at the Elementary Level in West Virginia

ERIC Educational Resources Information Center

Lee, Sarah L.

2012-01-01

The purpose of this study was to describe levels of RTI implementation in West Virginia elementary schools. Little is known about the national efforts that states are collectively undertaking to scale up implementation of RTI (Hoover, Baca, Wexler-Love, & Saenz, 2008). West Virginia's elementary schools were required by state policy to…

High Plains regional ground-water study

USGS Publications Warehouse

Dennehy, Kevin F.

2000-01-01

Over the last 25 years, industry and government have made large financial investments aimed at improving water quality across the Nation. Significant progress has been made; however, many water-quality concerns remain. In 1991, the U.S. Geological Survey (USGS) began implementing a full-scale National Water-Quality Assessment Program to provide consistent and scientifically sound information for managing the Nation's water resources. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers, (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality. Assessing the quality of water in every location in the Nation would not be practical; therefore, NAWQA Program studies are conducted within a set of areas called study units (fig. 1). These study units are composed of more than 50 important river and aquifer systems that represent the diverse geography, water resources, and land and water uses of the Nation. The High Plains Regional Ground-Water Study is one such study area, designed to address issues relevant to the High Plains Aquifer system while supplementing water-quality information collected in other study units across the Nation. Implementation of the NAWQA Program for the High Plains Regional Ground-Water Study area began in 1998.

Teacher and Learner Perceptions on Mobile Learning Technology: A Case of Namibian High Schools from the Hardap Region

ERIC Educational Resources Information Center

Osakwe, Jude Odiakaosa; Nomusa, Dlodlo; Jere, Nobert

2017-01-01

Although the National ICT Policy for Education in Namibia was adopted in 2005, immediately followed by the National ICT Policy Implementation Plan in 2006, no known studies have been undertaken so far to evaluate its implementation. This has made it difficult to ascertain the ICT/mobile learning readiness of teachers and learners. This study…

Large-Scale Curriculum Reform in Finland--Exploring the Interrelation between Implementation Strategy, the Function of the Reform, and Curriculum Coherence

ERIC Educational Resources Information Center

Pietarinen, Janne; Pyhältö, Kirsi; Soini, Tiina

2017-01-01

The study aims to gain a better understanding of the national large-scale curriculum process in terms of the used implementation strategies, the function of the reform, and the curriculum coherence perceived by the stakeholders accountable in constructing the national core curriculum in Finland. A large body of school reform literature has shown…

Quality Rating Improvement System "for" Early Care "and" Education: Development, Implementation, Evaluation and Learning

ERIC Educational Resources Information Center

Shen, Jianping; Ma, Xin

2013-01-01

Quality Rating Improvement System (QRIS) has gained national momentum. The authors first present a national scene of QRIS and then use Children's Services Council of Palm Beach County as a case study to illustrate a number of things. First, they look at the logic model behind the QRIS. Next, they review the design and implementation of the QRIS in…

Good governance in national solid waste management policy (NSWMP) implementation: A case study of Malaysia

NASA Astrophysics Data System (ADS)

Wee, Seow Ta; Abas, Muhamad Azahar; Mohamed, Sulzakimin; Chen, Goh Kai; Zainal, Rozlin

2017-10-01

The National Solid Waste Management Policy (NSWMP) was introduced in 2007 under the Act 672. The execution of NSWMP involves stakeholders from various government agencies and a collaboration with the private sectors. Despite the initiatives taken by the stakeholders, the objectives of NSWMP failed to materialise. One of the major constraints is weak governance among stakeholders with regards to the NSWMP implementation. This paper will explore the good governance practices implemented by the stakeholders. Identifying the current good governance practices implemented by the stakeholders is crucial as it will serve as a guideline to improve good governance practice in the future. An exploratory research approach is applied in this study through in-depth interviews with several government agencies and concessionaires involved in the NSWMP implementation. A total of six respondents took part in this study. The findings of this study show that there are several good governance practices implemented in policy promotion, participation of stakeholders, and capacity enhancement programme for the staff. This study also proposed some points on good governance practices in the context of policy promotion and staff development. A paradigm shift by the stakeholders is imperative so as to enhance the good governance practice in NSWMP implementation towards an efficient solid waste management in Malaysia.

Enabling fast charging – Introduction and overview

DOE PAGES

Michelbacher, Christopher; Ahmed, Shabbir; Bloom, Ira; ...

2017-10-23

Argonne National Laboratory (Argonne), Idaho National Laboratory (INL), and the National Renewable Energy Laboratory (NREL), with guidance from VTO, initiated this study to understand the technical, cost, infrastructure, and implementation barriers associated with high rate charging up to 350 kW.

Nursing and the national policy of education for health care professionals for the Brazilian national Health System.

PubMed

Haddad, Ana Estela

2011-12-01

The objective of the present article is to identify the aspects and characteristic of creating and implementing the national policy for the administration of health education, over the last six years, with particular emphasis on the central role of nursing undergraduate studied and the profession as a field of knowledge that structures the management of care and the working process in health. The advancements and the current challenges that are posed to implement the National Health System and the role of connecting health care and education administrators and establishing an interfederal network to assure the success of the ongoing initiatives.

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

PubMed

Morgan, Karen; Burke, Helen; McGee, Hannah

2013-02-01

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

Organizational learning in the implementation and adoption of national electronic health records: case studies of two hospitals participating in the National Programme for Information Technology in England.

PubMed

Takian, Amirhossein; Sheikh, Aziz; Barber, Nicholas

2014-09-01

To explore the role of organizational learning in enabling implementation and supporting adoption of electronic health record systems into two English hospitals. In the course of conducting our prospective and sociotechnical evaluation of the implementation and adoption of electronic health record into 12 "early adopter" hospitals across England, we identified two hospitals implementing virtually identical versions of the same "off-the-shelf" software (Millennium) within a comparable timeframe. We undertook a longitudinal qualitative case study-based analysis of these two hospitals (referred to hereafter as Alpha and Omega) and their implementation experiences. Data included the following: 63 in-depth interviews with various groups of internal and external stakeholders; 41-h on-site observation; and content analysis of 218 documents of various types. Analysis was both inductive and deductive, the latter being informed by the "sociotechnical changing" theoretical perspective. Although Alpha and Omega shared a number of contextual similarities, our evaluation revealed fundamental differences in visions of electronic health record and the implementation strategy between the hospitals, which resulted in distinct local consequences of electronic health record implementation and impacted adoption. Both hospitals did not, during our evaluation, see the hoped-for benefits to the organization as a result of the introduction of electronic health record, such as speeding-up tasks. Nonetheless, the Millennium software worked out to be easier to use at Omega. Interorganizational learning was at the heart of this difference. Despite the turbulent overall national "roll out" of electronic health record systems into the English hospitals, considerable opportunities for organizational learning were offered by sequential delivery of the electronic health record software into "early adopter" hospitals. We argue that understanding the process of organizational learning and its enabling factors has the potential to support efforts at implementing national electronic health record implementation endeavors. © The Author(s) 2013.

Implementation and adoption of nationwide electronic health records in secondary care in England: final qualitative results from prospective national evaluation in “early adopter” hospitals

PubMed Central

Cornford, Tony; Barber, Nicholas; Avery, Anthony; Takian, Amirhossein; Lichtner, Valentina; Petrakaki, Dimitra; Crowe, Sarah; Marsden, Kate; Robertson, Ann; Morrison, Zoe; Klecun, Ela; Prescott, Robin; Quinn, Casey; Jani, Yogini; Ficociello, Maryam; Voutsina, Katerina; Paton, James; Fernando, Bernard; Jacklin, Ann; Cresswell, Kathrin

2011-01-01

Objectives To evaluate the implementation and adoption of the NHS detailed care records service in “early adopter” hospitals in England. Design Theoretically informed, longitudinal qualitative evaluation based on case studies. Setting 12 “early adopter” NHS acute hospitals and specialist care settings studied over two and a half years. Data sources Data were collected through in depth interviews, observations, and relevant documents relating directly to case study sites and to wider national developments that were perceived to impact on the implementation strategy. Data were thematically analysed, initially within and then across cases. The dataset consisted of 431 semistructured interviews with key stakeholders, including hospital staff, developers, and governmental stakeholders; 590 hours of observations of strategic meetings and use of the software in context; 334 sets of notes from observations, researchers’ field notes, and notes from national conferences; 809 NHS documents; and 58 regional and national documents. Results Implementation has proceeded more slowly, with a narrower scope and substantially less clinical functionality than was originally planned. The national strategy had considerable local consequences (summarised under five key themes), and wider national developments impacted heavily on implementation and adoption. More specifically, delays related to unrealistic expectations about the capabilities of systems; the time needed to build, configure, and customise the software; the work needed to ensure that systems were supporting provision of care; and the needs of end users for training and support. Other factors hampering progress included the changing milieu of NHS policy and priorities; repeatedly renegotiated national contracts; different stages of development of diverse NHS care records service systems; and a complex communication process between different stakeholders, along with contractual arrangements that largely excluded NHS providers. There was early evidence that deploying systems resulted in important learning within and between organisations and the development of relevant competencies within NHS hospitals. Conclusions Implementation of the NHS Care Records Service in “early adopter” sites proved time consuming and challenging, with as yet limited discernible benefits for clinicians and no clear advantages for patients. Although our results might not be directly transferable to later adopting sites because the functionalities we evaluated were new and untried in the English context, they shed light on the processes involved in implementing major new systems. The move to increased local decision making that we advocated based on our interim analysis has been pursued and welcomed by the NHS, but it is important that policymakers do not lose sight of the overall goal of an integrated interoperable solution. PMID:22006942

Healthcare professionals’ perceptions of clinical governance implementation: a qualitative New Zealand study of 3205 open-ended survey comments

PubMed Central

Gauld, Robin; Horsburgh, Simon

2015-01-01

Objectives To investigate healthcare professional perceptions of local implementation of a national clinical governance policy in New Zealand. Design Respondent comments written at the end of a national healthcare professional survey designed to assess implementation of core components of the clinical governance policy. Setting The written comments were provided by respondents to a survey distributed to over 41 000 registered healthcare professionals employed in 19 of New Zealand's government-funded District Health Boards. Comments were analysed and categorised within emerging themes. Results 3205 written comments were received. Five key themes illustrating barriers to clinical governance implementation were found, representing problems with: developing management–clinical relations; clinicians stepping up into clinical governance and leadership activities; interprofessional relations; training needs for governance and leadership; and having insufficient time to get involved. Conclusions Despite a national policy on clinical governance which New Zealand's government launched in 2009, this study found that considerable effort is required to build clinical governance at the local level. This finding parallels with other studies in the field. Two areas demand attention: building systems for organisational governance and leadership; and building professional governance arrangements. PMID:25564142

Implementing clinical guidelines in stroke: a qualitative study of perceived facilitators and barriers.

PubMed

Donnellan, Claire; Sweetman, S; Shelley, E

2013-08-01

Clinical guidelines are frequently used as a mechanism for implementing evidence-based practice. However research indicates that health professionals vary in the extent to which they adhere to these guidelines. This study aimed to study the perceptions of stakeholders and health professionals on the facilitators and barriers to implementing national stroke guidelines in Ireland. Qualitative interviews using focus groups were conducted with stakeholders (n=3) and multidisciplinary team members from hospitals involved in stroke care (n=7). All focus group interviews were semi-structured, using open-ended questions. Data was managed and analysed using NVivo 9 software. The main themes to emerge from the focus groups with stakeholders and hospital multidisciplinary teams were very similar in terms of topics discussed. These were resources, national stroke guidelines as a tool for change, characteristics of national stroke guidelines, advocacy at local level and community stroke care challenges. Facilitators perceived by stakeholders and health professionals included having dedicated resources, user-friendly guidelines relevant at local level and having supportive advocates on the ground. Barriers were inadequate resources, poor guideline characteristics and insufficient training and education. This study highlights health professionals' perspectives regarding many key concepts which may affect the implementation of stroke care guidelines. The introduction of stroke clinical guidelines at a national level is not sufficient to improve health care quality as they should be incorporated in a quality assurance cycle with education programmes and feedback from surveys of clinical practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Evaluating Social and National Education Textbooks Based on the Criteria of Knowledge-Based Economy from the Perspectives of Elementary Teachers in Jordan

ERIC Educational Resources Information Center

Al-Edwan, Zaid Suleiman; Hamaidi, Diala Abdul Hadi

2011-01-01

Knowledge-based economy is a new implemented trend in the field of education in Jordan. The ministry of education in Jordan attempts to implement this trend's philosophy in its textbooks. This study examined the extent to which the (1st-3rd grade) social and national textbooks reflect knowledge-based economy criteria from the perspective of…

The Economic Impact of Domestic Military Installations on Regional Economies.

DTIC Science & Technology

1979-12-01

to implement the National Environmental Protection Act. The research examined the theoretical basis for impact determination especially economic base...installation on a regional economw. Such impacts ore reuirtd to be estimated to implement the National Environmental Protection Act. The research examined the...Published in the Second Proliminarw Draft Environmental Impact Statement Part I Fort Ord CREF 21]. E. ORGANIZATION OF THE STUDY The background of interest in

78 FR 40663 - Delegation of Authority to the Southern Ute Indian Tribe To Implement and Enforce National...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-08

...] Delegation of Authority to the Southern Ute Indian Tribe To Implement and Enforce National Emissions... Indian Tribe's (SUIT) July 3, 2012 request for delegation of authority to implement and enforce National... Southern Ute Indian Tribe's (SUIT) July 3, 2012 request for delegation of authority to implement and...

Identifying Barriers and Facilitators in Implementing Schoolwide Positive Behavior Support

ERIC Educational Resources Information Center

Kincaid, Don; Childs, Karen; Blase, Karen A.; Wallace, Frances

2007-01-01

As the number of schools implementing systemic, schoolwide positive behavior support (PBS) processes expands (nationally, at least 5,000 schools are participating), increasing attention is being paid to the efficacy of implementation. This article describes a case study of the experiences of Florida's Positive Behavior Support Project, which used…

Improving Programs and Outcomes: Implementation Frameworks and Organization Change

ERIC Educational Resources Information Center

Bertram, Rosalyn M.; Blase, Karen A.; Fixsen, Dean L.

2015-01-01

This article presents recent refinements to implementation constructs and frameworks. It updates and clarifies the frequently cited study conducted by the National Implementation Research Network that introduced these frameworks for application in diverse endeavors. As such, it may serve as a historical marker in the rapidly developing science and…

Plan of Study for the Tidal Power Study, Cobscook Bay, Maine, USA

DTIC Science & Technology

1978-09-01

Considerations and Acceptability * Implementation Feasibility s Financial -Institutional Aspects * Public Health In preparing data for the System of Accounts ...Goals and Objectives a. National Objectives b. National Accounts c. Related National Policies d. The Study Objectives e. New England Federal Regional...Alternatives Development of Intermediate Plans 1. System of Accounts 2. Range of Alternatives to be considered 3. Other Evaluation Considerations 4

Costs and cost-effectiveness of a mobile phone text-message reminder programmes to improve health workers' adherence to malaria guidelines in Kenya.

PubMed

Zurovac, Dejan; Larson, Bruce A; Sudoi, Raymond K; Snow, Robert W

2012-01-01

Simple interventions for improving health workers' adherence to malaria case-management guidelines are urgently required across Africa. A recent trial in Kenya showed that text-message reminders sent to health workers' mobile phones improved management of pediatric outpatients by 25 percentage points. In this paper we examine costs and cost-effectiveness of this intervention. We evaluate costs and cost-effectiveness in 2010 USD under three implementation scenarios: (1) as implemented under study conditions in study areas; (2) if the intervention was routinely implemented by the Ministry of Health (MoH) in the same areas; and (3) if the intervention was scaled up nationally. Under study conditions, intervention costs were 19,342 USD, of which 45% were for developing and pretesting text-messages, 12% for developing text-message distribution system, 29% for collecting health workers' phone numbers, and 13% were costs of sending text-messages and monitoring of the system. If the intervention was implemented in the same areas by the MoH, the costs would be 28% lower (13,920 USD) due to lower costs of collecting health workers' numbers. The cost of national scale-up would be 97,350 USD, and the majority of these costs (66%) would be for sending text-messages. The cost per additional child correctly managed was 0.50 USD under study conditions, 0.36 USD if implemented by the MoH in the same area, and estimated at only 0.03 USD if implemented nationally. Even if the effect size was only 5% or the cost on the national scale was 400% higher than estimated, the cost per additional child correctly managed would be only 0.16 USD. A simple text-messaging intervention improving health worker adherence to malaria guidelines is effective and inexpensive. Further research is justified to optimize delivery of the intervention and expand targets beyond children and malaria disease.

Implementation of National Science Education Standards in suburban elementary schools: Teachers' perceptions and classroom practices

NASA Astrophysics Data System (ADS)

Khan, Rubina Samer

2005-07-01

This was an interpretive qualitative study that focused on how three elementary school science teachers from three different public schools perceived and implemented the National Science Education Standards based on the Reformed Teaching Observation Protocol and individual interviews with the teachers. This study provided an understanding of the standards movement and teacher change in the process. Science teachers who were experienced with the National Science Education Standards were selected as the subjects of the study. Grounded in the theory of teacher change, this study's phenomenological premise was that the extent to which a new reform has an effect on students' learning and achievement on standardized tests depends on the content a teacher teaches as well as the style of teaching. It was therefore necessary to explore how teachers understand and implement the standards in the classrooms. The surveys, interviews and observations provided rich data from teachers' intentions, reflections and actions on the lessons that were observed while also providing the broader contextual framework for the understanding of the teachers' perspectives.

Implementation science in cancer prevention and control: a decade of grant funding by the National Cancer Institute and future directions.

PubMed

Neta, Gila; Sanchez, Michael A; Chambers, David A; Phillips, Siobhan M; Leyva, Bryan; Cynkin, Laurie; Farrell, Margaret M; Heurtin-Roberts, Suzanne; Vinson, Cynthia

2015-01-08

The National Cancer Institute (NCI) has supported implementation science for over a decade. We explore the application of implementation science across the cancer control continuum, including prevention, screening, treatment, and survivorship. We reviewed funding trends of implementation science grants funded by the NCI between 2000 and 2012. We assessed study characteristics including cancer topic, position on the T2-T4 translational continuum, intended use of frameworks, study design, settings, methods, and replication and cost considerations. We identified 67 NCI grant awards having an implementation science focus. R01 was the most common mechanism, and the total number of all awards increased from four in 2003 to 15 in 2012. Prevention grants were most frequent (49.3%) and cancer treatment least common (4.5%). Diffusion of Innovations and Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) were the most widely reported frameworks, but it is unclear how implementation science models informed planned study measures. Most grants (69%) included mixed methods, and half reported replication and cost considerations (49.3%). Implementation science in cancer research is active and diverse but could be enhanced by greater focus on measures development, assessment of how conceptual frameworks and their constructs lead to improved dissemination and implementation outcomes, and harmonization of measures that are valid, reliable, and practical across multiple settings.

Upper Illinois River basin

USGS Publications Warehouse

Friedel, Michael J.

1998-01-01

During the past 25 years, industry and government made large financial investments that resulted in better water quality across the Nation; however, many water-quality concerns remain. Following a 1986 pilot project, the U.S. Geological Survey began implementation of the National Water-Quality Assessment (NAWQA) Program in 1991. This program differs from other national water-quality assessment studies in that the NAWQA integrates monitoring of surface- and ground-water quality with the study of aquatic ecosystems. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers (water-bearing sediments and rocks), (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality.The Upper Illinois River Basin National Water- Quality Assessment (NAWQA) study will increase the scientific understanding of surface- and ground-water quality and the factors that affect water quality in the basin. The study also will provide information needed by water-resource managers to implement effective water-quality management actions and evaluate long-term changes in water quality.

[Systematization of nursing assistance: subsidies for implementation].

PubMed

Hermida, Patrícia Madalena Vieira; Araújo, Izilda Esmênia Muglia

2006-01-01

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

Multisector Nutrition Program Governance and Implementation in Ethiopia: Opportunities and Challenges.

PubMed

Kennedy, Eileen; Tessema, Masresha; Hailu, Tesfaye; Zerfu, Dilnesaw; Belay, Adamu; Ayana, Girmay; Kuche, Desalegn; Moges, Tibebu; Assefa, Tsehai; Samuel, Aregash; Kassaye, Tarik; Fekadu, Habtamu; Van Wassenhove, Joan

2015-12-01

Governments globally are stressing both direct nutrition interventions combined with nutrition sensitive policies and programs to combat malnutrition. Governance at all levels has been identified as a critical element in ensuring success of national nutrition plans. For example, the most recent National Nutrition Program (NNP) in Ethiopia discusses the essentiality of governance and coordination at all levels. The research uses a qualitative study based on semi-structured interviews with key informant. The research discussed in this article focuses on governance structures from national to regional to district level in Ethiopia with an emphasis on translation of a strategy and implementation of the NNP. This article concentrates primarily on results from the national and regional levels. Data at both the national and regional levels indicate that there is general agreement on the nature of the nutrition problems in Ethiopia. At all levels of government, under nutrition, food insecurity, and micronutrient deficiencies were listed as the main nutrition problems. The challenges in governance and implementation identified at both the national and regional levels, however, varied. The implementation of the 2013 NNP was in its early stages at the time of this research. While there was palpable energy around the launch of the NNP, respondents indicated issues related to leadership, coordination, collaboration, advocacy, and budget would be challenges in sustaining momentum. © The Author(s) 2015.

Explaining implementation behaviour of the National Incident Management System (NIMS).

PubMed

Jensen, Jessica; Youngs, George

2015-04-01

This paper explains the perceived implementation behaviour of counties in the United States with respect to the National Incident Management System (NIMS). The system represents a massive and historic policy mandate designed to restructure, standardise and thereby unify the efforts of a wide variety of emergency management entities. Specifically, this study examined variables identified in the NIMS and policy literature that might influence the behavioural intentions and actual behaviour of counties. It found that three key factors limit or promote how counties intend to implement NIMS and how they actually implement the system: policy characteristics related to NIMS, implementer views and a measure of local capacity. One additional variable-inter-organisational characteristics-was found to influence only actual behaviour. This study's findings suggest that the purpose underlying NIMS may not be fulfilled and confirm what disaster research has long suggested: the potential for standardisation in emergency management is limited. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

State and Local Implementation of the "No Child Left Behind Act." Volume III--Accountability under "NCLB" Interim Report

ERIC Educational Resources Information Center

Le Floch, Kerstin Carlson; Martinez, Felipe; O'Day, Jennifer; Stecher, Brian; Taylor, James; Cook, Andrea

2007-01-01

This report presents findings about accountability from two longitudinal studies, the National Longitudinal Study of "No Child Left Behind" (NLS-"NCLB"), and the Study of State Implementation of Accountability and Teacher Quality Under "No Child Left Behind" (SSI-"NCLB"). The research teams for these two…

Dialectical Behavior Therapy Training and Desired Resources for Implementation: Results From a National Program Evaluation in the Veterans Health Administration.

PubMed

Landes, Sara J; Matthieu, Monica M; Smith, Brandy N; Trent, Lindsay R; Rodriguez, Allison L; Kemp, Janet; Thompson, Caitlin

2016-08-01

Little is known about nonresearch training experiences of providers who implement evidence-based psychotherapies for suicidal behaviors among veterans. This national program evaluation identified the history of training, training needs, and desired resources of clinicians who work with at-risk veterans in a national health care system. This sequential mixed methods national program evaluation used a post-only survey design to obtain needs assessment data from clinical sites (N = 59) within Veterans Health Administration (VHA) facilities that implemented dialectical behavior therapy (DBT). Data were also collected on resources preferred to support ongoing use of DBT. While only 33% of clinical sites within VHA facilities reported that staff attended a formal DBT intensive training workshop, nearly 97% of participating sites reported having staff who completed self-study using DBT manuals. Mobile apps for therapists and clients and templates for documentation in the electronic health records to support measurement-based care were desired clinical resources. Results indicate that less-intensive training models can aid staff in implementing DBT in real-world health care settings. While more training is requested, a number of VHA facilities have successfully implemented DBT into the continuum of care for veterans at risk for suicide. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

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

Implementing Data-Informed Decision Making in Schools: Teacher Access, Supports and Use

ERIC Educational Resources Information Center

Means, Barbara; Padilla, Christine; DeBarger, Angela; Bakia, Marianne

2009-01-01

Implementation of the No Child Left Behind (NCLB) legislation has been accompanied by demand for data systems capable of providing a longitudinal record of each student's educational experiences and performance over time. The national Study of Education Data Systems and Decision Making is examining both the implementation of student data systems…

Barriers, facilitators, and benefits of implementation of dialectical behavior therapy in routine care: results from a national program evaluation survey in the Veterans Health Administration.

PubMed

Landes, Sara J; Rodriguez, Allison L; Smith, Brandy N; Matthieu, Monica M; Trent, Lindsay R; Kemp, Janet; Thompson, Caitlin

2017-12-01

National implementation of evidence-based psychotherapies (EBPs) in the Veterans Health Administration (VHA) provides important lessons on the barriers and facilitators to implementation in a large healthcare system. Little is known about barriers and facilitators to the implementation of a complex EBP for emotional and behavioral dysregulation-dialectical behavioral therapy (DBT). The purpose of this study was to understand VHA clinicians' experiences with barriers, facilitators, and benefits from implementing DBT into routine care. This national program evaluation survey measured site characteristics of VHA sites (N = 59) that had implemented DBT. DBT was most often implemented in general mental health outpatient clinics. While 42% of sites offered all four modes of DBT, skills group was the most frequently implemented mode. Fifty-nine percent of sites offered phone coaching in any form, yet only 11% of those offered it all the time. Providers were often provided little to no time to support implementation of DBT. Barriers that were difficult to overcome were related to phone coaching outside of business hours. Facilitators to implementation included staff interest and expertise. Perceived benefits included increased hope and functioning for clients, greater self-efficacy and compassion for providers, and ability to treat unique symptoms for clinics. There was considerable variability in the capacity to address implementation barriers among sites implementing DBT in VHA routine care. Mental health policy makers should note the barriers and facilitators reported here, with specific attention to phone coaching barriers.

A qualitative study of the determinants of HIV guidelines implementation in two south-eastern districts of Tanzania

PubMed Central

Geubbels, Eveline; Wringe, Alison; Todd, Jim; Klatser, Paul; Dieleman, Marjolein

2017-01-01

Abstract Current HIV policies in Tanzania have adopted the three long-term impact results of zero new infections, zero HIV deaths and zero stigma and discrimination. Strategies to reach these results include scaling-up HIV Testing and Counselling (HTC); Preventing Mother-To-Child Transmission (PMTCT); and strengthening Care and Treatment Clinic (CTC) services. Previous studies showed that HIV policy and guideline recommendations were not always implemented in rural South Tanzania. This study aims to identify the determinants of HIV guideline implementation. A qualitative study of 23 semi-structured interviews with facility in-charges; healthcare workers; district, regional and national HIV coordinators was conducted. Five health facilities were purposively selected by level, ownership and proximity to district headquarters. Interviews were analysed according to Fleuren’s five determinants of innovation uptake related to: strategies used in guideline development and dissemination; guideline characteristics; the guideline implementing organization; guideline users; and the socio-cultural and regulatory context. None of the facilities had the HTC national guideline document. Non-involvement of providers in revisions and weak planning for guideline dissemination impeded their implementation. Lengthy guidelines and those written in English were under-used, and activities perceived to be complicated, like WHO-staging, were avoided. Availability of staff and lack of supplies like test kits and medication impeded implementation. Collaboration between facilities enhanced implementation, as did peer-support among providers. Provider characteristics including education level, knowledge of, and commitment to the guideline influenced implementation. According to providers, determinants of clients’ service use included gender norms, stigma, trust and perceived benefits. The regulatory context prohibited private hospitals from buying HIV supplies. Being tools for bringing policies to practice, national guidelines are crucial in the efforts towards the three zeros. Strategies to improve providers’ adherence to guidelines should include development of clearer guideline dissemination plans, strengthening of the health system, and possibly addressing of provider-perceived patient-level barriers to utilizing HIV services. PMID:28369374

Developing a national framework for safe drinking water--case study from Iceland.

PubMed

Gunnarsdottir, Maria J; Gardarsson, Sigurdur M; Bartram, Jamie

2015-03-01

Safe drinking water is one of the fundaments of society and experience has shown that a holistic national framework is needed for its effective provision. A national framework should include legal requirements on water protection, surveillance on drinking water quality and performance of the water supply system, and systematic preventive management. Iceland has implemented these requirements into legislation. This case study analyzes the success and challenges encountered in implementing the legislation and provide recommendations on the main shortcomings identified through the Icelandic experience. The results of the analysis show that the national framework for safe drinking water is mostly in place in Iceland. The shortcomings include the need for both improved guidance and control by the central government; and for improved surveillance of the water supply system and implementation of the water safety plan by the Local Competent Authorities. Communication to the public and between stakeholders is also insufficient. There is also a deficiency in the national framework regarding small water supply systems that needs to be addressed. Other elements are largely in place or on track. Most of the lessons learned are transferable to other European countries where the legal system around water safety is built on a common foundation from EU directives. The lessons can also provide valuable insights into how to develop a national framework elsewhere. Copyright © 2014 Elsevier GmbH. All rights reserved.

75 FR 20598 - Agency Information Collection Request: 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

... Feasibility of Creating and Maintaining a National Registry of Child Abuse and Neglect Perpetrators--OMB No... from the National Child Abuse and Neglect Data System. These data will be supplemented with encoded... assess the feasibility of implementing a national registry of child maltreatment perpetrators. The study...

75 FR 37808 - Agency Information Collection Request; 30-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... Assess the Feasibility of Creating and Maintaining a National Registry of Child Abuse and Neglect... primarily from records from the National Child Abuse and Neglect Data System. These data will be... study will assess the feasibility of implementing a national registry of child maltreatment perpetrators...

Technology Education In Australia: National Policy and State Implementation.

ERIC Educational Resources Information Center

Gardner, Paul L.

This paper reviews a decade of development of technology education at the secondary school level in Australia. It traces the influences, both national and international, which have pressed the nation's education systems to introduce technology studies into the school curriculum. The increasing globalization, the movement of capital and labor, the…

National positioning, navigation, and timing architecture : implementation plan.

DOT National Transportation Integrated Search

2010-04-01

The Assistant Secretary of Defense for Networks and Information Integration (ASD/NII) and the : Under Secretary of Transportation for Policy (UST/P) sponsored a National Positioning, : Navigation, and Timing (PNT) Architecture Study to provide mor...

75 FR 43528 - Seeking Public Comment on Draft National Health Security Strategy Biennial Implementation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Seeking Public Comment on Draft National Health Security Strategy Biennial Implementation Plan AGENCY: Department of Health and Human... Interim Implementation Guide for the National Health Security Strategy of the United States of America...

Implementing Learning Communities in American Higher Education: A Meta-Ethnographic Study

ERIC Educational Resources Information Center

Noga, Michael A.

2012-01-01

Using meta-ethnography as a research method, this study identified, organized, and synthesized efforts to implement learning communities at the 19 American colleges and universities that prepared written reports at the conclusion of the 1996-1999 National Learning Communities Dissemination Project (FIPSE). The researcher used 10 research questions…

Science Teachers' Perceptions of Implementing Constructivist Principles into Instruction

ERIC Educational Resources Information Center

Saunders, Saundra M.

2009-01-01

The purpose of this research study was to examine the differences in beliefs and perceptions about the implementation of constructivist principles into instruction, in support of the National Science Education Standards, for science teachers who adopt constructivist principles and those who do not. The study also examined correlations between a…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

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

Implementing Competence Frameworks in Mexico

ERIC Educational Resources Information Center

de Anda, Maria Luisa

2011-01-01

This article is based on the Mexican case study undertaken as part of the comparative study of the implementation and impact of National Qualifications Frameworks (NQF). Even though Mexico does not have a comprehensive NQF, the country has considerable experience in the development of labour competence technical standards; these share some aims…

Opening the black box: a study of the process of NICE guidelines implementation.

PubMed

Spyridonidis, Dimitrios; Calnan, Michael

2011-10-01

This study informs 'evidence-based' implementation by using an innovative methodology to provide further understanding of the implementation process in the English NHS using two distinctly different NICE clinical guidelines as exemplars. The implementation process was tracked retrospectively and prospectively using a comparative case-study and longitudinal design. 74 unstructured interviews were carried out with 48 key informants (managers and clinicians) between 2007 and 2009. This study has shown that the NICE guidelines implementation process has both planned and emergent components, which was well illustrated by the use of the prospective longitudinal design in this study. The implementation process might be characterised as strategic and planned to begin with but became uncontrolled and subject to negotiation as it moved from the planning phase to adoption in everyday practice. The variations in the implementation process could be best accounted for in terms of differences in the structure and nature of the local organisational context. The latter pointed to the importance of managers as well as clinicians in decision-making about implementation. While national priorities determine the context for implementation the shape of the process is influenced by the interactions between doctors and managers, which influence the way they respond to external policy initiatives such as NICE guidelines. NICE and other national health policy-makers need to recognise that the introduction of planned change 'initiatives' in clinical practice are subject to social and political influences at the micro level as well as the macro level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

77 FR 15052 - National Ocean Council-National Ocean Policy Draft Implementation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-14

... COUNCIL ON ENVIRONMENTAL QUALITY National Ocean Council--National Ocean Policy Draft Implementation Plan AGENCY: Council on Environmental Quality. ACTION: Extension of comment period. SUMMARY: On July 19, 2010, President Obama signed Executive Order 13547 establishing a National Policy for the...

Factors Affecting the Implementation of Argument in the Elementary Science Classroom. A Longitudinal Case Study

NASA Astrophysics Data System (ADS)

Martin, Anita M.; Hand, Brian

2009-01-01

This longitudinal case study describes the factors that affect an experienced teacher’s attempt to shift her pedagogical practices in order to implement embedded elements of argument into her science classroom. Research data was accumulated over 2 years through video recordings of science classes. The Reformed Teacher Observation Protocol (RTOP) is an instrument designed to quantify changes in classroom environments as related to reform as defined by the National Research Council ( National science education standards. Washington, DC: National Academy Press, 1996b) and the National Research Council ( Fulfilling the promise: Biology education in the nation’s schools, Washington, DC: National Academy Press, 1990) and was used to analyze videotaped science lessons. Analysis of the data shows that there was a significant shift in the areas of teacher questioning, and student voice. Several levels of subsequent analysis were completed related to teacher questioning and student voice. The data suggests a relationship between these areas and the implementation of scientific argument. Results indicate that the teacher moved from a traditional, teacher-centered, didactic teaching style to instructional practices that allowed the focus and direction of the lesson to be affected by student voice. This was accomplished by a change in teacher questioning that included a shift from factual recall to more divergent questioning patterns allowing for increased student voice. As student voice increased, students began to investigate ideas, make statements or claims and to support these claims with strong evidence. Finally, students were observed refuting claims in the form of rebuttals. This study informs professional development related to experienced teachers in that it highlights pedagogical issues involved in implementing embedded elements of argument in the elementary classroom.

[An overview of the definition and implementation of the Brazilian National Policy on Health Data and Information Technology].

PubMed

Cavalcante, Ricardo Bezerra; Kerr-Pinheiro, Marta Macedo; Guimarães, Eliete Albano de Azevedo; Miranda, Richardson Machado

2015-05-01

The This qualitative study aimed to analyze the development and implementation of the Brazilian National Policy on Health Data and Information Technology (NPIIH). We analyzed documents and applied an online questionnaire to the experts involved in developing the policy. The data were submitted to content analysis using the categorical thematic modality. The PNIIS is the target of debate and proposals at various levels. Provisions have appeared in parallel to regulate measures on health data and information technology. Community participation in developing this policy and the convergence of laws, standards, resolutions, and policy-making levels in a common and broadly acknowledged and enforced policy are challenges, in addition to linking the public and private sectors. The study concludes that the National Policy on Health Data and Information Technology is making gradual progress, predominantly in theoretical debates, revisions, and updates. There are numerous challenges for its implementation and a prevailing need for legitimation.

STATUS REPORT, BEGIN TO DEVELOP COMPLETE OPERATIONS MANUALS FOR THE COHORT: PREPARE TO IMPLEMENT A COHORT STUDY OF CHILDREN'S ENVIRONMENTAL HEALTH

EPA Science Inventory

As a precursor to the National Children's Study (NCS), the North Carolina Cohort Study (NC Cohort Study) will provide the opportunity to field test procedures to better inform the implementation of the NCS. In order to test some of the study hypotheses, it will be important to ob...

Essential Medicines List Implementation Dynamics: A Case Study Using Brazilian Federal Medicines Expenditures.

PubMed

Magarinos-Torres, Rachel; Lynd, Larry David; Luz, Tatiana Chama Borges; Marques, Paulo Eduardo Potyguara Coutinho; Osorio-de-Castro, Claudia Garcia Serpa

2017-09-01

The aim was to analyse the implementation dynamics of the essential medicines list (EML). We used the government expenditures on medicines and Brazil as a case study. Drug purchases were considered as a proxy for utilization. The essential medicines (EMs) expenditures were followed over time by Brazilian National EMLs life-time and defined by broad therapeutic categories and by specific medicines. Brazil increased the number of the medicines during the last four editions of Brazilian National EMLs and the federal government expenditures on them. The EML implementation dynamics changed the distribution of expenditures on EMs. We identified a common set of 404 EMs present in all four editions of the Brazilian National EMLs. There was a proportional decrease in expenditures on anti-infectives for systemic use, blood and blood-forming organs and alimentary tract and metabolism, and increase in expenditures on antineoplastic and immunomodulating agents. The expenditures distribution per specific medicines revealed that a small set of EMs was responsible for 50% or more of expenditures considering Brazilian National EML life-time for all four periods. The increase in expenditures on EMs in Brazil was a consequence of the newer medicines incorporated over time in the Brazilian National EMLs. The use of the medicines expenditures as a source of data and the definition of an EML life-time permitted follow-up of the implementation dynamics of different versions of the Brazilian National EMLs. Our results have implications for policymakers and stakeholders to gain a better understanding of the role EMLs play in health system sustainability and in the provision of the most beneficial heath care. © 2017 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Evidence-based practice implementation in community mental health settings: the relative importance of key domains of implementation activity.

PubMed

Torrey, William C; Bond, Gary R; McHugo, Gregory J; Swain, Karin

2012-09-01

Implementation research has examined practice prioritization, implementation leadership, workforce development, workflow re-engineering, and practice reinforcement, but not addressed their relative importance as implementation drivers. This study investigated domains of implementation activities and correlated them to implementation success during a large national evidence-based practice implementation project. Implementation success was correlated with active leadership strategically devoted to redesigning the flow of work and reinforcing implementation through measurement and feedback. Relative attention to workforce development was negatively correlated with implementation. Active leaders should focus on redesigning the flow of work to support the implementation and on reinforcing program improvements.

A National Study of Fluoride Mouthrinse Adoption: Implications for School Health Personnel.

ERIC Educational Resources Information Center

Coombs, Jeanne A.; And Others

1983-01-01

The ongoing adoption of school-based fluoride mouthrinse programs has provided the opportunity to study issues surrounding the adoption and implementation of health technology by public schools. This article reports data on and implications of the National Study on the Diffusion of Preventive Health Measures to Schools. (Authors/CJ)

Toward a Nation-Building Operating Concept

DTIC Science & Technology

2010-04-13

of United Nations intervention in Timor, argues that an interim protectorate is useful only if implemented by a multi -national coalition. However...to a franchise agreement or venture capital investment. The United States provides capital and expertise to indigenous group predicated on agreed...Toward a Nation-Building Operating Concept by Colonel John DeJarnette United States Army School of Advanced Military Studies United States

Implementing Nepal's national building code—A case study in patience and persistence

USGS Publications Warehouse

Arendt, Lucy; Hortacsu, Ayse; Jaiswal, Kishor; Bevington, John; Shrestha, Surya; Lanning, Forrest; Mentor-William, Garmalia; Naeem, Ghazala; Thibert, Kate

2017-01-01

The April 2015 Gorkha Nepal earthquake revealed the relative effectiveness of the Nepal Standard, or national building code (NBC), and irregular compliance with it in different parts of Nepal. Much of the damage to more than half a million Nepal's residential structures may be attributed to the prevalence of owner-built or owner-supervised construction and the lack of owner and builder responsiveness to seismic risk and training in the appropriate means of complying with the NBC. To explain these circumstances, we review the protracted implementation of the NBC and the role played by one organization, the National Society for Earthquake Technology-Nepal (NSET), in the NBC's implementation. We also share observations on building code compliance made by individuals in Nepal participating in workshops led by the Earthquake Engineering Research Institute's 2014 class of Housner Fellows.

Three years of national hand hygiene campaign in Germany: what are the key conclusions for clinical practice?

PubMed

Reichardt, C; Königer, D; Bunte-Schönberger, K; van der Linden, P; Mönch, N; Schwab, F; Behnke, M; Gastmeier, P

2013-02-01

The World Health Organization (WHO) started the 'Clean Care is Safer Care' campaign in 2005. Since then, more than 120 countries have pledged to improve hand hygiene as a keystone of their national or subnational healthcare-associated infection prevention programmes. Thirty-eight countries have implemented national campaigns. Germany started a national campaign to improve hand hygiene compliance on 1 January 2008. The campaign, 'AKTION Saubere Hände', is funded by the German Ministry of Health and was initiated by the National Reference Centre for the Surveillance of Nosocomial Infections, the Society for Quality Management in Health Care and the German Coalition for Patient Safety. The campaign is designed as a multi-modal campaign based on the WHO implementation strategy. Since the end of 2010, more than 700 healthcare institutions have been actively participating in the campaign, among which are 28 university hospitals. Voluntarily participating hospitals have to implement the following measures: active support by hospital administrators of local campaign implementation, participation in a one-day introductory course, education of healthcare workers at least once a year, measurement of alcohol-based hand-rub consumption (AHC) and feedback on resulting data, implementation of the WHO 'My Five Moments for Hand Hygiene' model, increase in hand-rub availability, participation in national hand hygiene day at least every two years, and participation in national campaign network workshops at least once every two years. Observational studies to measure hand hygiene compliance are optional. Overall, there has been a significant increase of 11% in hand hygiene compliance in 62 hospitals that observed compliance before and after intervention. A total of 129 hospitals provided AHC data for three years and achieved an overall increase of 30.7%. The availability of alcohol-based hand rub increased from 86.8% to > 100% in intensive care units and from 63.6% to 91.3% in non-intensive care units. Overall, the implementation of a national campaign using the WHO multi-modal intervention strategy has led to improved hand hygiene compliance and hand-rub availability in participating settings. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

BARRIERS AND FACILITATORS TO THE IMPLEMENTATION OF A NATIONAL HIV LINKAGE, RE-ENGAGEMENT, AND RETENTION IN CARE PROGRAM

PubMed Central

Maulsby, Cathy; Sacamano, Paul; Jain, Kriti M.; Enobun, Blessing; Brantley, Meredith L.; Kim, Hae-Young; Riordan, Morey; Werner, Melissa; Holtgrave, David R.

2018-01-01

The 2020 National HIV AIDS Strategy (NHAS) sets a target of 90% of diagnosed people living with HIV (PLWH) retained in HIV care. Access to Care (A2C) was a national HIV linkage, re-engagement, and retention in care program funded by AIDS United with support from the Corporation for National and Community Service that aimed to link and retain the most vulnerable PLWH into high-quality HIV care. This study explores the barriers and facilitators of implementing the A2C program from the perspective of program staff. Ninety-eight qualitative interviews were conducted with staff at implementing organizations over the 5 years of the project. Barriers included challenges with recruiting and retaining participants, staffing and administration, harmonizing partnerships, and addressing the basic and psychosocial needs of participants. Facilitators included strong relationships with partner organizations, flexible program models, and the passion and dedication of staff. Findings will inform the development of future programs and policy. PMID:29068718

Strategy for Upgrading Preparedness in Small and Rural Communities to Meet National Preparedness Standards

DTIC Science & Technology

2010-12-01

National Academy of Public Administration NEMA National Emergency Managers Association xii NICC National Infrastructure Coordinating Center NIMS...2003, p. 3). A blunt conclusion stated succinctly in the 2008 study conducted by the National Emergency Managers Association ( NEMA ) on barriers to...NIMS compliance speaks to the heart of the issue: “Poorer, rural states can’t meet implementation, training, compliance requirements” ( NEMA , 2008

76 FR 49826 - Bureau of Educational and Cultural Affairs (ECA) Request for Grant Proposals: Study of the United...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-11

... for Grant Proposals: Study of the United States Institute on U.S. National Security Policymaking... 11, 2011. Executive Summary: The Branch for the Study of the U.S., Office of Academic Exchange... design and implementation of the Study of the United States Institute on U.S. National Security...

A Case Study of a National University Research Project and Its Technological Innovation

ERIC Educational Resources Information Center

Ziegel, Melina

2012-01-01

This case study examined the implementation of a major research endeavor in an institution of higher education, Trinity College, Dublin, in Ireland, with particular focus on the change process during the initiation of the project and the subsequent needs assessment and implementation of technological solutions. This study identified the stages,…

Nationally Certified School Psychologists' use and reported barriers to using evidence-based interventions in schools: the influence of graduate program training and education.

PubMed

Hicks, Taylor B; Shahidullah, Jeffrey D; Carlson, John S; Palejwala, Mohammed H

2014-12-01

The purpose of this study was to empirically investigate Nationally Certified School Psychologists' (NCSP) training in and use of evidence-based interventions (EBIs) for child behavior concerns as well as their reported implementation barriers. A modified Tailored Design Method (TDM; Dillman, Smyth, & Christian, 2009) using up to four mail-based participant contacts was used to obtain survey data (72% usable response rate; n = 392) from a randomly selected national sample of 548 currently practicing NCSPs. Lack of time was rated as the most serious barrier to behavioral EBI implementation, followed by a lack of necessary resources, and financial constraints. Nearly three-quarters (71%) of respondents reported a perceived inadequacy of graduate program training in behavioral EBIs, with a statistically significant difference found between respondents who attended American Psychological Association (APA)-accredited/National Association of School Psychologists (NASP)-approved programs and those who did not. These findings highlight the significant barriers school psychologists encounter when attempting to implement behavioral EBIs within applied practice, as well as the importance of graduate program training in implementation science. Implications for training, practice, and research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

78 FR 23219 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-18

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... Federal Advisory Committee Act. The purpose of the committee is to provide advice and recommendations on...

78 FR 9883 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... Advisory Committee Act. The purpose of the committee is to provide advice and recommendations on the...

Case Studies in Implementing Functional Requirements for Bibliographic Records [FRBR]: AustLit and MusicAustralia

ERIC Educational Resources Information Center

Ayres, Marie-Louise

2005-01-01

AustLit: Australian Literature Gateway--the world's first major FRBR implementation--was developed as a co-operative service involving eight universities and the National Library of Australia in 2000-2001. This paper traces the reasons for adopting the FRBR information model, implementation experiences, and user responses to the service. The paper…

Project: Toward a National Educational Testing Network. Final Report.

ERIC Educational Resources Information Center

Bock, Darrell R.

Three fiscal year 1987 deliverables due for the "Toward a National Educational Testing Network: Feasibility Study of Duplex Design" are presented. The study is concerned with implementation of statewide and interstate testing of student attainment. The report includes: (1) a duplex design (DD) review paper discussing the means by which…

EXPOSURE ASSESSMENT IMPLICATIONS FOR THE DESIGN AND IMPLEMENTATION OF THE NATIONAL CHILDREN'S STUDY

EPA Science Inventory

Examining the influence of environmental exposures on various health indices is a critical component of the planned National Children¿s Study (NCS). An ideal strategy for the exposure monitoring component of the NCS is to measure indoor and outdoor concentrations and personal exp...

QUALITY MANAGEMENT PLAN FOR THE NATIONAL CHILDREN'S STUDY

EPA Science Inventory

EPA has taken the lead, in consort with NIH, in developing the Quality Management Plan (QMP) for the National Children's Study (NCS); the QMP will delineate a systematic planning process for the implementation of the NCS. The QMP will state the goals and objectives of the NCS, th...

Interactive Radio Counseling in Indira Gandhi National Open University: A Study.

ERIC Educational Resources Information Center

Chaudhary, Sohanvir S.; Bansal, Kiron

2000-01-01

Explains interactive radio as an effective tool for open and distance learning provided it is planned, designed, implemented, and monitored systematically. Describes the interactive radio counseling at Indira Gandhi National Open University (IGNOU) that provides support to students who study print material and may attend weekend…

A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

PubMed Central

Yao, Katy; Nkengasong, John N.

2014-01-01

Background Since its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented widely throughout Africa, as well as in the Caribbean, Central and South America, and Southeast Asia. Objective We compiled results from local, national and global studies to provide a broad view of the programme and identify directions for the future. The review consists of two companion papers; this paper focuses on content analysis, examining various thematic components of the SLMTA programme and future priorities. Methods A systematic literature search identified 28 published articles about implementing the SLMTA programme. Results for various components of the SLMTA programme were reviewed and summarised. Results Local and national studies provide substantial information on previous experiences with quality management systems; variations on SLMTA implementation; building human resource capacity for trainers, mentors and auditors; the benefits and effectiveness of various types of mentorship; the importance of management buy-in to ensure country ownership; the need to instill a culture of quality in the laboratory; success factors and challenges; and future directions for the programme. Conclusions Local, national and global results suggest that the SLMTA programme has been overwhelmingly successful in transforming laboratory quality management. There is an urgent need to move forward in four strategic directions: progression (continued improvement in SLMTA laboratories), saturation (additional laboratories within countries that have implemented SLMTA), expansion (implementation in additional countries), and extension (adapting SLMTA for implementation beyond the laboratory), to lead to transformation of overall health systems and patient care. PMID:29043200

Lessons learned from the National Medicare & You Education Program.

PubMed

Goldstein, E; Teichman, L; Crawley, B; Gaumer, G; Joseph, C; Reardon, L

2001-01-01

In fall 1998 CMS implemented the National Medicare Education Program (NMEP) to educate beneficiaries about their Medicare program benefits; health plan choices; supplemental health insurance; beneficiary rights, responsibilities, and protections; and health behaviors. CMS has been monitoring the implementation of the NMEP in six case study sites as well as monitoring each of the information channels for communicating with beneficiaries. This article describes select findings from the case studies, and highlights from assessment activities related to the Medicare & You handbook, the toll-free 1-800-MEDICARE Helpline, Internet, and Regional Education About Choices in Health (REACH).

Lessons Learned from the National Medicare & You Education Program

PubMed Central

Goldstein, Elizabeth; Teichman, Lori; Crawley, Barbara; Gaumer, Gary; Joseph, Catherine; Reardon, Leo

2001-01-01

In fall 1998 CMS implemented the National Medicare Education Program (NMEP) to educate beneficiaries about their Medicare program benefits; health plan choices; supplemental health insurance; beneficiary rights, responsibilities, and protections; and health behaviors. CMS has been monitoring the implementation of the NMEP in six case study sites as well as monitoring each of the information channels for communicating with beneficiaries. This article describes select findings from the case studies, and highlights from assessment activities related to the Medicare & You handbook, the toll-free 1-800-MEDICARE Helpline, Internet, and Regional Education About Choices in Health (REACH). PMID:12500359

National Study of Student Support Services. Third-Year Longitudinal Study Results and Program Implementation Study Update.

ERIC Educational Resources Information Center

Chaney, Bradford; Muraskin, Lana; Cahalan, Margaret; Rak, Rebecca

This follow-up study, part of the National Study of Student Support Services compared the status of 2,900 disadvantaged students receiving student support services (SSS) since entering college 3 years earlier and 2,900 nonparticipating comparable students. Services offered varied among institutions but were all intended to help students stay in…

Policy Intermediaries and the Reform of e-Education in South Africa

ERIC Educational Resources Information Center

Vandeyar, Thirusellvan

2015-01-01

Utilising a case study approach and backward mapping principles to policy implementation, this study set out to explore how well district and province's e-learning officials are equipped for the task of implementing the national e-Education policy. Qualitative methods were employed to capture data through interviews and document analysis. Data…

ICT Implementation Challenges and Strategies for ODL Institutions: The ZOU's National Centre Academic Staff Experiences

ERIC Educational Resources Information Center

Nenge, Richard Tafara; Chimbadzwa, Zvinaiye; Mapolisa, Tichaona

2012-01-01

This study highlighted some of the major challenges that Zimbabwe Open University (ZOU) academic staff experiences in connection with Information Communication Technology (ICT) implementation. It employed a qualitative paradigm rooted in a case study research design focusing on ZOU Academic Staff at the selected Faculties. It purposively sampled…

75 FR 51328 - Agency Information Collection Activities: Request for Comments for a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... National Transportation Systems Center (Volpe Center) have designed the survey and will submit the survey... Phase 2 Implementation Study Survey. The Federal Register notice with a 60-day public comment period...-LU Section 6009 Phase 2 Implementation Study Survey. Background: Section 6009 of the Safe...

75 FR 57220 - Rule To Implement the 1997 8-Hour Ozone National Ambient Air Quality Standard: New Source Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... Rule To Implement the 1997 8-Hour Ozone National Ambient Air Quality Standard: New Source Review Anti-Backsliding Provisions for Former 1-Hour Ozone Standard--Public Hearing Notice AGENCY: Environmental... be held for the proposed ``Rule to Implement the 1997 8-Hour Ozone National Ambient Air Quality...

76 FR 40817 - Implementation of Section 224 of the Act; A National Broadband Plan for Our Future

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

...-50] Implementation of Section 224 of the Act; A National Broadband Plan for Our Future AGENCY... information collection requirements. The Office of Management and Budget (OMB) gave approval for these..., Implementation of Section 224 of the Act; A National Broadband Plan for Our Future. DATES: The final rules...

40 CFR 142.19 - EPA review of State implementation of national primary drinking water regulations for lead and...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false EPA review of State implementation of national primary drinking water regulations for lead and copper. 142.19 Section 142.19 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Primar...

78 FR 68811 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... (FACA) (Pub. L. 92-463). The purpose of the Committee is to provide advice and recommendations on the...

78 FR 46565 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Advisory Committee for Implementation of the National Forest System Land... Committee Act (FACA) (Pub. L. 92-463). The purpose of the Committee is to provide advice and recommendations...

32 CFR 2004.11 - Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)].

Code of Federal Regulations, 2010 CFR

2010-07-01

... National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION NATIONAL INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Implementation and Oversight § 2004.11 Agency...

The Impact of National Standards Assessment in New Zealand, and National Testing Protocols in Norway on Indigenous Schooling

ERIC Educational Resources Information Center

Özerk, Kamil; Whitehead, David

2012-01-01

This paper first provides a critic of the implementation of compulsory national assessment protocols internationally, and then nationally through a review of the implementation process used for the introduction of National Standards in New Zealand, and National Testing in Norwegian mainstream schools. It then reviews the impact of these two…

Chapter 10: Case studies in ecosystem management: the Mammoth-June ecosystem management project, Inyo National Forest

Treesearch

Constance I. Millar

1996-01-01

To assess the various ways organizations and people come together to manage Sierran ecosystems, SNEP conducted four case studies to examine the efficacy of different institutional arrangements:The Mammoth-June case study examines how a single national forest is attempting to implement the new Forest Service policy for ecosystem analysis...

National Skill Standards Implementation Guide.

ERIC Educational Resources Information Center

National Vocational Technical Education Foundation, Washington, DC.

This guide was developed to encourage state policy makers and local school boards to implement the national skill standards formulated by the National Institute for Automotive Service Excellence (ASE) and the National Automotive Technician Education Foundation (NATEF) in high schools, technical schools, and technical and community colleges.…

National Water-Quality Assessment program: The Trinity River Basin

USGS Publications Warehouse

Land, Larry F.

1991-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at the national, State, and local levels. A major design feature of the NAWQA program will enable water-quality information at different areal scales to be integrated. A major component of the program is study-unit investigations, which comprise the principal building blocks of the program on which national-level assessment activities will be based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Trinity River basin study was among the first 20 NAWQA study units selected for study under the full-scale implementation plan.

32 CFR 2004.11 - Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)].

Code of Federal Regulations, 2014 CFR

2014-07-01

..., or Guidelines [102(b)(3)]. 2004.11 Section 2004.11 National Defense Other Regulations Relating to... NATIONAL INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Implementation and Oversight § 2004.11 Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)]. (a) Reviews and Updates. All implementing...

32 CFR 2004.11 - Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)].

Code of Federal Regulations, 2012 CFR

2012-07-01

..., or Guidelines [102(b)(3)]. 2004.11 Section 2004.11 National Defense Other Regulations Relating to... NATIONAL INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Implementation and Oversight § 2004.11 Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)]. (a) Reviews and Updates. All implementing...

32 CFR 2004.11 - Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)].

Code of Federal Regulations, 2013 CFR

2013-07-01

..., or Guidelines [102(b)(3)]. 2004.11 Section 2004.11 National Defense Other Regulations Relating to... NATIONAL INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Implementation and Oversight § 2004.11 Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)]. (a) Reviews and Updates. All implementing...

32 CFR 2004.11 - Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)].

Code of Federal Regulations, 2011 CFR

2011-07-01

..., or Guidelines [102(b)(3)]. 2004.11 Section 2004.11 National Defense Other Regulations Relating to... NATIONAL INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Implementation and Oversight § 2004.11 Agency Implementing Regulations, Internal Rules, or Guidelines [102(b)(3)]. (a) Reviews and Updates. All implementing...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

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

Instructional strategies in science classrooms of specialized secondary schools for the gifted

NASA Astrophysics Data System (ADS)

Poland, Donna Lorraine

This study examined the extent to which science teachers in Academic Year Governor's Schools were adhering to the national standards for suggested science instruction and providing an appropriate learning environment for gifted learners. The study asked 13 directors, 54 instructors of advanced science courses, and 1190 students of advanced science courses in 13 Academic Year Governor's Schools in Virginia to respond to researcher-developed surveys and to participate in classroom observations. The surveys and classroom observations collected demographic data as well as instructors' and students' perceptions of the use of various instructional strategies related to national science reform and gifted education recommendations. Chi-square analyses were used to ascertain significant differences between instructors' and students' perceptions. Findings indicated that instructors of advanced science classes in secondary schools for the gifted are implementing nationally recognized gifted education and science education instructional strategies with less frequency than desired. Both students and instructors concur that these strategies are being implemented in the classroom setting, and both concur as to the frequency with which the implementation occurs. There was no significant difference between instructors' and students' perceptions of the frequency of implementation of instructional strategies. Unfortunately, there was not a single strategy that students and teachers felt was being implemented on a weekly or daily basis across 90% of the sampled classrooms. Staff development in gifted education was found to be minimal as an ongoing practice. While this study offers some insights into the frequency of strategy usage, the study needs more classroom observations to support findings; an area of needed future research. While this study was conducted at the secondary level, research into instructional practices at the middle school and elementary school gifted science classroom settings would be appropriate and warranted.

The iPad as an Instructional Tool: An Examination of Teacher Implementation Experiences

ERIC Educational Resources Information Center

Benton, Brandie Kay

2012-01-01

At present, handheld devices and tablet computers are infiltrating public schools across the nation, the most popular model being the Apple iPad. Schools and teachers are attempting to integrate the devices and are using a variety of methods and models for implementation. The purpose of this study was to examine the implementation of the iPad as…

One Health Integration: A Proposed Framework for a Study on Veterinarians and Zoonotic Disease Management in Ghana.

PubMed

Valeix, Sophie Françoise

2018-01-01

In parallel with the recent world-wide promotion of One Health (OH) as a policy concept, a growing body of social science studies has raised questions about how successful OH policies and programs have been in managing some global health issues, such as zoonotic diseases. This paper briefly reviews this literature to clarify its critical perspective. Much of the literature on OH also is focused on health management at an international level and has paid less attention to implementation programs and policies for OH at the national and local levels, especially in low-and-middle-income countries (LMICs). Programs to implement OH often are linked to the concept of "integration", a notion that lacks a universal definition, but is nonetheless a central tenet and goal in many OH programs. At the local and national levels, strong differences in perspectives about OH among different professions can be major barriers to integration of those professions into OH implementation. Policies based on integration among professions in sectors like animal, human and environmental health can threaten professions' identities and thus may meet with resistance. Taking into account these criticisms of OH research and implementation, this paper proposes a research framework to probe the dominant social dimensions and power dynamics among professional participants that affect OH implementation programs at the local and national levels in a low-income country. The proposed research focus is the veterinary profession and one aspect of OH in which veterinarians are necessary actors: zoonotic disease management. Results from research framed in this way can have immediate application to the programs under study and can inform more expansive research on the social determinants of successful implementation of OH programs and policies.

Partnering for Transportation Success at Acadia National Park : A Case Study of the Island Explorer Shuttle Bus System at Mount Desert Island and Acadia National Park.

DOT National Transportation Integrated Search

2003-05-01

This report presents the first in a series of case studies on lessons learned from planning and : implementing alternative transportation systems (ATS) and from developing partnerships with : local and regional communities. The report is supported by...

Advanced Study Center: Proceedings of the National Faculty Plenary Conference (Columbus, Ohio, October 30-November 1, 1978).

ERIC Educational Resources Information Center

Jackson, Elise B., Ed.; Russell, Earl B., Ed.

These proceedings contain presentations made at the National Faculty Plenary Conference, whose theme, Nurturing Vocational Education's Leadership and Intellectual Capital, involved these topics: planning, evaluation, recruitment, and policy implications as they relate to the development and implementation of an Advanced Study Center. Introductory…

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

PubMed Central

Fusheini, Adam

2016-01-01

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

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

PubMed

Fusheini, Adam

2016-04-27

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

National Remodelling Team: Evaluation and Impact Study (Year 1) Final Report

ERIC Educational Resources Information Center

Wilson, Rebekah; Easton, Claire; Smith, Paula; Sharp, Caroline

2005-01-01

The National Remodelling Team (NRT) was established in April 2003 by the Department for Education and Skills (DfES) and hosted within the National College for School Leadership (NCSL). The role of the NRT was to work with local education authorities (LEAs) to support schools in the implementation of the changes to teachers' contracts introduced by…

A Global Perspective: Teaching about the United Nations.

ERIC Educational Resources Information Center

United Nations Association of the United States of America, New York, NY.

This guide is intended as an aid to social studies classroom teachers as they develop and implement educational programs on the United Nations. The objective is to help to counteract the scarcity of available teaching materials on the role and scope of the United Nations and its specialized agencies in the contemporary world. The guide is…

National Trainers’ Perspectives on Challenges to Implementation of an Empirically-Supported Mental Health Treatment

PubMed Central

Hanson, Rochelle F.; Gros, Kirstin Stauffacher; Davidson, Tatiana M.; Barr, Simone; Cohen, Judith; Deblinger, Esther; Mannarino, Anthony P.; Ruggiero, Kenneth J.

2013-01-01

This study examined perceived challenges to implementation of an empirically supported mental health treatment for youth (Trauma-Focused Cognitive Behavioral Therapy; TF-CBT) and explored the potential use of technology-based resources in treatment delivery. Thematic interviews were conducted with 19 approved national TF-CBT trainers to assess their perspectives about challenges to implementation of TF-CBT and to explore their perceptions about the potential value of innovative, technology-based solutions to enhance provider fidelity and improve quality of care. These data offer some important insights and implications for training in evidence-based treatments, provider fidelity and competence, and patient engagement, particularly for those interventions targeting trauma-related symptoms among youth. PMID:23605292

Clinical Research Nursing: A Critical Resource in the National Research Enterprise

PubMed Central

Hastings, Clare E.; Fisher, Cheryl A.; McCabe, Margaret A.

2012-01-01

Translational clinical research has emerged as an important priority for the national research enterprise, with a clearly stated mandate to deliver prevention strategies, treatments and cures based on scientific innovations faster to the public. Within this national effort, a lack of consensus persists concerning the need for clinical nurses with expertise and specialized training in study implementation and the delivery of care to research participants. This paper reviews efforts to define and document the role of practicing nurses in implementing studies and coordinating clinical research in a variety of clinical settings and differentiates this clinical role from the role of nurses as scientists and principal investigators. We propose an agenda for building evidence that having nurses provide and coordinate study treatments and procedures can potentially improve research efficiency, participant safety, and the quality of research data. We also provide recommendations for the development of the emerging specialty of clinical research nursing. PMID:22172370

Implementing Health Impact Assessment at National Level: An Experience in Iran.

PubMed

Damari, Behzad; Vosoogh-Moghaddam, Abbas; Riazi-Isfahani, Sahand

2018-02-01

According to the general health policies issued in 2014, Health Impact Assessment (HIA) or Health Annex should be implemented in Iran. The present study provided a model for executing HIA in the Iranian context as a developing country. This is a system design study with the qualitative approach. The data on the system components were gathered via reviews of the literature, in-depth interviews and focused group discussions (FGDs) with experts. The information were contently analyzed in order to draft the model and a consensus was reached on by the steering committee. Fifteen in-depth interviews and six FGD meeting were conducted. The equity-based approach in assessing the health impacts of policies, programs and projects were chosen as the most practical tool. Experts believe that for the next five years, HIA should be used just for the "national projects" so that the ministries and national agencies could be empowered. Components of the model including structure, procedures, and standards, management style, mission and resources were prepared. The national regulations and protocols were sent to the SCHFS Secretariat for final revision and the council approval. The hasty implementation of HIA will face serious resistances as the health-oriented attitude and behavior in both government and non-governmental sectors will gradually form. Also, the overlapping of the contents of HIA with other tools such as Environmental, Cultural and Social Impact Assessments, currently used by other sectors, causes difficulties in implementing the HIA by the Ministry of Health and Medical Education.

Intensive Evaluation of Head Start Implementation in the Tucson Early Education Model.

ERIC Educational Resources Information Center

Rentfrow, Robert K.

As part of the national Head Start Planned Variation Study, this study used a relatively small sample in an intensive evaluation of program implementation in one field community using the Tucson Early Education Model (TEEM). A modified Solomon four-group research design formed the organization framework. Evaluation of six TEEM classrooms and two…

"Informed Self-Placement" at American River College: A Case Study. National Center Report Number #07-2

ERIC Educational Resources Information Center

Felder, Jonathan E.; Finney, Joni E.; Kirst, Michael W.

2007-01-01

"Informed math self-placement," a program implemented at American River College in Sacramento, California, to determine students' readiness for college-level math, has been in place for three years. This case study describes the development and implementation of math self-placement at American River. Math self-placement consists of a…

The Implementation of the Bologna Process

ERIC Educational Resources Information Center

Kettunen, Juha; Kantola, Mauri

2006-01-01

This study identifies the responsibilities of the bodies and institutions involved in the implementation of the Bologna Process. They include the levels of Europe, nations, higher education institutions, departments, degree programmes, teachers and students. The future planning is analysed using the Balanced Scorecard approach designed for the…

Predicting Abandonment of School-Wide Behavior Support Interventions

ERIC Educational Resources Information Center

Nese, Rhonda N. T.; McIntosh, Kent; Nese, Joseph F. T.; Ghemraoui, Adam; Bloom, Jerry; Johnson, Nanci W.; Phillips, Danielle; Richter, Mary F.; Hoselton, Robert

2016-01-01

This study examines predictors of abandonment of evidence-based practices through descriptive analyses of extant state-level training data, fidelity of implementation data, and nationally reported school demographic data across 915 schools in 3 states implementing school-wide positive behavioral interventions and supports (SWPBIS). Schools…

77 FR 472 - National Advisory Committee for Implementation of the National Forest System Land Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

... DEPARTMENT OF AGRICULTURE Forest Service National Advisory Committee for Implementation of the National Forest System Land Management Planning Rule; Correction AGENCY: USDA Forest Service. ACTION... for the deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1 (800) 877-8339 between 8...

Stakeholders' Perception on National Heatwave Plans and Their Local Implementation in Belgium and The Netherlands.

PubMed

van Loenhout, Joris Adriaan Frank; Rodriguez-Llanes, Jose Manuel; Guha-Sapir, Debarati

2016-11-10

National heatwave plans are aimed at reducing the avoidable human health consequences due to heatwaves, by providing warnings as well as improving communication between relevant stakeholders. The objective of this study was to assess the perceptions of key stakeholders within plans in Belgium and The Netherlands on their responsibilities, the partnerships, and the effectiveness of the local implementation in Brussels and Amsterdam. Key informant interviews were held with stakeholders that had an important role in development of the heatwave plan in these countries, or its implementation in Brussels or Amsterdam. Care organisations, including hospitals and elderly care organisations, had a lack of familiarity with the national heatwave plan in both cities, and prioritised heat the lowest. Some groups of individuals, specifically socially isolated individuals, are not sufficiently addressed by the current national heatwave plans and most local plans. Stakeholders reported that responsibilities were not clearly described and that the national plan does not describe tasks on a local level. We recommend to urgently increase awareness on the impact of heat on health among care organisations. More emphasis needs to be given to the variety of heat-risk groups. Stakeholders should be involved in the development of updates of the plans.

Awareness of the implementation of the Falsified Medicines Directive among pharmaceutical companies' professionals in the European Economic Area.

PubMed

WŁodarczak, Urszula; Swieczkowski, Damian; Religioni, Urszula; Jaguszewski, Milosz; Krysinski, Jerzy; Merks, Piotr

2017-01-01

The Falsified Medicines Directive (FMD) is a response of the European Union to the increasing number of falsified medicines present in the legal supply chain within the Member States of the community. Effective implementation of the new regulations will depend on the effective cooperation of all parties involved in the distribution of medicinal products including the managers of pharmaceutical companies. The objective of the study was to examine awareness of the Implementation of the FMD among pharmaceutical company professionals in the European Economic Area. Sampling was conducted using a method called purposive sampling. An appropriate research tool in the form of an original questionnaire was made available to the respondents in electronic form. During the period from January 2016 to June 2016, 1,496 e-mail messages were sent. The response rate was 17.37%. The study included 99 women (39.3%) and 153 men (60.7%). In the study group, 95.7% of people had heard of FMD. Doctors had rarely heard about the falsified medicine directive when compared to pharmacists (p=0.0063), people working in the pharmaceutical industry (p=0.0014), and respondents with a different professional profile (p=0.0114). In the study group, 89.6% of people were aware of the role of National Medicines Verification Organization in the process of implementing the provisions of FMD into the national system of distribution of medicinal products. The number of the respondents who knew the deadline for the implementation of FMD was significantly higher in the study population, i.e. 91.9% (p=0.0001). Both the younger respondents and those with lower level of education were less aware of the time requirements posed to national regulators (p=0.0003, p=0.0023, respectively). Awareness of the regulations related to the implementation of the FMD, although relatively high among pharmaceutical company professionals in the EEA, is still insufficient.

Implementing an Effective and Efficient System to Manage the National School Lunch Program in a Private PreK-12 School: An Action Research Study

ERIC Educational Resources Information Center

Rafidi, Jessica A.

2012-01-01

To ensure the health of children in the United States, and to encourage the domestic consumption of nutritious agricultural commodities, President Harry S. Truman signed the National School Lunch Act. The Act, a federally assisted meal program established as a national security measure, was signed on June 4, 1946. Today, the National School Lunch…

A technical framework for implementing aquatic ecosystem loading limits (TMDLs) to reduce selenium pollution from phosphate mining wastes on Caribou National Forest, Idaho

Treesearch

A. Dennis Lemly

2001-01-01

Beginning in 1996, selenium associated with phosphate mining on Caribou National Forest (CNF) was implicated as the cause of death to horses and sheep grazing on private land adjacent to the national forest. In response to these concerns, the Forest Service began a monitoring study to determine selenium concentrations in and around the mine sites. By 1998, the study...

Implementation of Strategies to Leverage Public and Private Resources for National Security Workforce Development

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

None

2009-04-01

This report documents implementation strategies to leverage public and private resources for the development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP), being performed under a U.S. Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. There are numerous efforts across the United States to develop a properly skilled and trained national security workforce. Some of these efforts are the result of the leveraging of public and private dollars. As budget dollars decrease and the demand for a properly skilled and trained national security workforce increases, it will become even more important tomore » leverage every education and training dollar. This report details some of the efforts that have been implemented to leverage public and private resources, as well as implementation strategies to further leverage public and private resources.« less

Lowell National Historical Park alternative transportation system historic trolley planning study

DOT National Transportation Integrated Search

2002-12-01

This report assesses opportunities for expanding Lowell National Historical Parks historic trolley line by implementing a light rail system reminiscent of late 19th/early 20th Century trolley lines. This is in line with the Park Services Transp...

Linked symptom monitoring and depression treatment programmes for specialist cancer services: protocol for a mixed-methods implementation study

PubMed Central

Walker, Jane; Burke, Katy; Sevdalis, Nick; Richardson, Alison; Mulick, Amy; Frost, Chris; Sharpe, Michael

2017-01-01

Introduction There is growing awareness that cancer services need to address patients’ well-being as well as treating their cancer. We developed systematic approaches to (1) monitoring patients’ symptoms including depression using a ‘Symptom Monitoring Service’ and (2) providing treatment for those with major depression using a programme called ‘Depression Care for People with Cancer’. Used together, these two programmes were found to be highly effective and cost-effective in clinical trials. The overall aims of this project are to: (1) study the process of introducing these programmes into routine clinical care in a large cancer service, (2) identify the challenges associated with implementation and how these are overcome, (3) determine their effectiveness in a routine non-research setting and (4) describe patients’ and clinicians’ experience of the programmes. Methods and analysis This is a mixed-methods longitudinal implementation study. We will study the process of implementation in three phases (April 2016–December 2018): ‘Pre-implementation’ (setting up of the new programmes), ‘Early Implementation’ (implementation of the programmes in a small number of clinics) and ‘Implementation and Maintenance’ (implementation in the majority of clinics). We will use the following methods of data collection: (1) contemporaneous logs of the implementation process, (2) interviews with healthcare professionals and managers, (3) interviews with patients and (4) routinely collected clinical data. Ethics and dissemination The study has been reviewed by a joint committee of Oxford University Hospitals National Health Service Foundation Trust Research and Development Department and the University of Oxford’s Clinical Trials and Research Governance Department and judged to be service evaluation, not requiring ethics committee approval. The findings of this study will guide the scaling up implementation of the programmes across the UK and will enable us to construct an implementation toolkit. We will disseminate our findings in publications and at relevant national and international conferences. PMID:28674143

Early Warning System Implementation Guide: For Use with the National High School Center's Early Warning System Tool v2.0

ERIC Educational Resources Information Center

Therriault, Susan Bowles; Heppen, Jessica; O'Cummings, Mindee; Fryer, Lindsay; Johnson, Amy

2010-01-01

This Early Warning System (EWS) Implementation Guide is a supporting document for schools and districts that are implementing the National High School Center's Early Warning System (EWS) Tool v2.0. Developed by the National High School Center at the American Institutes for Research (AIR), the guide and tool support the establishment and…

A qualitative study of the determinants of HIV guidelines implementation in two south-eastern districts of Tanzania.

PubMed

Mwangome, Mary N; Geubbels, Eveline; Wringe, Alison; Todd, Jim; Klatser, Paul; Dieleman, Marjolein

2017-07-01

Current HIV policies in Tanzania have adopted the three long-term impact results of zero new infections, zero HIV deaths and zero stigma and discrimination. Strategies to reach these results include scaling-up HIV Testing and Counselling (HTC); Preventing Mother-To-Child Transmission (PMTCT); and strengthening Care and Treatment Clinic (CTC) services. Previous studies showed that HIV policy and guideline recommendations were not always implemented in rural South Tanzania. This study aims to identify the determinants of HIV guideline implementation. A qualitative study of 23 semi-structured interviews with facility in-charges; healthcare workers; district, regional and national HIV coordinators was conducted. Five health facilities were purposively selected by level, ownership and proximity to district headquarters. Interviews were analysed according to Fleuren's five determinants of innovation uptake related to: strategies used in guideline development and dissemination; guideline characteristics; the guideline implementing organization; guideline users; and the socio-cultural and regulatory context. None of the facilities had the HTC national guideline document. Non-involvement of providers in revisions and weak planning for guideline dissemination impeded their implementation. Lengthy guidelines and those written in English were under-used, and activities perceived to be complicated, like WHO-staging, were avoided. Availability of staff and lack of supplies like test kits and medication impeded implementation. Collaboration between facilities enhanced implementation, as did peer-support among providers. Provider characteristics including education level, knowledge of, and commitment to the guideline influenced implementation. According to providers, determinants of clients' service use included gender norms, stigma, trust and perceived benefits. The regulatory context prohibited private hospitals from buying HIV supplies. Being tools for bringing policies to practice, national guidelines are crucial in the efforts towards the three zeros. Strategies to improve providers' adherence to guidelines should include development of clearer guideline dissemination plans, strengthening of the health system, and possibly addressing of provider-perceived patient-level barriers to utilizing HIV services. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

[Study on the effectiveness of implementation: the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

PubMed

Zhang, J; Jin, R R; Li, J J; Li, J L; Su, X W; Deng, G J; Ma, S; Zhao, J; Wang, Y P; Bian, F; Qu, Y M; Shen, Z Z; Jiang, Y; Liu, Y L

2018-04-10

Objective: To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December, 2016 in order to conduct on process and outcome evaluation of the above mentioned objective. In the meantime, case study was also conducted. Results: All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country, with health education and health promotion, surveillance and safeguard measures in particular. A government-led and inter-sector coordination and communication mechanism had been well established, with more than 16 non-health departments actively involved. 28.7% of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases. Among the residents, 72.1% of them consumed vegetables and 53.6% consumed fruits daily, with another 86.9% walked at least 10 minutes per day. Over 70% of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers, and above 50% of them were under standardized management. Residents, living in the National Demonstration Areas under higher ranking of implementation scores, were more likely to be aware of relevant knowledge on chronic disease control and prevention ( OR =6.591, 95% CI : 5.188-8.373), salt reduction ( OR =1.352, 95% CI : 1.151-1.589), oil reduction ( OR =1.477, 95% CI : 1.249-1.746) and recommendation on physical activities ( OR =1.975, 95% CI : 1.623- 2.403). Conclusion: The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases, and thus become an important 'carrier' for chronic disease prevention and control programs in China.

44 CFR 73.1 - Purpose of part.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program IMPLEMENTATION OF SECTION 1316 OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 § 73.1 Purpose of part. This part implements section 1316 of the National Flood Insurance Act of 1968. ...

44 CFR 73.1 - Purpose of part.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program IMPLEMENTATION OF SECTION 1316 OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 § 73.1 Purpose of part. This part implements section 1316 of the National Flood Insurance Act of 1968. ...

Web-based Survey Data Collection With Peer Support and Advocacy Organizations: Implications of Participatory Methods.

PubMed

Ostrow, Laysha; Penney, Darby; Stuart, Elizabeth; Leaf, Phillip J

2017-01-01

The 2012 National Survey of Peer-Run Organizations is one of the first to survey a nationally representative sample of mental health peer-run organizations, nonprofit venues for support and advocacy which are defined by people with psychiatric histories being in positions of authority and control. This paper describes data collection methods and demonstrates how participatory strategies to involve people with psychiatric histories intersected with Internet research to achieve study aims. People with psychiatric histories were involved in designing and implementing a web-based survey to collect data on peer-run organizations' operations and views on national policy. Participatory approaches were used throughout design, data collection analysis, and dissemination. The extensive involvement of people with psychiatric histories in project design and implementation were important strategies that contributed to this study's success.

Predicting Abandonment of School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Nese, Rhonda; McIntosh, Kent; Nese, Joseph; Hoselton, Robert; Bloom, Jerry; Johnson, Nanci; Richter, Mary; Phillips, Danielle; Ghemraoui, Adam

2016-01-01

This study examines predictors of abandonment of evidence-based practices through descriptive analyses of extant state-level training data, fidelity of implementation data, and nationally reported school demographic data across 915 schools in three states implementing school-wide positive behavioral interventions and supports (SWPBIS). Schools…

Contested Notions of Civics and Citizenship Education as National Education in the "Australian Curriculum"

ERIC Educational Resources Information Center

Tudball, Libby; Henderson, Deborah

2014-01-01

Civics and Citizenship (CC) education is a contested concept and a learning area that creates curriculum and implementation challenges for schools in many nations. The current development of the first national curriculum to be implemented in Australia, the "Australian Curriculum," provides a national opportunity for educators to rethink…

National visitor use monitoring implementation in Alaska.

Treesearch

Eric M. White; Joshua B. Wilson

2008-01-01

The USDA Forest Service implemented the National Visitor Use Monitoring (NVUM) program across the entire National Forest System (NFS) in calendar year 2000. The primary objective of the NVUM program is to develop reliable estimates of recreation use on NFS lands via a nationally consistent, statistically valid sampling approach. Secondary objectives of NVUM are to...

Students' Attitudes and Their Academic Performance in Nationhood Education

ERIC Educational Resources Information Center

Awang, Mohd Mahzan; Ahmad, Abdul Razaq; Bakar, Nora'asikin Abu; Ghani, Sayuti Abd; Yunus, Asyraf Nadia Mohd; Ibrahim, Mohd Asrul Hery; Ramalu, Jaya Chitra; Saad, Che Pee; Rahman, Mohd Jasmy Abd

2013-01-01

The main goal of the nationhood education is to instill the sense of loyalty and passion into the nation. In a Malaysian context, several academic subjects at higher education such as Malaysian Studies, Ethnic Relations and National Language have been implemented in order to achieve the goal. Malaysian Study is one of the compulsory courses…

Analysis of Risks in a Learning Management System: A Case Study in the Spanish National University of Distance Education (UNED)

ERIC Educational Resources Information Center

Vázquez-Cano, Esteban; Sevillano García, Ma. Luisa

2015-01-01

This article presents a research that examines the university students' risk perception when using a Learning Management System called "aLF" and implemented by the Spanish National University of Distance Education (UNED) for the development of its university distance studies. The development of comprehensive Learning Management Systems…

National Corn Growers Association Clean Water Act and TMDL Program: An Introduction and Basic Desk Reference for Corn Growers

EPA Pesticide Factsheets

The primer from the National Corn Growers Association includes information on the Clean Water Act, TMDLs, a hypothetical TMDL case study and opportunities for the agricultural community's involvement in development and implementation of TMDLs.

40 CFR 6.403 - Environmental review and assessment requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS Assessing the Environmental Effects Abroad of EPA Actions § 6.403 Environmental review... study. EPA shall afford the affected foreign nation or international body or organization an opportunity...

40 CFR 6.403 - Environmental review and assessment requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS Assessing the Environmental Effects Abroad of EPA Actions § 6.403 Environmental review... study. EPA shall afford the affected foreign nation or international body or organization an opportunity...

40 CFR 6.403 - Environmental review and assessment requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS Assessing the Environmental Effects Abroad of EPA Actions § 6.403 Environmental review... study. EPA shall afford the affected foreign nation or international body or organization an opportunity...

40 CFR 6.403 - Environmental review and assessment requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS Assessing the Environmental Effects Abroad of EPA Actions § 6.403 Environmental review... study. EPA shall afford the affected foreign nation or international body or organization an opportunity...

40 CFR 6.403 - Environmental review and assessment requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT AND ASSESSING THE ENVIRONMENTAL EFFECTS ABROAD OF EPA ACTIONS Assessing the Environmental Effects Abroad of EPA Actions § 6.403 Environmental review... study. EPA shall afford the affected foreign nation or international body or organization an opportunity...

78 FR 52893 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 50, 51, 70 and 71 [EPA-HQ-OAR-2010-0885, FRL-9810-3] RIN 2060-AR34 Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation Plan Requirements Correction In proposed rule document 2013-13233 appearing on pages 34178 through...

Policy implementation of the Republic Act (RA) No. 9003 in the Philippines: a case study of Cebu City.

PubMed

Premakumara, Dickella Gamaralalage Jagath; Canete, Aloysius Mariae L; Nagaishi, Masaya; Kurniawan, Tonni Agustiono

2014-06-01

Municipal Solid Waste Management (MSWM) is considered to be one of the most serious environmental issues in the Philippines. The annual waste generation was estimated at 10.6 million tonnes in 2012 and this is expected to double in 2025. The Republic Act (RA) No. 9003, widely known as the Ecological Solid Waste Management Act of 2000, provides the required policy framework, institutional mechanisms and mandate to the Local Government Units (LGUs) to achieve 25% waste reduction target through establishing an integrated solid waste management plan based on the 3Rs (reduce, reuse and recycling). Although the initial impact of the LGUs is still very limited in implementing the national mandate, this article highlights the successful experiences of Cebu, the second largest city in the Philippines, in reducing its MSW generation by more than 30% in the past three years. This study also explores the implementation process, innovative actions taken by the Cebu City Government in implementing the national mandate at local level and identifies the factors that influence the policy implementation. The findings suggest that the impacts of the national mandate can be achieved if the LGUs have the high degree of political commitment, planning and development of effective local strategies in a collaborative manner to meet with local conditions, partnership building with other stakeholders, capacity development, adequate financing and incentives, and in the close monitoring and evaluation of performance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Physical Activity in Schools: A Qualitative Case Study of Eight Norwegian Schools' Experiences with the Implementation of a National Policy

ERIC Educational Resources Information Center

Larsen, Torill; Samdal, Oddrun; Tjomsland, Hege

2013-01-01

Purpose: Over the past decades numerous policies, programmes and interventions have been undertaken to increase students' participation in physical activity in school. Research shows that intervention effects are mostly related to the way in which the program or policy is implemented, nevertheless, few studies have focused on the implementation…

Implementation of Case Studies in an Introduction to Engineering Course for "LITEE National Dissemination Grant Competition"

ERIC Educational Resources Information Center

Le, Qiang

2012-01-01

This paper discusses the year 2008 and the 2009 results of implementing the Laboratory for Innovative Technology and Engineering Education (LITEE) case studies in an engineering class at Hampton University (HU), a HBCU. Questionnaires were administered at the conclusion of the experiment. The goal of this research is to investigate the relevance…

Implementation of national palliative care guidelines in Swedish acute care hospitals: A qualitative content analysis of stakeholders' perceptions.

PubMed

Lind, S; Wallin, L; Brytting, T; Fürst, C J; Sandberg, J

2017-11-01

In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. The results showed little knowledge of the two documents at all levels of the health care organisation. Palliative care was primarily described as end of life care and only few of the participants talked about the opportunity to integrate palliative care early in a disease trajectory. The environment and culture at hospitals, characterised by quick decisions and actions, were perceived as obstacles to implementation. Health professionals' expressed need for palliative care training is an opportunity for implementation of clinical guidelines. There is a need for further implementation of palliative care in hospitals. One option for further research is to evaluate implementation strategies tailored to acute care. Copyright © 2017 Elsevier B.V. All rights reserved.

Diverse Approaches to Implement and Monitor River Restoration: A Comparative Perspective in France and Germany

NASA Astrophysics Data System (ADS)

Morandi, Bertrand; Kail, Jochem; Toedter, Anne; Wolter, Christian; Piégay, Hervé

2017-11-01

River restoration is a main emphasis of river management in European countries. Cross-national comparisons of its implementation are still rare in scientific literature. Based on French and German national censuses, this study compares river restoration practices and monitoring by analysing 102 French and 270 German projects. This comparison aims to draw a spatial and temporal framework of restoration practices in both countries to identify potential drivers of cross-national similarities and differences. The results underline four major trends: (1) a lag of almost 15 years in river restoration implementation between France and Germany, with a consequently higher share of projects in Germany than in France, (2) substantial similarities in restored reach characteristics, short reach length, small rivers, and in "agricultural" areas, (3) good correspondences between stressors identified and restoration measures implemented. Morphological alterations were the most important highlighted stressors. River morphology enhancement, especially instream enhancements, were the most frequently implemented restoration measures. Some differences exist in specific restoration practices, as river continuity restoration were most frequently implemented in French projects, while large wood introduction or channel re-braiding were most frequently implemented in German projects, and (4) some quantitative and qualitative differences in monitoring practices and a significant lack of project monitoring, especially in Germany compared to France. These similarities and differences between Germany and France in restoration application and monitoring possibly result from a complex set of drivers that might be difficult to untangle (e.g., environmental, technical, political, cultural).

Diverse Approaches to Implement and Monitor River Restoration: A Comparative Perspective in France and Germany.

PubMed

Morandi, Bertrand; Kail, Jochem; Toedter, Anne; Wolter, Christian; Piégay, Hervé

2017-11-01

River restoration is a main emphasis of river management in European countries. Cross-national comparisons of its implementation are still rare in scientific literature. Based on French and German national censuses, this study compares river restoration practices and monitoring by analysing 102 French and 270 German projects. This comparison aims to draw a spatial and temporal framework of restoration practices in both countries to identify potential drivers of cross-national similarities and differences. The results underline four major trends: (1) a lag of almost 15 years in river restoration implementation between France and Germany, with a consequently higher share of projects in Germany than in France, (2) substantial similarities in restored reach characteristics, short reach length, small rivers, and in "agricultural" areas, (3) good correspondences between stressors identified and restoration measures implemented. Morphological alterations were the most important highlighted stressors. River morphology enhancement, especially instream enhancements, were the most frequently implemented restoration measures. Some differences exist in specific restoration practices, as river continuity restoration were most frequently implemented in French projects, while large wood introduction or channel re-braiding were most frequently implemented in German projects, and (4) some quantitative and qualitative differences in monitoring practices and a significant lack of project monitoring, especially in Germany compared to France. These similarities and differences between Germany and France in restoration application and monitoring possibly result from a complex set of drivers that might be difficult to untangle (e.g., environmental, technical, political, cultural).

Implementing the national priorities for injury surveillance.

PubMed

Mitchell, Rebecca J; McClure, Rod J; Williamson, Ann M; McKenzie, Kirsten

2008-04-07

Injury is a leading cause of disability and death in Australia and is recognised as a national health priority area. The foundation of successful injury prevention is injury surveillance, and national policies and strategies developed over the past 20 years to reduce the burden of injury in Australia have included 22 recommendations on surveillance--only three of which have been completely implemented. Priorities for improving injury surveillance include: improving current injury mortality and morbidity data collection systems; filling the gaps in injury surveillance; maintaining vigilance over data quality; increasing the integration and accessibility of injury data; developing technical expertise in surveillance. Barriers to implementation of the current National Injury Prevention and Safety Promotion Plan include the lack of an implementation plan, performance management structure, appropriate national governance structure and resources--all of which could be overcome with government commitment.

Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

PubMed

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes involved in developing CHW programmes at scale, and specifically the negotiated and multilevel nature of leadership and governance in such programmes, spanning analytic, managerial, technical and political roles.

Evidence-informed policy formulation and implementation: a comparative case study of two national policies for improving health and social care in Sweden.

PubMed

Strehlenert, H; Richter-Sundberg, L; Nyström, M E; Hasson, H

2015-12-08

Evidence has come to play a central role in health policymaking. However, policymakers tend to use other types of information besides research evidence. Most prior studies on evidence-informed policy have focused on the policy formulation phase without a systematic analysis of its implementation. It has been suggested that in order to fully understand the policy process, the analysis should include both policy formulation and implementation. The purpose of the study was to explore and compare two policies aiming to improve health and social care in Sweden and to empirically test a new conceptual model for evidence-informed policy formulation and implementation. Two concurrent national policies were studied during the entire policy process using a longitudinal, comparative case study approach. Data was collected through interviews, observations, and documents. A Conceptual Model for Evidence-Informed Policy Formulation and Implementation was developed based on prior frameworks for evidence-informed policymaking and policy dissemination and implementation. The conceptual model was used to organize and analyze the data. The policies differed regarding the use of evidence in the policy formulation and the extent to which the policy formulation and implementation phases overlapped. Similarities between the cases were an emphasis on capacity assessment, modified activities based on the assessment, and a highly active implementation approach relying on networks of stakeholders. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was empirically useful to organize the data. The policy actors' roles and functions were found to have a great influence on the choices of strategies and collaborators in all policy phases. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was found to be useful. However, it provided insufficient guidance for analyzing actors involved in the policy process, capacity-building strategies, and overlapping policy phases. A revised version of the model that includes these aspects is suggested.

Linked symptom monitoring and depression treatment programmes for specialist cancer services: protocol for a mixed-methods implementation study.

PubMed

Wanat, Marta; Walker, Jane; Burke, Katy; Sevdalis, Nick; Richardson, Alison; Mulick, Amy; Frost, Chris; Sharpe, Michael

2017-07-02

There is growing awareness that cancer services need to address patients' well-being as well as treating their cancer. We developed systematic approaches to (1) monitoring patients' symptoms including depression using a 'Symptom Monitoring Service' and (2) providing treatment for those with major depression using a programme called 'Depression Care for People with Cancer'. Used together, these two programmes were found to be highly effective and cost-effective in clinical trials. The overall aims of this project are to: (1) study the process of introducing these programmes into routine clinical care in a large cancer service, (2) identify the challenges associated with implementation and how these are overcome, (3) determine their effectiveness in a routine non-research setting and (4) describe patients' and clinicians' experience of the programmes. This is a mixed-methods longitudinal implementation study. We will study the process of implementation in three phases (April 2016-December 2018): 'Pre-implementation' (setting up of the new programmes), 'Early Implementation' (implementation of the programmes in a small number of clinics) and 'Implementation and Maintenance' (implementation in the majority of clinics). We will use the following methods of data collection: (1) contemporaneous logs of the implementation process, (2) interviews with healthcare professionals and managers, (3) interviews with patients and (4) routinely collected clinical data. The study has been reviewed by a joint committee of Oxford University Hospitals National Health Service Foundation Trust Research and Development Department and the University of Oxford's Clinical Trials and Research Governance Department and judged to be service evaluation, not requiring ethics committee approval. The findings of this study will guide the scaling up implementation of the programmes across the UK and will enable us to construct an implementation toolkit. We will disseminate our findings in publications and at relevant national and international conferences. © 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.

Implications of NCLB Accountability for Comprehensive School Reform

ERIC Educational Resources Information Center

Le Floch, Kerstin Carlson; Taylor, James E.; Thomsen, Kerri

2006-01-01

No Child Left Behind (NCLB) accountability mechanisms have the potential to derail comprehensive school reform (CSR) implementation. For those pursuing CSR, the question is how to reconcile the implementation of NCLB accountability mandates with ongoing CSR efforts. Drawing from longitudinal data from a national study of CSR, this article explores…

Politicising Curriculum Implementation: The Case of Primary Schools

ERIC Educational Resources Information Center

Molapo, Moyahabo Rodgers; Pillay, Venitha

2018-01-01

Since 2012, the Curriculum Assessment Policy Statements (CAPS) comprise the new National Curriculum Statement currently implemented in South African schools. CAPS encapsulates a series of radical curriculum changes since the dawn of a new democratic dispensation in 1994. This study aims to understand how Grade Three educators in Limpopo, South…

Primary School Teachers' Views and Opinions about the Idea of the National Levels of Students' Attainment: "Case Study England"

ERIC Educational Resources Information Center

Maksimovic, Aleksandra; Vuletic, Sanja

2017-01-01

The aim of this study is to research perceptions of primary school teachers in England about the implementation of the national levels of students' attainment and Standard Assessment Task (SAT). Teachers' views and opinions were studied by using a semi-structured interview created for this purpose. The following themes are explored: procedure of…

Can health care financing policy be emulated? The Singaporean medical savings accounts model and its Shanghai replica.

PubMed

Dong, Weizhen

2006-09-01

Each nation's government is searching for a cost-effective health care system. Some nations are developing their health care financing methods through gradual evolution of the existing ones, and others are trying to adopt other nations' successful schemes as their own financing strategies. The Singaporean government seems able to finance its nation's health care with a very low gross domestic product (GDP) input. Since the implementation of the medical savings accounts schemes (MSAs) in 1984, Singaporean government's share of the nation's total health care expenditure dropped from about 50% to 20%. Inspired by Singapore's success, the Chinese government adopted the Singaporean MSAs model as its health care financing schemes for urban areas. Shanghai was the first large urban centre to implement the MSAs in China. Through the study of the Singapore and Shanghai experiences, this article examines whether it is rational to borrow another nation's health care financing model, especially when the two societies have very different socioeconomic characteristics. However, the MSAs' success in Singapore did not guarantee its Shanghai success, because health care systems do not work alone. Through study of the MSAs' experiences in Singapore and Shanghai, this paper examines whether it is rational to borrow another nation's health care financing model, especially when the two societies have very different socioeconomic characteristics.

[Clarifying the implementation of nursing care systematization].

PubMed

Hermida, Patricia Madalena Vieira

2004-01-01

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

Under the knife: a national survey of six sigma programs in US healthcare organizations.

PubMed

Feng, Qianmei; Manuel, Chris M

2008-01-01

Medical and policy literature reports many six sigma applications at specific healthcare organizations. However, there is a lack of studies that investigate the broader status of six sigma in US healthcare systems. The purpose of this paper is to present the results from a national survey of six sigma programs in US healthcare organizations. Through the design, distribution, and analysis of a nationwide survey, this paper assesses the implementation of six sigma in healthcare facilities. Two sets of surveys were designed based on whether an organization has adopted six sigma or not. Findings from this paper indicate the common six sigma projects implemented in healthcare organizations, typical implementation durations, cost benefits, and major barriers in implementation, and so on. This paper is limited by the low-response rate owing to time and budget constraints. Through the dissemination of this paper, it is hoped that more organizations will become interested in this subject and participate in future studies. This work is the first study to investigate the implementation status of six sigma in US healthcare systems. It will share experiences amongst six sigma institutions and promote its application in many institutions. The findings will provide instructive information to six sigma practitioners and researchers, and particularly to health care management.

Persistent Socioeconomic and Political Dilemmas to the Implementation of the 1989 United Nations' Convention on the Rights of the Child in Sub-Saharan Africa

ERIC Educational Resources Information Center

Mulinge, Munyae M.

2010-01-01

Objective: The aim of this article is to revisit the subject of the implementation of the 1989 United Nations Convention on the Rights of the Child in Africa. Specifically, the article is an update to a previous article titled "Implementing the 1989 United Nations' Convention on the Rights of the Child in sub-Saharan Africa: The Overlooked…

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

PubMed

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

2015-01-22

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

HIV policy and implementation: a national policy review and an implementation case study of a rural area of northern Malawi.

PubMed

Dasgupta, Aisha N Z; Wringe, Alison; Crampin, Amelia C; Chisambo, Christina; Koole, Olivier; Makombe, Simon; Sungani, Charles; Todd, Jim; Church, Kathryn

2016-09-01

Malawi is a global leader in the design and implementation of progressive HIV policies. However, there continues to be substantial attrition of people living with HIV across the "cascade" of HIV services from diagnosis to treatment, and program outcomes could improve further. Ability to successfully implement national HIV policy, especially in rural areas, may have an impact on consistency of service uptake. We reviewed Malawian policies and guidelines published between 2003 and 2013 relating to accessibility of adult HIV testing, prevention of mother-to-child transmission and HIV care and treatment services using a policy extraction tool, with gaps completed through key informant interviews. A health facility survey was conducted in six facilities serving the population of a demographic surveillance site in rural northern Malawi to investigate service-level policy implementation. Survey data were analyzed using descriptive statistics. Policy implementation was assessed by comparing policy content and facility practice using pre-defined indicators covering service access: quality of care, service coordination and patient tracking, patient support, and medical management. ART was rolled out in Malawi in 2004 and became available in the study area in 2005. In most areas, practices in the surveyed health facilities complied with or exceeded national policy, including those designed to promote rapid initiation onto treatment, such as free services and task-shifting for treatment initiation. However, policy and/or practice were/was lacking in certain areas, in particular those strategies to promote retention in HIV care (e.g., adherence monitoring and home-based care). In some instances, though, facilities implemented alternative progressive practices aimed at improving quality of care and encouraging adherence. While Malawi has formulated a range of progressive policies aiming to promote rapid initiation onto ART, increased investment in policy implementation strategies and quality service delivery, in particular to promote long-term retention on treatment may improve outcomes further.

Perception survey on the introduction of clinical performance examination as part of the national nursing licensing examination in Korea.

PubMed

Shin, Su Jin; Kim, Yeong Kyeong; Suh, Soon-Rim; Jung, Duk Yoo; Kim, Yunju; Yim, Mi Kyoung

2017-01-01

The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees' ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses' work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.

Perception survey on the introduction of clinical performance examination as part of the national nursing licensing examination in Korea

PubMed Central

2017-01-01

Purpose The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. Methods This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. Results First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees’ ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses’ work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. Conclusion In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training. PMID:29129904

Is the metaphor of 'barriers to change' useful in understanding implementation? Evidence from general medical practice.

PubMed

Checkland, Kath; Harrison, Stephen; Marshall, Martin

2007-04-01

To investigate how general medical practices in the UK react to bureaucratic initiatives, such as National Health Service (NHS) National Service Frameworks (NSFs), and to explore the value of the metaphor of 'barriers to change' for understanding this. Interviews, non-participant observation and documentary analysis within case studies of four practices in northern England. The practices had not actively implemented NSFs. At interview, various 'barriers' that had prevented implementation were listed, including the complexity of the documents and lack of time. Observation suggested that these barriers were constructions used by the participants to make sense of the situation in which they found themselves. The metaphor of 'removing barriers to change' was of limited use in a context where non-implementation of policy was an emergent property of underlying organizational realities, likely to be modifiable only if these realities were addressed.

Evidence-Based Programs for Older Adults: A Disconnect Between U.S. National Strategy and Local Senior Center Implementation.

PubMed

Bobitt, Julie; Schwingel, Andiara

2017-01-01

While U.S. national policies have been developed to support evidence-based (EB) lifestyle programs for older adults, there has been limited research to determine the extent to which these programs actually reach local communities. This study sought to identify factors that impact the implementation of EB physical activity, nutrition, and chronic disease management programs at regional (Area Agencies on Aging [AAAs]) and community levels (senior Centers [SCs]). Interviews were conducted with directors of four AAAs and 12 SCs to understand their perspectives on EB program implementation. Narratives revealed differences between AAAs and SCs regarding knowledge about EB programs and reasons to promote and adopt these programs. The only agreement occurred when discussing concerns about funding and program inflexibility. Substantial gaps exist between how EB lifestyle programs are promoted and implemented at the regional and community levels.

Factors affecting speech pathologists' implementation of stroke management guidelines: a thematic analysis.

PubMed

Miao, Melissa; Power, Emma; O'Halloran, Robyn

2015-01-01

Although clinical practice guidelines can facilitate evidence-based practice and improve the health outcomes of stroke patients, they continue to be underutilised. There is limited research into the reasons for this, especially in speech pathology. This study provides the first in-depth, qualitative examination of the barriers and facilitators that speech pathologists perceive and experience when implementing guidelines. A maximum variation sample of eight speech pathologists participated in a semi-structured interview concerning the implementation of the National Stroke Foundation's Clinical Guidelines for Stroke Management 2010. Interviews were transcribed, thematically analysed and member checked before overall themes were identified. Three main themes and ten subthemes were identified. The first main theme, making implementation explicit, reflected the necessity of accessing and understanding guideline recommendations, and focussing specifically on implementation in context. In the second theme, demand versus ability to change, the size of changes required was compared with available resources and collaboration. The final theme, Speech pathologist motivation to implement guidelines, demonstrated the influence of individual perception of the guidelines and personal commitment to improved practice. Factors affecting implementation are complex, and are not exclusively barriers or facilitators. Some potential implementation strategies are suggested. Further research is recommended. In most Western nations, stroke remains the single greatest cause of disability, including communication and swallowing disabilities. Although adherence to stroke clinical practice guidelines improves stroke patient outcomes, guidelines continue to be underutilised, and the reasons for this are not well understood. This is the first in-depth qualitative study identifying the complex barriers and facilitators to guideline implementation as experienced by speech pathologists in stroke care. Suggested implementation strategies include local monitoring of guideline implementation (e.g. team meetings, audits), increasing collaboration on implementation projects (e.g. managerial involvement, networking), and seeking speech pathologist input into guideline development.

75 FR 16698 - Privacy Act of 1974: Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... OFFICE OF THE DIRECTOR OF NATIONAL INTELLIGENCE 32 CFR Part 1701 Privacy Act of 1974: Implementation AGENCY: Office of the Director of National Intelligence. ACTION: Proposed rulemaking. SUMMARY: The Office of the Director of National Intelligence (ODNI) proposes to exempt fourteen (14) new systems of...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

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

[Implementation of the National Expert Standard Prophylaxis of Pressure Ulcers in nurse practise - a cost-benefit analysis].

PubMed

Wolke, R; Hennings, D; Scheu, P

2007-06-01

By developing evidence-based, national Expert Standards, agreed-upon by an association of nursing professionals, the German Care Science participates in the international discussion. Up to now, five National Expert Standards on relevant care-related topics have been developed and have been widely implemented in Care Practice. However, sufficient evaluations of these Expert Standards are still required, especially from an economic perspective. The following paper addresses this topic by performing a cost-benefit analysis for the National Expert Standard Prophylaxis of Pressure Ulcers. The authors demonstrate which costs are caused by the implementation of this National Expert Standard for a residential care agency providing services. The benefit of the implementation of the Expert Standard is then being compared to its cost for a period of three years. The evaluation concludes that, in consideration of opportunity costs, the introduction of the National Expert Standard Prophylaxis of Pressure Ulcers appears economically viable for the residential care agency only if the rate of pressure ulcers in the reference agency can be lowered at least by 26.48%. In this case, when exclusively considering direct benefits and direct costs, a positive impact of the implementation will be achieved.

Increased Breakfast Frequency and Nutritional Quality among Schoolchildren after a National Breakfast Promotion Campaign in Australia between 2000 and 2006

ERIC Educational Resources Information Center

O'Dea, Jennifer A.; Wagstaff, Samantha

2011-01-01

This national study examined student breakfast consumption and nutritional quality of breakfast in 2000 and 2006 by gender, school grade, school socioeconomic status (SES) and weight status after the implementation of a national breakfast promotion campaign. Participants were 4237 schoolchildren in grades 2-12 from 32 schools in 2000 and 5645…

For My Children: Mexican American Women, Work, and Welfare. Focus Study Report #2.

ERIC Educational Resources Information Center

Quiroz, Julia Teresa; Tosca, Regina

This is the final report of the National Council of La Raza's (NCLR) Focus Study examining the opinions, attitudes, and needs of Mexican American single women, relating to implementation of national welfare reform legislation. Over a 2-year period NCLR staff held focus groups with Mexican American women in four communities: Phoenix, Arizona; Mora,…

Exemplar Units of Work for English. Key Stage 3: National Strategy.

ERIC Educational Resources Information Center

Department for Education and Skills, London (England).

These exemplar units of work for National Strategy Key Stage 3 English show how medium and short-term planning can be based on the Key Stage 3 Framework objectives and support the implementation of Curriculum 2000. The Key Stage 3 English strand introduces pupils to more specialist study of language and literature and supports the study of…

Workloads, Achievement and Stress: Two Follow-Up Studies of Teacher Time in Key Stage 1.

ERIC Educational Resources Information Center

Campbell, R. J.; And Others

The first of two follow-up studies, involving 53 infant teachers in England and Wales, was conducted to monitor changes in the workloads of teachers as the national curriculum and assessment were brought in following ministerial promises to reduce the burdens imposed on teachers by the implementation of the national curriculum. Data were collected…

Environmental Education (EE) Policy and Content of the Contemporary (2009-2017) Mexican National Curriculum for Primary Schools

ERIC Educational Resources Information Center

Paredes-Chi, Arely Anahy; Viga-de Alva, María Dolores

2018-01-01

In Mexico a reformed curriculum is being implemented at the national primary level focused on the competence model and incorporating EE as a key element. This article reports our analyses of what theories, policies and/or EE related-contents were included in the documents that integrated this curriculum: general study plan, study programs of…

Results and Recommendations from the 2009 National Surveys of Randomly Selected and Highly Successful Middle Level Schools

ERIC Educational Resources Information Center

McEwin, C. Kenneth; Greene, Melanie W.

2010-01-01

While a number of studies have yielded useful information regarding the status of middle level schools in the United States, four linked national surveys provide a longitudinal perspective on the degree of implementation of key middle grades programs and practices. These studies were conducted in 1968 (Alexander, 1968), 1988 (Alexander &…

The implementation of quality management systems in hospitals: a comparison between three countries

PubMed Central

Wagner, C; Gulácsi, L; Takacs, E; Outinen, M

2006-01-01

Background Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient progress is being made and how this can be stimulated. The objective of the study was to investigate agreement and disparities in the implementation of QMS between The Netherlands, Hungary and Finland with respect to the evaluation model used and the national policy strategy of the three countries. Methods The study has a cross sectional design, based on measurements in 2000. Empirical data about QM-activities in hospitals were gathered by a self-administered questionnaire. The questionnaires were answered by the directors of the hospitals or the quality coordinators. The analyses are based on data from 101 hospitals in the Netherlands, 116 hospitals in Hungary and 59 hospitals in Finland. Outcome measures are the developmental stage of the Quality Management System (QMS), the development within five focal areas, and distinct QM-activities which were listed in the questionnaire. Results A mean of 22 QM-activities per hospital was found in the Netherlands and Finland versus 20 QM-activities in Hungarian hospitals. Only a small number of hospitals has already implemented a QMS (4% in The Netherlands,0% in Hungary and 3% in Finland). More hospitals in the Netherlands are concentrating on quality documents, whereas Finnish hospitals are concentrating on training in QM and guidelines. Cyclic quality improvement activities have been developed in the three countries, but in most hospitals the results were not used for improvements. All three countries pay hardly any attention to patient participation. Conclusion The study demonstrates that the implementation of QM-activities can be measured at national level and that differences between countries can be assessed. The hypothesis that governmental legislation or financial reimbursement can stimulate the implementation of QM-activities, more than voluntary recommendations, could not be confirmed. However, the results show that specific obligations can stimulate the implementation of QM-activities more than general, framework legislation. PMID:16608510

Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial

PubMed Central

Abbott, Allan; Schröder, Karin; Enthoven, Paul; Nilsen, Per; Öberg, Birgitta

2018-01-01

Introduction Low back pain (LBP) is a major health problem commonly requiring healthcare. In Sweden, there is a call from healthcare practitioners (HCPs) for the development, implementation and evaluation of a best practice primary healthcare model for LBP. Aims (1) To improve and understand the mechanisms underlying changes in HCP confidence, attitudes and beliefs for providing best practice coherent primary healthcare for patients with LBP; (2) to improve and understand the mechanisms underlying illness beliefs, self-care enablement, pain, disability and quality of life in patients with LBP; and (3) to evaluate a multifaceted and sustained implementation strategy and the cost-effectiveness of the BetterBack☺ model of care (MOC) for LBP from the perspective of the Swedish primary healthcare context. Methods This study is an effectiveness-implementation hybrid type 2 trial testing the hypothesised superiority of the BetterBack☺ MOC compared with current routine care. The trial involves simultaneous testing of MOC effects at the HCP, patient and implementation process levels. This involves a prospective cohort study investigating implementation at the HCP level and a patient-blinded, pragmatic, cluster, randomised controlled trial with longitudinal follow-up at 3, 6 and 12 months post baseline for effectiveness at the patient level. A parallel process and economic analysis from a healthcare sector perspective will also be performed. Patients will be allocated to routine care (control group) or the BetterBack☺ MOC (intervention group) according to a stepped cluster dogleg structure with two assessments in routine care. Experimental conditions will be compared and causal mediation analysis investigated. Qualitative HCP and patient experiences of the BetterBack☺ MOC will also be investigated. Dissemination The findings will be published in peer-reviewed journals and presented at national and international conferences. Further national dissemination and implementation in Sweden and associated national quality register data collection are potential future developments of the project. Date and version identifier 13 December 2017, protocol version 3. Trial registration number NCT03147300; Pre-results. PMID:29691246

Health information technology and sociotechnical systems: a progress report on recent developments within the UK National Health Service (NHS).

PubMed

Waterson, Patrick

2014-03-01

This paper summarises some of the research that Ken Eason and colleagues at Loughborough University have carried out in the last few years on the introduction of Health Information Technologies (HIT) within the UK National Health Service (NHS). In particular, the paper focuses on three examples which illustrate aspects of the introduction of HIT within the NHS and the role played by the UK National Programme for Information Technology (NPfIT). The studies focus on stages of planning and preparation, implementation and use, adaptation and evolution of HIT (e.g., electronic patient records, virtual wards) within primary, secondary and community care settings. Our findings point to a number of common themes which characterise the use of these systems. These include tensions between national and local strategies for implementing HIT and poor fit between healthcare work systems and the design of HIT. The findings are discussed in the light of other large-scale, national attempts to introduce similar technologies, as well as drawing out a set of wider lessons learnt from the NPfIT programme based on Ken Eason's earlier work and other research on the implementation of large-scale HIT. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Using δ2H and δ18O in assessing water quality condition of the nation’s water

EPA Science Inventory

The Clean Water Act mandates reporting on the condition of the nation’s waters. The Environmental Protection Agency implemented National Aquatic Resource Surveys (NARS) to address this mandate, including the National Lakes Assessment conducted in 2007. This study focuses on whe...

The Online Translator: Implementing National Standard 4.1.

ERIC Educational Resources Information Center

Burton, Christine

2003-01-01

A pedagogical idea for addressing National Standard 4.1 (Students demonstrate understanding of the nature of language through comparisons of language studied and their own) suggests the deliberate use of the online translator to illustrate to students the syntactical errors that occur when translating idioms from one language to another. (VWL)

77 FR 19263 - Proposed Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... Veterans and Military Families in National Service. The Field Assessment will include interviews with Corporation-funded programs and projects that involve veterans and military family members as national service... implemented to engage and serve veterans and military families. The aim of the study is to begin to build...

National and Scottish Vocational Qualifications: Early Indications of Employers' Take-up and Use.

ERIC Educational Resources Information Center

Callender, C.; And Others

A study examined British employers' adoption of National Vocational Qualifications and Scottish Vocational Qualifications (NVQ/SVQs) and the occupational standards underpinning them. Data regarding current/projected use of the NVQ/SVQs and their perceived costs, benefits, and difficulties of implementation were collected from the following:…

Zero Tolerance Policy in Schools: Rationale, Consequences, and Alternatives.

ERIC Educational Resources Information Center

Casella, Ronnie

2003-01-01

Discusses theory/policies supporting zero tolerance policy in schools, including rational choice theory in criminology and national crime policies based on deterrence. Potential consequences of zero tolerance policy implementation are described and shown to involve outcomes similar to those identified by researchers studying national crime policy.…

Cybersecurity Strategy in Developing Nations: A Jamaica Case Study

ERIC Educational Resources Information Center

Newmeyer, Kevin Patrick

2014-01-01

Developing nations have been slow to develop and implement cybersecurity strategies despite a growing threat to governance and public security arising from an increased dependency on Internet-connected systems in the developing world and rising cybercrime. Using a neorealist theoretical framework that draws from Gilpin and Waltz, this qualitative…

WORLD AND NATIONAL EXPERIENCE IN ORGANIZATION OF PREVENTION OF CARDIOVASCULAR DISEASES.

PubMed

Biduchak, А; Chornenka, Zh

2017-11-01

The aim of the study was to examine the global, European and national experience in the implementation of preventive programs and to reveal their value in health, economy and social health development. The conducted research has found that the implementation of the national program, the correct methodological approach of the physician to evaluate risk factors, and implementing preventive measures of diseases of the circulatory system bring positive results (reduction of prevalence and incidence of cerebral stroke by 13,7% and 1,4%, respectively). The results of the analysis of the health care industry pointed out the possible directions of optimization of prevention of behavioral risk factors in the practice of family medicine as the first point of contact with the patient, where preventive measures are essential and effective. Summing up, it should be noted that at the level of primary health care, particularly family medicine, with effectively coordinated work and correctly set motivation, the preventive measures against risk factors of diseases of circulatory system can be quite effective.

76 FR 67599 - Privacy Act of 1974: Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... OFFICE OF THE DIRECTOR OF NATIONAL INTELLIGENCE 32 CFR Part 1701 Privacy Act of 1974: Implementation AGENCY: Office of the Director of National Intelligence. ACTION: Final rule. SUMMARY: The Office of the Director of National Intelligence (ODNI) is issuing a final rule exempting six new systems of...

76 FR 43629 - Privacy Act of 1974: Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-21

... OFFICE OF THE DIRECTOR OF NATIONAL INTELLIGENCE 32 CFR Part 1701 Privacy Act of 1974: Implementation AGENCY: Office of the Director of National Intelligence. ACTION: Proposed rule. SUMMARY: The Office of the Director of National Intelligence (ODNI) proposes to exempt six new systems of records from...

78 FR 44138 - National Environmental Policy Act; Implementing Procedures; Addition of Categorical Exclusion for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

... Policy Act; Implementing Procedures; Addition of Categorical Exclusion for Real Property Disposal AGENCY... announces the addition of a new Categorical Exclusion (CATEX) for Real Property Disposal under the National... Security NEPA implementing procedures by establishing a new CATEX for real property disposal undertaken by...

The National Shipbuilding Research Program. Report on Short Course on: Implementation of Zone Technology in the Repair and Overhaul Environment

DTIC Science & Technology

1997-05-01

INNOVATION MARINE INDUSTRY STANDARDS WELDING INDUSTRIAL ENGINEERING EDUCATION AND TRAINING THE NATIONAL SHIPBUILDING RESEARCH PROGRAM May 1, 1997 NSRP 0495...Report on Short Course on: Implementation of Zone Technology in the Repair and Overhaul Environment U.S. DEPARTMENT OF THE NAVY CARDEROCK DIVISION...COVERED - 4. TITLE AND SUBTITLE The National Shipbuilding Research Program, Report on Short Course on: Implementation of Zone Technology in the

Economics of Early Warning Scores for identifying clinical deterioration-a systematic review.

PubMed

Murphy, A; Cronin, J; Whelan, R; Drummond, F J; Savage, E; Hegarty, J

2018-02-01

In 2013, a National Early Warning System (EWS) was implemented in Ireland. Whilst evidence exists to support the clinical effectiveness of EWS in the acute health care setting, there is a paucity of information on their cost and cost effectiveness. The objective of this systematic literature review was to critically evaluate the economic literature on the use of EWS in adult patients in acute health care settings for the timely detection of physiological deterioration. A systematic literature review was conducted to accumulate the economic evidence on the use of EWS in adult patients in acute health care settings. The search yielded one health technology assessment, two budget impact analyses and two cost descriptions. Three of the studies were Irish, and considered the national EWS system. A Dutch study reported financial consequences of a single parameter EWS, as part of a rapid response system, in a surgical ward. The fifth study examined an advanced triage system in a medical emergency admission unit in Wales. The economic evidence on the use of EWS amongst adult patients in acute health care settings for the timely detection of physiological deterioration is limited. Further research is required to investigate the cost effectiveness of EWS, and the appropriateness of using standard methods to do so. The recent implementation of a national EWS in Ireland offers a unique opportunity to bridge this gap in the literature to examine the costs and cost effectiveness of a nationally implemented EWS system.

Advancing Evidence-Based Practice in Physical Therapy Settings: Multinational Perspectives on Implementation Strategies and Interventions.

PubMed

Bernhardsson, Susanne; Lynch, Elizabeth; Dizon, Janine Margarita; Fernandes, Jasmin; Gonzalez-Suarez, Consuelo; Lizarondo, Lucylynn; Luker, Julie; Wiles, Louise; Grimmer, Karen

2017-01-01

It is of critical importance that findings from the wealth of clinical physical therapist research are transferred into clinical practice without unnecessary delays. There is a lack of knowledge about strategies that can be used to effectively implement physical therapist research findings and evidence-based practice (EBP) into everyday clinical practice in different national settings and contexts. The purpose of this article is to contribute to knowledge about effective strategies for implementing EBP that have been studied in different national physical therapy settings. The specific aims of this article are to share experiences and provide a current multinational perspective on different approaches and strategies for implementing EBP and to highlight important considerations and implications for both research and practice. Six research studies from various settings in 3 countries are described and synthesized. Key characteristics of the studies and intervention components are tabulated and mapped to the Cochrane Effective Practice and Organisation of Care taxonomy. Commonalities and differences are presented. The implementation strategies described were: a theory-based guideline implementation tailored to identified barriers and facilitators; a multifaceted EBP training package; journal clubs; a multifaceted strategy comprising contextualized procedures, protocols, and standardized resources; barrier identification, education, audit, feedback, and reminders; and contextualized guidelines. Commonalities were the use of a multifaceted approach, educational measures, and clinical guidelines. Key outcomes across the studies were improved attitudes and increased awareness, knowledge, skills, and confidence in EBP; better access to clinical practice guidelines and other EBP resources; identification of barriers that could be targeted in future implementation activities; earlier referrals; and use of recommended outcome measures. The article can serve as a template for other physical therapist researchers in designing implementation studies, as well as to inform policies and practice for health care managers and decision makers who are looking for ways to implement research findings in their organizations. © 2017 American Physical Therapy Association.

Understanding the challenges of service change – learning from acute pain services in the UK

PubMed Central

Powell, AE; Davies, HTO; Bannister, J; Macrae, WA

2009-01-01

Summary Objectives To explore organizational difficulties faced when implementing national policy recommendations in local contexts. Design Qualitative case study involving semi-structured interviews with health professionals and managers working in and around acute pain services. Setting Three UK acute hospital organizations. Main outcome measures Identification of the content, context and process factors impacting on the implementation of the national policy recommendations on acute pain services; insights into and deeper understanding of the generic obstacles to change facing service improvements. Results The process of implementing policy recommendations and improving services in each of the three organizations was undermined by multiple factors relating to: doubts and disagreements about the nature of the change; challenging local organizational contexts; and the beliefs, attitudes and responses of health professionals and managers. The impact of these factors was compounded by the interaction between them. Conclusions Local implementation of national policies aimed at service improvement can be undermined by multiple interacting factors. Particularly important are the pre-existing local organizational contexts and histories, and the deeply-ingrained attitudes, beliefs and assumptions of diverse staff groups. Without close attention to all of these underlying issues and how they interact in individual organizations against the background of local and national contexts, more resources or further structural change are unlikely to deliver the intended improvements in patient care. PMID:19208870

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

PubMed

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

2017-08-22

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

The influence of medical cost controls implemented by Taiwan's national health insurance program on doctor-patient relationships.

PubMed

Chiu, Jhih-Ling

2015-01-01

To prevent medical costs from rising, the National Health Insurance administration implemented the global budget system for financial reform, effective 1 July 2004. Since the implementation of this system, patients have been required to pay for some medicines to limit costs to the system. More recently, as they have faced constant increases in health insurance fees and also faced an increase in the number of medical expenses they must pay during an economic recession and a rise in unemployment, would the economic burden on the people of Taiwan not be increased? Even though National Health Insurance is a form of social insurance, does it guarantee social equality? The value of the healthcare industry is irreplaceable, so the most critical concern is whether worsening doctor-patient relationships will worsen healthcare quality. In short, while the global budget system saves on National Health Insurance costs, whether its implementation has affected healthcare quality is also worth exploring. This commentary also hopes to serve as a reference for the implementation of national health insurance in the United States. Copyright © 2014 John Wiley & Sons, Ltd.

Implementation of Common Core State Standards: Voices, Positions, and Frames

ERIC Educational Resources Information Center

Pense, Seburn L.; Freeburg, Beth Winfrey; Clemons, Christopher A.

2015-01-01

The purpose of this study was to describe the voices heard, positions portrayed, and frames of newspaper messages regarding the implementation of Common Core State Standards (CCSS). The dataset contained 69 articles from 38 community newspapers in 24 states (n = 62) and from three national newspapers (n = 7). Researchers identified five voices…

Barriers Associated with Implementing a Campus-Wide Smoke-Free Policy

ERIC Educational Resources Information Center

Harbison, Philip Adam; Whitman, Marilyn V.

2008-01-01

Purpose: The purpose of this study is to review the barriers associated with implementing a campus-wide smoke-free policy as perceived by the American Cancer Society's Colleges against Cancer (CAC) Program chapter representatives. Design/methodology/approach: Four focus group sessions were conducted at the annual CAC National Leadership Summit in…

Fidelity of Implementation of a State Antibullying Policy with a Focus on Protected Social Classes

ERIC Educational Resources Information Center

Hall, William J.; Chapman, Mimi V.

2018-01-01

Bullying threatens the mental and educational well-being of students. All states have enacted antibullying laws. This study surveyed 634 educators about the implementation of the North Carolina School Violence Prevention Act, which enumerated social classes protected from bullying: race, national origin, gender, socioeconomic status, sexual…

Understanding the End User Perspective: A Multiple-Case Study of Successful Health Information Technology Implementation

ERIC Educational Resources Information Center

Behravesh, Bardia

2010-01-01

The United States continues to lag behind other countries in its adoption of health information technology. A failure to increase adoption will jeopardize the nation's ability to reduce medical errors, address the rapid growth of healthcare costs, and enact effective healthcare reform. Health information technology (HIT) implementation success…

Fidelity of Problem Solving in Everyday Practice: Typical Training May Miss the Mark

ERIC Educational Resources Information Center

Ruby, Susan F.; Crosby-Cooper, Tricia; Vanderwood, Michael L.

2011-01-01

With national attention on scaling up the implementation of Response to Intervention, problem solving teams remain one of the central components for development, implementation, and monitoring of school-based interventions. Studies have shown that problem solving teams evidence a sound theoretical base and demonstrated efficacy; however, limited…

Equity and the "B" Word: Budgeting and Professional Capacity in Student Affairs

ERIC Educational Resources Information Center

McCambly, Heather N.; Haley, Karen J.

2016-01-01

The dual pressures of the national college completion agenda and diminished public investment in higher education have led to a growing reliance on performance-based policies. Using a policy implementation framework, this qualitative study examines the implementation of a performance-based budgeting model at a broad-access urban research…

Perceptions of Contextual Features Related to Implementation and Sustainability of School-Wide Positive Behavior Support

ERIC Educational Resources Information Center

McIntosh, Kent; Predy, Larissa K.; Upreti, Gita; Hume, Amanda E.; Turri, Mary G.; Mathews, Susanna

2014-01-01

The purpose of this study was to assess the perceived importance of specific contextual variables for initial implementation and sustainability of School-Wide Positive Behavior Support (SWPBS). A large, national sample of 257 school team members completed the "School-Wide Universal Behavior Sustainability Index: School Teams", a…

Implementing nationally determined contributions: building energy policies in India’s mitigation strategy

NASA Astrophysics Data System (ADS)

Yu, Sha; Evans, Meredydd; Kyle, Page; Vu, Linh; Tan, Qing; Gupta, Ashu; Patel, Pralit

2018-03-01

The Nationally Determined Contributions are allowing countries to examine options for reducing emissions through a range of domestic policies. India, like many developing countries, has committed to reducing emissions through specific policies, including building energy codes. Here we assess the potential of these sectoral policies to help in achieving mitigation targets. Collectively, it is critically important to see the potential impact of such policies across developing countries in meeting national and global emission goals. Buildings accounted for around one third of global final energy use in 2010, and building energy consumption is expected to increase as income grows in developing countries. Using the Global Change Assessment Model, this study finds that implementing a range of energy efficiency policies robustly can reduce total Indian building energy use by 22% and lower total Indian carbon dioxide emissions by 9% in 2050 compared to the business-as-usual scenario. Among various policies, energy codes for new buildings can result in the most significant savings. For all building energy policies, well-coordinated, consistent implementation is critical, which requires coordination across different departments and agencies, improving capacity of stakeholders, and developing appropriate institutions to facilitate policy implementation.

A patient centered electronic health: eHealth system development.

PubMed

Schiza, Eirini C; Neokleous, Kleanthis C; Petkov, Nikolai; Schizas, Christos N

2015-01-01

Medical practice and patient-doctor relationship will continue improving while technology is integrated in our everyday life. In recent years the term eHealth landmarked a new era with improved health provider's skills and knowledge, and increased patient participation in medical care activities. To show why the design and implementation of a healthcare system needs to follow a specific philosophy dictated by the level of eHealth maturity of a country and its citizens. Based on the maturity level, an adaptable framework for implementing an Electronic Health System at national level is derived, guided by the Patient Centered Philosophy as defined and introduced by the EU directives. Implementation prerequisites are analyzed together with guiding principles for identifying the maturity level of an organization or country. Cyprus being a small EU country, it can be used as pilot site for the whole Europe, was chosen for this study and its maturity level analysis is presented. Recommendations that determine general steps needed to prepare the ground for an adequate patient-centered national healthcare system are accompanied. The implementation of an integrated Electronic Health Record at National level, as a prerequisite for a patient-centered eHealth environment is evidently demonstrated.

Sporting programs for inactive population groups: factors influencing implementation in the organized sports setting.

PubMed

Ooms, Linda; Veenhof, Cindy; Schipper-van Veldhoven, Nicolette; de Bakker, Dinny H

2015-01-01

The organized sports sector has received increased attention as a setting to promote health-enhancing physical activity (HEPA) to the general population. For significant public health impact, it is important that successful HEPA programs are widely adopted, implemented and continued as ongoing practice. The importance of evaluating the context in which programs are implemented has been identified as critical. However, little research has focused on understanding the organized sports implementation context, including factors facilitating and impeding implementation. In this study, the main factors influencing implementation of HEPA programs in the organized sports setting were studied. Fourteen sporting programs in the Netherlands aimed at increasing participation in sports by inactive population groups and funded within the National Action Plan for Sport and Exercise (NAPSE) were investigated. The programs were developed by ten Dutch National Sports Federations (NSFs) and implemented by different sports clubs in the Netherlands over a 3-year implementation period (June 2008-June 2011). The qualitative research component involved yearly face-to-face interviews (i.e. fourteen interviews each year, n = 12 program coordinators) and a group meeting with the program coordinators of the NSFs (n = 8). Cross-case comparisons and thematic analyses were performed to identify and categorize important facilitating and impeding factors respectively. The quantitative research component, used to identify the most important facilitating and impeding factors across all sporting programs, consisted of ranking of factors according to importance by the program coordinators (n = 12). Different factors act during six identified (implementation) phases. When comparing factors across phases, several key learnings were evident. Successful implementation relied, for example, on program design and enthusiastic individuals within sporting organizations. On the other hand, inactive people were hard to reach and participation of sports clubs was not self-evident. The findings were discussed in a broader context. This study adds to the knowledge base concerning the implementation of sporting programs, aimed at inactive people, in the organized sports setting. The main factors facilitating and impeding implementation were identified. The results of this study can be used by sports practitioners and policy makers when developing and implementing HEPA programs in this setting.

77 FR 8197 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: Nonattainment Area...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

...-AR32 Implementation of the 2008 National Ambient Air Quality Standards for Ozone: Nonattainment Area Classifications Approach, Attainment Deadlines and Revocation of the 1997 Ozone Standards for Transportation... proposing thresholds for classifying nonattainment areas for the 2008 ozone National Ambient Air Quality...

77 FR 30160 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: Nonattainment Area...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

...-AR32 Implementation of the 2008 National Ambient Air Quality Standards for Ozone: Nonattainment Area Classifications Approach, Attainment Deadlines and Revocation of the 1997 Ozone Standards for Transportation... all nonattainment areas for the 2008 ozone national ambient air quality standards (NAAQS) (the ``2008...

38 CFR 200.4 - Implementation of NEPA and related authorities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... action reveals that air emissions exceed de minimis levels or otherwise that a formal Clean Air Act... RETIREMENT HOME COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT § 200.4 Implementation of NEPA and... aquifers (potential sources of drinking water); National Wildlife Refuges; National Parks; areas of...

44 CFR 63.1 - Purpose of part.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program IMPLEMENTATION OF SECTION 1306(c) OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 General § 63.1 Purpose of part. The purpose of this part is to implement section 1306(c) of the National Flood Insurance Act of 1968, as amended (the Act...

44 CFR 63.1 - Purpose of part.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program IMPLEMENTATION OF SECTION 1306(c) OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 General § 63.1 Purpose of part. The purpose of this part is to implement section 1306(c) of the National Flood Insurance Act of 1968, as amended (the Act...

44 CFR 63.1 - Purpose of part.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program IMPLEMENTATION OF SECTION 1306(c) OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 General § 63.1 Purpose of part. The purpose of this part is to implement section 1306(c) of the National Flood Insurance Act of 1968, as amended (the Act...

44 CFR 63.1 - Purpose of part.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program IMPLEMENTATION OF SECTION 1306(c) OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 General § 63.1 Purpose of part. The purpose of this part is to implement section 1306(c) of the National Flood Insurance Act of 1968, as amended (the Act...

44 CFR 63.1 - Purpose of part.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program IMPLEMENTATION OF SECTION 1306(c) OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 General § 63.1 Purpose of part. The purpose of this part is to implement section 1306(c) of the National Flood Insurance Act of 1968, as amended (the Act...

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

PubMed

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

2017-06-01

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

[Views of health system administrators, professionals, and users concerning the electronic health record and facilitators and obstacles to its implementation].

PubMed

Costa, Jose Felipe Riani; Portela, Margareth Crisóstomo

2018-02-05

The design and deployment of complex technologies like the electronic health record (EHR) involve technical, personal, social, and organizational issues. The Brazilian public and private scenario includes different local and regional initiatives for implementation of the electronic health record. The Brazilian Ministry of Health also has a proposal to develop a national EHR. The current study aimed to provide a comprehensive view of perceptions by health system administrators, professionals, and users concerning their experiences with the electronic health record and their opinions of the possibility of developing a national EHR. This qualitative study involved 28 semi-structured interviews. The results revealed both the diversity of factors that can influence the implementation of an electronic health record and the existence of convergences and aspects that tend to be valued differently according to the different points of view. Key aspects include discussions on the electronic health record's attributes and it impact on healthcare, especially in the case of local electronic health records, concerns over costs and confidentiality and privacy pertaining to electronic health records in general, and the possible implications of centralized versus decentralized data storage in the case of a national EHR. The interviews clearly showed the need to establish more effective communication among the various stakeholders, and that the different perspectives should be considered when drafting and deploying an EHR at the local, regional, and national levels.

National forest change monitoring system in South Korea: an analysis of forest tree species distribution shifts

Treesearch

Eun-Sook Kim; Cheol-Min Kim; Jisun Lee; Jong-Su Yim

2015-01-01

Since 1971, South Korea has implemented national forest inventory (NFI) in pursuance of understanding current state and change trend of national forest resources. NFI1 (1971~1975), NFI2 (1978~1981), NFI3 (1986~1992) and NFI4 (1996~2005) were implemented in order to produce national forest resources statistics. However, since the early 1990s, international conventions...

Creating a Common Scale by Post-Hoc IRT Equating to Investigate the Effects of the New National Educational Policy in Japan

ERIC Educational Resources Information Center

Saida, Chisato

2017-01-01

The new national educational policy was implemented at secondary schools in 2002 in Japan. The revised Course of Study for foreign language education corresponding to the national educational policy decreased the number of English lessons per week from four to three at the junior high school level, which resulted in a 25% decrease in English…

Human Resource Information System implementation readiness in the Ethiopian health sector: a cross-sectional study.

PubMed

Dilu, Eyilachew; Gebreslassie, Measho; Kebede, Mihiretu

2017-12-20

Health workforce information systems in low-income countries tend to be defective with poor relationship to information sources. Human Resource Information System (HRIS) is currently in a pilot implementation phase in the Federal Ministry of Health and Regional Health Bureaus of Ethiopia. Before scaling up the implementation, it is important to understand the implementation readiness of hospitals and health departments. The aims of this study were to assess the readiness for HRIS implementation, identify associated factors, and explore the implementation challenges in public hospitals and health departments of the Amhara National Regional State, Ethiopia. An institution-based cross-sectional study supplemented with a qualitative study was conducted from the 15th of February to the 30th of March 2016 in 19 public hospitals and health departments of the Amhara National Regional State, Ethiopia. A self-administered questionnaire was used to collect the data. The questionnaire includes items on socio-demographic characteristics and questions measuring technical, personal, and organizational factors adapted from the 32-item questionnaire of the Management Science for Health (MSH) HRIS readiness assessment tool. The data were entered and analyzed with statistical software. Descriptive statistics and bivariate and multivariable logistic regression analyses were performed. Odds ratios with 95% confidence interval were computed to identify the factors statistically associated with readiness of HRIS implementation. In-depth interviews and observation checklists were used to collect qualitative data. Thematic content analysis was used to analyze the qualitative data. A total of 246 human resource (HR) employees and 16 key informants have been included in the study. The HR employee's level of readiness for HRIS implementation in this study was 35.8%. Employee's Internet access (AOR = 2.59, 95%CI = 1.19, 5.62), availability of separate HR section (AOR = 8.08, 95%CI = 3.69, 17.70), basic computer skills (AOR = 6.74, 95%CI = 2.75, 16.56), and fear of unemployment (AOR = 2.83, 95%CI = 1.27, 6.32) were associated with readiness of HRIS implementation. Poor logistic supply, lack of competency, poor commitment, and shortage of finance were the challenges of HRIS implementation. In this study, readiness of HRIS implementation was low. Strategies targeting to improve skills, awareness, and attitude of HR employees would facilitate the implementation process.

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.

The Role of National Industry-Based Skill Standards in the Development, Implementation, and Assessment of Community College Curriculum

ERIC Educational Resources Information Center

Aragon, Steven R.; Woo, Hui-Jeong; Marvel, Matthew R.

2005-01-01

Using a descriptive survey design, a nationally representative sample of community college career and technical deans were asked to complete a questionnaire that assessed awareness and implementation of industry-based skill standards. For those institutions implementing industry-based skill standards, the questionnaire sought additional…

77 FR 55419 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Section 110(a)(2...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-10

... the 2008 Lead National Ambient Air Quality Standards AGENCY: Environmental Protection Agency (EPA...) of the Clean Air Act (CAA), necessary to implement, maintain, and enforce the 2008 lead national..., necessary to implement, maintain, and enforce the 2008 lead NAAQS. II. Summary of SIP Revision On October 17...

28 CFR Appendix D to Part 61 - Office of Justice Assistance, Research, and Statistics Procedures Relating to the Implementation...

Code of Federal Regulations, 2011 CFR

2011-07-01

..., and Statistics Procedures Relating to the Implementation of the National Environmental Policy Act D... Assistance, Research, and Statistics Procedures Relating to the Implementation of the National Environmental... Statistics (OJARS) assists State and local units of government in strengthening and improving law enforcement...

28 CFR Appendix D to Part 61 - Office of Justice Assistance, Research, and Statistics Procedures Relating to the Implementation...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and Statistics Procedures Relating to the Implementation of the National Environmental Policy Act D... Assistance, Research, and Statistics Procedures Relating to the Implementation of the National Environmental... Statistics (OJARS) assists State and local units of government in strengthening and improving law enforcement...

The Role of Educational Leadership on Participation in the Costa Rican National Program of Science and Technology Fairs at Escuela Abraham Lincoln in the Coastal Region

ERIC Educational Resources Information Center

Marquez, Fernando

2016-01-01

The purpose of this study was to identify the role that Costa Rican educational leaders play in implementing the National Program of Science and Technology Fairs (Programa Nacional de Ferias de Ciencia y Tecnologia [PRONAFECYT]) initiative. The study provides an examination of leadership practices, instructional strategies, and professional…

An Evaluation of the National Information Communication and Technology (ICT) Policy at the University of Namibia in the Faculty of Education

ERIC Educational Resources Information Center

Isaacs, Albert; Kazembe, Lawrence; Kazondovi, Collins

2018-01-01

The purpose of this evaluation study was to determine the extent to which the teacher educators in the Faculty of Education at the University of Namibia implemented the national Information and Communication Technology (ICT) Policy for Education. This study employed both the quantitative method in the form of questionnaires and the qualitative…

National Science Foundation Grant Implementation: Perceptions of Teachers and Graduate Fellows in One School Regarding the Barriers and Successes

ERIC Educational Resources Information Center

Pickering, Sharon Durham

2013-01-01

The purpose of this qualitative case study was to examine the perceptions of partner teachers and graduate fellows in 1 school regarding the barriers and successes made during their participation in a National Science Foundation Grant. This study included 9 partner teachers and 7 graduate fellows who participated in the Science First! NSF GK-12…

Readiness for Delivering Digital Health at Scale: Lessons From a Longitudinal Qualitative Evaluation of a National Digital Health Innovation Program in the United Kingdom

PubMed Central

Lennon, Marilyn R; Bouamrane, Matt-Mouley; Devlin, Alison M; O'Connor, Siobhan; O'Donnell, Catherine; Chetty, Ula; Agbakoba, Ruth; Bikker, Annemieke; Grieve, Eleanor; Finch, Tracy; Watson, Nicholas; Wyke, Sally

2017-01-01

Background Digital health has the potential to support care delivery for chronic illness. Despite positive evidence from localized implementations, new technologies have proven slow to become accepted, integrated, and routinized at scale. Objective The aim of our study was to examine barriers and facilitators to implementation of digital health at scale through the evaluation of a £37m national digital health program: ‟Delivering Assisted Living Lifestyles at Scale” (dallas) from 2012-2015. Methods The study was a longitudinal qualitative, multi-stakeholder, implementation study. The methods included interviews (n=125) with key implementers, focus groups with consumers and patients (n=7), project meetings (n=12), field work or observation in the communities (n=16), health professional survey responses (n=48), and cross program documentary evidence on implementation (n=215). We used a sociological theory called normalization process theory (NPT) and a longitudinal (3 years) qualitative framework analysis approach. This work did not study a single intervention or population. Instead, we evaluated the processes (of designing and delivering digital health), and our outcomes were the identified barriers and facilitators to delivering and mainstreaming services and products within the mixed sector digital health ecosystem. Results We identified three main levels of issues influencing readiness for digital health: macro (market, infrastructure, policy), meso (organizational), and micro (professional or public). Factors hindering implementation included: lack of information technology (IT) infrastructure, uncertainty around information governance, lack of incentives to prioritize interoperability, lack of precedence on accountability within the commercial sector, and a market perceived as difficult to navigate. Factors enabling implementation were: clinical endorsement, champions who promoted digital health, and public and professional willingness. Conclusions Although there is receptiveness to digital health, barriers to mainstreaming remain. Our findings suggest greater investment in national and local infrastructure, implementation of guidelines for the safe and transparent use and assessment of digital health, incentivization of interoperability, and investment in upskilling of professionals and the public would help support the normalization of digital health. These findings will enable researchers, health care practitioners, and policy makers to understand the current landscape and the actions required in order to prepare the market and accelerate uptake, and use of digital health and wellness services in context and at scale. PMID:28209558

The Lancet Countdown on PM2·5 pollution-related health impacts of China's projected carbon dioxide mitigation in the electric power generation sector under the Paris Agreement: a modelling study.

PubMed

Cai, Wenjia; Hui, Jingxuan; Wang, Can; Zheng, Yixuan; Zhang, Xin; Zhang, Qiang; Gong, Peng

2018-04-01

Except for comparing the implementation costs of the Paris Agreement with potential health benefits at the national levels, previous studies have not explored the health impacts of the nationally determined contributions (NDCs) by countries and in regional details. In this Lancet Countdown study, we aimed to estimate and monetise the health benefits of China's NDCs in the electric power generation sector, and then compare them with the implementation costs, both at the national and regional levels. In this modelling study, we linked the Multi-regional model for Energy Supply system and their Environmental ImpaCts, the Multi-resolution Emission Inventory for China model, the offline-coupled Weather Research and Forecasting model, the Community Multiscale Air Quality model, and the Integrated Health Impact Assessment model with a time scope from 2010 to 2050. We calculated the PM 2·5 concentrations and compared the health impacts and implementation costs between two scenarios that reflect CO 2 and air pollutant emissions-the reference (REF) scenario (no climate policy) and the NDC scenario (100% realisation of NDC targets: CO 2 emission intensity needs to be about 40% below 2010 emissions by 2030 [roughly 35% below 2030 emissions in REF], and about 90% below 2010 emissions by 2050 [roughly 96% below 2050 emissions in REF]). Under a comparatively optimistic health benefits valuation condition, at the national level, 18-62% of implementation costs could be covered by the health benefits in 2030. In 2050, the overall health benefits would substantially increase to 3-9 times of the implementation costs. However, northwest China would require the highest implementation costs and will also have more premature deaths because of a more carbon-intensive energy structure than business as usual. By 2030, people in northwest China (especially in Gansu, Shaanxi, and Xinjiang provinces) would need to bear worse air quality, and 10 083 (95% CI 3419-16 138) more premature deaths annually. This undesirable situation would diminish by about 2050. A solution that assumes no growth in air pollutant emissions in 2030 at the regional level is technically feasible, but would not be cost-effective. Our results suggest that cost-benefit analysis of climate policy that omits regional air pollution could greatly underestimate benefits. A compensation mechanism for inter-regional interests (including financial, technological, and knowledge support) should be established for regions that give up their human health benefits for the sake of the whole nation to realise the climate change targets. National Natural Science Foundation of China and Cyrus Tang Foundation. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Teacher Perspectives of School-Level Implementation of Alternate Assessments for Students with Significant Cognitive Disabilities. A Report from the National Study on Alternate Assessments. NCSER 2010-3007

ERIC Educational Resources Information Center

Cameto, Renee; Bergland, Frances; Knokey, Anne-Marie; Nagle, Katherine M.; Sanford, Christopher; Kalb, Sara C.; Blackorby, Jose; Sinclair, Beth; Riley, Derek L.; Ortega, Moreica

2010-01-01

The report is organized to provide information on the school-level implementation of alternate assessments for students with significant cognitive disabilities. Following the Introduction in Chapter 1, Chapter 2 describes the study design and methods, including the development of the teacher survey and data collection procedures and analyses.…

Adapting the Quebecois method for assessing implementation to the French National Alzheimer Plan 2008–2012: lessons for gerontological services integration

PubMed Central

Somme, Dominique; Trouvé, Hélène; Perisset, Catherine; Corvol, Aline; Ankri, Joël; Saint-Jean, Olivier; de Stampa, Matthieu

2014-01-01

Introduction Many countries face ageing-related demographic and epidemiological challenges, notably neurodegenerative disorders, due to the multiple care services they require, thereby pleading for a more integrated system of care. The integrated Quebecois method issued from the Programme of Research to Integrate Services for the Maintenance of Autonomy inspired a French pilot experiment and the National Alzheimer Plan 2008–2012. Programme of Research to Integrate Services for the Maintenance of Autonomy method implementation was rated with an evaluation grid adapted to assess its successive degrees of completion. Discussion The approaching end of the president's term led to the method's institutionalization (2011–2012), before the implementation study ended. When the government changed, the study was interrupted. The results extracted from that ‘lost’ study (presented herein) have, nonetheless, ‘found’ some key lessons. Key lessons/conclusion It was possible to implement a Quebecois integrated-care method in France. We describe the lessons and pitfalls encountered in adapting this evaluation tool. This process is necessarily multidisciplinary and requires a test phase. A simple tool for quantitative assessment of integration was obtained. The first assessment of the tool was unsatisfactory but requires further studies. In the meantime, we recommend using mixed methodologies to assess the services integration level. PMID:24959112

Evaluating the impact of a new pay system on nurses in the UK.

PubMed

Buchan, James; Ball, Jane

2011-01-01

This study examines the impact of implementing a new pay system (Agenda for Change) on nursing staff in the National Health Service (NHS) in the UK. This new pay system covered approximately 400,000 nursing staff. Its objectives were to improve the delivery of patient care as well as staff recruitment, retention and motivation. The new system aimed to provide a simplified approach to pay determination, with a more systematic use of agreed job descriptions and job evaluation to 'price' individual jobs, linked to a new career development framework. Secondary analysis of survey data. Analysis of results of large-scale surveys of members of the Royal College of Nursing of the United Kingdom (RCN) to assess the response of nurses to questions about the implementation process itself and their attitude to pay levels. The results demonstrated that there was some positive change after implementation of Agenda for Change in 2006, mainly some time after implementation, and that the process of implementation itself raised expectations that were not fully met for all nurses. There were clear indications of differential impact and reported experiences, with some categories of nurse being less satisfied with the process of implementation. The overall message is that a national pay system has strengths and weaknesses compared to the local systems used in other countries and that these benefits can only be maximised by effective communication, adequate funding and consistent management of the system. How nurses' pay is determined and delivered can be a major satisfier and incentive to nurses if the process is well managed and can be a factor in supporting clinical practice, performance and innovation. This study highlights that a large-scale national exercise to reform the pay system for nurses is a major undertaking, carries risk and will take significant time to implement effectively. © 2010 Blackwell Publishing Ltd.

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.

National Testing: Gains or Strains? School Leaders' Responses to Policy Demands

ERIC Educational Resources Information Center

Gunnulfsen, Ann Elisabeth; Møller, Jorunn

2017-01-01

Studies have shown that principals are essential in successfully implementing large-scale policy reforms in schools. However, the issue of how school leaders interpret and transform reforms is understudied. This article explores how twelve Norwegian school leaders respond to external demands in a new policy context emphasizing national test…

Implementing Peer-Assisted Writing Support in German Secondary Schools

ERIC Educational Resources Information Center

Rensing, Julia; Vierbuchen, Marie-Christine; Hillenbrand, Clemens; Grünke, Matthias

2016-01-01

The alarming results of large studies such as the National Assessment of Educational Progress (NAEP; National Center for Education Statistics, 2012) point to an urgent need for writing support and call for specific and effective methods to foster writing competencies. The main purpose of this paper is to describe an innovative peer-assisted…

IMPLEMENTATION STRATEGY FOR PRODUCTION OF NATIONAL LAND-COVER DATA (NLCD) FROM THE LANDSAT 7 THEMATIC MAPPER SATELLITE

EPA Science Inventory

As environmental programs within and outside the federal government continue to move away from point-based studies to larger and larger spatial (not cartographic) scale, the need for land-cover and other geographic data have become ineluctable. The national land-cover mapping pr...

The Prevalence of Effective Substance Use Prevention Curricula in the Nation's High Schools

ERIC Educational Resources Information Center

Ringwalt, Chris; Hanley, Sean; Vincus, Amy A.; Ennett, Susan T.; Rohrbach, Louise A.; Bowling, J. Michael

2008-01-01

Despite a substantial proportion of high school students who initiate substance use following middle school, the implementation of universal evidence-based prevention curricula appears to be scant. We report data collected in 2005 from 1392 school district-based drug prevention coordinators, from a national, representative study of school-based…

Beyond Interdisciplinary Teaming: Findings and Implications of the NASSP National Middle Level Study.

ERIC Educational Resources Information Center

Hackmann, Donald G.; Petzko, Vicki N.; Valentine, Jerry W.; Clark, Donald C.; Nori, John R.; Lucas, Stephen E.

2002-01-01

Reports trends and implications of interdisciplinary teaming practices in middle schools, based on findings from a national survey. Noting that nearly 80 percent of schools currently implement teaming, challenges principals and teachers to move beyond simple formation of teams to the creation of an infrastructure that supports high-performing…

Will National Vocational Qualifications Work? Evidence from the Construction Industry.

ERIC Educational Resources Information Center

Callender, Claire

A study was conducted in Britain between October 1990 and June 1991 to evaluate the implementation and delivery of National Vocational Qualifications (NVQs) and the implications for the training of trainers. (NVQs are a device for assessing performance; they represent the systemization of the skills and competencies required in a wide variety of…

Coupling Changing Student Demographics with Evidence-Based Leadership Practices: Leading Hispanic Friendly Learning Organizations

ERIC Educational Resources Information Center

Farmer, Tod Allen

2012-01-01

The study assessed the need for learning organizations to implement evidence-based policies and practices designed to enhance the academic and social success of Hispanic learners. Descriptive statistics and longitudinal data from the National Center for Educational Statistics (NCES) and the National Clearinghouse for English Language Acquisition…

Institutionalizing Expanded Schools: Evaluation Findings from the Second Year of TASC's National Demonstration

ERIC Educational Resources Information Center

Sinclair, Beth; Russell, Christina A.; McCann, Colleen; Hildreth, Jeanine L.

2014-01-01

Policy Studies Associates (PSA) is conducting a five-year evaluation of the implementation and impact of the national demonstration of a model for expanded learning time developed by "The After-School Corporation" (TASC). This model, called "ExpandED Schools," aims to transform the educational experiences of students in ways…

78 FR 66027 - Center for Scientific Review; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... Implementation Research in Health Study Section, October 1, 2013, 08:00 a.m. to October 1, 2013, 05:00 p.m... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review... at the National Institutes of Health, 6701 Rockledge Dr., Bethesda, MD 20892. The meeting will start...

Incorporation of National Universities in Japan Design, Implementation and Consequences

ERIC Educational Resources Information Center

Kaneko, Motohisa

2009-01-01

As of April 1 of 2004, Japanese national universities became National University Corporations (NUCs hereafter). While the reform was implemented in a wave of initiatives for restructuring government activities, it reflected to an extent the current global trend toward marketization of higher education. Examination of this reform will not only help…

Implementing a National Qualifications Framework in Lithuania

ERIC Educational Resources Information Center

Tutlys, Vidmantas; Spudyte, Irma

2011-01-01

The design of the national qualifications framework (NQF) in Lithuania started in 2006. The NQF was officially approved by the government decree in May 2010. This article explores the influence of the processes of institutional change on the reform of the national system of qualifications in Lithuania through the implementation of the NQF, looking…

A national general pediatric clerkship curriculum: the process of development and implementation.

PubMed

Olson, A L; Woodhead, J; Berkow, R; Kaufman, N M; Marshall, S G

2000-07-01

To describe a new national general pediatrics clerkship curriculum, the development process that built national support for its use, and current progress in implementing the curriculum in pediatric clerkships at US allopathic medical schools. CURRICULUM DEVELOPMENT: A curriculum project team of pediatric clerkship directors and an advisory committee representing professional organizations invested in pediatric student education developed the format and content in collaboration with pediatric educators from the Council on Medical Student Education in Pediatrics (COMSEP) and the Ambulatory Pediatric Association (APA). An iterative process or review by clerkship directors, pediatric departmental chairs, and students finalized the content and built support for the final product. The national dissemination process resulted in consensus among pediatric educators that this curriculum should be used as the national curricular guideline for clerkships. MONITORING IMPLEMENTATION: Surveys were mailed to all pediatric clerkship directors before dissemination (November 1994), and in the first and third academic years after national dissemination (March 1996 and September 1997). The 3 surveys assessed schools' implementation of specific components of the curriculum. The final survey also assessed ways the curriculum was used and barriers to implementation. The final curriculum provided objectives and competencies for attitudes, skills, and 18 knowledge areas of general pediatrics. A total of 216 short clinical cases were also provided as an alternative learning method. An accompanying resource manual provided suggested strategies for implementation, teaching, and evaluation. A total of 103 schools responded to survey 1; 84 schools to survey 2; and 85 schools responded to survey 3 from the 125 medical schools surveyed. Before dissemination, 16% of schools were already using the clinical cases. In the 1995-1996 academic year, 70% of schools were using some or all of the curricular objectives/competencies, and 45% were using the clinical cases. Two years later, 90% of schools surveyed were using the curricular objectives, 88% were using the competencies, 66% were using the clinical cases. The extent of curriculum use also increased. Schools using 11 or more of the 18 curriculum's knowledge areas increased from 50% (1995-1996) to 73% (1996-1997). This new national general pediatric clerkship curriculum developed broad support during its development and has been implemented very rapidly nationwide. During this period the COMSEP and the APA have strongly supported its implementation with a variety of activities. This development and implementation process can be a model for other national curricula.

Perspectives of key stakeholders and experts in infant feeding on the implementation of the Australian National Breastfeeding Strategy 2010-2015.

PubMed

Hull, Naomi S; Schubert, Lisa C; Smith, Julie P

2017-03-01

Breastfeeding is widely accepted as an important public health issue for babies and their mothers. Yet, despite this, Australia continues to struggle with reaching global targets for breastfeeding indicators. In 2007, the Best Start Parliamentary Inquiry Report was released and set the stage for the Australian National Breastfeeding Strategy [2010-2015), which was announced in November 2009, with the vision to increase Australia's breastfeeding rates of infants at 6 months of age and beyond. The aim of this research project was to explore the perspectives of key stakeholders in the field of infant feeding in Australia on the implementation of the strategy, barriers and enablers to its successful implementation and actions that were still needed. Using qualitative research methods of in-depth, semi-structured interviews and thematic analysis, this study identifies main themes of these perceptions about the strategy implementation and some recommendations for future strategies and further research. The main themes identified were initial opinions of the strategy as a blueprint for action, the strategy as a driver for action, lessons learned and recommendations for the future. For success in improving implementation of national breastfeeding strategies, it is recommended that Australia establish an independent breastfeeding/infant feeding committee, increase the political prioritisation of issues surrounding infant feeding and strengthen the regulation of the marketing of breastmilk substitutes.

Implementing a lessons learned process at Sandia National Laboratories

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

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

2016-01-01

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

An international comparison of stakeholder motivation to implement liver cancer control.

PubMed

Bridges, John F P; Joy, Susan M; Blauvelt, Barri M; Yan, Weili; Marsteller, Jill A

2015-06-01

The World Health Organization offers clear guidance on the development of national cancer control programmes based on a country's level of resources, yet the motivation to implement such programmes may be driven by factors other than resources. To compare stakeholder motivation to implement a national liver cancer control programme and assess if variation in motivation was associated with stakeholder characteristics or with national indicators of need and resources. Relevant stakeholders were purposively selected from 13 countries (Australia, China, France, Germany, Italy, Japan, Nigeria, South Korea, Spain, Taiwan, Thailand, Turkey and USA) to participate in a structured survey on liver cancer control. Respondents included 12 individuals working in clinical, 5 in policy and 3 in advocacy roles from each country. Stakeholders' motivation was measured using a scale grounded in expectancy theory and knowledge gained during previous qualitative interviews. Comparisons across countries and respondent characteristics were conducted using hierarchical regression. Country level motivation scores, holding constant individual level covariates, were correlated with indicators of need and resources and tested using Pearson's correlation coefficients. In total, 260 stakeholders, equally drawn from the study countries, completed the survey (45% response rate). At the national level, motivation was highest in Nigeria, Thailand and China (P < 0.001), and lowest in Italy (P < 0.001) and Germany (P = 0.003). Higher motivation was observed among stakeholders working at the international level relative to the local level (P = 0.017). Motivation was positively associated with a country's relative burden of liver cancer (P = 0.015) and negatively associated with their level of resources (P = 0.018). This study provides the first empirical evidence on the motivation of stakeholders to implement national cancer control programmes. Furthermore, we demonstrate that motivation is more clearly associated with a country's cancer control needs rather than resources. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Perceptions of importance, preparedness and classroom implementation of the National Science Education Standards as perceived by Texas science education leaders

NASA Astrophysics Data System (ADS)

Dutcher, Joyce Marie

At a time when the nation is challenged by a competitive world economy, learning organizations are experiencing the dynamics of change. Recent mandates, like the No Child Left Behind Act (2001) and the Texas' 1999 education reform law initiating the Texas Assessment of Knowledge and Skills put an impetus on educators to implement standards reform practices that would lead to improved teaching and learning. Texas science education leaders have the challenging task of leading National Science Education Standards (NSES) reform in Texas schools/districts. Therefore, it is important that they are informed about the NSES and are prepared to provide leadership support for their implementation. How they perceive themselves in this role could possibly affect the support they give to teachers and others, ultimately affecting how the NSES are implemented in classrooms. This correlational and descriptive research study used archival data collected at a time the NSES were first being implemented to (a) determine the degree of relations that exist between the leaders' perceived importance of effective practices and their perceived preparedness to provide leadership support for their implementation, and (b) examine influences that may exist between the leaders' perceived importance/preparedness and their perceived frequency of occurrence of related teacher and student activities. The data set used was gathered from a preliminary study of the researcher (Dutcher, 2000). It involved responses from 90 Texas science education leaders who voluntarily responded to the, "Leader Survey Questionnaire: Principles of the National Science Education Standards". Results showed support for the idea that leaders' perceptions of importance for effective practices were significant predictors of their own perceived preparedness to provide leadership support for the same. However in contrast, the results did not show consistent support for the idea that the leaders' perceived importance or preparedness to provide leadership support for the effective practices influenced their perceived frequency of occurrence of related teacher or student activities. These findings will contribute to existing literature and may help educators identify gaps that exist in the science education reform process. These results may be used to design and plan professional development programs for leaders and their teachers.

If Not "the Best of the West," Then "Look East": Imported Teacher Education Curricula in the Arabian Gulf

ERIC Educational Resources Information Center

Aydarova, Olena

2013-01-01

By examining why nations borrow policy discourses, research on transfer has overlooked the implementation of transferred educational practices, models, or curricula. This study attempts to bridge this gap by examining the transfer and implementation of teacher education curricula in the United Arab Emirates (UAE). Based on interviews with teacher…

School Lunch before and after Implementation of the Healthy Hunger-Free Kids Act

ERIC Educational Resources Information Center

Bergman, Ethan A.; Englund, Tim; Taylor, Katie Weigt; Watkins, Tracee; Schepman, Stephen; Rushing, Keith

2014-01-01

Purpose/Objectives: This study compares the mean nutrients selected and consumed in National School Lunch Program (NSLP) meals before and after implementation of the new nutrition standards mandated by the Healthy Hunger-Free Kids Act of 2010 (HHFKA) in July 2012. Four elementary schools achieving Healthier US Schools Challenge awards serving…

Comparing Public and Private Institutions That Have and Have Not Implemented Enterprise Resource Planning (ERP) Systems: A Resource Dependence Perspective

ERIC Educational Resources Information Center

Sendhil, Geetha R.

2012-01-01

The purpose of this national study was to utilize quantitative methods to examine institutional characteristics, financial resource variables, personnel variables, and customer variables of public and private institutions that have and have not implemented enterprise resource planning (ERP) systems, from a resource dependence perspective.…

Is the Class Schedule the Only Difference between Morning and Afternoon Shift Schools in Mexico?

ERIC Educational Resources Information Center

Cardenas Denham, Sergio

2009-01-01

Double-shift schooling has been implemented in Mexico for several decades as a strategy to achieve universal access to basic education. This study provides evidence on the existence of social inequalities related to the implementation of this schooling model. Using quantitative data from several databases including the National Census, the…

Implementing a Social-Ecological Model of Health in Wales

ERIC Educational Resources Information Center

Rothwell, Heather; Shepherd, Michael; Murphy, Simon; Burgess, Stephen; Townsend, Nick; Pimm, Claire

2010-01-01

Purpose: The purpose of this paper is to assess the implementation of the Welsh Network of Healthy School Schemes (WNHSS) at national, local and school levels, using a systems approach drawing on the Ottawa Charter. Design/methodology/approach: The approach takes the form of a single-case study using data from a documentary analysis, interviews…

What Do We Know: Widely Implemented School Improvement Programs.

ERIC Educational Resources Information Center

Wang, Margaret C.; Haertel, Geneva D.; Walberg, Herbert J.

The study examines the defining features of school improvement programs. Twelve research-based programs that have been implemented for 5 or more years in at least 50 schools or for 3,000 students were analyzed. All have achieved national visibility. Eight of the programs focused on curricular reform and topics included: (1) Core Knowledge; (2)…

Secondary Geography and the Australian Curriculum--Directions in School Implementation: A Comparative Study

ERIC Educational Resources Information Center

Casinader, Niranjan

2016-01-01

At first glance, the introduction of a national curriculum for Australian schools suggested a new era of revival for school geography. Since the late 1980s, the development and introduction of more integrated conceptions of curriculum design and implementation has seen the decline of Geography as a distinct subject in Australian schools, with…

Activities of the National Water-Quality Assessment Program in the upper Snake River Basin, Idaho and western Wyoming, 1991-2001

USGS Publications Warehouse

Low, Walton H.

1997-01-01

In 1991, the U.S. Geological Survey (USGS) began a full-scale National Water-Quality Assessment (NAWQA) Program. The long-term goals of the NAWQA Program are to describe the status and trends in the water quality of a large part of the Nation's rivers and aquifers and to improve understanding of the primary natural and human factors that affect water-quality conditions. In meeting these goals, the program will produce water-quality, ecological, and geographic information that will be useful to policy makers and managers at the national, State, and local levels. A major component of the program is study-unit investigations, upon which national-level assessment activities are based. The program's 60 study-unit investigations are associated with principal river basins and aquifer systems throughout the Nation. Study units encompass areas from 1,200 to more than 65,000 mi2 (square miles) and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the upper Snake River Basin was among the first 20 NAWQA study units selected for implementation. From 1991 to 1995, a high-intensity data-collection phase of the upper Snake River Basin study unit (fig. 1) was implemented and completed. Components of this phase are described in a report by Gilliom and others (1995). In 1997, a low-intensity phase of data collection began, and work continued on data analysis, report writing, and data documentation and archiving activities that began in 1996. Principal data-collection activities during the low-intensity phase will include monitoring of surface-water and ground-water quality, assessment of aquatic biological conditions, and continued compilation of environmental setting information.

Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England.

PubMed

Ovseiko, Pavel V; O'Sullivan, Catherine; Powell, Susan C; Davies, Stephen M; Buchan, Alastair M

2014-11-08

Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N = 17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the central mandate by HIEC leaders to serve their local needs. These findings augur well for Academic Health Science Networks, which pick up the mantle of large-scale, cross-sector collaborations for health and innovation. This study also highlights that a supportive policy environment and sufficient time would be crucial to the successful implementation of new cross-sector health collaborations.

Key Informants' Perceptions on the Implementation of a National Program for Improving Nutritional Status of Children in Iran.

PubMed

Ghodsi, Delaram; Omidvar, Nasrin; Rashidian, Arash; Raghfar, Hossein; Eini-Zinab, Hassan; Ebrahimi, Marziyeh

2016-01-01

Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children. This study aimed to evaluate the implementation aspect of the program and to explore key informants' perceptions and experience regarding the factors affected its implementation. Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases' checklist to interpret the viewpoints of the study participants. Results showed that the program had successes in improving mother's knowledge on health, nutrition, and child care through health system and increased families' access to food, but there were some aspects that affected program's implementation. Some of these factors are the lack of clarity in the program's protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition. Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.

A Systemic Approach to Implementing Response to Intervention in Three Colorado High Schools

ERIC Educational Resources Information Center

Duffy, Helen; Scala, Jenny

2012-01-01

The National High School Center continues to receive inquiries about how to support high school implementation of response to intervention (RTI). Given the National High School Center's previous work on the topic, the authors wanted to better understand the conditions that contribute to or inhibit implementation of tiered frameworks in high…

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

PubMed

Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and healthcare service contexts. Despite the explicit provider focus, this study was limited by a lack of Indigenous stakeholder perspectives. Key study findings are of direct relevance to inform the future implementation and delivery of culturally appropriate primary mental healthcare programs for Indigenous populations in Australia and internationally.

Implementing community-based provider participation in research: an empirical study.

PubMed

Teal, Randall; Bergmire, Dawn M; Johnston, Matthew; Weiner, Bryan J

2012-05-08

Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute's (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation. Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness.

Medical home implementation: a sensemaking taxonomy of hard and soft best practices.

PubMed

Hoff, Timothy

2013-12-01

The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. I found two distinct taxonomies of implementation best practices, which I labeled "hard" and "soft" because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. © 2013 Milbank Memorial Fund.

23 CFR 970.206 - Funds for establishment, development, and implementation of the systems.

Code of Federal Regulations, 2013 CFR

2013-04-01

... TRANSPORTATION FEDERAL LANDS HIGHWAYS NATIONAL PARK SERVICE MANAGEMENT SYSTEMS National Park Service Management Systems § 970.206 Funds for establishment, development, and implementation of the systems. The Park Roads...

23 CFR 970.206 - Funds for establishment, development, and implementation of the systems.

Code of Federal Regulations, 2011 CFR

2011-04-01

... TRANSPORTATION FEDERAL LANDS HIGHWAYS NATIONAL PARK SERVICE MANAGEMENT SYSTEMS National Park Service Management Systems § 970.206 Funds for establishment, development, and implementation of the systems. The Park Roads...

23 CFR 970.206 - Funds for establishment, development, and implementation of the systems.

Code of Federal Regulations, 2012 CFR

2012-04-01

... TRANSPORTATION FEDERAL LANDS HIGHWAYS NATIONAL PARK SERVICE MANAGEMENT SYSTEMS National Park Service Management Systems § 970.206 Funds for establishment, development, and implementation of the systems. The Park Roads...

Albemarle Sound demonstration study of the national monitoring network for US coastal waters and their tributaries

Treesearch

Michelle Moorman; Sharon Fitzgerald; Keith Loftin; Elizabeth Fensin

2016-01-01

The U.S. Geological Survey’s (USGS) is implementing a demonstration project in the Albemarle Sound for the National Monitoring Network for U.S. coastal waters and their tributaries. The goal of the National Monitoring Network is to provide information about the health of our oceans and coastal ecosystems and inland influences on coastal waters for improved resource...

77 FR 30294 - National Institute of Child Health and Human Development; Submission for OMB Review; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-22

... NCS was designed to include a preliminary pilot study known as the Vanguard Study. The purpose of the... multiple methodological studies conducted during the Vanguard phase will inform the implementation and...

77 FR 15780 - New Proposed Collection; Comment Request: Child Health Disparities Measurement for the National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... NCS was designed to include a preliminary pilot study known as the Vanguard Study. The purpose of the... multiple methodological studies conducted during the Vanguard phase will inform the implementation and...

40 CFR 142.19 - EPA review of State implementation of national primary drinking water regulations for lead and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... national primary drinking water regulations for lead and copper. 142.19 Section 142.19 Protection of... implementation of national primary drinking water regulations for lead and copper. (a) Pursuant to the procedures... control or source water treatment requirements for lead or copper and may issue an order establishing...

40 CFR 142.19 - EPA review of State implementation of national primary drinking water regulations for lead and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... national primary drinking water regulations for lead and copper. 142.19 Section 142.19 Protection of... implementation of national primary drinking water regulations for lead and copper. (a) Pursuant to the procedures... control or source water treatment requirements for lead or copper and may issue an order establishing...

Using Implementation and Program Theory to Examine Communication Strategies in National Wildlife Federation's Backyard Wildlife Habitat Program

ERIC Educational Resources Information Center

Palmer, Dain; Dann, Shari L.

2004-01-01

Our evaluative approach used implementation theory and program theory, adapted from Weiss (1998) to examine communication processes and results for a national wildlife habitat stewardship education program. Using a mail survey of 1427 participants certified in National Wildlife Federation's (NWF) Backyard Wildlife Habitat (BWH) program and a study…

Implementation of the "Education" Priority National Project in Tiumen Oblast

ERIC Educational Resources Information Center

Tavokin, Evgenii Petrovich

2009-01-01

In the two years that the "Education" priority national project has been in the process of implementation, it has been found that in spite of its obviously abstract character in terms of strategy (a shortcoming that is characteristic of all four of the national projects), a flexible mechanism of state and civic administration is built…

The Development and Testing of a Model for a Nationally Based Vehicle Dedicated to the Continuing Professional Growth of School Administrators. Final Report.

ERIC Educational Resources Information Center

Knezevich, Stephen J.

The primary objectives of the study were to develop a model for a National Academy for School Executives (NASE), to determine the receptivity of school administrators to such a program, and to determine the feasibility of implementing the model within the near future. Four academic task forces studied the structural elements, fiscal requirements,…

A pragmatic cluster randomised trial evaluating three implementation interventions.

PubMed

Rycroft-Malone, Jo; Seers, Kate; Crichton, Nicola; Chandler, Jackie; Hawkes, Claire A; Allen, Claire; Bullock, Ian; Strunin, Leo

2012-08-30

Implementation research is concerned with bridging the gap between evidence and practice through the study of methods to promote the uptake of research into routine practice. Good quality evidence has been summarised into guideline recommendations to show that peri-operative fasting times could be considerably shorter than patients currently experience. The objective of this trial was to evaluate the effectiveness of three strategies for the implementation of recommendations about peri-operative fasting. A pragmatic cluster randomised trial underpinned by the PARIHS framework was conducted during 2006 to 2009 with a national sample of UK hospitals using time series with mixed methods process evaluation and cost analysis. Hospitals were randomised to one of three interventions: standard dissemination (SD) of a guideline package, SD plus a web-based resource championed by an opinion leader, and SD plus plan-do-study-act (PDSA). The primary outcome was duration of fluid fast prior to induction of anaesthesia. Secondary outcomes included duration of food fast, patients' experiences, and stakeholders' experiences of implementation, including influences. ANOVA was used to test differences over time and interventions. Nineteen acute NHS hospitals participated. Across timepoints, 3,505 duration of fasting observations were recorded. No significant effect of the interventions was observed for either fluid or food fasting times. The effect size was 0.33 for the web-based intervention compared to SD alone for the change in fluid fasting and was 0.12 for PDSA compared to SD alone. The process evaluation showed different types of impact, including changes to practices, policies, and attitudes. A rich picture of the implementation challenges emerged, including inter-professional tensions and a lack of clarity for decision-making authority and responsibility. This was a large, complex study and one of the first national randomised controlled trials conducted within acute care in implementation research. The evidence base for fasting practice was accepted by those participating in this study and the messages from it simple; however, implementation and practical challenges influenced the interventions' impact. A set of conditions for implementation emerges from the findings of this study, which are presented as theoretically transferable propositions that have international relevance. ISRCTN18046709--Peri-operative Implementation Study Evaluation (POISE).

Evaluation of the uptake of the Australian standardized terminology and definitions for texture modified foods and fluids.

PubMed

Jukes, Sarah; Cichero, Julie A Y; Haines, Terrence; Wilson, Christina; Paul, Kate; O'Rourke, Michelle

2012-06-01

This paper discusses the uptake of standardized terminology and definitions for texture modified foods and fluids. The Australian dietetic and speech-language pathology associations endorsed national standards in 2007. This project sought to determine the barriers and enablers for use of the national standards in clinical practice. Cross-sectional online surveys were developed, including open- and closed-response questions. The surveys targeted different professional groups in Australia including speech-language pathologists, dietitians, nurses, and food service personnel. Australian accredited universities were contacted to determine penetration of the standards. A total of 574 surveys were received. Sixty-five per cent of respondents indicated full implementation, 23% partial implementation, and 10% no implementation of the standards in their workplace. Speech-language pathologists and dietitians were most likely to have championed implementation of the standards. Barriers to implementation included: lack of knowledge about the standards, time, and resistance to change. Enablers included: encouragement to use the standards and 'buy-in' from stakeholders. Benefits of implementation included: consistent terminology and perceived improvements in patient safety. It was concluded that the standards have been successfully implemented in a majority of facilities and Australian universities. This study provides insight into the complexity of introducing and managing change in healthcare environments.

The Catch-up Education Programme in Turkey: Opportunities and challenges

NASA Astrophysics Data System (ADS)

Börkan, Bengü; Ünlühisarcıklı, Özlem; Caner, H. Ayşe; Sart, Z. Hande

2015-02-01

Turkish children between the ages of 10-14 who either never enrolled in primary education, dropped out of school, or were at least three years behind their peers had the opportunity of joining an accelerated learning programme. It was developed by the Turkish Ministry of National Education General Directorate of Primary Education as a response to the urgent need to secure these children's right to education. The programme, called "Catch-up Education Programme" (CEP), was implemented between September 2008 and 2013 in collaboration with the United Nations Children's Fund (UNICEF) to enable those children to complete several grades in a short time and then to continue their education with their peers. This paper presents the findings of a study, conducted in 2010, reviewing the challenges and opportunities experienced during the implementation process from the points of view of beneficiaries (pupils and parents) and implementers. The results are discussed in relation to educational policy and its implementation in general.

Improving the implementation of marine monitoring in the northeast Atlantic.

PubMed

Turrell, W R

2018-03-01

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

Mobile Audience Response Systems at a Continuing Medical Education Conference.

PubMed

Beaumont, Alexandra; Gousseau, Michael; Sommerfeld, Connor; Leitao, Darren; Gooi, Adrian

2017-01-01

Mobile audience response systems (mARS) are electronic systems allowing speakers to ask questions and audience members to respond anonymously and immediately on a screen which enables learners to view their peers' responses as well as their own. mARS encourages increased interaction and active learning. This study aims to examine the perceptions of audience members and speakers towards the implementation of mARS at a national medical conference. mARS was implemented at the CSO Annual Meeting in Winnipeg 2015. Eleven presenters agreed to participate in the mARS trial. Both audience and presenters received instructions. Five-point Likert questions and short answer questions were emailed to all conference attendees and the data was evaluated. Twenty-seven participants responded, 23 audience members and 4 instructors. Overall, responders indicated improved attention, involvement, engagement and recognition of audience's understanding of topics with the use of mARS. mARS was perceived as easy to use, with clear instructions, and the majority of respondents expressed an interest in using mARS in more presentations and in future national medical conferences. Most respondents preferred lectures with mARS over lectures without mARS. Some negative feedback on mARS involved dissatisfaction with how some presenters implemented mARS into the workshops. Overall mARS was perceived positively with the majority of respondents wanting mARS implemented in more national medical conferences. Future studies should look at how mARS can be used as an educational tool to help improve patient outcomes.

National standards in science education: Teacher perceptions regarding utilization

NASA Astrophysics Data System (ADS)

Fletcher, Carol Louise Parsons

The purpose of this naturalistic study was to determine what factors most influence middle school science teachers' intentions to utilize or ignore national standards, as a toot for reform in their classrooms, schools, or districts. Results indicate. that teachers with. minimal training were unlikely to use national standards documents due to their perceptions of a lack of support from peers, administrators and a high-stakes state accountability system. Teachers with more extensive training were more inclined to use national standards documents as philosophical guides for reform because they believed in the validity of the recommendations. Implications are discussed, chief among them that short-term professional development may actually do more harm than good if teachers retain or develop unexamined misconceptions about national standards recommendations as a result. In addition, due to the concerns expressed by teachers regarding state curriculum mandates and standardized testing, this study indicates that changes in these external factors must be instituted before teachers will commit themselves to standards-based reforms. It is suggested that staff development focus on opportunities for reflection and application which will promote conceptual change in teachers. A model predicated on the notion that the process of implementing reform is essentially an issue of promoting conceptual change in teachers is proposed. This model, termed the Reform Implementation as Conceptual Change, or RICC, focuses specifically on the cognitive processes teachers may go through when they are exposed to an innovation such as national standards. Stages such as integrated application, accommodation, assimilation, disconnection, and false accommodation, are described. The impact that professional development and training may have on the likelihood that teachers will experience these various stages is also discussed. This model serves as a theoretical framework for explaining why some teachers are unlikely to embrace national standards while others choose to utilize them as a tool for reforming science education in their classrooms, schools, or districts. As such, it can be used by reformers to design and diagnostically evaluate the implementation process and its related staff development.

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

PubMed Central

2013-01-01

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

Food Service Perspectives on National School Lunch Program Implementation.

PubMed

Tabak, Rachel G; Moreland-Russell, Sarah

2015-09-01

Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation.

Clinical Guidelines and Implementation into Daily Dental Practice.

PubMed

Guncu, Guliz Nigar; Nemli, Secil Karakoca; Carrilho, Eunice; Yamalık, Nermin; Volodina, Elena; Melo, Paulo; Margvelashvili, Vladimer; Rossi, Alessandra

2018-01-31

The purpose of this study is to assess the extent of the familiarity, attitude and perceptions of dental professionals regarding clinical dental guidelines and their implementation into daily dental practice. For this purpose, a questionnaire which was developed by the members of the World Dental Federation, European Regional Organization Working Group - 'Relation Between Dental Practitioner and Universities', was implemented by the National Dental Associations of six European Regional Organization-zone countries (Georgian Stomatological Association - Georgia, Associazione Nazionale Dentisti Italiani - Italy, Portuguese Dental Association - Portugal, Russian Dental Association - Russia, Swiss Dental Association - Switzerland, and Turkish Dental Association - Turkey. The questionnaire was filled by a total of 910 dental professionals who are members of one of these national dental associations and who voluntarily wanted to participate to this survey. Most of the survey participants were familiar with clinical dental guidelines (68%), claimed that they implemented them into daily practice (61.7%), and generally acknowledged their benefits (81.8%). Many participants believed that clinical dental guidelines could help to improve the clinical treatment plan (50.6 %) and the accuracy of diagnosis (39.4%); which increased with age and years of practice (p < 0.05). The most frequently perceived barrier to the effective implementation of clinical dental guidelines was expressed as 'lack of awareness', while participants suggested a role for national dental associations in spreading clinical dental guidelines. A better understanding of the perceptions and attitudes of dentists towards clinical dental guidelines and the potential impact of factors affecting such perceptions and attitudes may be of particular importance for attempts aiming at overcoming the barriers for effective implementation of clinical dental guidelines into daily practice. Despite a significant familiarity and a common positive attitude, dental professionals are likely to have different perceptions towards clinical dental guidelines, especially regarding their effective implementation into daily practice, benefits and barriers.

Teaching English in English, "In Principle": The National Foreign Language Curriculum for Japanese Senior High Schools

ERIC Educational Resources Information Center

Glasgow, Gregory Paul

2014-01-01

Research in language-in-education policy and planning (LEP) rarely examines how language teachers negotiate official policy statements on teaching methodologies. In this study, I investigate the current upper secondary school foreign language national curriculum in Japan that requires English classes to be conducted in English, implemented since…

Interrater Reliability in Large-Scale Assessments--Can Teachers Score National Tests Reliably without External Controls?

ERIC Educational Resources Information Center

Pantzare, Anna Lind

2015-01-01

In most large-scale assessment systems a set of rather expensive external quality controls are implemented in order to guarantee the quality of interrater reliability. This study empirically examines if teachers' ratings of national tests in mathematics can be reliable without using monitoring, training, or other methods of external quality…

Preservice Students' and Teacher Educators' Perceptions of the Indian National Policy of Education for Women.

ERIC Educational Resources Information Center

Dey, Chhaya

1987-01-01

Reports a study which investigated the alleged failure of Indian teacher education institutions to further the goal of equal education opportunities for women, an official goal of the Indian National Policy of Education. Concludes that official policy has not been translated into action. Offers five recommendations to help implement the policy.…

Who's Afraid Now? Reconstructing Canadian Citizenship Education through Transdisciplinarity

ERIC Educational Resources Information Center

Mitchell, Richard C.

2010-01-01

Viewed through the lenses of the United Nations Convention on the Rights of the Child (CRC), this article critically evaluates the growing controversy surrounding the teaching of human rights in Canada. In line with critiques and with previous empirical studies on the implementation of the United Nations (UN) Convention on the Rights of the Child…

Teen Outreach: Data from the Second Year of a National Replication.

ERIC Educational Resources Information Center

Philliber, Susan

Teen Outreach is a school-based teenage pregnancy prevention program designed to decrease the incidence of teenage pregnancy and to increase the number of at-risk teenagers who successfully complete their high school education. Begun in 1981 in St. Louis, Missouri, Teen Outreach was implemented as a national replication study in 1983. There are…

Qatar's K-12 Education Reform Has Achieved Success in Its Early Years. Research Brief

ERIC Educational Resources Information Center

Larson, Judy

2009-01-01

To evaluate progress made in the first years of Qatar's implementation of K-12 education reform, RAND analyzed data from school-level observations, national surveys, and national student assessments. The study found that students in the new, Independent schools were performing better than those in Ministry schools, and there was greater student…

Promising Practices in Young Adult Employment: Lessons Learned from EMT Career Pathway Programs

ERIC Educational Resources Information Center

Leung, Loh-Sze

2015-01-01

The National Fund for Workforce Solution's Young Adult Initiatives aim to test and implement new strategies for targeting America's young adults and share this information so that employers and workforce development can join forces in investing in the millions of young adults across the nation. This case study will focus on challenges and…

Promising Practices in Young Adult Employment: Hands-On Multidisciplinary Career Exploration and Mentorships

ERIC Educational Resources Information Center

Wagner, Stacey

2015-01-01

The National Fund for Workforce Solution's Young Adult Initiatives aim to test and implement new strategies for targeting America's young adults and share this information so that employers and workforce development can join forces in investing in the millions of young adults across the nation. This case study focuses on promising findings from…

Implementing the General Education Development (GED) Program in First Nations Communities: Struggles for Power

ERIC Educational Resources Information Center

Shields, Tracy Jill; Melville, Wayne

2015-01-01

This paper describes an ethnographic case study of eleven First Nations adult learners in a Northern Ontario community attempting to earn secondary school equivalency through the General Education Development (GED) program. The paper maintains a focus on the power differentials at work in both the learners' prior educational endeavours and their…

Ten-year results of using oak Cleanings to maintain oak species dominance on the Allegheny National Forest

Treesearch

Kurt W. Gottschalk; Gary W. Miller; Robert White; Andrea Hille; Thomas M. Schuler

2014-01-01

The Allegheny National Forest (ANF) in northwestern Pennsylvania implemented precommercial thinning in young stands to maintain oak (Quercus spp.) stems in a competitive position. This administrative study was developed to test ANF standards for precommercial thinning for success in maintaining oak composition. An additional objective was to examine...

76 FR 1174 - Drugs for Human Use; Drug Efficacy Study Implementation; Oral Prescription Drugs Offered for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-07

... and 1962. FDA contracted with the National Academy of Science/National Research Council (NAS/NRC) to... Chlorpheniramine Maleate S.R. Capsules and Efedra-PA Tablets, and KV Pharmaceutical Co., 2503 South Hanley Rd., St.... On December 4, 2009, KV Pharmaceutical Co. also withdrew its hearing request. On February 15, 2010...

Development, Implementation, and Analysis of a National Survey of Faculty Goals for Undergraduate Chemistry Laboratory

ERIC Educational Resources Information Center

Bruck, Aaron D.; Towns, Marcy

2013-01-01

This work reports the development of a survey for laboratory goals in undergraduate chemistry, the analysis of reliable and valid data collected from a national survey of college chemistry faculty, and a synthesis of the findings. The study used a sequential exploratory mixed-methods design. Faculty goals for laboratory emerged across seven…

Transnational Private Authority in Education Policy in Jordan and South Africa: The Case of Microsoft Corporation

ERIC Educational Resources Information Center

Bhanji, Zahra

2012-01-01

The purpose of this article is to explore Microsoft Corporation as a new international actor shaping educational reforms and practices. This study examines how the implementation of Microsoft's global Partners in Learning (PiL) program varied and was mediated by national politics and national institutional practices in two different contexts,…

Promising Practices in Young Adult Employment: Lessons Learned from Manufacturing and Automotive Career Pathway Programs

ERIC Educational Resources Information Center

Wagner, Stacey

2015-01-01

The National Fund's Young Adult Initiatives aim to test and implement new strategies for targeting America's young adults and share this information so that employers and workforce development can join forces in investing in the millions of young adults across the nation. This case study focuses on promising findings from automotive and…

Implementation of Self Organizing Map (SOM) as decision support: Indonesian telematics services MSMEs empowerment

NASA Astrophysics Data System (ADS)

Tosida, E. T.; Maryana, S.; Thaheer, H.; Hardiani

2017-01-01

Information technology and communication (telematics) is one of the most rapidly developing business sectors in Indonesia. It has strategic position in its contribution towards planning and implementation of developmental, economics, social, politics and defence strategies in business, communication and education. Aid absorption for the national telecommunication SMEs is relatively low; therefore, improvement is needed using analysis on business support cluster of which basis is types of business. In the study, the business support cluster analysis is specifically implemented for Indonesian telecommunication service. The data for the business are obtained from the National Census of Economic (Susenas 2006). The method used to develop cluster model is an Artificial Neural Network (ANN) system called Self-Organizing Maps (SOM) algorithm. Based on Index of Davies Bouldin (IDB), the accuracy level of the cluster model is 0.37 or can be categorized as good. The cluster model is developed to find out telecommunication business clusters that has influence towards the national economy so that it is easier for the government to supervise telecommunication business.

Preparing for national implementation of an evidence-based, effective HIV prevention program among bahamian sixth-grade students.

PubMed

Knowles, Valerie; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Jones, Giavana; Harris, Carole; Kaljee, Linda; Li, Xiaoming; Koci, Veronica; Chen, Xinguang; Marshall, Sharon; Stanton, Bonita

2012-01-01

Using data from the preparatory phase prior to national implementation of an effective HIV prevention program (Focus on Youth in the Caribbean; FOYC) in all Bahamian government sixth-grade classes, we describe (1) actual FOYC implementation, (2) factors that influenced implementation, and (3) the relationship of implementation with intervention outcome. Six elementary schools (with 17 grade six classrooms) were selected to participate in the preparatory phase. The 17 teachers were invited to attend a training workshop, coordinate administration of questionnaires to the students, teach the 10 sessions of FOYC and complete self-assessment checklists. A total of 395 students submitted baseline and 311 students submitted year-end questionnaires. Thirteen teachers initiated FOYC; five completed all 10 sessions. Implementation of FOYC was not related to teacher FOYC workshop experience but did cluster by school. There were significant positive correlations between improved student knowledge of HIV/AIDS, protective health skills, perceived parental monitoring and reduced risk behaviours with the number of FOYC sessions delivered. Implementation was impeded by logistics issues, structural issues with the measures, and comfort-level issues, most of which can be addressed for national implementation. Degree of FOYC implementation is correlated with positive student outcomes.

Impact of Implementing National Guidelines on Antibiotic Prescriptions for Acute Respiratory Tract Infections in Pediatric Emergency Departments: An Interrupted Time Series Analysis.

PubMed

Ouldali, Naïm; Bellêttre, Xavier; Milcent, Karen; Guedj, Romain; de Pontual, Loïc; Cojocaru, Bogdan; Soussan-Banini, Valérie; Craiu, Irina; Skurnik, David; Gajdos, Vincent; Chéron, Gérard; Cohen, Robert; Alberti, Corinne; Angoulvant, François

2017-10-16

Many antibiotics are prescribed inappropriately in pediatric emergency departments (PEDs), but little data are available in these settings about effective interventions based on guidelines that follow the antimicrobial stewardship principle. Our aim was to assess the impact of implementing the 2011 national guidelines on antibiotic prescriptions for acute respiratory tract infection (ARTI) in PEDs. We conducted a multicentric, quasiexperimental, interrupted time series analysis of prospectively collected electronic data from 7 French PEDs. We included all pediatric patients who visited a participating PED during the study period from November 2009 to October 2014 and were diagnosed with an ARTI. The intervention consisted of local protocol implementation, education sessions, and feedback. The main outcome was the antibiotic prescription rate of discharge prescriptions for ARTI per 1000 PED visits before and after implementation, analyzed using the segmented regression model. We included 242534 patients with an ARTI. The intervention was associated with a significant change in slope for the antibiotic prescription rate per 1000 PED visits (-0.4% per 15-day period, P = .04), and the cumulative effect at the end of the study was estimated to be -30.9%, (95% CI [-45.2 to -20.1]), representing 13136 avoided antibiotic prescriptions. The broad-spectrum antibiotic prescription relative percentage decreased dramatically (-62.7%, 95% CI [-92.8; -32.7]) and was replaced by amoxicillin. Implementation of the 2011 national French guidelines led to a significant decrease in the antibiotic prescription rate for ARTI and a dramatic drop in broad-spectrum antibiotic prescriptions, in favor of amoxicillin. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol.

PubMed

McHugh, S; Tracey, M L; Riordan, F; O'Neill, K; Mays, N; Kearney, P M

2016-07-28

Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP). The NDP comprises a range of organisational and service delivery changes to support evidence-based practices and policies. This realist evaluation protocol sets out the approach that will be used to identify and explain which aspects of the programme are working, for whom and in what circumstances to produce the outcomes intended. This mixed method realist evaluation will develop theories about the relationship between the context, mechanisms and outcomes of the diabetes programme. In stage 1, to identify the official programme theories, documentary analysis and qualitative interviews were conducted with national stakeholders involved in the design, development and management of the programme. In stage 2, as part of a multiple case study design with one case per administrative region in the health system, qualitative interviews are being conducted with frontline staff and service users to explore their responses to, and reasoning about, the programme's resources (mechanisms). Finally, administrative data will be used to examine intermediate implementation outcomes such as service uptake, acceptability, and fidelity to models of care. This evaluation is using the principles of realist evaluation to examine the implementation of a national programme to standardise and improve services for people with diabetes in Ireland. The concurrence of implementation and evaluation has enabled us to produce formative feedback for the NDP while also supporting the refinement and revision of initial theories about how the programme is being implemented in the dynamic and unstable context of the Irish healthcare system.

The CRC 20 years: An overview of some of the major achievements and remaining challenges.

PubMed

Doek, Jaap E

2009-11-01

On 20 November 1989, the General Assembly of the United Nations adopted the Convention on the Rights of the Child (CRC). It entered into force on 2 September 1990 and has by now been ratified by 193 States, making the most universally ratified human rights treaty. This overview will present and discuss the impact of this treaty both at the international and the national level, an overview which necessarily has to be limited to some of the developments as a result of the implementation of the CRC. The first part of this paper will be devoted to the impact the CRC had and still has on the setting and development of the international agenda for the promotion and protection of the rights and welfare of children. Special attention will given to developments, achievements, and remaining challenges at the international level with regard to protection of children in armed conflict; prevention and the protection of children from sexual exploitation; and from all forms of violence. This will include some information on the impact of these international developments and actions at the national level, for example, in the area of legislation. The second part will focus on the impact at the national level. Given the wide scope of the CRC this part will be limited to some of the General Measures of Implementation (law reform, national programmes, and independent monitoring) and the General Principles (non-discrimination, best interest, right to be heard) of the CRC. This will be based on reports of States on the implementation of the CRC submitted to the CRC Committee and the Concluding Observations of this Committee and on a number of studies. The conclusion will provide remarks on poverty as one of the major remaining challenges for the implementation of children's rights.

Road traffic crash risk associated with benzodiazepine and z‐hypnotic use after implementation of a colour‐graded pictogram: a responsibility study

PubMed Central

Luxcey, Audrey; Contrand, Benjamin; Gadegbeku, Blandine; Delorme, Bernard; Tricotel, Aurore; Moore, Nicholas; Salmi, Louis‐Rachid; Lagarde, Emmanuel

2016-01-01

Aims To assess potential change in medicine exposure and association with the risk of road traffic crash across a time period that started before the implementation of a grading system warning of the effect of medicine on driving performance. Methods Data from three French national databases were extracted and matched: the national health care insurance database, police reports and the national police database of injurious crashes. Drivers involved in such crashes in France, from July 2005 to December 2011 and identified by their national identifier, were included. Association with the risk of crash was estimated using a case–control analysis comparing benzodiazepine and z‐hypnotic use among drivers responsible or not responsible for the crash. Results Totals of 69 353 responsible and 73 410 non‐responsible drivers involved in an injurious crash were included. Exposure to benzodiazepine anxiolytics was associated with an increased risk of being responsible for a road traffic crash during the pre‐intervention period (OR = 1.42 [1.24–1.62]). The association disappeared in the post‐intervention period, but became significant again thereafter. The risk of being responsible for a crash increased in users of z‐hypnotics across the study period. Conclusions Our results question the efficacy of the measures implemented to promote awareness about the effects of medicines on driving abilities. Prevention policies relating to the general driving population, but also to healthcare professionals, should be reviewed. PMID:27544927

Implementing the Patient-Centered Medical Home: Observation and Description of the National Demonstration Project

PubMed Central

Stewart, Elizabeth E.; Nutting, Paul A.; Crabtree, Benjamin F.; Stange, Kurt C.; Miller, William L.; Jaén, Carlos Roberto

2010-01-01

PURPOSE We provide an overall description of the National Demonstration Project (NDP) intervention to transform family practices into patient-centered medical homes. METHODS An independent evaluation team used multiple data sources and methods to describe the design and implementation of the NDP. These included direct observation of the implementation team and project meetings, site visits to practices, depth interviews with practice members and implementation team members, access to practice communications (eg, telephone calls, e-mails), and public domain materials (eg, the NDP Web site). RESULTS The American Academy of Family Physicians created a new division called TransforMED, which launched the 24-month NDP in June 2006. From 337 family medicine practices completing an extensive online application, 36 were selected and randomized to a facilitated group, which received tailored, intensive assistance and services from TransforMED, or a self-directed group, which received very limited assistance. Three facilitators from diverse backgrounds in finance, practice management, and organizational psychology used multiple practice change strategies including site visits, e-mails, metrics, and learning sessions. The self-directed practices worked primarily on their own, but self-organized a retreat midway through the project. The intervention model for the project evolved to be consistent with the emerging national consensus principles of the patient-centered medical home. The independent evaluation team studied the NDP and provided ongoing feedback to inform the implementation process. CONCLUSIONS The NDP illustrates that complex practice change interventions must combine flexibility in the intervention model, implementation strategy, and the evaluation, in order to maximize ongoing learning. PMID:20530392

Implementing the patient-centered medical home: observation and description of the national demonstration project.

PubMed

Stewart, Elizabeth E; Nutting, Paul A; Crabtree, Benjamin F; Stange, Kurt C; Miller, William L; Jaén, Carlos Roberto

2010-01-01

We provide an overall description of the National Demonstration Project (NDP) intervention to transform family practices into patient-centered medical homes. An independent evaluation team used multiple data sources and methods to describe the design and implementation of the NDP. These included direct observation of the implementation team and project meetings, site visits to practices, depth interviews with practice members and implementation team members, access to practice communications (eg, telephone calls, e-mails), and public domain materials (eg, the NDP Web site). The American Academy of Family Physicians created a new division called TransforMED, which launched the 24-month NDP in June 2006. From 337 family medicine practices completing an extensive online application, 36 were selected and randomized to a facilitated group, which received tailored, intensive assistance and services from TransforMED, or a self-directed group, which received very limited assistance. Three facilitators from diverse backgrounds in finance, practice management, and organizational psychology used multiple practice change strategies including site visits, e-mails, metrics, and learning sessions. The self-directed practices worked primarily on their own, but self-organized a retreat midway through the project. The intervention model for the project evolved to be consistent with the emerging national consensus principles of the patient-centered medical home. The independent evaluation team studied the NDP and provided ongoing feedback to inform the implementation process. The NDP illustrates that complex practice change interventions must combine flexibility in the intervention model, implementation strategy, and the evaluation, in order to maximize ongoing learning.

A follow-up evaluation of the impact of the Chief Nursing Officer's review of mental health nursing in Mental Health Trusts and Universities in England: comparisons of two e-surveys.

PubMed

Baker, John; Swarbrick, Caroline; Campbell, Malcolm; Playle, John; Lovell, Karina

2012-03-01

This article is a report of a study that aimed to establish a national picture of the implementation of Review recommendations over time in both Mental Health Trusts and Higher Education Institutions (Universities) in England. The 2006 Review of Mental Health Nursing in England by the Chief Nursing Officer made 17 key recommendations for Mental Health Trusts and Universities to improve mental health nursing. This article outlines key findings from a national survey of National Health Service Trusts and Universities in England with regard to prioritization and progress on implementation of these recommendations. An e-survey was carried out in 2008-2009 based on the Chief Nursing Officer review recommendations and guidance. Participants included all Trusts which delivered mental health services (n = 68) and Universities which delivered pre-registration mental health nursing education (n = 50) in England. There appears to be some evidence that the Chief Nursing Officer review of Mental Health Nursing in England continues to be implemented in both Mental Health Trusts and Universities. There is variety in levels of implementation, but Mental Health Trusts and Universities broadly agree on priority areas. The Chief Nursing Officer review has been influential in focusing the care and education of mental health nurses and services in England. There appears to be a range of barriers and facilitators which aid the implementation of healthcare policy. More attention is required from researchers to enhance and evaluate the impact of policy implementation on the quality of care provided. © 2011 Blackwell Publishing Ltd.

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

PubMed Central

Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B.; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

2016-01-01

Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations. PMID:27694661

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness.

PubMed

Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

2016-04-11

Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers' leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention's potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers' behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations. © 2016 by Kerman University of Medical Sciences

Addressing implementation challenges during guideline development - a case study of Swedish national guidelines for methods of preventing disease.

PubMed

Richter-Sundberg, Linda; Kardakis, Therese; Weinehall, Lars; Garvare, Rickard; Nyström, Monica E

2015-01-22

Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines. Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework. The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues. This case study provides examples of how guideline developers perceive and approach the issue of implementation during the development and early launch of prevention guidelines. Models for guideline development could benefit from an initial assessment of how the guideline topic, its target context and stakeholders will affect the upcoming implementation.

Implementing Primary Social and Emotional Aspects of Learning (SEAL) Small Group Interventions: Recommendations for Practitioners

ERIC Educational Resources Information Center

Lendrum, Ann; Humphrey, Neil; Kalambouka, Afroditi; Wigelsworth, Michael

2009-01-01

This article presents an extended vignette describing a good practice model for implementing SEAL small group work at "Mellington Primary", a fictional school. The vignette/model was developed from in-depth case studies at five primary schools in the north-west of England during a national evaluation of primary SEAL by the authors. The…

The Decision-Making Process in the Adoption of a New Physics Course in American High Schools. Final Report.

ERIC Educational Resources Information Center

Yegge, John F.; And Others

Reported is a study of the implementation of the new Project Physics course in American high schools. In the summer of 1970, 457 teachers attending 14 National Science Foundation institutes and 98 of their school administrators provided information through discussions and questionnaires. At the four institutes at which an implementation conference…

Young Children in Wales: An Evaluation of the Implementation of the Children Act 1989 for Day Care Services.

ERIC Educational Resources Information Center

Statham, June

This 3-year study examined the implementation of the Children Act in Wales, which deals with providing, coordinating, and regulating day care and related services for children under 8 years. Data were collected through interviews with key officers and representatives of child care organizations, a national survey of day care providers, and an…

76 FR 43616 - Procedures for Implementing the National Environmental Policy Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-21

... Studies. 4. NASA HQ 09/23/2009 ARRA Implementation of Venture-Class Mission, HQ ID-1095. 5. LaRC, VA 11/20.../2009 Develop Air Traffic Management Concepts. 5. NASA HQ 12/23/2009 ARRA-Funded Activities (HQ ID-1119... Composition, Cloud, Climate Coupling (TC-4). 3. WFF, VA 03/28/2008 ARCTAS Mission. The third proposed CatEx...

New Legislation in Brazilian Music Education: Studying the Law and Its Implementation

ERIC Educational Resources Information Center

Manning, Dwight; Kamil, Marilia

2017-01-01

In 2008, Brazilian legislators approved a law that added music on a mandatory basis to the basic national school curriculum. Despite the possibilities afforded by this legislation, music educators affirm that many questions remain due to its ambiguity. Given the 2012 deadline for the implementation of this law, there is a need to understand how it…

Leading Change for the Implementation of Common Core State Standards in Rural School Districts

ERIC Educational Resources Information Center

Lopez, Paul; Wise, Donald

2015-01-01

Rural school districts across the nation, with their limited resources, face daunting challenges posed by the implementation of the Common Core State Standards. This article presents a recent study of 13 rural school districts in the Central Valley of California and how these districts are responding to those challenges. A total of 352 teachers…

Boot Camps for Juvenile Offenders: An Implementation Evaluation of Three Demonstration Programs. National Institute of Justice Research Brief.

ERIC Educational Resources Information Center

Bourque, Blair B.; And Others

A study evaluated the implementation of three demonstration programs for male juveniles that explored how the adult boot camp strategy could be modified to serve the unique needs of juveniles. Evaluation efforts sought to determine how the three demonstration sites--Cleveland, Ohio; Denver, Colorado; and Mobile, Alabama--were choosing and…

Suicide Prevention Guideline Implementation in Specialist Mental Healthcare Institutions in The Netherlands.

PubMed

Mokkenstorm, Jan; Franx, Gerdien; Gilissen, Renske; Kerkhof, Ad; Smit, Johannes Hendrikus

2018-05-03

In The Netherlands, on average 40% of all suicides concern patients treated by mental healthcare institutions (MHIs). Recent evidence indicates that implemented guideline recommendations significantly reduce the odds for patients to die by suicide. Implementation of the multidisciplinary guideline for diagnosis and treatment of suicidal behaviors is a main objective of the Dutch National Suicide Prevention Strategy. To this end, 24 MHIs that collectively reported 73% of patient suicides in 2015 received an educational outreach intervention offered by the national center of expertise. To investigate changes in levels of implementation of guideline recommendations; and to assess the degree of variation on suicide prevention policies and practices between MHIs. Implementation study with a prospective cohort design studying change over time on all domains of a Suicide Prevention Monitor, a guideline-based instrument assessing suicide prevention policies and practices within MHIs. Data were collected in six-month intervals between 2015 and 2017. MHIs improved significantly on four out of ten domains: the development of an organizational suicide prevention policy; monitoring and trend-analysis of suicides numbers; evaluations after suicide; and clinician training. No improvement was measured on the domains pertaining to multi-annual training policies; collaborative care with external partners; recording and evaluation of suicide attempts; routine assessment of suicidality in all patients; safety planning and involving next of kin and carers. Furthermore, marked practice variation between MHIs was found which did not decrease over time. This study shows significant improvement in the implementation of four out of ten guideline-based suicide prevention policies in 24 specialist mental healthcare institutions in The Netherlands. The implementation level of suicide prevention policies and practices still appears to vary significantly between MHIs in The Netherlands.

The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015.

PubMed

Manser, Tanja; Frings, Janina; Heuser, Gregory; Mc Dermott, Fiona

2016-01-01

Despite the growing recognition of the need to implement systematic approaches for managing the risks associated with healthcare, few studies have investigated the level of implementation for clinical risk management (CRM) at a national level. Therefore, this study aimed to assess the current level of CRM implementation in German hospitals and to explore differences across hospital types. From March to June 2015, persons responsible for CRM in 2,617 hospitals and rehabilitation clinics in Germany were invited to participate in a voluntary online survey assessing the level of implementation for various aspects of CRM: CRM strategy, structures and processes; risk assessment (risk identification, risk analysis, risk evaluation) with a focus on incident reporting systems; risk mitigation measures; and risk monitoring and reporting. 572 hospitals participated in the survey (response rate 22 %). Most of these hospitals had a formalised, binding CRM strategy (72 %). 66 % had a centralised and 34 % a decentralised CRM structure. We also found that, despite a broad range of risk assessment methods being applied, there was a lack of integration of risk information from different data sources. Hospitals also reported a high level of implementation of critical incident reporting systems with a strong preference for local (74 %) over transorganisational systems. This study provides relevant data to inform targeted interventions concerning CRM implementation at a national level and to consider the specific context of different types of hospitals more carefully in this process. The approach to CRM assessment illustrated in this article could be the basis of a system for monitoring CRM over time and, thus, for evaluating the impact of strategy decisions at the policy level on CRM development. Copyright © 2016. Published by Elsevier GmbH.

Suicide Prevention Guideline Implementation in Specialist Mental Healthcare Institutions in The Netherlands

PubMed Central

Franx, Gerdien; Gilissen, Renske; Kerkhof, Ad; Smit, Johannes Hendrikus

2018-01-01

In The Netherlands, on average 40% of all suicides concern patients treated by mental healthcare institutions (MHIs). Recent evidence indicates that implemented guideline recommendations significantly reduce the odds for patients to die by suicide. Implementation of the multidisciplinary guideline for diagnosis and treatment of suicidal behaviors is a main objective of the Dutch National Suicide Prevention Strategy. To this end, 24 MHIs that collectively reported 73% of patient suicides in 2015 received an educational outreach intervention offered by the national center of expertise. Aim: To investigate changes in levels of implementation of guideline recommendations; and to assess the degree of variation on suicide prevention policies and practices between MHIs. Methods: Implementation study with a prospective cohort design studying change over time on all domains of a Suicide Prevention Monitor, a guideline-based instrument assessing suicide prevention policies and practices within MHIs. Data were collected in six-month intervals between 2015 and 2017. Results: MHIs improved significantly on four out of ten domains: the development of an organizational suicide prevention policy; monitoring and trend-analysis of suicides numbers; evaluations after suicide; and clinician training. No improvement was measured on the domains pertaining to multi-annual training policies; collaborative care with external partners; recording and evaluation of suicide attempts; routine assessment of suicidality in all patients; safety planning and involving next of kin and carers. Furthermore, marked practice variation between MHIs was found which did not decrease over time. Conclusion: This study shows significant improvement in the implementation of four out of ten guideline-based suicide prevention policies in 24 specialist mental healthcare institutions in The Netherlands. The implementation level of suicide prevention policies and practices still appears to vary significantly between MHIs in The Netherlands. PMID:29751572

75 FR 36782 - Unblocking of Specially Designated National Pursuant to Executive Order 13219, as Amended

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... obstructing implementation of the Dayton Accords in Bosnia or United Nations Security Council Resolution 1244... Representative, the Peace Implementation Council or its Steering Board, relating to Bosnia and Herzegovina; or (D...

[The German program for disease management guidelines. Results and perspectives].

PubMed

Ollenschläger, Günter; Kopp, Ina

2007-05-15

The Program for National Disease Management Guidelines (German DM-CPG Program) is a joint initiative of the German Medical Association (umbrella organization of the German Chambers of Physicians), the Association of the Scientific Medical Societies (AWMF), and of the National Association of Statutory Health Insurance Physicians (NASHIP). The program aims at developing, implementing and continuously updating best-practice recommendations for countrywide and regional disease management programs in Germany. Since 2003 twelve national guidelines (topics: asthma, chronic obstructive pulmonary disease, HI (Chronic heart failure), CVD (Chronic coronary heart disease) back pain, depression, several aspects of diabetes) have been produced by use of a standardized procedure in accordance with internationally consented methodologies. For countrywide dissemination and implementation the program uses a wide range of specialist journals, continuous medical education and quality management programs. So far, 36 out of 150 national scientific medical associations, four allied health profession organizations, and twelve national consumer organizations have been participating in the DM-CPG Program. Studies to evaluate the program's effects on health-care providers' behavior and patients' outcomes are under way.

The global and domestic politics of health policy in emerging nations.

PubMed

Gómez, Eduardo J; Ruger, Jennifer Prah

2015-02-01

In recent years, several emerging nations with burgeoning economies and in transition to democracy have pursued health policy innovations. As these nations have integrated into the world economy through bilateral trade and diplomacy, they have also become increasingly exposed to international pressures and norms and focused on more effective, equitable health care systems. There are several lessons learned from the case studies of Brazil, Ghana, India, China, Vietnam, and Thailand in this special issue on the global and domestic politics of health policy in emerging nations. For the countries examined, although sensitive to international preferences, domestic governments preferred to implement policy on their own and at their own pace. During the policy-making and implementation process, international and domestic actors played different roles in health policy making vis-à-vis other reform actors -- at times the state played an intermediary role. In several countries, civil society also played a central role in designing and implementing policy at all levels of government. International institutions also have a number of mechanisms and strategies in their tool box to influence a country's domestic health governance, and they use them, particularly in the context of an uncertain state or internal discordance within the state. Copyright © 2015 by Duke University Press.

Implementation fidelity of Multidimensional Family Therapy in an international trial.

PubMed

Rowe, Cynthia; Rigter, Henk; Henderson, Craig; Gantner, Andreas; Mos, Kees; Nielsen, Philip; Phan, Olivier

2013-04-01

Implementation fidelity, a critical aspect of clinical trials research that establishes adequate delivery of the treatment as prescribed in treatment manuals and protocols, is also essential to the successful implementation of effective programs into new practice settings. Although infrequently studied in the drug abuse field, stronger implementation fidelity has been linked to better outcomes in practice but appears to be more difficult to achieve with greater distance from model developers. In the INternational CAnnabis Need for Treatment (INCANT) multi-national randomized clinical trial, investigators tested the effectiveness of Multidimensional Family Therapy (MDFT) in comparison to individual psychotherapy (IP) in Brussels, Berlin, Paris, The Hague, and Geneva with 450 adolescents with a cannabis use disorder and their parents. This study reports on the implementation fidelity of MDFT across these five Western European sites in terms of treatment adherence, dose and program differentiation, and discusses possible implications for international implementation efforts. Copyright © 2013 Elsevier Inc. All rights reserved.

Effects of Fuel-Reduction Techniques on Vegetative Composition of Piedmont Loblolly-Shortleaf Pine Communities: Preliminary Results of the National Fire and Fire Surrogate Study

Treesearch

Ross J. Phillips; Thomas A. Waldrop; Gregg L. Chapman; Helen H. Mohr; Mac A. Callaham; Charles T. Flint

2004-01-01

As part of the National Fire and Fire Surrogate (NFFS) Study, prescribed burning, thinning, and a combination of burning and thinning were conducted in loblolly ( Pinus taeda L.) and shortleaf pine ( P. echinata Mill.) communities in the Piedmont of South Carolina to test the effectiveness of these treatments for fuel reduction. Treatment implementation resulted in an...

Asking Questions of (What) Assessment (Should Do) for Learning: The Case of Bite-Sized Assessment for Learning in Singapore

ERIC Educational Resources Information Center

Tan, Kelvin Heng Kiat

2017-01-01

The recent focus on AfL has shifted from defining its scope and extent to understanding its implementation, and research has revealed AfL implementation to be complex and contested. AfL implementation is especially challenging in national contexts that emphasise high stakes examination performance and grades. One such example is the nation state…

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

PubMed

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

2015-03-01

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

40 CFR 63.7570 - Who implements and enforces this subpart?

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Industrial, Commercial, and Institutional Boilers and Process Heaters Other Requirements and Information § 63.7570 Who implements and...

78 FR 5116 - NASA Information Security Protection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... 2700-AD61 NASA Information Security Protection AGENCY: National Aeronautics and Space Administration... implement the provisions of Executive Order (E.O.) 13526, Classified National Security Information, and... Information, that establishes the Agency's requirements for the proper implementation and management of a...

Food Service Perspectives on National School Lunch Program Implementation

PubMed Central

Tabak, Rachel G.; Moreland-Russell, Sarah

2015-01-01

Objectives Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Methods Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Results Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Conclusions Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation. PMID:26417607

Adapting and enhancing PAX Good Behavior Game for First Nations communities: a mixed-methods study protocol developed with Swampy Cree Tribal Council communities in Manitoba

PubMed Central

Fortier, Janique; Chartier, Mariette; Turner, Sarah; Murdock, Nora; Turner, Frank; Sareen, Jitender; Afifi, Tracie O; Katz, Laurence Y; Brownell, Marni; Bolton, James; Elias, Brenda; Isaak, Corinne; Woodgate, Roberta; Jiang, Depeng

2018-01-01

Introduction High rates of mental health problems, such as suicidal behaviours, among First Nations youth in Canada are a major public health concern. The Good Behavior Game (GBG) is a school-based intervention that provides a nurturing environment for children and has been shown to promote positive outcomes. PAX Good Behavior Game (PAX GBG) is an adaptation and enhancement of the GBG. While PAX GBG has been implemented in Indigenous communities, little research exists examining the cultural and contextual appropriateness and effectiveness of the intervention in First Nations communities. Methods and analysis The present paper describes a protocol of the mixed-methods approach guided by an Indigenous ethical engagement model adopted to implement, adapt and evaluate PAX GBG in First Nations communities in Manitoba, Canada. First, implementation outcomes (eg, acceptability, adoption) of PAX GBG will be evaluated using qualitative interviews with teachers, principals and community members from Swampy Cree Tribal Council (SCTC) communities. Second, by linking administrative databases to programme data from schools in 38 First Nations communities, we will compare PAX GBG and control groups to evaluate whether PAX GBG is associated with improved mental health and academic outcomes. Third, the qualitative results will help inform a cultural and contextual adaptation of PAX GBG called First Nations PAX (FN PAX). Fourth, FN PAX will be implemented in a few SCTC communities and evaluated using surveys and qualitative interviews followed by the remaining communities the subsequent year. Ethics and dissemination Ethical approval was obtained from the University of Manitoba Health Research Ethics Board and will be obtained from the Health Information Privacy Committee and respective data providers for the administrative database linkages. Dissemination and knowledge translation will include community and stakeholder engagement throughout the research process, reports and presentations for policymakers and community members, presentations at scientific conferences and journal publications. PMID:29449291

77 FR 96 - Revision to the Notice for the Great Lakes and Mississippi River Interbasin Study (GLMRIS...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-03

... conducting GLMRIS in accordance with the National Environmental Policy Act (NEPA) and with the Economic and Environmental Principles and Guidelines for Water and Related Land Resource Implementation Studies, Water...

National Facilities study

NASA Technical Reports Server (NTRS)

1994-01-01

This study provides a set of recommendations for improving the effectiveness of our nation's aeronautics and space facilities. The study plan considers current and future government and commercial needs as well as DOD and NASA mission requirements through the year 2023. It addresses shortfalls in existing capabilities, new facility requirements, upgrades, consolidations, and phase-out of existing facilities. If the recommendations are implemented, they will provide world-class capability where it is vital to our country's needs and make us more efficient in meeting future needs.

Safe Surgery for All: Early Lessons from Implementing a National Government-Driven Surgical Plan in Ethiopia.

PubMed

Burssa, Daniel; Teshome, Atlibachew; Iverson, Katherine; Ahearn, Olivia; Ashengo, Tigistu; Barash, David; Barringer, Erin; Citron, Isabelle; Garringer, Kaya; McKitrick, Victoria; Meara, John; Mengistu, Abraham; Mukhopadhyay, Swagoto; Reynolds, Cheri; Shrime, Mark; Varghese, Asha; Esseye, Samson; Bekele, Abebe

2017-12-01

Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity. As Ethiopia progresses with its commitment to prioritize surgery within its Health Sector Transformation Plan, disseminating the process and outcomes of the SaLTS initiative will inform other countries on successful national implementation strategies. The following article describes the process by which the Ethiopian FMOH established surgical system reform and the preliminary results of implementation across these eight pillars.

Diffusion of palliative care in nursing homes: lessons from the culture change movement.

PubMed

Tyler, Denise A; Shield, Renée R; Miller, Susan C

2015-05-01

Studies have found that nursing homes (NHs) that rely heavily on Medicaid funding are less likely to implement innovative approaches to care, such as palliative care (PC) or resident-centered approaches commonly referred to as "culture change" (CC). However, a nationally representative survey we previously conducted found that some high Medicaid facilities have implemented these innovative approaches. The purpose of this study was to identify the factors that enable some high Medicaid NHs to implement innovative approaches to care. We conducted telephone interviews with 16 NH administrators in four categories of facilities: 1) low PC and low CC, 2) low PC and high CC, 3) high PC and low CC, and 4) high PC and high CC. Interviews explored strategies used to overcome barriers to implementation and the resources needed for implementation. We had expected to find differences between low and high NHs but instead found differences in NHs' experiences with CC and PC. Since the time of our national survey in 2009-2010, most previously low CC NHs had implemented at least some CC practices; however, we did not find similar changes around PC. Administrators reported numerous ways in which they had received information and assistance from outside entities for implementing CC. This was not the case for PC where administrators reported relying exclusively and heavily on hospices for both their residents' PC needs and information related to PC. PC advocates could learn much from the CC model in which advocates have used multipronged efforts to institute reform. Published by Elsevier Inc.

The impact of national health insurance on the utilization of health care services by pregnant women: the case in Taiwan.

PubMed

Chen, L M; Wen, S W; Li, C Y

2001-03-01

Substantially increased funding for health care services occurred in Taiwan after the implementation of a national health insurance plan in 1995. This study attempts to examine the impact of this national health insurance plan on the utilization of prenatal and intrapartum care services. Nationally representative surveys of all pregnant women in Taiwan in 1989 (1,662 participants) and in 1996 (3,626 participants) were included in the analysis. We first compared the distribution of birth characteristics between the two surveys. We then calculated the rate of utilization of various prenatal and intrapartum care services in the two surveys in the overall sample and in subsamples, stratified by maternal education, age, and parity. The utilization of most prenatal and intrapartum care services, especially the complicated laboratory tests, increased in 1996 compared to 1989. For example, the proportion of women who received amniocentesis increased from 1.62% in 1989 to 5.60% in 1996 and German measles testing increased from 5.96% to 27.11%. By contrast, the proportion of women who received consultation services was stable over time, or for family planning, consultation declined from 33.21% to 27.00%. These changes in utilization over time were consistently observed across different maternal education, age, and parity groups. The utilization of prenatal and intrapartum care services, especially for the more expensive services, has substantially increased in Taiwan since the implementation of the national health insurance. For countries considering similar national health insurance plan, it may be helpful to consider cost-containing measures before the implementation of such a plan.

Cost Assessment of Implementation of Immune Tolerance Induction in Iran.

PubMed

Cheraghali, Abdol Majid; Eshghi, Peyman

2012-05-01

A number of hemophilia A patients who receive clotting factors may develop antibodies (inhibitors) against clotting factors. The immune tolerance induction (ITI) method has proved to be a very cost-effective alternative to bypassing agents. Iran's national health authority is interested in implementing the ITI method for the management of hemophilia patients with inhibitors. The objective of this study was to calculate the breakeven point between costs attributed to the ITI method and the use of bypassing agents for the management of high-responder hemophilia patients with inhibitors. This study assessed costs attributed to the implementation of ITI for the management of Iranian hemophilia patients with costs of high-titer and high-responding inhibitors from the perspective of the national health system. The main objective was to find the breakeven point for the ITI method in comparison with the use of bypassing medicine, recombinant factor VIIa (Novoseven). Based on the sensitivity analysis performed, the breakeven point mainly depends on costs of factor VIII, Novoseven, and the success rate of the ITI intervention. According to this analysis, the breakeven point of ITI and Novoseven methods varies between 16 and 34 months posttreatment. The optimized point is about 17 months posttreatment. Iran's national health system spends more than 24 million euros for providing bypassing agents to about 124 hemophilia patients with inhibitors. Because of limited resources available in Iran's health sector, this is a huge burden. Results of this study show that the implementation of the ITI method for the management of Iranian hemophilia patients with inhibitors is a cost-saving method and Iran's health system will recover all the expenditure related to the implementation of ITI in less than 2 years and will make a considerable saving along with providing standard care for these patients. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

28 CFR Appendix C to Part 61 - Immigration and Naturalization Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Procedures Relating to the Implementation of the National Environmental Policy Act C Appendix C to Part 61... ENVIRONMENTAL POLICY ACT Pt. 61, App. C Appendix C to Part 61—Immigration and Naturalization Service Procedures... published pursuant to the National Environmental Policy Act of 1969 (NEPA), as amended (42 U.S.C. 4321 et...

28 CFR Appendix C to Part 61 - Immigration and Naturalization Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Procedures Relating to the Implementation of the National Environmental Policy Act C Appendix C to Part 61... ENVIRONMENTAL POLICY ACT Pt. 61, App. C Appendix C to Part 61—Immigration and Naturalization Service Procedures... published pursuant to the National Environmental Policy Act of 1969 (NEPA), as amended (42 U.S.C. 4321 et...

A Study of the Physiological Factors Affecting the Nature of the Adult Learner in the Phoenix Air National Guard.

ERIC Educational Resources Information Center

Torbert, James Brison

An investigation reviewed current literature in the field of physiological factors affecting the adult learning environment. These findings were compared to the academic learning environment at the Phoenix Air National Guard. The end product was a set of recommendations for management to implement in order to improve the learning climate for the…

Handicapped and Disadvantaged Students: Access to Quality Vocational Education. National Assessment of Vocational Education Final Report. Volume V.

ERIC Educational Resources Information Center

Hayward, Becky J.; Wirt, John G.

The National Assessment of Vocational Education (NAVE) examined how the federal law was implemented and federal funds were distributed under the Carl D. Perkins Vocational Education Act of 1984. This part of the study described the access of handicapped and academically disadvantaged high school students to vocational education and analyzed the…

The Paper Implementation of the German Educational Standards in Geography for the Intermediate School Certificate in the German Federal States

ERIC Educational Resources Information Center

Schöps, Andreas

2017-01-01

Up to the publication of the results of Germany's first participation in the PISA study in 2001, there had been no national educational standards in Germany's 16 federal states. In the aftermath of the discussions about the disappointing outcomes, Germany's federal states decided to develop national standards, yet focusing on "core…

Readiness for Delivering Digital Health at Scale: Lessons From a Longitudinal Qualitative Evaluation of a National Digital Health Innovation Program in the United Kingdom.

PubMed

Lennon, Marilyn R; Bouamrane, Matt-Mouley; Devlin, Alison M; O'Connor, Siobhan; O'Donnell, Catherine; Chetty, Ula; Agbakoba, Ruth; Bikker, Annemieke; Grieve, Eleanor; Finch, Tracy; Watson, Nicholas; Wyke, Sally; Mair, Frances S

2017-02-16

Digital health has the potential to support care delivery for chronic illness. Despite positive evidence from localized implementations, new technologies have proven slow to become accepted, integrated, and routinized at scale. The aim of our study was to examine barriers and facilitators to implementation of digital health at scale through the evaluation of a £37m national digital health program: ‟Delivering Assisted Living Lifestyles at Scale" (dallas) from 2012-2015. The study was a longitudinal qualitative, multi-stakeholder, implementation study. The methods included interviews (n=125) with key implementers, focus groups with consumers and patients (n=7), project meetings (n=12), field work or observation in the communities (n=16), health professional survey responses (n=48), and cross program documentary evidence on implementation (n=215). We used a sociological theory called normalization process theory (NPT) and a longitudinal (3 years) qualitative framework analysis approach. This work did not study a single intervention or population. Instead, we evaluated the processes (of designing and delivering digital health), and our outcomes were the identified barriers and facilitators to delivering and mainstreaming services and products within the mixed sector digital health ecosystem. We identified three main levels of issues influencing readiness for digital health: macro (market, infrastructure, policy), meso (organizational), and micro (professional or public). Factors hindering implementation included: lack of information technology (IT) infrastructure, uncertainty around information governance, lack of incentives to prioritize interoperability, lack of precedence on accountability within the commercial sector, and a market perceived as difficult to navigate. Factors enabling implementation were: clinical endorsement, champions who promoted digital health, and public and professional willingness. Although there is receptiveness to digital health, barriers to mainstreaming remain. Our findings suggest greater investment in national and local infrastructure, implementation of guidelines for the safe and transparent use and assessment of digital health, incentivization of interoperability, and investment in upskilling of professionals and the public would help support the normalization of digital health. These findings will enable researchers, health care practitioners, and policy makers to understand the current landscape and the actions required in order to prepare the market and accelerate uptake, and use of digital health and wellness services in context and at scale. ©Marilyn R Lennon, Matt-Mouley Bouamrane, Alison M Devlin, Siobhan O'Connor, Catherine O'Donnell, Ula Chetty, Ruth Agbakoba, Annemieke Bikker, Eleanor Grieve, Tracy Finch, Nicholas Watson, Sally Wyke, Frances S Mair. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.02.2017.

U.S. Solar-Terrestrial Research Program

NASA Astrophysics Data System (ADS)

Intriligator, Devrie S.

The Committee on Solar-Terrestrial Research (CSTR) of the National Research Council of the National Academy of Sciences is charged with looking after the health of solar-terrestrial research in the United States. In 1984 the National Academy Press published the CSTR report “National Solar-Terrestrial Research Program.” This program implements the recommendations of the earlier National Research Council study “Solar-Terrestrial Research for the 1980's” (1981). The earlier study, which took over 18 months to complete and involved the participation of more than 150 scientists, specifically identified the principal scientific and management recommendations required for a balanced solar-terrestrial program. The present study was undertaken by CSTR in the fall of 1983 in response to a request from several concerned federal agencies and the Board on Atmospheric Sciences and Climate. Together, the two studies constitute a set that prescribes a broad-gaged solar-terrestrial program.

[Real-time PCR detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae DNA in clinical specimens].

PubMed

Vacková, Z; Lžičařová, D; Stock, N K; Kozáková, J

2015-10-01

The study aim was to implement a molecular real-time polymerase chain reaction (PCR) assay recommended by the CDC (Centers for Disease Control and Prevention) for the detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in clinical (culture negative) specimens from patients with suspected invasive bacterial disease. Clinical specimens are referred to the National Reference Laboratory (NRL) for Meningococcal Infections, Unit for Airborne Bacterial Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health from various regions of the Czech Republic. Clinical specimens are, in particular, cerebrospinal fluid, anti-coagulated blood or serum and, exceptionally, post-mortem specimens. The NRL has implemented molecular diagnosis of these bacterial pathogens involved in meningitis and sepsis from clinical specimens since 1999. The first diagnostic method was semi-nested PCR followed by electrophoretic analysis. In 2014, a molecular qualitative real-time PCR assay was implemented.

Stakeholder management for conservation projects: a case study of Ream National Park, Cambodia.

PubMed

De Lopez, T T

2001-07-01

The paper gives an account of the development and implementation of a stakeholder management framework at Ream National Park, Cambodia. Firstly, the concept of stakeholder is reviewed in management and in conservation literatures. Secondly, the context in which the stakeholder framework was implemented is described. Thirdly, a five-step methodological framework is suggested: (1) stakeholder analysis, (2) stakeholder mapping, (3) development of generic strategies and workplan, (4) presentation of the workplan to stakeholders, and (5) implementation of the workplan. This framework classifies stakeholders according to their level of influence on the project and their potential for the conservation of natural resources. In a situation characterized by conflicting claims on natural resources, park authorities were able to successfully develop specific strategies for the management of stakeholders. The conclusion discusses the implications of the Ream experience and the generalization of the framework to other protected areas.

Linking national and global population agendas: case studies from eight developing countries.

PubMed

Lee, K; Walt, G

1995-06-01

This comparative study of the determinants of family planning policy initiation and implementation focuses on four pairs of countries: Zambia/Zimbabwe, Algeria/Tunisia, Pakistan/Bangladesh, and Philippines/Thailand. The conclusion is drawn that global efforts had an influence on national policy makers and on putting family planning issues on the policy agenda. Global impacts were affected by national economic and social conditions and the broader political and economic relations with Western countries. The absolute level of economic development was found to be unrelated to the timing of initiation of family planning on national policy agendas. Stronger national family planning programs occurred in countries where policy makers linked economic development at whatever level with the need to limit population growth. Pakistan and Thailand in the 1960s illustrated this commitment to family planning programs, and Zambia and Algeria illustrated the lack of connection between development and population growth at the policy level and the lack of family planning on the policy agenda. Affiliation with the West during the 1960s meant early initiation of family planning in Pakistan/Bangladesh and Philippines/Thailand. Stronger commitment to program implementation occurred only in Thailand during the 1970s and Zimbabwe during the 1980s. Commitment lessened in the Philippines and Pakistan. Program implementation and national support of family planning were viewed as also dependent upon domestic factors, such as sufficient resources. Algeria/Tunisia and Zambia/Zimbabwe were countries that promoted family planning only after national political ideology shifted and anti-imperialist sentiments subsided. The impact of the international Cairo conference on these countries was minimal in terms of policy change. Most of the countries however desired greater support from donors. Even objections from the Vatican and internal domestic pressures were insufficient to prevent countries such as the Philippines and Pakistan from supporting the Cairo Plan of Action and a family planning and reproductive health agenda. Bangladesh and Pakistan are given as examples of countries where differences in the focus of foreign aid impacted on the national support for social services.

Policy development and challenges of global mental health: a systematic review of published studies of national-level mental health policies.

PubMed

Zhou, Wei; Yu, Yu; Yang, Mei; Chen, Lizhang; Xiao, Shuiyuan

2018-05-18

Mental health policy can be an essential and powerful tool to improve a population's mental health. However, around one third of countries do not possess a mental health policy, and there are large disparities in population coverage rates between high- and low-income countries. The goal of this study is to identify the transition and implementation challenges of mental health policies in both high-income countries (HICs) as well as middle- and low-income countries (MLICs). PubMed, Cochrane Library and Campbell Library were searched from inception to 31 December 2017, for studies on implemented mental health policies at the national level. Abstracts and the main texts of papers were double screened, and extracted data were analysed through thematic synthesis. A total of 93 papers were included in this study, covering 24 HICs, 28 MLICs and 5 regions. Studies on mental health policies, especially those of MLICs, kept increasing, but MLICs were still underrepresented in terms of publication quantity and study frequency. Based on the included studies, nine policy domains were summarized: service organizing, service provision, service quality, human resources, legislation and human rights, advocacy, administration, surveillance and research, and financing and budgeting. HICs incrementally enriched their policy content in all domains over centuries of development; following HICs' experience, mental health policies in MLICs have boomed since the 1990s and quickly extended to all domains. Implementation problems in HICs were mainly related to service organizing and service provision; for MLICs, more severe implementation problems converged on financing and budgeting, administration and human resources. Mental health policy developments in both HICs and MLICs present a process of diversification and enrichment. In terms of implementation, MLICs are faced with more and greater challenges than HICs, especially in funding, human resources and administration. Therefore, future efforts should not only be made on helping MLICs developing mental health policies, but also on promoting policy implementation under MLICs' local context.

The Impact of State and Federal Accountability Standards upon the Implementation of Inclusion in Johnston County, NC High Schools

ERIC Educational Resources Information Center

Howard, Rex Ivan

2012-01-01

As student accountability models have become the norm in the United States, first in individual states such as North Carolina and then throughout the nation with No Child Left Behind (NCLB), the implementation of inclusion as a curriculum delivery model for students with disabilities has been explored. The purpose of this study was to examine how…

Balancing Considerations of Equity, Content Quality, and Technical Excellence in Designing, Validating and Implementing Performance Assessments in the Context of Mathematics Instructional Reform: The Experience of the QUASAR Project.

ERIC Educational Resources Information Center

Silver, Edward A.; Lane, Suzanne

Issues of educational equity and quality are explored in the context of the Quantitative Understanding: Amplifying Student Achievement and Reasoning (QUASAR) project, a national educational reform project aimed at fostering and studying the development and implementation of enhanced mathematics instructional programs for students attending middle…

On the Frontline of CCSS Implementation: A National Study of Factors Influencing Teachers' Perceptions of Teaching Conditions and Job Satisfaction

ERIC Educational Resources Information Center

Endacott, Jason L.; Collet, Vicki; Goering, Christian Z.; Turner, Ronna; Denny, George S.; Wright, Ginney; Jennings-Davis, Jennifer

2016-01-01

The Common Core State Standards (CCSS) represent an unprecedented change in American education. As an increasingly integral part of the school accountability movement under No Child Left Behind and Race to the Top, responsibility for implementing CCSS rests largely with school leadership. One important factor in the success or failure of these…

An Empirical Study of Implementing an Academic Unit Planning Tool: Implications for Institutional Research and Management. AIR Forum Paper 1978.

ERIC Educational Resources Information Center

Miyataki, Glenn K.

The need to focus upon the organizational factors and consequences of a technological innovation is discussed and the outcome of the pilot implementation of the Academic Unit Planning Manual (AUPM) are reported. The primary intent of the AUPM, a tool developed at the National Center for Higher Education Management Systems (NCHEMS), is to assist…

The central role of national programme management for the achievement of malaria elimination: a cross case-study analysis of nine malaria programmes.

PubMed

Smith Gueye, Cara; Newby, Gretchen; Tulloch, Jim; Slutsker, Laurence; Tanner, Marcel; Gosling, Roland D

2016-09-22

A malaria eradication goal has been proposed, at the same time as a new global strategy and implementation framework. Countries are considering the strategies and tools that will enable progress towards malaria goals. The eliminating malaria case-study series reports were reviewed to identify successful programme management components using a cross-case study analytic approach. Nine out of ten case-study reports were included in the analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for malaria elimination programme management was developed and data were extracted and synthesized. Findings were reviewed at a consultative workshop, which led to a revision of the framework and further data extraction and synthesis. Success factors of implementation, programme choices and changes, and enabling factors were distilled. Decentralized programmes enhanced engagement in malaria elimination by sub-national units and communities. Integration of the malaria programme into other health services was also common. Decentralization and integration were often challenging due to the skill and experience levels of newly tasked staff. Accountability for programme impact was not clarified for most programmes. Motivation of work force was a key factor in maintaining programme quality but there were few clear, detailed strategies provided. Different incentive schemes targeted various stakeholders. Training and supervision, although not well described, were prioritized by most programmes. Multi-sectoral collaboration helped some programmes share information, build strategies and interventions and achieve a higher quality of implementation. In most cases programme action was spurred by malaria outbreaks or a new elimination goal with strong leadership. Some programmes showed high capacity for flexibility through introduction of new strategies and tools. Several case-studies described methods for monitoring implementation quality and coverage; however analysis and feedback to those implementing malaria elimination in the periphery was not well described. Political commitment and sustained financing contributed to malaria programme success. Consistency of malaria programmes depends on political commitment, human and financial resources, and leadership. Operational capacity of the programme and the overall health system structure and strength are also important aspects. Malaria eradication will require adaptive, well-managed malaria programmes that are able to tailor implementation of evidence-based strategies, founded upon strong sub-national surveillance and response, with adequate funding and human resources.

Designing for action: adapting and implementing a community-based newborn care package to affect national change in Uganda.

PubMed

Waiswa, Peter; Namazzi, Gertrude; Kerber, Kate; Peterson, Stefan

2015-01-01

There is a lack of literature on how to adapt new evidence-based interventions for maternal and newborn care into local health systems and policy for rapid scale-up, particularly for community-based interventions in low-income settings. The Uganda Newborn Study (UNEST) was a cluster randomised control trial to test a community-based care package which was rapidly taken up at national level. Understanding this process may help inform other studies looking to design and evaluate with scale-up in mind. This study aimed to describe the process of using evidence to design a community-based maternal and newborn care package in rural eastern Uganda, and to determine the dissemination and advocacy approaches used to facilitate rapid policy change and national uptake. We reviewed UNEST project literature including meeting reports and minutes, supervision reports, and annual and midterm reports. National stakeholders, project and district staff were interviewed regarding their role in the study and perceptions of what contributed to uptake of the package under evaluation. Data related to UNEST formative research, study design, implementation and policy influence were extracted and analysed. An advisory committee of key players in development of maternal and newborn policies and programmes in Uganda was constituted from many agencies and disciplines. Baseline qualitative and quantitative data collection was done at district, community and facility level to examine applicability of aspects of a proposed newborn care package to the local setting. Data were summarised and presented to stakeholders to adapt the intervention that was ultimately tested. Quarterly monitoring of key activities and events around the interventions were used to further inform implementation. The UNEST training package, home visit schedule and behaviour change counselling materials were incorporated into the national Village Health Team and Integrated Community Case Management packages while the study was ongoing. Designing interventions for national scale-up requires strategies and planning from the outset. Use of evidence alongside engagement of key stakeholders and targeted advocacy about the burden and potential solutions is important when adapting interventions to local health systems and communities. This approach has the potential to rapidly translate research into policy, but care must be taken not to exceed available evidence while seizing the policy opportunity.

Proceedings of National Symposium on the Role of Academia in National Competitiveness and Total Quality Management (1st) Held in Morgantown, West Virginia on 18-20 July 1990

DTIC Science & Technology

1990-07-20

sciences: The engineering sciences have their roots in mathematics and basic sciences but carry knowledge further toward creative application. These studies...business, and government partnership to develop TQM as a process to improve national competitiveness. • Investigate and develop resources to implement...and develop TQM. 4 • Investigate and resolve TQM curriculum and accreditation issues. • Develop measurements to assess the effectiveness of TQM in the

Implementing the European Quality Assurance in Vocational Education and Training (EQAVET) at National Level: Some Insights from the PEN Leonardo Project

ERIC Educational Resources Information Center

Gatt, Suzanne; Faurschou, Kim

2016-01-01

EQAVET, the quality assurance tool in vocational and educational training, was developed in response to the need for a supply of a trained workforce for labour market needs. Implementation of EQAVET at national level, however, remains a challenge. The research reported here focused on the implementation of QA processes by VET providers in 4…

The value of demonstration projects for new interventions: The case of human papillomavirus vaccine introduction in low- and middle-income countries.

PubMed

Howard, N; Mounier-Jack, S; Gallagher, K E; Kabakama, S; Griffiths, U K; Feletto, M; LaMontagne, D S; Burchett, H E D; Watson-Jones, D

2016-09-01

Demonstration projects or pilots of new public health interventions aim to build learning and capacity to inform country-wide implementation. Authors examined the value of HPV vaccination demonstration projects and initial national programmes in low-income and lower-middle-income countries, including potential drawbacks and how value for national scale-up might be increased. Data from a systematic review and key informant interviews, analyzed thematically, included 55 demonstration projects and 8 national programmes implemented between 2007-2015 (89 years' experience). Initial demonstration projects quickly provided consistent lessons. Value would increase if projects were designed to inform sustainable national scale-up. Well-designed projects can test multiple delivery strategies, implementation for challenging areas and populations, and integration with national systems. Introduction of vaccines or other health interventions, particularly those involving new target groups or delivery strategies, needs flexible funding approaches to address specific questions of scalability and sustainability, including learning lessons through phased national expansion.

Experiences of primary health care nurses in implementing integrated management of childhood illnesses strategy at selected clinics of Limpopo Province.

PubMed

Vhuromu, E N; Davhana-Maselesele, M

2009-09-01

Treatment of the under five years is a national priority as an attempt in curbing deaths and deformities affecting children. Primary health care was implemented in the clinics in order to help in the treatment of illnesses affecting the community, including children. As a result of childhood illnesses; the World Health Organization (WHO) and United Nation Children's Fund (UNICEF) came up with Integrated Management of Childhood illnesses (IMCI) strategy to enhance treatment of such illnesses in developing countries. Primary health care nurses (PHCNS) in Limpopo Province were also trained to implement the strategy. This study is intended to explore and describe the experiences of PHCNS in implementing the IMCI strategy at selected clinics in Vhembe District in the Limpopo Province. A qualitative, explorative, descriptive and contextual design was used. In-depth interviews were conducted with PHCNS who are IMCI trained and have implemented the strategy for a period of not less than two years. Data analysis was done through using Tesch 's method of open coding for qualitative analysis. Findings revealed that PHCNS had difficulty in rendering IMCI services due to lack of resources and poor working conditions. Recommendations address the difficulties experienced by PHCNS when implementing the IMCI strategy.

Evaluating the implementation of RxNorm in ambulatory electronic prescriptions

PubMed Central

Ward-Charlerie, Stacy; Rupp, Michael T; Kilbourne, John; Amin, Vishal P; Ruiz, Joshua

2016-01-01

Objective RxNorm is a standardized drug nomenclature maintained by the National Library of Medicine that has been recommended as an alternative to the National Drug Code (NDC) terminology for use in electronic prescribing. The objective of this study was to evaluate the implementation of RxNorm in ambulatory care electronic prescriptions (e-prescriptions). Methods We analyzed a random sample of 49 997 e-prescriptions that were received by 7391 locations of a national retail pharmacy chain during a single day in April 2014. The e-prescriptions in the sample were generated by 37 801 ambulatory care prescribers using 519 different e-prescribing software applications. Results We found that 97.9% of e-prescriptions in the study sample could be accurately represented by an RxNorm identifier. However, RxNorm identifiers were actually used as drug identifiers in only 16 433 (33.0%) e-prescriptions. Another 431 (2.5%) e-prescriptions that used RxNorm identifiers had a discrepancy in the corresponding Drug Database Code qualifier field or did not have a qualifier (Term Type) at all. In 10 e-prescriptions (0.06%), the free-text drug description and the RxNorm concept unique identifier pointed to completely different drug concepts, and in 7 e-prescriptions (0.04%), the NDC and RxNorm drug identifiers pointed to completely different drug concepts. Discussion The National Library of Medicine continues to enhance the RxNorm terminology and expand its scope. This study illustrates the need for technology vendors to improve their implementation of RxNorm; doing so will accelerate the adoption of RxNorm as the preferred alternative to using the NDC terminology in e-prescribing. PMID:26510879

Timber harvest calculations on a National Forest: A case study

NASA Astrophysics Data System (ADS)

Carey, Henry H.

1983-03-01

Harvest calculations determine sawtimber flows from public lands and are closely scruntinized by a wide spectrum of forest users. This study examines the reliability of harvest calculations on a single national forest in New Mexico Forest Service determinations of an array of variables were reviewed and evaluated. The study revealed a lack of precision in Forest Service adherence to self-imposed procedural standards governing the calculation process. Timber sales have taken place on lands where such standards prohibit harvesting and these lands have been included in annual harvest calculations. Assumptions required by a mathematical model used by the Forest Service in calculating the harvest were not followed in the subsequent implementation of the harvest level. These factors suggest that the Forest Service could have significantly over-stated annual harvest rate for the first decade. Opportunities exist to improve the calculation, and benefits realized may greatly exceed additional costs of implementation

The formulation and implementation of a national helmet law: a case study from Viet Nam.

PubMed

Passmore, Jonathon W; Nguyen, Lan Huong; Nguyen, Nam Phuong; Olivé, Jean-Marc

2010-10-01

Road traffic injuries are a leading cause of death and disability in Viet Nam. In 2008, official data reported 11 243 deaths and 7771 serious injuries on the roads, of which an estimated 60% of fatalities occur in motorcycle riders and passengers. In recognition of this problem, Viet Nam has had partial motorcycle helmet legislation since 1995. However, for a variety of reasons, implementation and enforcement have been limited. On 15 December 2007, Viet Nam's first comprehensive mandatory helmet law came into effect, covering all riders and passengers on all roads nationwide. Penalties increased ten-fold and cohorts of police were mobilized for enforcement. The Viet Nam national helmet legislation was developed and implemented by the National Traffic Safety Committee. Despite past barriers to enforcement, increased policing in 2008 led to 680 000 infringements being issued for non-helmet wearing. While changes in helmet wearing were not nationally observed, significant increases were documented in selected provinces in the first six months of the law's introduction. In Da Nang, helmet wearing increased from 27 to 99%. In the first three months after the law took effect, surveillance data from 20 urban and rural hospitals, found the risk of road traffic head injuries and deaths decreased by 16% and 18% respectively. Political leadership, intensive advanced public education and stringent enforcement have contributed to the successful implementation of the new law. Through continual monitoring of the legislation, loopholes detrimental to the effectiveness of the law have been identified and addressed.

The formulation and implementation of a national helmet law: a case study from Viet Nam

PubMed Central

Nguyen, Lan Huong; Nguyen, Nam Phuong; Olivé, Jean-Marc

2010-01-01

Abstract Problem Road traffic injuries are a leading cause of death and disability in Viet Nam. In 2008, official data reported 11 243 deaths and 7771 serious injuries on the roads, of which an estimated 60% of fatalities occur in motorcycle riders and passengers. In recognition of this problem, Viet Nam has had partial motorcycle helmet legislation since 1995. However, for a variety of reasons, implementation and enforcement have been limited. Approach On 15 December 2007, Viet Nam's first comprehensive mandatory helmet law came into effect, covering all riders and passengers on all roads nationwide. Penalties increased ten-fold and cohorts of police were mobilized for enforcement. Local setting The Viet Nam national helmet legislation was developed and implemented by the National Traffic Safety Committee. Relevant changes Despite past barriers to enforcement, increased policing in 2008 led to 680 000 infringements being issued for non-helmet wearing. While changes in helmet wearing were not nationally observed, significant increases were documented in selected provinces in the first six months of the law’s introduction. In Da Nang, helmet wearing increased from 27 to 99%. In the first three months after the law took effect, surveillance data from 20 urban and rural hospitals, found the risk of road traffic head injuries and deaths decreased by 16% and 18% respectively. Lessons learnt Political leadership, intensive advanced public education and stringent enforcement have contributed to the successful implementation of the new law. Through continual monitoring of the legislation, loopholes detrimental to the effectiveness of the law have been identified and addressed. PMID:20931064

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

PubMed

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

2016-01-01

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

A strategic approach for Water Safety Plans implementation in Portugal.

PubMed

Vieira, Jose M P

2011-03-01

Effective risk assessment and risk management approaches in public drinking water systems can benefit from a systematic process for hazards identification and effective management control based on the Water Safety Plan (WSP) concept. Good results from WSP development and implementation in a small number of Portuguese water utilities have shown that a more ambitious nationwide strategic approach to disseminate this methodology is needed. However, the establishment of strategic frameworks for systematic and organic scaling-up of WSP implementation at a national level requires major constraints to be overcome: lack of legislation and policies and the need for appropriate monitoring tools. This study presents a framework to inform future policy making by understanding the key constraints and needs related to institutional, organizational and research issues for WSP development and implementation in Portugal. This methodological contribution for WSP implementation can be replicated at a global scale. National health authorities and the Regulator may promote changes in legislation and policies. Independent global monitoring and benchmarking are adequate tools for measuring the progress over time and for comparing the performance of water utilities. Water utilities self-assessment must include performance improvement, operational monitoring and verification. Research and education and resources dissemination ensure knowledge acquisition and transfer.

Saving babies' lives project impact and results evaluation (SPiRE): a mixed methodology study.

PubMed

Widdows, Kate; Reid, Holly E; Roberts, Stephen A; Camacho, Elizabeth M; Heazell, Alexander E P

2018-01-30

Reducing stillbirth and early neonatal death is a national priority in the UK. Current evidence indicates this is potentially achievable through application of four key interventions within routine maternity care delivered as the National Health Service (NHS) England's Saving Babies' Lives care bundle. However, there is significant variation in the degree of implementation of the care bundle between and within maternity units and the effectiveness in reducing stillbirth and improving service delivery has not yet been evaluated. This study aims to evaluate the impact of implementing the care bundle on UK maternity services and perinatal outcomes. The Saving Babies' Lives Project Impact and Results Evaluation (SPiRE) study is a multicentre evaluation of maternity care delivered through the Saving Babies' Lives care bundle using both quantitative and qualitative methodologies. The study will be conducted in twenty NHS Hospital Trusts and will include approximately 100,000 births. It involves participation by both service users and care providers. To determine the impact of the care bundle on pregnancy outcomes, birth data and other clinical measures will be extracted from maternity databases and case-note audit from before and after implementation. Additionally, this study will employ questionnaires with organisational leads and review clinical guidelines to assess how resources, leadership and governance may affect implementation in diverse hospital settings. The cost of implementing the care bundle, and the cost per stillbirth avoided, will also be estimated as part of a health economic analysis. The views and experiences of service users and service providers towards maternity care in relation to the care bundle will be also be sought using questionnaires. This protocol describes a pragmatic study design which is necessarily limited by the availability of data and limitations of timescales and funding. In particular there was no opportunity to prospectively gather pre-intervention data or design a phased implementation such as a stepped-wedge study. Nevertheless this study will provide useful practice-based evidence which will advance knowledge about the processes that underpin successful implementation of the care bundle so that it can be further developed and refined. www.clinicaltrials.gov NCT03231007 (26th July 2017).

Healthcare access and mobility between the UK and other European Union states: an 'implementation surplus'.

PubMed

Sheaff, R

1997-12-01

European Union (EU) policy on mobility requires ensuring healthcare access for EU residents who travel between EU states. This case-study investigates how this policy has been implemented in respect of EU visitors to the UK. EU visitors to the UK have similar access to 'immediately needed' National Health Service (NHS) healthcare to UK residents. For non-urgent healthcare, the NHS has official systems to discourage 'medical tourism' and divert such patients to the private sector or to reclaim the costs of NHS hospital treatment for EU visitors. Yet these official systems contrast with the flexibility and liberality of actual NHS practice towards EU visitors. Research on health policy implementation mostly examines reasons for 'implementation failure'. However, the present study indicates a health policy being implemented more fully than policy-makers may have anticipated. In the case of healthcare access for EU visitors to the UK, an implementation surplus is evident rather than an implementation deficit.

Implementation Of Conservation Policy Through The Protection Of Life Support System In The Karimunjawa National Park

NASA Astrophysics Data System (ADS)

Ariyani, Nur Anisa Eka; Kismartini

2018-02-01

The Karimunjawa National Park as the only one marine protected area in Central Java, managed by zonation system has decreased natural resources in the form of decreasing mangrove forest area, coral cover, sea biota population such as clams and sea cucumbers. Conservation has been done by Karimunjawa National Park Authority through protection of life support system activities in order to protect the area from degradation. The objective of the research is to know the implementation of protection and security activities of Karimunjawa National Park Authority for the period of 2012 - 2016. The research was conducted by qualitative method, processing secondary data from Karimunjawa National Park Authority and interview with key informants. The results showed that protection and security activities in The Karimunjawa National Park were held with three activities: pre-emptive activities, preventive activities and repressive activities. Implementation of conservation policy through protection of life support system is influenced by factors of policy characteristic, resource factor and environmental policy factor. Implementation of conservation policy need support from various parties, not only Karimunjawa National Park Authority as the manager of the area, but also need participation of Jepara Regency, Central Java Provinces, communities, NGOs, researchers, developers and tourism actors to maintain and preserve existing biodiversity. Improving the quality of implementors through education and training activities, the availability of the state budget annually and the support of stakeholders is essential for conservation.

A health in all policies approach to promote active, healthy lifestyle in Israel

PubMed Central

2013-01-01

In December 2011, Israel launched the National Program to Promote Active, Healthy Lifestyle, an inter-ministerial, intersectoral effort to address obesity and its contribution to the country’s burden of chronic disease. This paper explores the National Program according to the “Health in All Policies” (HiAP) strategy for health governance, designed to engage social determinants of health and curb health challenges at the causal level. Our objective is twofold: to identify where Israel’s National Program both echoes and falls short of Health in All Policies, and to assess how the National Program can be utilized to enrich the Health in All Policies research-base. We review Health in All Policies’ evolution, why it developed and how it is diverges from other approaches to intersectoriality in health. We describe why obesity and related chronic diseases necessitate an intersectoral response, cite obstacles and gaps to implementation and list examples of HiAP-type initiatives from around the world. We then analyze Israel’s National Program as it relates to Health in All Policies, and propose directions through which the initiative may constitute a useful case study. We contend that joint planning, implementation and to a limited extent, budgeting, between the Ministries of Health, Education and Culture and Sport reflect an HiAP-approach, as does integrating health into the policymaking of other ministries. To further incorporate health in all Israeli policies, we suggest leveraging the Health Ministry’s presence on governmental and non-governmental committees in areas like building, land-use and urban planning, institutional food policy and environmental health, and focusing on knowledge translation according to the policy needs, strengths and limitations of other sectors. Finally, we suggest studying the National Program’s financing, decision-making and evaluation mechanisms in order to complement existing research on the implementation of Health in All Policies and intersectoral action for health. PMID:23607681

Implementation plans for the Korean certified tumor registrar qualification system.

PubMed

Boo, Yoo-Kyung; Lim, Hyun-Sook; Won, Young-Joo

2014-01-01

Cancer registration data is used to understand the nation's cancer burden, and to provide significant baseline data for cancer control efforts, as well as, research on cancer incidence, mortality, survival, and prevalence. A system that approves, assesses, and manages the qualification of specialists, responsible for performing cancer registration, has not been developed in Korea. This study presents ways to implement a certification system designed for the qualification of tumor registrars in Korea. Requirements for implementing a certified tumor registrar qualification system were determined by reviewing the system for establishing qualifications in Korea and the American qualification system via the National Cancer Registrars Association (NCRA). Moreover, a survey was conducted on Korean medical records administrators, who had taken the U.S. Certified Tumor Registrar (CTR) examination, in order to review their opinions regarding these requirements. This study verified the feasibility of a qualification examination based on the opinions of CTR specialists by determining the following: items, and the associated ratings, of the qualifications necessary to register individuals as certified tumor registrars in a private qualification system; status of human resources required for the examination or training processes; plans regarding the organization needed for management, and operation of qualifications, examination standards, subject areas, examination methods, examination qualifications, or education and training programs. The implementation of a certified tumor registrar qualification system will lead to enhanced job competency for specialists and a qualitative improvement of cancer registration data. It will also reliably foster human resources that will lay the groundwork needed to establish scientific and reasonable national cancer management policies.

75 FR 39527 - Environmental Impacts Statements; Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

... Livestock Grazing Management, Conejos Peak Ranger District, Rio Grande National Forest, Conejos, Rio Grande..., NOAA, NC, Atlantic Sea Scallop Fishery Management Plan, Amendment 15, Implementation of the Annual..., Implementation, Cedar City Ranger District, Dixie National Forest, Cedar City, Iron County, UT, Wait Period Ends...

77 FR 37672 - Environmental Impacts Statements; Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... EIS, NOAA, AS, Fagatele Bay National Marine Sanctuary Management Plan, Implementation, Tutuila Island.... 20120195, Draft EIS, NPS, FL, Fort Matanzas National Monument General Management Plan, Implementation, St... filing documents online and providing feedback on the process. To participate in the pilot, register at...

76 FR 49477 - Consideration of Extenuating Circumstances for Implementation of Modification of Annual National...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL [Docket No. AS11-23] Consideration of Extenuating Circumstances for Implementation of Modification of Annual National Registry Fee AGENCY: Appraisal Subcommittee (ASC) of the Federal Financial Institutions Examination Council. ACTION: The ASC is providing...

77 FR 12835 - Environmental Impacts Statements; Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

... EIS, BR, WA, PROGRAMMATIC--Yakima River Basin Integrated Water Resource Management Plan, To Meet the..., Buck Island Reef National Monument General Management Plan, Implementation, St. Croix, Virgin Islands... Management Plan, Implementation, Ice Age National Scenic Trail, Dane County, WI, Comment Period Ends: 04/30...

78 FR 49409 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

...] Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure Requirements for the 2010 Nitrogen Dioxide National Ambient Air Quality Standards AGENCY: Environmental Protection... national ambient air quality standards (NAAQS) are promulgated, the CAA requires states to submit a plan...

Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators.

PubMed

Shumba, Edwin; Nzombe, Phoebe; Mbinda, Absolom; Simbi, Raiva; Mangwanya, Douglas; Kilmarx, Peter H; Luman, Elizabeth T; Zimuto, Sibongile N

2014-01-01

In 2010, the Zimbabwe Ministry of Health and Child Welfare (MoHCW) adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a tool for laboratory quality systems strengthening. To evaluate the financial costs of SLMTA implementation using two models (external facilitators; and internal local or MoHCW facilitators) from the perspective of the implementing partner and to estimate resources needed to scale up the programme nationally in all 10 provinces. The average expenditure per laboratory was calculated based on accounting records; calculations included implementing partner expenses but excluded in-kind contributions and salaries of local facilitators and trainees. We also estimated theoretical financial costs, keeping all contextual variables constant across the two models. Resource needs for future national expansion were estimated based on a two-phase implementation plan, in which 12 laboratories in each of five provinces would implement SLMTA per phase; for the internal facilitator model, 20 facilitators would be trained at the beginning of each phase. The average expenditure to implement SLMTA in 11 laboratories using external facilitators was approximately US$5800 per laboratory; expenditure in 19 laboratories using internal facilitators was approximately $6000 per laboratory. The theoretical financial cost of implementing a 12-laboratory SLMTA cohort keeping all contextual variables constant would be approximately $58 000 using external facilitators; or $15 000 using internal facilitators, plus $86 000 to train 20 facilitators. The financial cost for subsequent SLMTA cohorts using the previously-trained internal facilitators would be approximately $15 000, yielding a break-even point of 2 cohorts, at $116 000 for either model. Estimated resources required for national implementation in 120 laboratories would therefore be $580 000 using external facilitators ($58 000 per province) and $322 000 using internal facilitators ($86 000 for facilitator training in each of two phases plus $15 000 for SLMTA implementation in each province). Investing in training of internal facilitators will result in substantial savings over the scale-up of the programme. Our study provides information to assist policy makers to develop strategic plans for investing in laboratory strengthening.

Sexuality education in Malaysia: perceived issues and barriers by professionals.

PubMed

Khalaf, Zahra Fazli; Low, Wah Yun; Merghati-Khoei, Effat; Ghorbani, Behzad

2014-07-01

This research explored the perspectives of Malaysian professionals on the issues and barriers affecting the implementation of sexuality education in Malaysia. This qualitative study involved in-depth interviews with 15 key professionals working in the field of sexuality and reproductive health in Malaysia. Thematic analysis was selected to analyze data. Barriers to sexuality education were perceived from 5 aspects: feasibility, acceptability, accountability, strategies, and community unawareness. Respondents believed that implementing national sexuality education is a time-consuming project. They regarded Malaysian multicultural society as a barrier to national sexuality education, and they believed that school-based sexuality education is not easily accomplished in Malaysia; also abstinence-only policy restricts the access of young people to accurate information. Lack of community involvement was perceived as a key concern to sexuality education. Campaigning to promote awareness of families, teachers, community leaders, and policy makers are recommended to help establishing national sexuality education in Malaysia. © 2014 APJPH.

Smokefree implementation in Colombia: Monitoring, outside funding, and business support.

PubMed

Uang, Randy; Crosbie, Eric; Glantz, Stanton A

2017-01-01

To analyze successful national smokefree policy implementation in Colombia, a middle income country. Key informants at the national and local levels were interviewed and news sources and government ministry resolutions were reviewed. Colombia's Ministry of Health coordinated local implementation practices, which were strongest in larger cities with supportive leadership. Nongovernmental organizations provided technical assistance and highlighted noncompliance. Organizations outside Colombia funded some of these efforts. The bar owners' association provided concerted education campaigns. Tobacco interests did not openly challenge implementation. Health organization monitoring, external funding, and hospitality industry support contributed to effective implementation, and could be cultivated in other low and middle income countries.

Perceptions of national guidelines and their (non) implementation in mental healthcare: a deductive and inductive content analysis.

PubMed

Sandström, Boel; Willman, Ania; Svensson, Bengt; Borglin, Gunilla

2015-04-01

National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines. The study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second inductively by means of qualitative content analysis. Our deductive analysis showed that the text strongly reflected two out of three categorisation matrices, i.e. evidence and context representing the PARIHS framework. However, the key element of facilitation was poorly mirrored in the text. Results from the inductive analysis can be seen in light of the main category sitting on the fence; thus, the informants' perceptions reflected ambivalence and contradiction. This was illustrated by conflicting views and differences in culture and ideology, a feeling of security in tradition, a certain amount of resistance to change and a lack of role clarity and clear directions. Together, our two analyses provide a rich description of an organisational culture that is highly unlikely to facilitate the implementation of the national guidelines, together with a distrust of the source behind such guidelines, which stands in stark contrast to the high confidence in the knowledge of experienced people in authority within the organisational context. Our findings have highlighted that, regardless of by whom guidelines are released, they are not likely to be utilised or implemented if those who are responsible for implementing them do not trust the source. This aspect (i.e. contextual trust) is not covered by PARIHS.

A qualitative study of Canada's experience with the implementation of electronic health information technology.

PubMed

Rozenblum, Ronen; Jang, Yeona; Zimlichman, Eyal; Salzberg, Claudia; Tamblyn, Melissa; Buckeridge, David; Forster, Alan; Bates, David W; Tamblyn, Robyn

2011-03-22

In 2001, Canada Health Infoway unveiled a plan to implement a national system of interoperable electronic health records. This government-funded corporation introduced a novel model for interprovincial/territorial collaboration to establish core aspects of a national framework. Despite this $1.6 billion initiative, Canada continues to lag behind other Western countries in adopting electronic health records. We conducted a study to identify the success of different aspects of the Canadian plan and ways to improve the adoption of electronic health records. We used a case study approach to assess the 10-year history of Canada's e-health plan. National reports and documents were reviewed, and structured interviews were conducted with 29 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Using grounded theory, we analyzed transcripts of the interviews to identify themes and their relationships. Key stakeholders identified funding, national standards, patient registries and digital imaging as important achievements of the e-health plan. Lack of an e-health policy, inadequate involvement of clinicians, failure to establish a business case for using electronic health records, a focus on national rather than regional interoperability, and inflexibility in approach were seen as barriers to adoption of the plan. To accelerate adoption of electronic health records and timely return on investment, an e-health policy needs to be tightly aligned with the major strategic directions of health care reform. Adoption needs to be actively fostered through a bottom-up, clinical-needs-first approach, a national policy for investment in electronic health records, and financial incentives based on patient outcomes that can be achieved with electronic health records.

A qualitative study of Canada’s experience with the implementation of electronic health information technology

PubMed Central

Rozenblum, Ronen; Jang, Yeona; Zimlichman, Eyal; Salzberg, Claudia; Tamblyn, Melissa; Buckeridge, David; Forster, Alan; Bates, David W.; Tamblyn, Robyn

2011-01-01

Background In 2001, Canada Health Infoway unveiled a plan to implement a national system of interoperable electronic health records. This government-funded corporation introduced a novel model for interprovincial/territorial collaboration to establish core aspects of a national framework. Despite this $1.6 billion initiative, Canada continues to lag behind other Western countries in adopting electronic health records. We conducted a study to identify the success of different aspects of the Canadian plan and ways to improve the adoption of electronic health records. Methods We used a case study approach to assess the 10-year history of Canada’s e-health plan. National reports and documents were reviewed, and structured interviews were conducted with 29 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Using grounded theory, we analyzed transcripts of the interviews to identify themes and their relationships. Results Key stakeholders identified funding, national standards, patient registries and digital imaging as important achievements of the e-health plan. Lack of an e-health policy, inadequate involvement of clinicians, failure to establish a business case for using electronic health records, a focus on national rather than regional interoperability, and inflexibility in approach were seen as barriers to adoption of the plan. Interpretation To accelerate adoption of electronic health records and timely return on investment, an e-health policy needs to be tightly aligned with the major strategic directions of health care reform. Adoption needs to be actively fostered through a bottom-up, clinical-needs-first approach, a national policy for investment in electronic health records, and financial incentives based on patient outcomes that can be achieved with electronic health records. PMID:21343262

75 FR 57820 - National Credit Union Administration Restoration Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-22

... NATIONAL CREDIT UNION ADMINISTRATION National Credit Union Administration Restoration Plan AGENCY: National Credit Union Administration (NCUA). ACTION: Approval of National Credit Union Administration restoration plan. On September 16, 2010, the National Credit Union Administration (NCUA) implemented a...

The Upper Colorado River; National Water-Quality Assessment Program; surface-water-monitoring network

USGS Publications Warehouse

Spahr, Norman E.; Driver, Nancy E.; Stephens, Verlin C.

1996-01-01

The U.S. Geological Survey began full implementation of the National Water-Quality Assessment (NAWQA) program in 1991. The long-term goals of the NAWQA program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams, rivers, and aquifers; (2) describe how water quality is changing over time; and (3) improve understanding of the primary natural and human factors that affect water-quality conditions (Leahy and others, 1990). To meet these goals, 60 study units representing the Nation's most important river basins and aquifers are being investigated. The program design balances the unique assessment requirements of individual study units with a nationally consistent design structure that incorporates a multiscale, interdisciplinary approach for assessment of surface and ground water.

76 FR 12367 - Proposed Information Collection; Visibility Valuation Survey Pilot Study

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-07

... Survey Pilot Study AGENCY: National Park Service, U.S. Department of the Interior. ACTION: Notice... Code of Federal Regulations). Updated estimates of visibility benefits are required because the studies... a pilot study to test the survey instrument and implementation procedures prior to the full survey...

One size fits all? An assessment tool for solid waste management at local and national levels

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

Broitman, Dani, E-mail: danib@techunix.technion.ac.il; Ayalon, Ofira; Kan, Iddo

2012-10-15

Highlights: Black-Right-Pointing-Pointer Waste management schemes are generally implemented at national or regional level. Black-Right-Pointing-Pointer Local conditions characteristics and constraints are often neglected. Black-Right-Pointing-Pointer We developed an economic model able to compare multi-level waste management options. Black-Right-Pointing-Pointer A detailed test case with real economic data and a best-fit scenario is described. Black-Right-Pointing-Pointer Most efficient schemes combine clear National directives with local level flexibility. - Abstract: As environmental awareness rises, integrated solid waste management (WM) schemes are increasingly being implemented all over the world. The different WM schemes usually address issues such as landfilling restrictions (mainly due to methane emissions and competingmore » land use), packaging directives and compulsory recycling goals. These schemes are, in general, designed at a national or regional level, whereas local conditions and constraints are sometimes neglected. When national WM top-down policies, in addition to setting goals, also dictate the methods by which they are to be achieved, local authorities lose their freedom to optimize their operational WM schemes according to their specific characteristics. There are a myriad of implementation options at the local level, and by carrying out a bottom-up approach the overall national WM system will be optimal on economic and environmental scales. This paper presents a model for optimizing waste strategies at a local level and evaluates this effect at a national level. This is achieved by using a waste assessment model which enables us to compare both the economic viability of several WM options at the local (single municipal authority) level, and aggregated results for regional or national levels. A test case based on various WM approaches in Israel (several implementations of mixed and separated waste) shows that local characteristics significantly influence WM costs, and therefore the optimal scheme is one under which each local authority is able to implement its best-fitting mechanism, given that national guidelines are kept. The main result is that strict national/regional WM policies may be less efficient, unless some type of local flexibility is implemented. Our model is designed both for top-down and bottom-up assessment, and can be easily adapted for a wide range of WM option comparisons at different levels.« less

Implementing secure laptop-based testing in an undergraduate nursing program: a case study.

PubMed

Tao, Jinyuan; Lorentz, B Chris; Hawes, Stacey; Rugless, Fely; Preston, Janice

2012-07-01

This article presents the implementation of secure laptop-based testing in an undergraduate nursing program. Details on how to design, develop, implement, and secure tests are discussed. Laptop-based testing mode is also compared with the computer-laboratory-based testing model. Five elements of the laptop-based testing model are illustrated: (1) it simulates the national board examination, (2) security is achievable, (3) it is convenient for both instructors and students, (4) it provides students hands-on practice, (5) continuous technical support is the key.

Implementing community-based provider participation in research: an empirical study

PubMed Central

2012-01-01

Background Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. Methods We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. Results The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation. Conclusion Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness. PMID:22568935

Effect of the Garrett Lee Smith Memorial Suicide Prevention Program on Suicide Attempts Among Youths.

PubMed

Godoy Garraza, Lucas; Walrath, Christine; Goldston, David B; Reid, Hailey; McKeon, Richard

2015-11-01

Youth suicide prevention is a major public health priority. Studies documenting the effectiveness of community-based suicide prevention programs in reducing the number of nonlethal suicide attempts have been sparse. To determine whether a reduction in suicide attempts among youths occurs following the implementation of the Garrett Lee Smith Memorial Suicide Prevention Program (hereafter referred to as the GLS program), consistent with the reduction in mortality documented previously. We conducted an observational study of community-based suicide prevention programs for youths across 46 states and 12 tribal communities. The study compared 466 counties implementing the GLS program between 2006 and 2009 with 1161 counties that shared key preintervention characteristics but were not exposed to the GLS program. The unweighted rounded numbers of respondents used in this analysis were 84 000 in the control group and 57 000 in the intervention group. We used propensity score-based techniques to increase comparability (on background characteristics) between counties that implemented the GLS program and counties that did not. We combined information on program activities collected by the GLS national evaluation with information on county characteristics from several secondary sources. The data analysis was performed between April and August 2014. P < .05 was considered statistically significant. Comprehensive, multifaceted suicide prevention programs, including gatekeeper training, education and mental health awareness programs, screening activities, improved community partnerships and linkages to service, programs for suicide survivors, and crisis hotlines. Suicide attempt rates for each county following implementation of the GLS program for youths 16 to 23 years of age at the time the program activities were implemented. We obtained this information from the National Survey on Drug Use and Health administered to a large national probabilistic sample between 2008 and 2011. Counties implementing GLS program activities had significantly lower suicide attempt rates among youths 16 to 23 years of age in the year following implementation of the GLS program than did similar counties that did not implement GLS program activities (4.9 fewer attempts per 1000 youths [95% CI, 1.8-8.0 fewer attempts per 1000 youths]; P = .003). More than 79 000 suicide attempts may have been averted during the period studied following implementation of the GLS program. There was no significant difference in suicide attempt rates among individuals older than 23 years during that same period. There was no evidence of longer-term differences in suicide attempt rates. Comprehensive GLS program activities were associated with a reduction in suicide attempt rates. Sustained suicide prevention programming efforts may be needed to maintain the reduction in suicide attempt rates.

Web-based international studies in limited populations of pediatric leukemia.

PubMed

Valsecchi, Maria Grazia; Silvestri, Daniela; Covezzoli, Anna; De Lorenzo, Paola

2008-02-01

Recent progress in cancer research leads to the characterization of small subgroups of patients by genetic/biological features. Clinical studies in this setting are frequently promoted by international networks of independent researchers and are limited by practical and methodological constraints, not least the regulations recently issued by national and international institutions (EU Directive 2001/20/EC). We reviewed various methods in the design of international multicenter studies, with focus on randomized clinical trials. This paper reports our experience in planning and conducting international studies in childhood leukemia. We applied a decentralized study conduct based on a two-level structure, comprising a national and an international coordinating level. For the more recent trials this structure was implemented as a web-based system. This approach accommodates major legal requirements (e.g., safety reporting) and ensures Good Clinical Practice principles by implementing risk-oriented monitoring procedures. Setting up international non-commercial trials is increasingly complicated. Still, they are strongly needed for answering relevant questions in limited populations. (c) 2007 Wiley-Liss, Inc.

32 CFR 152.5 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Department of Defense, and the United States Coast Guard by agreement of the Department of Homeland Security... 32 National Defense 1 2014-07-01 2014-07-01 false Implementation. 152.5 Section 152.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE REGULATIONS PERTAINING TO MILITARY...

32 CFR 152.5 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Department of Defense, and the United States Coast Guard by agreement of the Department of Homeland Security... 32 National Defense 1 2011-07-01 2011-07-01 false Implementation. 152.5 Section 152.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE REGULATIONS PERTAINING TO MILITARY...

32 CFR 152.5 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Department of Defense, and the United States Coast Guard by agreement of the Department of Homeland Security... 32 National Defense 1 2010-07-01 2010-07-01 false Implementation. 152.5 Section 152.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE REGULATIONS PERTAINING TO MILITARY...

32 CFR 152.5 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Department of Defense, and the United States Coast Guard by agreement of the Department of Homeland Security... 32 National Defense 1 2013-07-01 2013-07-01 false Implementation. 152.5 Section 152.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE REGULATIONS PERTAINING TO MILITARY...

32 CFR 152.5 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Department of Defense, and the United States Coast Guard by agreement of the Department of Homeland Security... 32 National Defense 1 2012-07-01 2012-07-01 false Implementation. 152.5 Section 152.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE REGULATIONS PERTAINING TO MILITARY...

National Emission Standards for Aerospace Manufacturing and Rework Facilities: Summary of Requirements for Implementing the National Emission Standards for Hazardous Air Pollutants (NESHAP)

EPA Pesticide Factsheets

This summary of implementation requirements document for the Aerospace Manufacturing and Rework facilties NESHAP was originally prepared in August 1997, but it was updated in January 2001 with a new amendments update.

78 FR 65593 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Infrastructure...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

...] Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Infrastructure Requirements for the 2010 Nitrogen Dioxide National Ambient Air Quality Standards AGENCY: Environmental Protection... revised national ambient air quality standards (NAAQS) are promulgated, the CAA requires states to submit...

Immunisation Registries at regional level in Italy and the roadmap for a future Italian National Registry.

PubMed

D'Ancona, F; Gianfredi, V; Riccardo, F; Iannazzo, S

2018-01-01

Immunization Information Systems, or Immunisation registries (IRs), are essential to monitor and evaluate the accessibility, quality and outcomes of immunisation programmes both at local and national level. We conducted a cross-sectional survey in order to investigate and map the level of IRs implementation obtained by the 21 Italian Regional Health Authorities. On this basis we defined a roadmap towards implementing an Italian National IR. We designed an online questionnaire. Data were collected from July to September 2016 from all the 21 Regional Health Authorities in charge of infectious diseases control and immunization management. 18/21 Italian Regions have fully implemented an IR, out of them, 11 use the same software for all Local Health Units. Two Regions have partially implemented their IRs and one Region is not yet computerised. The decentralization of the Italian Health System is reflected also on the IRs characteristics and functionalities in terms of fragmented implementation of IRs and diversity in the software systems and data flows in place. Future efforts should not only aim not only to clarify the functionalities of Regional IRs, but should also aim to define how aggregation of data at national level can be optimised.

Implementation and Integration of Regional Health Care Data Networks in the Hellenic National Health Service

PubMed Central

Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

2002-01-01

Background Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. Objectives To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. Methods The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. Results The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. Conclusions The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications. PMID:12554551

Implementation and integration of regional health care data networks in the Hellenic National Health Service.

PubMed

Lampsas, Petros; Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

2002-12-01

Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications.

NATIONAL FRAMEWORK FOR THE SUSTAINABILITY OF HEALTH KNOWLEDGE TRANSLATION INITIATIVES IN UGANDA.

PubMed

Basaza, Robert; Kinegyere, Alison; Mutatina, Boniface; Sewankambo, Nelson

2018-01-01

The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study. The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers. The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.

National Water-Quality Assessment Program - Western Lake Michigan Drainage Basin

USGS Publications Warehouse

Setmire, J.O.

1991-01-01

A major component of the program is study-unit investigations, which comprise the princ ipal bui lding blocks of the program on which national-level asses ment activities a re based . The 60 study-unit in vestigations that make up the program are hydrologic systems that include parts of most major river bas ins and a qui fer systems. These study units cover areas of I ,200 to more than 65 ,000 square mi les and incorporate about 60 to 70 percent of the Nation's water use and popul ation e rved by public water supply. In 1991 , the Western Lake Michigan drainage basin was among the fir st 20 NA WQA study unit selected for study under the full -scale implementation plan.

National water-quality assessment program : the Albemarle- Pamlico drainage

USGS Publications Warehouse

Lloyd, O.B.; Barnes, C.R.; Woodside, M.D.

1991-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. Long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water quality information that will be useful to policy makers and managers at the national, State, and local levels. Study-unit investigations constitute a major component of the NAWQA program, forming the principal building blocks on which national-level assessment activities are based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Albemarle-Pamlico drainage was among the first 20 NAWQA study units selected for study under the full-scale implementation plan. The Albemarle-Pamlico drainage study will examine the physical, chemical, and biological aspects of water quality issues in a coordinated investigation of surface water and ground water in the Albemarle-Pamlico drainage basin. The quantity and quality of discharge from the Albemarle-Pamlico drainage basin contribute to some water quality problems in the biologically sensitive waters of Albemarle and Pamlico Sounds. A retrospective analysis of existing water quality data will precede a 3-year period of intensive data-collection and analysis activities. The data resulting from this study and the improved understanding of important processes and issues in the upstream part of the study unit will enhance understanding of the quality of water in Albemarle-Pamlico Sounds, the second largest estuarine system in the United States.

Implementing Multisector Nutrition Programs in Ethiopia and Nepal: Challenges and Opportunities From a Stakeholder Perspective.

PubMed

Kennedy, Eileen; Fekadu, Habtamu; Ghosh, Shibani; Baral, Kedar; Davis, Dale; Sapkota, Diplav; Webb, Patrick

2016-12-01

Effective governance is essential for effective nutrition program implementation. There are additional challenges in launching multisector plans to enhance nutritional status. The present study compares the challenges and opportunities in Ethiopia and Nepal in designing and implementing a multisector plan for nutrition. A semi-quantitative questionnaire with open-ended questions was used to solicit information from senior national-level policy officials and other key stakeholders. The nature of the major nutrition problems in each country was similar; these include malnutrition (particularly stunting), food insecurity, and micronutrient malnutrition. The main challenges identified included the need for more specificity in the roles of agencies/individuals in program implementation, more effective mechanisms for linking national to subnational officials, methods for creating awareness of the plans, and a dedicated line item in the budgets of each agency. The level of enthusiasm was high in both countries. Respondents in both countries highlighted the need to identify a "champion" at the highest level who would keep the momentum for the respective plans alive. © The Author(s) 2016.

Maternal Health Situation in India: A Case Study

PubMed Central

Mavalankar, Dileep V.; Ramani, K.V.; Upadhyaya, Mudita; Sharma, Bharati; Iyengar, Sharad; Gupta, Vikram; Iyengar, Kirti

2009-01-01

Since the beginning of the Safe Motherhood Initiative, India has accounted for at least a quarter of maternal deaths reported globally. India's goal is to lower maternal mortality to less than 100 per 100,000 livebirths but that is still far away despite its programmatic efforts and rapid economic progress over the past two decades. Geographical vastness and sociocultural diversity mean that maternal mortality varies across the states, and uniform implementation of health-sector reforms is not possible. The case study analyzes the trends in maternal mortality nationally, the maternal healthcare-delivery system at different levels, and the implementation of national maternal health programmes, including recent innovative strategies. It identifies the causes for limited success in improving maternal health and suggests measures to rectify them. It recommends better reporting of maternal deaths and implementation of evidence-based, focused strategies along with effective monitoring for rapid progress. It also stresses the need for regulation of the private sector and encourages further public-private partnerships and policies, along with a strong political will and improved management capacity for improving maternal health. PMID:19489415

Implementing a National Scottish Digital Health & Wellbeing Service at Scale: A Qualitative Study of Stakeholders' Views.

PubMed

Agbakoba, Ruth; McGee-Lennon, Marilyn; Bouamrane, Matt-Mouley; Watson, Nicholas; Mair, Frances

2015-01-01

Digital technologies are being used as part of international efforts to revolutionize healthcare in order to meet increasing demands such as the rising burden of chronic disease and ageing populations. In Scotland there is a government push towards a national service (Living It Up) as a single point of reference where citizens can access information, products and services to support their health and wellbeing. The aim of the study is to examine implementation issues including the challenges or facilitators which can help to sustain this intervention. We gathered data in three ways: a) participant observation to gain an understanding of LiU (N=16); b) in-depth interviews (N=21) with stakeholders involved in the process; and c) analysis of documentary evidence about the progress of the implementation (N=45). Barriers included the need to "work at risk" due to delays in financing, inadequate infrastructure and skill-set deficiencies, whilst facilitators included trusted relationships, champions and a push towards normalisation. The findings suggest that a Scottish ehealth service is achievable but identifies key considerations for future large scale initiatives.

Medical Home Implementation: A Sensemaking Taxonomy of Hard and Soft Best Practices

PubMed Central

Hoff, Timothy

2013-01-01

Context The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. Methods I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. Findings I found two distinct taxonomies of implementation best practices, which I labeled “hard” and “soft” because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. Conclusions The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. PMID:24320169

An Observational Study of Tropical Cyclone Spin-Up in Supertyphoon Jangmi and Hurricane Georges

DTIC Science & Technology

2011-12-01

Reconnaissance Squadron stationed at Keesler Air Force Base in Biloxi, Mississippi, and the National Oceanic and Atmospheric Administration (NOAA) Aircraft...implementation of the National Center for Atmospheric Research (NCAR) Global Positioning System (GPS) dropsonde in specialized boundary-layer...transiting the western Pacific, Gulf of Mexico, and Atlantic Ocean basins. 107 APPENDIX A: NCAR GPS DROPSONDES The Global Positioning System (GPS

Electronic Commerce: A National Performance Review Initiative.

DTIC Science & Technology

1995-09-01

This study of the National Information Infrastructure (NII) was conducted as part of IDA’s Central Research Program. Electronic commerce is one of... commerce is nothing more than conducting business via electronic means. An outgrowth of the NPR, the electronic commerce initiative, commits the...private, and public sectors are committed to implementing electronic commerce throughout the United States. The objective ol this paper is to enhance

Middle School Mathematics Professional Development Impact Study: Findings After the First Year of Implementation. NCEE 2010-4009

ERIC Educational Resources Information Center

Garet, Michael S.; Wayne, Andrew J.; Stancavage, Fran; Taylor, James; Walters, Kirk; Song, Mengli; Brown, Seth; Hurlburt, Steven; Zhu, Pei; Sepanik, Susan; Doolittle, Fred

2010-01-01

Student achievement in mathematics has been a focal concern in the United States for many years. The National Research Council's 2001 report and the recent report of the National Mathematics Advisory Panel (2008) both called attention to student achievement in mathematics, and both called for all students to learn algebra by the end of eighth…

Implementing Technology Education in Finnish General Education Schools: Studying the Cross-Curricular Theme "Human Being and Technology"

ERIC Educational Resources Information Center

Järvinen, Esa-Matti; Rasinen, Aki

2015-01-01

In 2009 the Finnish Ministry of Education and Culture assigned the National Board of Education with the task of carrying out a nationwide evaluation of all seven cross-curricular themes. The evaluation is one of the largest education evaluation projects the National Board of Finland has ever organised. The present authors were invited to evaluate…

Implementation of a National Reference Laboratory for Buruli Ulcer Disease in Togo

PubMed Central

Badziklou, Kossi; Halatoko, Wemboo Afiwa; Maman, Issaka; Vogel, Felix; Bidjada, Bawimodom; Awoussi, Koffi Somenou; Piten, Ebekalisai; Helfrich, Kerstin; Mengele, Carolin; Nitschke, Jörg; Amekuse, Komi; Wiedemann, Franz Xaver; Diefenhardt, Adolf; Kobara, Basile; Herbinger, Karl–Heinz; Kere, Abiba Banla; Prince-David, Mireille; Löscher, Thomas; Bretzel, Gisela

2013-01-01

Background In a previous study PCR analysis of clinical samples from suspected cases of Buruli ulcer disease (BUD) from Togo and external quality assurance (EQA) for local microscopy were conducted at an external reference laboratory in Germany. The relatively poor performance of local microscopy as well as effort and time associated with shipment of PCR samples necessitated the implementation of stringent EQA measures and availability of local laboratory capacity. This study describes the approach to implementation of a national BUD reference laboratory in Togo. Methodology Large scale outreach activities accompanied by regular training programs for health care professionals were conducted in the regions “Maritime” and “Central,” standard operating procedures defined all processes in participating laboratories (regional, national and external reference laboratories) as well as the interaction between laboratories and partners in the field. Microscopy was conducted at regional level and slides were subjected to EQA at national and external reference laboratories. For PCR analysis, sample pairs were collected and subjected to a dry-reagent-based IS2404-PCR (DRB-PCR) at national level and standard IS2404 PCR followed by IS2404 qPCR analysis of negative samples at the external reference laboratory. Principal Findings The inter-laboratory concordance rates for microscopy ranged from 89% to 94%; overall, microscopy confirmed 50% of all suspected BUD cases. The inter-laboratory concordance rate for PCR was 96% with an overall PCR case confirmation rate of 78%. Compared to a previous study, the rate of BUD patients with non-ulcerative lesions increased from 37% to 50%, the mean duration of disease before clinical diagnosis decreased significantly from 182.6 to 82.1 days among patients with ulcerative lesions, and the percentage of category III lesions decreased from 30.3% to 19.2%. Conclusions High inter-laboratory concordance rates as well as case confirmation rates of 50% (microscopy), 71% (PCR at national level), and 78% (including qPCR confirmation at external reference laboratory) suggest high standards of BUD diagnostics. The increase of non-ulcerative lesions, as well as the decrease in diagnostic delay and category III lesions, prove the effect of comprehensive EQA and training measures involving also procedures outside the laboratory. PMID:23359828

Implementation of a national reference laboratory for Buruli ulcer disease in Togo.

PubMed

Beissner, Marcus; Huber, Kristina Lydia; Badziklou, Kossi; Halatoko, Wemboo Afiwa; Maman, Issaka; Vogel, Felix; Bidjada, Bawimodom; Awoussi, Koffi Somenou; Piten, Ebekalisai; Helfrich, Kerstin; Mengele, Carolin; Nitschke, Jörg; Amekuse, Komi; Wiedemann, Franz Xaver; Diefenhardt, Adolf; Kobara, Basile; Herbinger, Karl-Heinz; Kere, Abiba Banla; Prince-David, Mireille; Löscher, Thomas; Bretzel, Gisela

2013-01-01

In a previous study PCR analysis of clinical samples from suspected cases of Buruli ulcer disease (BUD) from Togo and external quality assurance (EQA) for local microscopy were conducted at an external reference laboratory in Germany. The relatively poor performance of local microscopy as well as effort and time associated with shipment of PCR samples necessitated the implementation of stringent EQA measures and availability of local laboratory capacity. This study describes the approach to implementation of a national BUD reference laboratory in Togo. Large scale outreach activities accompanied by regular training programs for health care professionals were conducted in the regions "Maritime" and "Central," standard operating procedures defined all processes in participating laboratories (regional, national and external reference laboratories) as well as the interaction between laboratories and partners in the field. Microscopy was conducted at regional level and slides were subjected to EQA at national and external reference laboratories. For PCR analysis, sample pairs were collected and subjected to a dry-reagent-based IS2404-PCR (DRB-PCR) at national level and standard IS2404 PCR followed by IS2404 qPCR analysis of negative samples at the external reference laboratory. The inter-laboratory concordance rates for microscopy ranged from 89% to 94%; overall, microscopy confirmed 50% of all suspected BUD cases. The inter-laboratory concordance rate for PCR was 96% with an overall PCR case confirmation rate of 78%. Compared to a previous study, the rate of BUD patients with non-ulcerative lesions increased from 37% to 50%, the mean duration of disease before clinical diagnosis decreased significantly from 182.6 to 82.1 days among patients with ulcerative lesions, and the percentage of category III lesions decreased from 30.3% to 19.2%. High inter-laboratory concordance rates as well as case confirmation rates of 50% (microscopy), 71% (PCR at national level), and 78% (including qPCR confirmation at external reference laboratory) suggest high standards of BUD diagnostics. The increase of non-ulcerative lesions, as well as the decrease in diagnostic delay and category III lesions, prove the effect of comprehensive EQA and training measures involving also procedures outside the laboratory.

How Are New Vaccines Prioritized in Low-Income Countries? A Case Study of Human Papilloma Virus Vaccine and Pneumococcal Conjugate Vaccine in Uganda

PubMed Central

Wallace, Lauren; Kapirir, Lydia

2017-01-01

Background: To date, research on priority-setting for new vaccines has not adequately explored the influence of the global, national and sub-national levels of decision-making or contextual issues such as political pressure and stakeholder influence and power. Using Kapiriri and Martin’s conceptual framework, this paper evaluates priority setting for new vaccines in Uganda at national and sub-national levels, and considers how global priorities can influence country priorities. This study focuses on 2 specific vaccines, the human papilloma virus (HPV) vaccine and the pneumococcal conjugate vaccine (PCV). Methods: This was a qualitative study that involved reviewing relevant Ugandan policy documents and media reports, as well as 54 key informant interviews at the global level and national and sub-national levels in Uganda. Kapiriri and Martin’s conceptual framework was used to evaluate the prioritization process. Results: Priority setting for PCV and HPV was conducted by the Ministry of Health (MoH), which is considered to be a legitimate institution. While respondents described the priority setting process for PCV process as transparent, participatory, and guided by explicit relevant criteria and evidence, the prioritization of HPV was thought to have been less transparent and less participatory. Respondents reported that neither process was based on an explicit priority setting framework nor did it involve adequate representation from the districts (program implementers) or publicity. The priority setting process for both PCV and HPV was negatively affected by the larger political and economic context, which contributed to weak institutional capacity as well as power imbalances between development assistance partners and the MoH. Conclusion: Priority setting in Uganda would be improved by strengthening institutional capacity and leadership and ensuring a transparent and participatory processes in which key stakeholders such as program implementers (the districts) and beneficiaries (the public) are involved. Kapiriri and Martin’s framework has the potential to guide priority setting evaluation efforts, however, evaluation should be built into the priority setting process a priori such that information on priority setting is gathered throughout the implementation cycle. PMID:29172378

Pikes Peak conceptual shuttle study : visitation trends and scenario planning

DOT National Transportation Integrated Search

2016-04-01

This study for the U.S. Forest Service provides a preliminary analysis and set of recommendations to support the agency's work moving forward to implement a shuttle system at Colorados popular Pikes Peak in Pike and San Isabel National Forests. Th...

A pragmatic cluster randomised trial evaluating three implementation interventions

PubMed Central

2012-01-01

Background Implementation research is concerned with bridging the gap between evidence and practice through the study of methods to promote the uptake of research into routine practice. Good quality evidence has been summarised into guideline recommendations to show that peri-operative fasting times could be considerably shorter than patients currently experience. The objective of this trial was to evaluate the effectiveness of three strategies for the implementation of recommendations about peri-operative fasting. Methods A pragmatic cluster randomised trial underpinned by the PARIHS framework was conducted during 2006 to 2009 with a national sample of UK hospitals using time series with mixed methods process evaluation and cost analysis. Hospitals were randomised to one of three interventions: standard dissemination (SD) of a guideline package, SD plus a web-based resource championed by an opinion leader, and SD plus plan-do-study-act (PDSA). The primary outcome was duration of fluid fast prior to induction of anaesthesia. Secondary outcomes included duration of food fast, patients’ experiences, and stakeholders’ experiences of implementation, including influences. ANOVA was used to test differences over time and interventions. Results Nineteen acute NHS hospitals participated. Across timepoints, 3,505 duration of fasting observations were recorded. No significant effect of the interventions was observed for either fluid or food fasting times. The effect size was 0.33 for the web-based intervention compared to SD alone for the change in fluid fasting and was 0.12 for PDSA compared to SD alone. The process evaluation showed different types of impact, including changes to practices, policies, and attitudes. A rich picture of the implementation challenges emerged, including inter-professional tensions and a lack of clarity for decision-making authority and responsibility. Conclusions This was a large, complex study and one of the first national randomised controlled trials conducted within acute care in implementation research. The evidence base for fasting practice was accepted by those participating in this study and the messages from it simple; however, implementation and practical challenges influenced the interventions’ impact. A set of conditions for implementation emerges from the findings of this study, which are presented as theoretically transferable propositions that have international relevance. Trial registration ISRCTN18046709 - Peri-operative Implementation Study Evaluation (POISE). PMID:22935241

National Energy Legislation

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

NONE

1992-12-31

The impact of state regulation of nuclear power, since PG&E and Silkwood, on the implementation of national energy policy on nuclear power is evident in the debates on federal legislation required for such implementation. The political demands that confront some states for an expanded role in the regulation of commercial nuclear power plants also confront Congress, which is responsible for the legislative implementation of the strategy proposed in the Report. The expansion of state and local regulation of nuclear plants, however, will complicate and possibly frustrate the efforts of Congress to enact the strategy for nuclear power into law. Themore » debates on Senate Bill 1220, the National Energy Security Act of 1991, indicate that the expansion of state regulation of nuclear power will frustrate the implementation of the national energy policy on nuclear power. Senate Bill 1220 would enact a comprehensive national energy policy. For example, Title XI would further deregulate the production of natural gas; Title XIV is concerned with secure supplies, and the use of coal in the future. Senate Bill 1220 would also amend PUHCA. Of particular significance for nuclear power, however, are Titles VIII and IX. The House and Senate debates on House Bill 1301 and Senate Bill 1220 are summarized.« less

[The Spanish National Health System patient safety strategy, results for the period 2005-2007].

PubMed

Terol, E; Agra, Y; Fernández-Maíllo, M M; Casal, J; Sierra, E; Bandrés, B; García, M J; del Peso, P

2008-12-01

In 2005 the Spanish National Health System (SNHS) implemented a strategy aimed at improving patient safety in Spanish healthcare centres. Promote and develop knowledge of patient safety and a patient safety culture among health professionals and patients; design and implement adverse event information and reporting systems for learning purposes; introduce recommended safe practices in SNHS centres; promote patient safety research and public and patient involvement in patient safety policies. An Institutional Technical Committee was created with representatives from all the Spanish regions. All national organizations involved in healthcare quality and patient safety took part in the project. The strategy follows the WHO World Alliance for Patient Safety and Council of Europe recommendations. Budget allocated in the period 2005-2007: approximately EUR35 million. Around 5,000 health professionals were educated in PS concepts. Several studies were conducted on: adverse events in Hospitals and Primary Care, as well as studies to obtain information on health professionals' perceptions on safety, the use of medications and the situation regarding hospital-acquired infections. All the regions have introduced safe clinical practices related with the strategy. The strategy has been implemented in all the Spanish regions. Awareness was raised among health professionals and the public. A network of alliances has been set up with the regions, universities, schools, agencies and other organizations supporting the strategy.

Historicizing Teaching in Awgni as a Mother Tongue Language at Primary Schools of Awi Nationality Administrative Zone: Challenges and Implementation

ERIC Educational Resources Information Center

Engida, Alemayehu Erkihun

2015-01-01

This study examined the challenges facing the teaching as well as the implementation of Awgni as a mother tongue language in primary schools of Awi administrative zone. The need to teach through mother tongue in Ethiopia was widely discussed following the change of the politics in 1991. To this end, the government issued new education and training…

Implementation of prevention of mother-to-child transmission of HIV programme through private hospitals of Delhi--policy implications.

PubMed

Gupta, A K; Garg, C R; Joshi, B C; Rawat, N; Dabla, V; Gupta, A

2015-01-01

In India, programme for prevention of mother-to-child transmission (PMTCT) of HIV is primarily implemented through public health system. State AIDS Control Societies (SACSs) encourage private hospitals to set up integrated counselling and testing centres (ICTCs). However, private hospitals of Delhi did not set up ICTCs. Consequently, there is no information on PMTCT interventions in private hospitals of Delhi. This study was undertaken by Delhi SACS during March 2013 through September 2013 to assess status of implementation of PMTCT programme in various private hospitals of Delhi to assist programme managers in framing national policy to facilitate uniform implementation of National PMTCT guidelines. Out of total 575 private hospitals registered with Government of Delhi, 336 (58.4%) catering to pregnant women were identified. About 100 private hospitals with facility of antenatal care, vaginal/caesarean delivery and postnatal care and minimum 10 indoor beds were selected for study. Study sample comprised of large corporate hospitals (≥100 beds; n = 29), medium-sized hospitals (25 to <100 beds; n = 42) and small nursing homes (10 to <25 beds; n = 29). A pre-tested questionnaire was designed to obtain basic information about hospital in context to PMTCT programme. Interviews of heads of obstetrics and gynaecology and paediatric departments were conducted by trained interviewers. It was observed that in private hospitals in year 2012, out of 38,186 antenatal women tested, 52 (0.14%) were detected HIV-positive. However, against National Policy, HIV testing was done without pre/post-test counselling/or consent of women, no PMTCT protocol existed, delivery of HIV-positive women was not undertaken and no efforts were made to link HIV-positive women to antiretroviral treatment. Major intervention observed was medical termination of pregnancy, which indicates lack of awareness in private hospitals about available interventions under national programme. The role of private hospitals in management of HIV in pregnant women must be recognized and mainstreamed in HIV control efforts. There is an urgent need for capacity building of private health care providers to improve standards of practice. National AIDS Control Organization may consider establishing linkages or adopting model developed by some countries with generalized epidemic for delivering PMTCT services in private health sector.

Implementing a national process for estimating growth, removals, and mortality at the Pacific Northwest’s Forest Inventory and Analysis’s Region: modeling diameter growth

Treesearch

Olaf. Kuegler

2015-01-01

The Pacific Northwest Research Station’s Forest Inventory and Analysis Unit began remeasurement of permanently located FIA plots under the annualized design in 2011. With remeasurement has come the need to implement the national FIA system for compiling estimates of forest growth, removals, and mortality. The national system requires regional diameter-growth models to...

75 FR 76744 - National Disaster Housing Task Force Concept of Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-09

... goals of the Strategy. Implementing the Strategy strengthens the Nation's collective capability and... docket ID FEMA-2008-0009, frames the full range of options that unified disaster housing efforts should... implementation of the Strategy. Additionally, the Strategy sets the goal of the NDHTF to create this CONOPS...

Mexico’s National Cancer Control Plan: From Development to Implementation

Cancer.gov

The National Cancer Institute and the Center for Global Health have had a long-standing and successful partnership with INCan, and at their request are identifying new or enhanced ways to provide technical support by way of resources, training, and collaborative programs to facilitate the implementation of the NCCP.

77 FR 28338 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Reasonably Available...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... Promulgation of Air Quality Implementation Plans; Maryland; Reasonably Available Control Technology for the 1997 8-Hour Ozone National Ambient Air Quality Standard AGENCY: Environmental Protection Agency (EPA... available control technology (RACT) for the 1997 8-hour ozone national ambient air quality standard (NAAQS...

36 CFR 1260.56 - What are NARA considerations when implementing automatic declassification?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false What are NARA considerations when implementing automatic declassification? 1260.56 Section 1260.56 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION DECLASSIFICATION DECLASSIFICATION OF NATIONAL SECURITY INFORMATION Automatic Declassification §...

78 FR 9650 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Amendments to Maryland's...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... Promulgation of Air Quality Implementation Plans; Maryland; Amendments to Maryland's Ambient Air Quality... adopting through incorporation by reference the national ambient air quality standards (NAAQS). In the... incorporation by reference of the national ambient air quality standards (NAAQS), please see the information...

77 FR 45354 - Notification of Single Source Cooperative Agreement Award for Project Hope

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-31

... Support of National Health Security Strategy (2009) and Implementation Plan (2012) and Homeland Security... Directive-21 (2007) and the National Health Security Strategy (2009) and Implementation Plan (2012). In the... of a Health Affairs thematic issue that will identify, explore and propose policy options for...

An action research study; cultural differences impact how manufacturing organizations receive continuous improvement

NASA Astrophysics Data System (ADS)

Kattman, Braden R.

National culture and organizational culture impact how continuous improvement methods are received, implemented and deployed by suppliers. Previous research emphasized the dominance of national culture over organizational culture. The countries studied included Poland, Mexico, China, Taiwan, South Korea, Estonia, India, Canada, the United States, the United Kingdom, and Japan. The research found that Canada was most receptive to continuous improvement, with China being the least receptive. The study found that organizational culture was more influential than national culture. Isomorphism and benchmarking is driving continuous-improvement language and methods to be more universally known within business. Business and management practices are taking precedence in driving change within organizations.

Implementation of national practice guidelines to reduce waste and optimize patient value.

PubMed

Langell, John T; Bledsoe, Amber; Vijaykumar, Sathya; Anderson, Terry; Zawalski, Ivy; Zimmerman, Joshua

2016-06-15

The financial health care crisis has provided the platform to drive operational improvements at US health care facilities. This has led to adoption of lean operation principles by many health care organizations as a means of eliminating waste and improving operational efficiencies and overall value to patients. We believe that standardized implementation of national practice guidelines can provide the framework to help to reduce financial waste. We analyzed our institutional preoperative electrocardiogram (ECG) ordering practices for patients undergoing elective surgery at our institution from February-March, 2012 to identify utilization and review compliance with American Heart Association guidelines. We then implemented an ECG ordering algorithm based on these guidelines and studied changes in ordering patterns, associated cost savings and hospital billing for the same period in 2013. From February-March 2012, 677 noncardiac surgical procedures were performed at our institution, and 312 (46.1%) had a preoperative ECG. After implementation of our evidence-based ECG ordering algorithm for the same period in 2013, 707 noncardiac surgical cases were performed, and 120 (16.9%) had a preoperative ECG. Preoperative ECG utilization dropped 63% with an annual institutional cost savings of $72,906 and $291,618 in total annual health care savings. Based on our data, US-wide implementation of our evidence-based ECG ordering algorithm could save the US health care system >$1,868,800,000 per year. Here, we demonstrate that standardized application of a national practice guideline can be used to eliminate nearly $2 billion per year in waste from the US health care system. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluating the implementation of a national disclosure policy for large-scale adverse events in an integrated health care system: identification of gaps and successes.

PubMed

Maguire, Elizabeth M; Bokhour, Barbara G; Wagner, Todd H; Asch, Steven M; Gifford, Allen L; Gallagher, Thomas H; Durfee, Janet M; Martinello, Richard A; Elwy, A Rani

2016-11-11

Many healthcare organizations have developed disclosure policies for large-scale adverse events, including the Veterans Health Administration (VA). This study evaluated VA's national large-scale disclosure policy and identifies gaps and successes in its implementation. Semi-structured qualitative interviews were conducted with leaders, hospital employees, and patients at nine sites to elicit their perceptions of recent large-scale adverse events notifications and the national disclosure policy. Data were coded using the constructs of the Consolidated Framework for Implementation Research (CFIR). We conducted 97 interviews. Insights included how to handle the communication of large-scale disclosures through multiple levels of a large healthcare organization and manage ongoing communications about the event with employees. Of the 5 CFIR constructs and 26 sub-constructs assessed, seven were prominent in interviews. Leaders and employees specifically mentioned key problem areas involving 1) networks and communications during disclosure, 2) organizational culture, 3) engagement of external change agents during disclosure, and 4) a need for reflecting on and evaluating the policy implementation and disclosure itself. Patients shared 5) preferences for personal outreach by phone in place of the current use of certified letters. All interviewees discussed 6) issues with execution and 7) costs of the disclosure. CFIR analysis reveals key problem areas that need to be addresses during disclosure, including: timely communication patterns throughout the organization, establishing a supportive culture prior to implementation, using patient-approved, effective communications strategies during disclosures; providing follow-up support for employees and patients, and sharing lessons learned.

Integration of a nationally procured electronic health record system into user work practices.

PubMed

Cresswell, Kathrin M; Worth, Allison; Sheikh, Aziz

2012-03-08

Evidence suggests that many small- and medium-scale Electronic Health Record (EHR) implementations encounter problems, these often stemming from users' difficulties in accommodating the new technology into their work practices. There is the possibility that these challenges may be exacerbated in the context of the larger-scale, more standardised, implementation strategies now being pursued as part of major national modernisation initiatives. We sought to understand how England's centrally procured and delivered EHR software was integrated within the work practices of users in selected secondary and specialist care settings. We conducted a qualitative longitudinal case study-based investigation drawing on sociotechnical theory in three purposefully selected sites implementing early functionality of a nationally procured EHR system. The complete dataset comprised semi-structured interview data from a total of 66 different participants, 38.5 hours of non-participant observation of use of the software in context, accompanying researcher field notes, and hospital documents (including project initiation and lessons learnt reports). Transcribed data were analysed thematically using a combination of deductive and inductive approaches, and drawing on NVivo8 software to facilitate coding. The nationally led "top-down" implementation and the associated focus on interoperability limited the opportunity to customise software to local needs. Lack of system usability led users to employ a range of workarounds unanticipated by management to compensate for the perceived shortcomings of the system. These had a number of knock-on effects relating to the nature of collaborative work, patterns of communication, the timeliness and availability of records (including paper) and the ability for hospital management to monitor organisational performance. This work has highlighted the importance of addressing potentially adverse unintended consequences of workarounds associated with the introduction of EHRs. This can be achieved with customisation, which is inevitably somewhat restricted in the context of attempts to implement national solutions. The tensions and potential trade-offs between achieving large-scale interoperability and local requirements is likely to be the subject of continuous debate in England and beyond with no easy answers in sight.

Implementation of national body contouring surgery guidelines following massive weight loss: A national cross-sectional survey of commissioning in England.

PubMed

Dunne, Jonathan A; Wormald, Justin C R; Ghedia, Reshma; Soldin, Mark

2017-01-01

National guidelines for commissioning of body contouring surgery (BCS) following massive weight loss (MWL) in England were published in 2014. Nearly three-quarters of patients who have MWL seek BCS; however, access is known to vary according to the region. The aim of national guidelines was to standardise access. The purpose of this study was to determine implementation of the national guidelines by clinical commissioning groups (CCGs) in England. A cross-sectional, web-based survey was sent to all CCG chairs in England. Of 211 potential respondents, 108 completed the survey or provided funding guidelines (response rate = 52%). Eight CCGs (7%) had implemented the guidelines. A total of 69 CCGs were aware of the new guidelines (64%), and 66 CCGs stated that they fund BCS after MWL (61%). A total of 81 CCGs (75%) identified local funding guidelines, while 15 CCGs (14%) cited individual funding requests (IFRs) as the means of accessing funding. To improve patient access to BCS; 58 of 65 respondents (89%) stated cost-effectiveness, whereas 56 of 75 respondents (75%) thought patient-reported outcome measures were key. Qualitative data to improve access included an integrated pathway from bariatric surgery to BCS, an improved evidence base and greater CCG finances. One CCG stated that it cannot afford to fund cosmetic procedures. The purpose of national guidelines was to simplify the pathway to BCS after MWL and create fair distribution of funds across the country to needy patients; however, their uptake has been poor. Access to funding for BCS across England varies according to the location. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

The role of economics in the QUERI program: QUERI Series

PubMed Central

Smith, Mark W; Barnett, Paul G

2008-01-01

Background The United States (U.S.) Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has implemented economic analyses in single-site and multi-site clinical trials. To date, no one has reviewed whether the QUERI Centers are taking an optimal approach to doing so. Consistent with the continuous learning culture of the QUERI Program, this paper provides such a reflection. Methods We present a case study of QUERI as an example of how economic considerations can and should be integrated into implementation research within both single and multi-site studies. We review theoretical and applied cost research in implementation studies outside and within VA. We also present a critique of the use of economic research within the QUERI program. Results Economic evaluation is a key element of implementation research. QUERI has contributed many developments in the field of implementation but has only recently begun multi-site implementation trials across multiple regions within the national VA healthcare system. These trials are unusual in their emphasis on developing detailed costs of implementation, as well as in the use of business case analyses (budget impact analyses). Conclusion Economics appears to play an important role in QUERI implementation studies, only after implementation has reached the stage of multi-site trials. Economic analysis could better inform the choice of which clinical best practices to implement and the choice of implementation interventions to employ. QUERI economics also would benefit from research on costing methods and development of widely accepted international standards for implementation economics. PMID:18430199

The role of economics in the QUERI program: QUERI Series.

PubMed

Smith, Mark W; Barnett, Paul G

2008-04-22

The United States (U.S.) Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has implemented economic analyses in single-site and multi-site clinical trials. To date, no one has reviewed whether the QUERI Centers are taking an optimal approach to doing so. Consistent with the continuous learning culture of the QUERI Program, this paper provides such a reflection. We present a case study of QUERI as an example of how economic considerations can and should be integrated into implementation research within both single and multi-site studies. We review theoretical and applied cost research in implementation studies outside and within VA. We also present a critique of the use of economic research within the QUERI program. Economic evaluation is a key element of implementation research. QUERI has contributed many developments in the field of implementation but has only recently begun multi-site implementation trials across multiple regions within the national VA healthcare system. These trials are unusual in their emphasis on developing detailed costs of implementation, as well as in the use of business case analyses (budget impact analyses). Economics appears to play an important role in QUERI implementation studies, only after implementation has reached the stage of multi-site trials. Economic analysis could better inform the choice of which clinical best practices to implement and the choice of implementation interventions to employ. QUERI economics also would benefit from research on costing methods and development of widely accepted international standards for implementation economics.

National Aeronautics and Space Administration Manned Spacecraft Center data based requirements study

NASA Technical Reports Server (NTRS)

1971-01-01

The results are summarized of a study to determine the requirements of a data management system to meet the needs of MSC in mission planning and program and resource management during the 1975 time frame. The study addresses overall system requirements, implementation considerations, and cost/benefit comparisions.

Diffusion of innovation in mental health policy adoption: what should we ask about the quality of policy and the role of stakeholders in this process? Comment on "Cross-national diffusion of mental health policy".

PubMed

Lee, Lucy

2015-03-10

In his recent study, Gordon Shen analyses a pertinent question facing the global mental health research and practice community today; that of how and why mental health policy is or is not adopted by national governments. This study identifies becoming a World Health Organization (WHO) member nation, and being in regional proximity to countries which have adopted a mental health policy as supportive of mental health policy adoption, but no support for its hypothesis that country recipients of higher levels of aid would have adopted a mental health policy due to conditionalities imposed on aid recipients by donors. Asking further questions of each may help to understand more not only about how and why mental health policies may be adopted, but also about the relevance and quality of implementation of these policies and the role of specific actors in achieving adoption and implementation of high quality mental health policies. © 2015 by Kerman University of Medical Sciences.

Smokefree implementation in Colombia: Monitoring, outside funding, and business support

PubMed Central

Uang, Randy; Crosbie, Eric; Glantz, Stanton A

2017-01-01

Objective To analyze successful national smokefree policy implementation in Colombia, a middle income country. Materials and methods Key informants at the national and local levels were interviewed and news sources and government ministry resolutions were reviewed. Results Colombia’s Ministry of Health coordinated local implementation practices, which were strongest in larger cities with supportive leadership. Nongovernmental organizations provided technical assistance and highlighted noncompliance. Organizations outside Colombia funded some of these efforts. The bar owners’ association provided concerted education campaigns. Tobacco interests did not openly challenge implementation. Conclusions Health organization monitoring, external funding, and hospitality industry support contributed to effective implementation, and could be cultivated in other low and middle income countries. PMID:28562713

Towards National eHealth Implementation--a comparative study on WHO/ITU National eHealth Strategy Toolkit in Iran.

PubMed

Riazi, Hossein; Jafarpour, Maryam; Bitaraf, Ehsan

2014-01-01

Experiences has shown that utilization of ICT in health sector requires national commitment and planned efforts to make the best use of existing capacity. Establishing the main directions as well as planning the detailed steps needed are key to achieving longer-term goals such as health sector efficiency, reform or more fundamental transformation. Collaboration between the health and ICT sectors, both public and private, is central to this effort. As the major United Nations agencies for health and telecommunications respectively, the World Health Organization (WHO) and the International Telecommunication Union (ITU) have recognized the importance of collaboration for eHealth in their global resolutions, which encourage countries to develop national eHealth strategies; the National eHealth Strategy Toolkit is the proof of these recommendations. In this study a mapping of eHealth components in WHO/ITU National eHealth Strategy Toolkit and our national eHealth vision is presented.

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

PubMed Central

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

2017-01-01

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

Minute Man National Historical Park : alternative transportation evaluation

DOT National Transportation Integrated Search

2005-05-29

This study examines issues relevant to the implementation of an alternative transportation system designed to facilitate the movement of visitors throughout the park and, potentially, to sites of historical and recreational interest located outside t...

75 FR 39922 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

...' capabilities in reading, mathematics, and science literacy. It was first implemented by the National Center for... study clearance in 2012. As in 2003, in PISA 2012, mathematics will be the major subject domain. The...

Evaluation of the implementation outcomes of the Essential Medicines System in Anhui county-level public hospitals: a before-and-after study.

PubMed

Xu, Shuman; Bian, Cheng; Wang, Heng; Li, Niannian; Wu, Jingya; Li, Peng; Lu, Hua

2015-09-22

In August 2009, China formally established the National Essential Medicines System (NEMS) and implemented this system in the government-funded primary care medical and health institutions. After nearly four years of practice, the system has already been generalized to the county-level public hospitals. This study aimed to examine the impact on the operation of the hospitals through implementing the NEMS in Anhui Province and put forward some improvement measures. For quantitative analyses, we distributed 21 questionnaires to 21 county-level public hospitals in Anhui Province, which had implemented the national public hospital reform. Twenty valid questionnaires were returned, response rate was 95.2 %. Questions covered storage, usage and supply of essential medicines, compensation mechanisms, insurance policies, hospital incomes, service amounts and fees from January to June in each of the years from 2011 to 2013. For qualitative study, we chose three from 21 hospitals based on geographical distribution and conducted focus group interviews based on a planned interview outline centered on the implementation status of the system. Following implementation, the types of essential medicines stocked and the proportion of total sales that were composed of essential medicines have increased but do not yet meet the required standards issued in the government document, which was not less than 95 % and 30 % of the total, respectively. The average financial subsidies had increased by 1,665,200 yuan, and significant increases appeared in provincial financial assistance. The average inpatient fees per visit decreased by 487.41 yuan. Increases in income from medicines during hospitalization led to increases in per-visit hospitalization fees. Unexpectedly, higher financial assistance revenue also led to higher average per-visit hospitalization fees. The guiding role of the National Essential Medicines List remains to be reinforced, and specific lists for county hospitals should be developed. Supervision was required to implement the process of guaranteeing the storage and usage of essential medicines. The compensation mechanism was far from sound, and the leverage of the health insurance policies was not obvious. Regarding the reductions in the proportion of income derived from medicines and per-visit inpatient fees, the policy had been partially successful. Our results showed that the implementation of the Essential Medicines System do have a beneficial role in the reduction of the drug fees and further alleviates the burden of the masses. Much effort should be made to the redesign of the compensation mechanism, mainly including the government and the medical insurance compensation, emphasizing on both the fairness and the rationality of the compensation in the future.

Understanding health care providers' reluctance to adopt a national electronic patient record: an empirical and legal analysis.

PubMed

Zwaanswijk, M; Ploem, M C; Wiesman, F J; Verheij, R A; Friele, R D; Gevers, J K M

2013-03-01

Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch n-EPR also raised considerable controversy, which eventually caused the Dutch government to stop its contribution to the national infrastructure. To explain Dutch health care providers' reluctance in adopting the n-EPR, we investigated their perceptions of problems associated with the n-EPR and their legal position regarding then-EPR. We hereby aim to provide suggestions about approaches that could promote successful implementation. The study consisted of two parts. The empirical part of the study was conducted in three health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, 17 stakeholders working in these organisations were interviewed to investigate health care providers' perceptions of problems associated with the n-EPR. In the legal part of the study, legal documents were analysed to study health care providers' legal position regarding the n-EPR and any associated problems. The respondents expressed concerns about the confidentiality and safety of information exchange and the reliability and quality of patient data in the n-EPR, and indicated that their liability in case of medical errors was not sufficiently clear. The perceived problems could partly be attributed to legal uncertainties. It is recommended to start the implementation of an n-EPR in limited geographical areas. This will allow health care providers to experience benefits of electronic information exchange before being asked to participate in information exchange at a larger scale. The problems that health care providers perceive in the n-EPR should be minimised. Legislation underlying the n-EPR should provide sufficient clarity about health care professionals' responsibilities and liabilities.

Change in Adverse Events After Enrollment in the National Surgical Quality Improvement Program: A Systematic Review and Meta-Analysis

PubMed Central

Montroy, Joshua; Breau, Rodney H.; Cnossen, Sonya; Witiuk, Kelsey; Binette, Andrew; Ferrier, Taylor; Lavallée, Luke T.; Fergusson, Dean A.; Schramm, David

2016-01-01

Background The American College of Surgeons’ National Surgical Quality Improvement Program (NSQIP) is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery. Study Design A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR) and 95% confidence intervals (CI). Results Eleven articles reporting on 35 health care institutions were included. Nine (82%) of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72–0.91), deep (pRR 0.82; 95% CI0.64–1.05) and organ space (pRR 1.15; 95% CI 0.96–1.37) infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39–0.77; deep pRR 0.61, 95% CI 0.50–0.75, and organ space pRR 0.60, 95% CI 0.50–0.71). Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program. Conclusions These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities. PMID:26812596

The association between implementation strategy use and the uptake of hepatitis C treatment in a national sample.

PubMed

Rogal, Shari S; Yakovchenko, Vera; Waltz, Thomas J; Powell, Byron J; Kirchner, JoAnn E; Proctor, Enola K; Gonzalez, Rachel; Park, Angela; Ross, David; Morgan, Timothy R; Chartier, Maggie; Chinman, Matthew J

2017-05-11

Hepatitis C virus (HCV) is a common and highly morbid illness. New medications that have much higher cure rates have become the new evidence-based practice in the field. Understanding the implementation of these new medications nationally provides an opportunity to advance the understanding of the role of implementation strategies in clinical outcomes on a large scale. The Expert Recommendations for Implementing Change (ERIC) study defined discrete implementation strategies and clustered these strategies into groups. The present evaluation assessed the use of these strategies and clusters in the context of HCV treatment across the US Department of Veterans Affairs (VA), Veterans Health Administration, the largest provider of HCV care nationally. A 73-item survey was developed and sent to all VA sites treating HCV via electronic survey, to assess whether or not a site used each ERIC-defined implementation strategy related to employing the new HCV medication in 2014. VA national data regarding the number of Veterans starting on the new HCV medications at each site were collected. The associations between treatment starts and number and type of implementation strategies were assessed. A total of 80 (62%) sites responded. Respondents endorsed an average of 25 ± 14 strategies. The number of treatment starts was positively correlated with the total number of strategies endorsed (r = 0.43, p < 0.001). Quartile of treatment starts was significantly associated with the number of strategies endorsed (p < 0.01), with the top quartile endorsing a median of 33 strategies, compared to 15 strategies in the lowest quartile. There were significant differences in the types of strategies endorsed by sites in the highest and lowest quartiles of treatment starts. Four of the 10 top strategies for sites in the top quartile had significant correlations with treatment starts compared to only 1 of the 10 top strategies in the bottom quartile sites. Overall, only 3 of the top 15 most frequently used strategies were associated with treatment. These results suggest that sites that used a greater number of implementation strategies were able to deliver more evidence-based treatment in HCV. The current assessment also demonstrates the feasibility of electronic self-reporting to evaluate ERIC strategies on a large scale. These results provide initial evidence for the clinical relevance of the ERIC strategies in a real-world implementation setting on a large scale. This is an initial step in identifying which strategies are associated with the uptake of evidence-based practices in nationwide healthcare systems.

Current legal regime for environmental impact assessment in areas beyond national jurisdiction and its future approaches

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

Ma, Deqiang; Coastal and Ocean Management Institute, Xiamen University, 361102; Fang, Qinhua, E-mail: qhfang@xmu.edu.cn

In 2004, the United Nations launched an Ad Hoc Open-ended Informal Working Group to study issues relating to the conservation and sustainable use of marine biological diversity in areas beyond national jurisdiction. Since then, the topic of governing marine areas beyond national jurisdiction (ABNJ) has been widely discussed by politicians, policy makers and scholars. As one of management tools to protect marine biodiversity in ABNJ, environmental impact assessment (EIA) has been widely recognized and accepted by the international community, however, the biggest challenge is how to effectively implement the EIA regime in ABNJ. This paper explores the impacts of anthropogenicmore » activities in ABNJ on marine ecosystems, reviews the existing legal regime for EIA in ABNJ and discusses possible measures to strengthen the implementation of EIA in ABNJ. - Highlights: • We identify human activities in ABNJ and their impacts on marine ecosystems. • We analyze the characters and gaps of the existing legal regime for EIA in ABNJ. • We analyze the pros and cons of alternative approaches of EIA in ABNJ.« less

Paid maternity leave and breastfeeding practice before and after California's implementation of the nation's first paid family leave program.

PubMed

Huang, Rui; Yang, Muzhe

2015-01-01

California was the first state in the United States to implement a paid family leave (PFL) program in 2004. We use data from the Infant Feeding Practices Study to examine the changes in breastfeeding practices in California relative to other states before and after the implementation of PFL. We find an increase of 3-5 percentage points for exclusive breastfeeding and an increase of 10-20 percentage points for breastfeeding at several important markers of early infancy. Our study supports the recommendation of the Surgeon General to establish paid leave policies as a strategy for promoting breastfeeding. Copyright © 2014 Elsevier B.V. All rights reserved.

Implementation of a protocol proposed by the Brazilian National Health Surveillance Agency for antibiotic use in very low birth weight infants.

PubMed

Pinto, Maria Cristina F Guedes; Bueno, Arnaldo C; Vieira, Alan A

2013-01-01

To analyze the implementation of a protocol proposed by the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA) to improve sepsis diagnosis in very low birth weight newborns. This was a prospective study that evaluated the implementation of a protocol involving clinical and laboratory criteria (hematologic scoring system of Rodwell and C-reactive protein serial measurements), recommended by ANVISA, to improve the diagnosis of neonatal sepsis in very low birth weight newborns. The study included all patients who were born and remained in the neonatal intensive care unit until discharge or death, and excluded those with congenital diseases. The main outcomes measured in newborns before (2006-2007) and after implementation of the protocol (2008) were the rates of early and late-onset sepsis, use of antibiotics, and mortality. Means were compared by Student's t-test and categorical variables were compared by the chi-squared test; the significance level for all tests was set at 95%. The study included 136 newborns with very low birth weight. There was no difference between groups regarding general clinical characteristics in the studied periods. There was, however, a decrease in the number of diagnoses of probable early-onset sepsis (p<0.001), use of antimicrobial regimens (p<0.001), and overall mortality and infection-related mortality (p=0.009 and p=0.049, respectively). The implementation of the protocol allowed improvement of sepsis diagnosis by reducing the diagnosis of probable early-onset sepsis, thus promoting efficient antimicrobial use in this population. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Strategies to facilitate implementation and sustainability of large system transformations: a case study of a national program for improving quality of care for elderly people.

PubMed

Nyström, Monica Elisabeth; Strehlenert, Helena; Hansson, Johan; Hasson, Henna

2014-09-18

Large-scale change initiatives stimulating change in several organizational systems in the health and social care sector are challenging both to lead and evaluate. There is a lack of systematic research that can enrich our understanding of strategies to facilitate large system transformations in this sector. The purpose of this study was to examine the characteristics of core activities and strategies to facilitate implementation and change of a national program aimed at improving life for the most ill elderly people in Sweden. The program outcomes were also addressed to assess the impact of these strategies. A longitudinal case study design with multiple data collection methods was applied. Archival data (n = 795), interviews with key stakeholders (n = 11) and non-participant observations (n = 23) were analysed using content analysis. Outcome data was obtained from national quality registries. This study presents an approach for implementing a large national change program that is characterized by initial flexibility and dynamism regarding content and facilitation strategies and a growing complexity over time requiring more structure and coordination. The description of activities and strategies show that the program management team engaged a variety of stakeholders and actor groups and accordingly used a palate of different strategies. The main strategies used to influence change in the target organisations were to use regional improvement coaches, regional strategic management teams, national quality registries, financial incentives and annually revised agreements. Interactive learning sessions, intense communication, monitor and measurements, and active involvement of different experts and stakeholders, including elderly people, complemented these strategies. Program outcomes showed steady progress in most of the five target areas, less so for the target of achieving coordinated care. There is no blue-print on how to approach the challenging task of leading large scale change programs in complex contexts, but our conclusion is that more attention has to be given to the multidimensional strategies that program management need to consider. This multidimensionality comprises different strategies depending on types of actors, system levels, contextual factors, program progress over time, program content, types of learning and change processes, and the conditions for sustainability.

The WHO-ITU national eHealth strategy toolkit as an effective approach to national strategy development and implementation.

PubMed

Hamilton, Clayton

2013-01-01

With few exceptions, national eHealth strategies are the pivotal tools upon which the launch or refocusing of national eHealth programmes is hinged. The process of their development obviates cross-sector ministerial commitment led by the Ministry of Health. Yet countries often grapple with the task of strategy development and best efforts frequently fail to address strategic components of eHealth key to ensure successful implementation and stakeholder engagement. This can result in strategies that are narrowly focused, with an overemphasis placed on achieving technical outcomes. Without a clear link to a broader vision of health system development and a firm commitment from partners, the ability of a strategy to shape development of a national eHealth framework will be undermined and crucial momentum for implementation will be lost. WHO and ITU have sought to address this issue through the development of the National eHealth Strategy Toolkit that provides a basis for the components and processes to be considered in a strategy development or refocusing exercise. We look at this toolkit and highlight those areas which the countries should consider in formulating their national eHealth strategy.