Prevention-Related Research Targeting African American Alternative Education Program Students

ERIC Educational Resources Information Center

Carswell, Steven B.; Hanlon, Thomas E.; Watts, Amy M.; O'Grady, Kevin E.

2014-01-01

This article reports on a program of research that examined the background, planning, implementation, and evaluation of an after-school preventive intervention program within an ongoing urban alternative education program targeting African American students referred to the school because of their problematic behavior in regular schools. The…

Paediatric patient navigation models of care in Canada: An environmental scan.

PubMed

Luke, Alison; Doucet, Shelley; Azar, Rima

2018-05-01

(1) To provide other organizations with useful information when implementing paediatric navigation programs and (2) to inform the implementation of a navigation care centre in New Brunswick for children with complex health conditions. This environmental scan consisted of a literature review of published and grey literature for paediatric patient navigation programs across Canada. Additional programs were found following discussions with program coordinators and navigators. Interviews were conducted with key staff from each program and included questions related to patient condition; target population and location; method delivery; navigator background; and navigator roles. Data analysis included analysis of interviews and identification of common themes across the different programs. We interviewed staff from 19 paediatric navigation programs across Canada. Programs varied across a number of different themes, including: condition and disease type, program location (e.g., hospital or clinic), navigator background (e.g., registered nurse or peer/lay navigator) and method of delivery (e.g., phone or face-to-face). Overall, navigator roles are similar across all programs, including advocacy, education, support and assistance in accessing resources from both within and outside the health care system. This scan offers a road map of Canadian paediatric navigation programs. Knowledge learned from this scan will inform stakeholders who are either involved in the delivery of paediatric patient navigation programs or planning to implement such a program. Specifically, our scan informed the development of a navigation centre for children with complex health conditions in New Brunswick.

Factors Influencing Teachers' Implementation of an Innovative Tobacco Prevention Curriculum for Multiethnic Youth: Project SPLASH

ERIC Educational Resources Information Center

Sy, Angela; Glanz, Karen

2008-01-01

Background: The effectiveness of school-based tobacco use prevention programs depends on proper implementation. This study examined factors associated with teachers' implementation of a smoking prevention curriculum in a cluster randomized trial called Project SPLASH (Smoking Prevention Launch Among Students in Hawaii). Methods: A process…

Challenges and Facilitators to the Implementation of a Sport Education Season: The Voices of Teacher Candidates

ERIC Educational Resources Information Center

Braga, Luciana; Liversedge, Philip

2017-01-01

Background/Purpose: Physical education teacher education (PETE) programs have been encouraged to provide teacher candidates (TCs) with the competencies and dispositions needed to implement a variety of curriculum and instructional models. Likewise, it has been suggested that TCs should have opportunities to practice implementing such models in…

Educational Choice. A Background Paper.

ERIC Educational Resources Information Center

Quality Education for Minorities Network, Washington, DC.

This paper addresses school choice, one proposal to address parental involvement concerns, focusing on historical background, definitions, rationale for advocating choice, implementation strategies, and implications for minorities and low-income families. In the past, transfer payment programs such as tuition tax credits and vouchers were…

Pride in Oklahoma.

ERIC Educational Resources Information Center

Moore, Gordon; Blackburn, Bob L.

This booklet is intended to be used as background material by social studies and history classroom teachers as they develop and implement educational programs on Oklahoma's heritage. It includes background information on the land and people of Oklahoma (geology, climate, topography, vegetation, animals, prehistoric peoples, French explorers,…

Examining Dissatisfaction with an Online Doctoral Program

ERIC Educational Resources Information Center

Fenby, Frank

2006-01-01

Background: Online learning community based education is still new. As institutions implement new programs they can encounter learner satisfaction issues. Purpose: To investigate learner unhappiness during the second semester of a new online doctoral program and develop a substantive grounded theory concerning its cause(s). Setting: The Doctorado…

A Preventive Intervention Program for Urban African American Youth Attending an Alternative Education Program: Background, Implementation, and Feasibility.

PubMed

Carswell, Steven B; Hanlon, Thomas E; O'Grady, Kevin E; Watts, Amy M; Pothong, Pattarapan

2009-01-01

This paper presents background, implementation, and feasibility findings associated with planning and conducting an after-school intervention program in an alternative education setting designed to prevent the initiation and escalation of violence and substance abuse among urban African American youth at high risk for life-long problem behaviors. Evolving from earlier preventive interventions implemented in clinic and school settings, the program, entitled The Village Model of Care, consisted of structured group mentoring, parental support, and community outreach services administered to alternative education students and their primary caregiver(s) during the school year. Over a two-year intake period, 109 youth participated in the present process evaluation study. Findings from the study not only provided relevant demographic information on the characteristics of youth likely to be included in such programs but also indicated the importance of including the family in the rehabilitation effort and the need for school administrative system support for the underlying alternative education approach. The information presented in this report has a direct bearing on the planning of future prevention efforts conducted in similar settings that are aimed at reducing problem behaviors and promoting positive lifestyles among high-risk youth.

Sustaining School-Based Asthma Interventions through Policy and Practice Change

ERIC Educational Resources Information Center

Carpenter, Laurie M.; Lachance, Laurie; Wilkin, Margaret; Clark, Noreen M.

2013-01-01

Background: Schools are an ideal setting for implementation of asthma interventions for children; however, sustaining school-based programs can be challenging. This study illustrates policy and practice changes brought about through the Childhood Asthma Linkages in Missouri (CALM) program to sustain such programs. Methods: Researchers analyzed…

Guidelines for Implementing a Real Estate Cooperative Education Program.

ERIC Educational Resources Information Center

Pearson, Thomas R.

Background information and guidelines are provided for the development of cooperative education programs for real estate industry personnel. The first section outlines the operation of cooperative education programs and presents two organizational plans: the alternating plan, where students attend class full-time and work full-time during…

Why and How Schools Make Nutrition Education Programs "Work"

ERIC Educational Resources Information Center

Porter, Kathleen J.; Koch, Pamela A.; Contento, Isobel R.

2018-01-01

Background: There are many potential health benefits to having nutrition education programs offered by expert outside sources in schools. However, little is known about why and how schools initiate, implement, and institutionalize them. Gaining this understanding may allow the impact and reach of nutrition and other health education programs in…

Computer-Aided Corrosion Program Management

NASA Technical Reports Server (NTRS)

MacDowell, Louis

2010-01-01

This viewgraph presentation reviews Computer-Aided Corrosion Program Management at John F. Kennedy Space Center. The contents include: 1) Corrosion at the Kennedy Space Center (KSC); 2) Requirements and Objectives; 3) Program Description, Background and History; 4) Approach and Implementation; 5) Challenges; 6) Lessons Learned; 7) Successes and Benefits; and 8) Summary and Conclusions.

The Impact of Service-Learning in Supporting Family Empowerment and Welfare Program

ERIC Educational Resources Information Center

Natadjaja, Listia; Cahyono, Yohanes Budi

2009-01-01

Background: Facilitated by Community Outreach Centre, the Packaging Design class of Visual Communication Design major at Petra Christian University implements Service-Learning Program to assist micro-industries that have joined in the Family Empowerment and Welfare Program in Kabupaten Kediri. Students, in cooperation with lecturer assist…

Psi4NumPy: An Interactive Quantum Chemistry Programming Environment for Reference Implementations and Rapid Development.

PubMed

Smith, Daniel G A; Burns, Lori A; Sirianni, Dominic A; Nascimento, Daniel R; Kumar, Ashutosh; James, Andrew M; Schriber, Jeffrey B; Zhang, Tianyuan; Zhang, Boyi; Abbott, Adam S; Berquist, Eric J; Lechner, Marvin H; Cunha, Leonardo A; Heide, Alexander G; Waldrop, Jonathan M; Takeshita, Tyler Y; Alenaizan, Asem; Neuhauser, Daniel; King, Rollin A; Simmonett, Andrew C; Turney, Justin M; Schaefer, Henry F; Evangelista, Francesco A; DePrince, A Eugene; Crawford, T Daniel; Patkowski, Konrad; Sherrill, C David

2018-06-11

Psi4NumPy demonstrates the use of efficient computational kernels from the open-source Psi4 program through the popular NumPy library for linear algebra in Python to facilitate the rapid development of clear, understandable Python computer code for new quantum chemical methods, while maintaining a relatively low execution time. Using these tools, reference implementations have been created for a number of methods, including self-consistent field (SCF), SCF response, many-body perturbation theory, coupled-cluster theory, configuration interaction, and symmetry-adapted perturbation theory. Furthermore, several reference codes have been integrated into Jupyter notebooks, allowing background, underlying theory, and formula information to be associated with the implementation. Psi4NumPy tools and associated reference implementations can lower the barrier for future development of quantum chemistry methods. These implementations also demonstrate the power of the hybrid C++/Python programming approach employed by the Psi4 program.

What Will Be the Impact of Programs of Study? A Preliminary Assessment Based on Similar Previous Initiatives, State Plans for Implementation, and Career Development Theory

ERIC Educational Resources Information Center

Lewis, Morgan V.; Kosine, Natalie R.

2008-01-01

This publication provides background to inform the implementation of Programs of Study (POS) as required by grantees of funds authorized under the Carl D. Perkins Career and Technical Education Improvement Act of 2006. The report is a review of the evidence on the effectiveness of previous similar initiatives and an examination of the implications…

Career Ladders and Teacher Incentives: The Utah Experiment. Part I: The Implementation. Final Report: Secretary's Discretionary Program Implementation Grant to Develop Teacher Incentive Structures.

ERIC Educational Resources Information Center

Peterson, Ken; Kauchak, Don

This volume, the first of two reports on development of teacher incentive structures, focuses on implementation of a career ladder design and teacher evaluation experiment in four Utah school districts. The report has five sections. Section 1 describes study background and implementation of an evaluation-reward system that featured data collection…

Assessing the Feasibility of a Multi-Program School-Based Intervention to Promote Physical Activity and Healthful Eating in Middle Schools Prior to Wide-Scale Implementation

ERIC Educational Resources Information Center

Greaney, Mary; Hardwick, Cary K.; Mezgebu, Solomon; Lindsay, Ana C.; Roover, Michelle L.; Peterson, Karen E.

2007-01-01

Background: University-community partnerships can support schools in implementing evidence-based responses to youth obesity trends. An inter-organizational partnership was established to implement and evaluate the Healthy Choices Collaborative Intervention (HCCI). HCCI combines an interdisciplinary curriculum, before/after school activities, and…

Nurse Leaders’ Experiences of Implementing Career Advancement Programs for Nurses in Iran

PubMed Central

Sheikhi, Mohammad Reza; Khoshknab, Masoud Fallahi; Mohammadi, Farahnaz; Oskouie, Fatemeh

2015-01-01

Background and purpose: Career advancement programs are currently implemented in many countries. In Iran, the first career advancement program was Nurses’ Career Advancement Pathway. The purpose of this study was to explore nurse leaders’ experiences about implementing the Nurses’ Career Advancement Pathway program in Iran. Methods: This exploratory qualitative study was conducted in 2013. Sixteen nurse managers were recruited from the teaching hospitals affiliated to Shahid Behesthi, Qazvin, and Iran Universities of Medical Sciences in Iran. Participants were recruited using purposive sampling method. Study data were collected through in-depth semi-structured interviews. The conventional content analysis approach was used for data analysis. Results: participants’ experiences about implementing the Nurses’ Career Advancement Pathway fell into three main categories including: a) the shortcomings of performance evaluation, b) greater emphasis on point accumulation, c) the advancement-latitude mismatch. Conclusion: The Nurses’ Career Advancement pathway has several shortcomings regarding both its content and its implementation. Therefore, it is recommended to revise the program. PMID:26156907

Organizational Strategies to Implement Hospital Pressure Ulcer Prevention Programs: Findings from a National Survey

PubMed Central

SOBAN, LYNN M.; KIM, LINDA; YUAN, ANITA H.; MILTNER, REBECCA S.

2017-01-01

Aim To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system. Background Comprehensive pressure ulcer programs include nursing interventions such as use of a risk assessment tool and organizational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programs. Methods Data were collected by an email survey to all Chief Nursing Officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarize survey responses and evaluate relationships between some variables. Results Organizational strategies that support pressure ulcer prevention program implementation (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalized within individual hospitals. Conclusion Organizational strategies to support implementation of pressure ulcer preventive programs are often not optimally operationalized to achieve consistent, sustainable performance. Implications for Nursing Management The results of this study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. PMID:27487972

A Literature-Based Approach on International Perspectives of Bilingual Education

ERIC Educational Resources Information Center

Ozfidan, Burhan; Burlbaw, Lynn M.

2017-01-01

This study examines the bilingual education in Spain and in Canada, and discusses their historical backgrounds, current bilingual education programs in use, and teacher proficiency within their bilingual education programs. The purpose of this study is to examine these two countries' bilingual education programs and find a way to implement a…

Establishing the LINC (Learning Individualized for Canadians) Program: A Manual for Administrators and Instructors.

ERIC Educational Resources Information Center

Tippett, Glen; Mullen, Vernon

A manual to accompany LINC courses in communications and mathematics, containing information on background, objectives, components, individualized process, and procedures for curriculum development and implementation of LINC Program, is presented. It was formerly referred to as The LINC Program User's Manual. An appendix includes a Reading List…

Building Your Program. Supported Education: A Promising Practice. Evidence-Based Practices KIT (Knowledge Informing Transformation)

ERIC Educational Resources Information Center

Unger, Karen V.

2011-01-01

"Building Your Program" is intended to help mental health authorities, agency administrators, and program leaders think through and develop Supported Education. The first part of this booklet gives you background information about the Supported Education model. Specific information about your role in implementing and sustaining Supported Education…

MasterMind: Empower Yourself with Mental Health. A Program for Adolescents

ERIC Educational Resources Information Center

Tacker, Katherine A.; Dobie, Sharon

2008-01-01

Background: Teachers need classroom-based programs to develop and support mental health fitness in adolescents because this age group faces significant challenges to their mental health. There is a paucity of such ready-made programs. This article describes the development and proposed implementation of a low-cost, effective, adaptable, 6-week,…

Skills for Diversity: Description, Evaluation and Recommendations.

ERIC Educational Resources Information Center

Janus, Eric S.

A diversity skills program was developed and implemented at the William Mitchell College of Law (WMCL) in Saint Paul, Minnesota. The program was designed to offer to all first year students a program to assist them in learning how to work effectively with people from diverse backgrounds in professional situations and to develop a heightened…

Implementing a collaborative return-to-work program: Lessons from a qualitative study in a large Canadian healthcare organization

PubMed Central

Skivington, Kathryn; Lifshen, Marni; Mustard, Cameron

2016-01-01

BACKGROUND: Comprehensive workplace return-to-work policies, applied with consistency, can reduce length of time out of work and the risk of long-term disability. This paper reports on the findings from a qualitative study exploring managers’ and return-to-work-coordinators’ views on the implementation of their organization’s new return-to-work program. OBJECTIVES: To provide practical guidance to organizations in designing and implementing return-to-work programs for their employees. METHODS: Semi-structured qualitative interviews were undertaken with 20 managers and 10 return-to-work co-ordinators to describe participants’ perspectives on the progress of program implementation in the first 18 months of adoption. The study was based in a large healthcare organization in Ontario, Canada. Thematic analysis of the data was conducted. RESULTS: We identified tensions evident in the early implementation phase of the organization’s return-to-work program. These tensions were attributed to uncertainties concerning roles and responsibilities and to circumstances where objectives or principles appeared to be in conflict. CONCLUSIONS: The implementation of a comprehensive and collaborative return-to-work program is a complex challenge. The findings described in this paper may provide helpful guidance for organizations embarking on the development and implementation of a return-to-work program. PMID:27792035

76 FR 5055 - Loan Servicing; Farm Loan Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

..., Conservation, and Energy Act of 2008 (the 2008 Farm Bill). This rule implements four amendments to the direct...). SUPPLEMENTARY INFORMATION: Background This final rule implements multiple provisions of the 2008 Farm Bill (Pub... loan servicing proposed rule (74 FR 39565-39569). As discussed below, FSA proposed three substantive...

Marketing the Job Training Partnership Act.

ERIC Educational Resources Information Center

Markowicz, Arlene, Ed.; And Others

1984-01-01

This quarterly contains 11 bulletins that profile marketing campaigns for the Job Training Partnership Act (JTPA) that have been implemented successfully in local programs throughout the United States. For each program, the description provides information on the operator, funding, results, time span, background, marketing/public relations…

Implementation of the Hammersmith Infant Neurological Exam in a High-Risk Infant Follow-Up Program

PubMed Central

Maitre, Nathalie L; Chorna, Olena; Romeo, Domenico M; Guzzetta, Andrea

2017-01-01

Background High-Risk Infant Follow-Up (HRIF) programs provide early identification and referral for treatment of neurodevelopmental delays and impairments. In these programs, a standardized neurological exam is a critical component of evaluation for clinical and research purposes. Implementation To address primary challenges of provider educational diversity and standardized documentation, we designed an approach to training and implementation of the Hammersmith Infant Neurological Exam (HINE) with pre-course materials, a workshop model and adaptation of the electronic medical record. Conclusions Provider completion and documentation of a neurologic exam were evaluated before and after HINE training. Standardized training and implementation of the HINE in a large HRIF is feasible and effective and allows for quantitative evaluation of neurological findings and developmental trajectories. PMID:27765470

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program

PubMed Central

Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S

2006-01-01

Background and objectives Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. Methods The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. Results This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Conclusion Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity. PMID:17067388

Physical Activity and Energy Expenditure during an After-School Running Club: Laps versus Game Play

ERIC Educational Resources Information Center

Kahan, David; McKenzie, Thomas L.

2018-01-01

Background: After-school programs (ASPs) have the potential to contribute to student physical activity (PA), but there is limited empirical evidence to guide program development and implementation. Methods: We used pedometry to assess the overall effectiveness of an elementary school ASP running program relative to national and state PA…

Improved Physical Fitness among Older Female Participants in a Nationally Disseminated, Community-Based Exercise Program

ERIC Educational Resources Information Center

Seguin, Rebecca A.; Heidkamp-Young, Eleanor; Kuder, Julia; Nelson, Miriam E.

2012-01-01

Background: Strength training (ST) is an important health behavior for aging women; it helps maintain strength and function and reduces risk for chronic diseases. This study assessed change in physical fitness following participation in a ST program implemented and evaluated by community leaders. Method: The StrongWomen Program is a nationally…

Fidelity of After-School Program Implementation Targeting Adolescent Youth: Identifying Successful Curricular and Programmatic Characteristics

ERIC Educational Resources Information Center

Rajan, Sonali; Basch, Charles E.

2012-01-01

Background: This study consisted of a formative evaluation of an after-school health education program designed for adolescent females, entitled Girls on Track. Evidence-based after-school programs have potential to supplement the traditional school day, encourage social and emotional skill development, improve the quality of student health, and…

Pilot Investigation of the Katie Brown Educational Program: A School-Community Partnership

ERIC Educational Resources Information Center

Joppa, Meredith C.; Rizzo, Christie J.; Nieves, Amethys V.; Brown, Larry K.

2016-01-01

Background: Schools in the United States are increasingly being urged to address the problem of adolescent dating violence (DV) with their students. Given the limited time available to implement prevention programming during the school day, brief programs are needed. The purpose of this study was to test the efficacy of a widely disseminated,…

An Objective Assessment of Children's Physical Activity during the Keep It Moving! After-School Program

ERIC Educational Resources Information Center

Schuna, John M., Jr.; Lauersdorf, Rebekah L.; Behrens, Timothy K.; Liguori, Gary; Liebert, Mina L.

2013-01-01

Background: After-school programs may provide valuable opportunities for children to accumulate healthful physical activity (PA). This study assessed the PA of third-, fourth-, and ?fth-grade children in the Keep It Moving! (KIM) after-school PA program, which was implemented in an ethnically diverse and low socioeconomic status school district in…

What Works? Process Evaluation of a School-Based Fruit and Vegetable Distribution Program in Mississippi

ERIC Educational Resources Information Center

Potter, Susan C.; Schneider, Doris; Coyle, Karin K.; May, Gary; Robin, Leah; Seymour, Jenna

2011-01-01

Background: During the 2004-2005 school year, the Mississippi Department of Education, Office of Child Nutrition, initiated a pilot program to distribute free fruit and vegetable snacks to students during the school day. This article describes the first-year implementation of the Mississippi Fruit and Vegetable Pilot Program. Methods: The process…

Factors related to leader implementation of a nationally disseminated community-based exercise program: a cross-sectional study

PubMed Central

Seguin, Rebecca A; Palombo, Ruth; Economos, Christina D; Hyatt, Raymond; Kuder, Julia; Nelson, Miriam E

2008-01-01

Background The benefits of community-based health programs are widely recognized. However, research examining factors related to community leaders' characteristics and roles in implementation is limited. Methods The purpose of this cross-sectional study was to use a social ecological framework of variables to explore and describe the relationships between socioeconomic, personal/behavioral, programmatic, leadership, and community-level social and demographic characteristics as they relate to the implementation of an evidence-based strength training program by community leaders. Eight-hundred fifty-four trained program leaders in 43 states were invited to participate in either an online or mail survey. Corresponding community-level characteristics were also collected. Programmatic details were obtained from those who implemented. Four-hundred eighty-seven program leaders responded to the survey (response rate = 57%), 78% online and 22% by mail. Results Of the 487 respondents, 270 implemented the program (55%). One or more factors from each category – professional, socioeconomic, personal/behavioral, and leadership characteristics – were significantly different between implementers and non-implementers, determined by chi square or student's t-tests as appropriate. Implementers reported higher levels of strength training participation, current and lifetime physical activity, perceived support, and leadership competence (all p < 0.05). Logistic regression analysis revealed a positive association between implementation and fitness credentials/certification (p = 0.003), program-specific self-efficacy (p = 0.002), and support-focused leadership (p = 0.006), and a negative association between implementation and educational attainment (p = 0.002). Conclusion Among this sample of trained leaders, several factors within the professional, socioeconomic, personal/behavioral, and leadership categories were related to whether they implemented a community-based exercise program. It may benefit future community-based physical activity program disseminations to consider these factors when selecting and training leaders. PMID:19055821

Developing a Statewide Childhood Body Mass Index Surveillance Program

ERIC Educational Resources Information Center

Paul, David R.; Scruggs, Philip W.; Goc Karp, Grace; Ransdell, Lynda B.; Robinson, Clay; Lester, Michael J.; Gao, Yong; Petranek, Laura J.; Brown, Helen; Shimon, Jane M.

2014-01-01

Background: Several states have implemented childhood obesity surveillance programs supported by legislation. Representatives from Idaho wished to develop a model for childhood obesity surveillance without the support of state legislation, and subsequently report predictors of overweight and obesity in the state. Methods: A coalition comprised of…

Educating Jewish and Arab Children for Tolerance and Coexistence in a Situation of Ongoing Conflict: An Encounter Program

ERIC Educational Resources Information Center

Lazovsky, Rivka

2007-01-01

The "Children Teach Children" (CTC) program aimed to educate Jewish and Arab children in Israel for tolerance and coexistence is first described against the general background of coexistence programs in Israel and in other countries. Results of a study that examined the influence of the program implementation in Grade 7 in a pair of…

In Preparation of the Nationwide Dissemination of the School-Based Obesity Prevention Program DOiT: Stepwise Development Applying the Intervention Mapping Protocol

ERIC Educational Resources Information Center

van Nassau, Femke; Singh, Amika S.; van Mechelen, Willem; Brug, Johannes; Chin A. Paw, Mai J. M.

2014-01-01

Background: The school-based Dutch Obesity Intervention in Teenagers (DOiT) program is an evidence-based obesity prevention program. In preparation for dissemination throughout the Netherlands, this study aimed to adapt the initial program and to develop an implementation strategy and materials. Methods: We revisited the Intervention Mapping (IM)…

An Evaluation of the Early Implementation of School-Based Bullying Prevention Programs in Massachusetts

ERIC Educational Resources Information Center

Sautter Errichetti, Karen

2014-01-01

Background: A quarter of U.S. children are bullied annually. State legislatures have responded to high profile media exposure of bullying and increased public concern by passing legislation aimed at preventing bullying among school children. Methods: The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework was used to…

Planning, Collaboration, and Implementation Strategies for Truancy Programs. Truancy Prevention in Action

ERIC Educational Resources Information Center

Cash, Terry; Duttweiler, Patricia Cloud

2006-01-01

This truancy prevention publication provides a general background discussion on the issue of truancy but mainly centers on the nuts and bolts of developing and implementing an effective community wide collaborative to address truancy. The first section provides some understanding of the factors associated with truancy and the resulting high costs…

The Relationship between School-Level Characteristics and Implementation Fidelity of a Coordinated School Health Childhood Obesity Prevention Intervention

ERIC Educational Resources Information Center

Lederer, Alyssa M.; King, Mindy H.; Sovinski, Danielle; Seo, Dong-Chul; Kim, Nayoung

2015-01-01

Background: Curtailing childhood obesity is a public health imperative. Although multicomponent school-based programs reduce obesity among children, less is known about the implementation fidelity of these interventions. This study examines process evaluation findings for the Healthy, Energetic Ready, Outstanding, Enthusiastic, Schools (HEROES)…

Adapting and Implementing an Evidence-Based Sun-Safety Education Program in Rural Idaho, 2012

PubMed Central

Gonzales, Melanie; Krebill, Hope

2014-01-01

Background Melanoma incidence and mortality rates in Idaho are higher than national averages. The importance of increased awareness of skin cancer has been cited by state and local organizations. St. Luke’s Mountain States Tumor Institute (MSTI) prioritized educational outreach efforts to focus on the implementation of a skin cancer prevention program in rural Idaho. Community Context As a community cancer center, MSTI expanded cancer education services to include dedicated support to rural communities. Through this expansion, an MSTI educator sought to partner with a community organization to provide sun-safety education. MSTI selected, adapted, and implemented an evidence-based program, Pool Cool. Methods The education program was implemented in 5 phases. In Phase I, we identified and recruited a community partner; in Phase 2, after thorough research, we selected a program, Pool Cool; in Phase 3, we planned the details of the program, including identification of desired short- and long-term outcomes and adaptation of existing program materials; in Phase 4, we implemented the program in summer 2012; in Phase 5, we assessed program sustainability and expansion. Outcome MSTI developed a sustainable partnership with Payette Municipal Pool, and in summer 2012, we implemented Pool Cool. Sun-safety education was provided to more than 700 young people aged 2 to 17 years, and educational signage and sunscreen benefitted hundreds of additional pool patrons. Interpretation Community cancer centers are increasingly being asked to assess community needs and implement evidence-based prevention and screening programs. Clinical staff may become facilitators of evidence-based public health programs. Challenges of implementing evidence-based programs in the context of a community cancer centers are staffing, leveraging of resources, and ongoing training and support. PMID:24809363

School Fire Safety Manual.

ERIC Educational Resources Information Center

Arkansas State Dept. of Education, Little Rock. General Education Div.

This manual provides the background information necessary for the planning of school fire safety programs by local school officials, particularly in Arkansas. The manual first discusses the need for such programs and cites the Arkansas state law regarding them. Policies established by the Arkansas State Board of Education to implement the legal…

Physical Activity and Psychological Correlates during an After-School Running Club

ERIC Educational Resources Information Center

Kahan, David; McKenzie, Thomas L.

2018-01-01

Background: After-school programs (ASPs) have the potential to contribute to moderate-to-vigorous physical activity (MVPA), but there is limited empirical evidence to guide their development and implementation. Purpose: This study assessed the replication of an elementary school running program and identified psychological correlates of children's…

A Simplified Program Needs Assessment Process.

ERIC Educational Resources Information Center

Clark, Larry

A rationale, background information, and a discussion of methodology are presented for a needs assessment process intended for pilot implementation at Western Piedmont Community College (WPCC). This process was designed to assess the local need for paraprofessional programs in the Human Services area, i.e., Early Childhood Associate, Mental Health…

Active Generations: An Intergenerational Approach to Preventing Childhood Obesity

ERIC Educational Resources Information Center

Werner, Danilea; Teufel, James; Holtgrave, Peter L.; Brown, Stephen L.

2012-01-01

Background: Over the last 3 decades, US obesity rates have increased dramatically as more children and more adults become obese. This study explores an innovative program, Active Generations, an intergenerational nutrition education and activity program implemented in out-of-school environments (after school and summer camps). It utilizes older…

Illinois Programs of Study Guide: 2009

ERIC Educational Resources Information Center

Taylor, Jason L.; Kirby, Catherine L., Bragg, Debra D.; Oertle, Kathleen M.; Jankowski, Natasha A.; Khan, Sadya S.

2009-01-01

This guide begins with background information useful to understanding Illinois' framework for implementation and evaluation of Programs of Study. It starts with a visual depiction of the relationships between activity at the federal, state and local levels that evolved to the creation of Illinois' Career Cluster Model. This Model, which is based…

Bilingual Education and Social Change. Bilingual Education and Bilingualism: 14.

ERIC Educational Resources Information Center

Freeman, Rebecca D.

A case study is provided of dual-language planning and implementation at the Oyster Bilingual School, a successful Spanish-English public elementary school program in the District of Columbia. The first three chapters offer background information for understanding how the program interacts with the larger sociopolitical context of minority…

Notification: Background Investigation Services Project Notification US Virgin Islands Environmental Program Evaluation

EPA Pesticide Factsheets

Projects #OPE-FY14-0004, OPE-FY14-0005 and OPE-FY14-0006, October 30, 2013. The EPA OIG plans to begin preliminary research on October 30, 2013 into the environmental programs the US Virgin Islands (USVI) has implemented on EPA’s behalf.

A School-Based Program for Overweight and Obese Adolescents: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Pbert, Lori; Druker, Susan; Barton, Bruce; Schneider, Kristin L.; Olendzki, Barbara; Gapinski, Mary A.; Kurtz, Stephen; Osganian, Stavroula

2016-01-01

Background: Given the dramatic increase in adolescent overweight and obesity, models are needed for implementing weight management treatment through readily accessible venues. We evaluated the acceptability and efficacy of a school-based intervention consisting of school nurse-delivered counseling and an afterschool exercise program in improving…

Planning Adolescent Mental Health Promotion Programming in Saskatoon

ERIC Educational Resources Information Center

Cushon, Jennifer; Waldner, Cheryl; Scott, Christina; Neudorf, Cordell

2016-01-01

Background: We assessed associations between key demographic risk factors and the outcome of depressed mood in Saskatoon, Saskatchewan, to inform the planning and implementation of mental health promotion programming in schools. Methods: In the 2008/2009 school year, 3,958 students from grades 5 through 8 from 76 elementary schools completed…

Evaluation of a Life Skills Program to Prevent Adolescent Alcohol Use in Two European Countries: One-Year Follow-Up

ERIC Educational Resources Information Center

Giannotta, Fabrizia; Weichold, Karina

2016-01-01

Background: Life skills programs are effective tools to combat youth substance use. However there is a lack of studies concerning their effectiveness in Europe. Objective: This study investigated the 1 year follow up effects and the program implementation of a life skills school-based intervention (IPSY: Information + Psychosocial…

The Wide-Scale Implementation of a Support Program for Parents of Children with an Intellectual Disability and Difficult Behaviour

ERIC Educational Resources Information Center

Hudson, Alan; Cameron, Christine; Matthews, Jan

2008-01-01

Background: While there have been several evaluations of programs to help parents manage difficult behaviour of their child with an intellectual disability, little research has focused on the evaluation of such programs when delivered to large populations. Method: The benchmarks recommended by Wiese, Stancliffe, and Hemsley (2005) were used to…

Suicide Prevention among High School Students: Evaluation of a Nonrandomized Trial of a Multi-Stage Suicide Screening Program

ERIC Educational Resources Information Center

Torcasso, Gina; Hilt, Lori M.

2017-01-01

Background: Suicide is a leading cause of death among youth. Suicide screening programs aim to identify mental health issues and prevent death by suicide. Objective: The present study evaluated outcomes of a multi-stage screening program implemented over 3 school years in a moderately-sized Midwestern high school. Methods: One hundred ninety-three…

Implementation of Lifestyle Modification Program Focusing on Physical Activity and Dietary Habits in a Large Group, Community-Based Setting

ERIC Educational Resources Information Center

Stoutenberg, Mark; Falcon, Ashley; Arheart, Kris; Stasi, Selina; Portacio, Francia; Stepanenko, Bryan; Lan, Mary L.; Castruccio-Prince, Catarina; Nackenson, Joshua

2017-01-01

Background: Lifestyle modification programs improve several health-related behaviors, including physical activity (PA) and nutrition. However, few of these programs have been expanded to impact a large number of individuals in one setting at one time. Therefore, the purpose of this study was to determine whether a PA- and nutrition-based lifestyle…

Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management. Part 1

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

Not Available

This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management.

A computer program for predicting nonlinear uniaxial material responses using viscoplastic models

NASA Technical Reports Server (NTRS)

Chang, T. Y.; Thompson, R. L.

1984-01-01

A computer program was developed for predicting nonlinear uniaxial material responses using viscoplastic constitutive models. Four specific models, i.e., those due to Miller, Walker, Krieg-Swearengen-Rhode, and Robinson, are included. Any other unified model is easily implemented into the program in the form of subroutines. Analysis features include stress-strain cycling, creep response, stress relaxation, thermomechanical fatigue loop, or any combination of these responses. An outline is given on the theoretical background of uniaxial constitutive models, analysis procedure, and numerical integration methods for solving the nonlinear constitutive equations. In addition, a discussion on the computer program implementation is also given. Finally, seven numerical examples are included to demonstrate the versatility of the computer program developed.

Options and Opportunities: A Community College Educator's Guidebook for Nontraditional Vocational Program Improvement.

ERIC Educational Resources Information Center

Carvell, Fred; And Others

Based upon data collected in a survey of students (N=500) and administrators (N=100) at 12 California community colleges, this guidebook provides background information and implementation strategies for the improved recruitment, retention, and placement of male and female students in non-traditional vocational programs. Part I examines legislation…

Design and Implementation of a Community Program to Promote Cognitive Vitality among Seniors

ERIC Educational Resources Information Center

Parisien, Manon; Lorthios-Guilledroit, Agathe; Bier, Nathalie; Gilbert, Norma; Nour, Kareen; Guay, Danielle; Langlois, Francis; Fournier, Baptiste; Laforest, Sophie

2016-01-01

Background: Jog Your Mind is a community-based program aiming to enable seniors to maintain their cognitive abilities. It includes stimulating activities, information on aging, mnemonic strategies, and promotion of a healthy lifestyle and is offered over 10 weekly sessions to seniors with no known cognitive impairment. Purpose: This article…

Effectiveness of School-Initiated Physical Activity Program on Secondary School Students' Physical Activity Participation

ERIC Educational Resources Information Center

Gråstén, Arto; Yli-Piipari, Sami; Watt, Anthony; Jaakkola, Timo; Liukkonen, Jarmo

2015-01-01

Background: The promotion of physical activity and health has become a universal challenge. The Sotkamo Physical Activity as Civil Skill Program was implemented to increase students' physical activity by promoting supportive psychological and physical school environment. The aim of this study was to evaluate the effectiveness of the…

Implementing an Alcohol and Other Drug Use Prevention Program Using University-High School Partnerships: Challenges and Lessons Learned

ERIC Educational Resources Information Center

Milroy, Jeffrey J.; Orsini, Muhsin Michael; Wyrick, David L.; Fearnow-Kenney, Melodie; Wagoner, Kimberly G.; Caldwell, Rebecca

2015-01-01

Background: School-based alcohol and other drug use prevention remains an important national strategy. Collaborative partnerships between universities and high schools have the potential to enhance prevention programming; however, there are challenges to sustaining such partnerships. Purpose: The purpose of this commentary is to underscore…

Report of the Task Force on School Health.

ERIC Educational Resources Information Center

Maryland State Dept. of Health and Mental Hygiene, Baltimore.

The 1990 Report of the Task Force on School Health examines the current status of Maryland's school health programs and proposes 16 recommendations designed to implement a comprehensive school health (CSH) program to meet the needs of all students. The report describes the Task Force, which was appointed in 1989. After presenting a background on…

The Impact of the School-Based Psychosocial Structured Activities (PSSA) Program on Conflict-Affected Children in Northern Uganda

ERIC Educational Resources Information Center

Ager, Alastair; Akesson, Bree; Stark, Lindsay; Flouri, Eirini; Okot, Braxton; McCollister, Faith; Boothby, Neil

2011-01-01

Background: Children in northern Uganda have undergone significant psychosocial stress during the region's lengthy conflict. A Psychosocial Structured Activities (PSSA) program was implemented in 21 schools identified as amongst those most severely affected by conflict-induced displacement across Gulu and Amuru Districts. The PSSA intervention…

Implementation of a Values Training Program in Physical Education and Sport: A Follow-Up Study

ERIC Educational Resources Information Center

Koh, Koon Teck; Camiré, Martin; Lim Regina, Si Hui; Soon, Woo Sin

2017-01-01

Background: There is growing evidence indicating that physical education and sport (PES) are environments that, when appropriately structured, can promote positive youth developmental outcomes. In recent years, a number of researchers working in PES have designed programs and interventions aimed at helping teachers and coaches teach life skills…

Defining, Valuing, and Teaching Clinical Outcomes Assessment in Professional and Post-Professional Athletic Training Education Programs

ERIC Educational Resources Information Center

Snyder, Alison R.; McLeod, Tamara C. Valovich; Sauers, Eric L.

2007-01-01

Objective: To provide a basic introduction for athletic training educators about the importance of clinical outcomes measures and to recommend strategies for implementing clinical outcomes assessment education in professional and post-professional athletic training education programs. Background: Outcomes is a frequently used term amongst…

Federal Programs Supporting Educational Change, Vol. VIII: Implementing and Sustaining Innovations.

ERIC Educational Resources Information Center

Berman, Paul; McLaughlin, Milbrey Wallin

This report reviews and synthesizes the findings of a four year, two-phase study conducted by the Rand Corporation to examine and evaluate a national sample of educational innovations funded by Federal programs. Section I of this document provides background information and descriptions of the study. Section II discusses Rand's research approach…

Promoting Physical Activity among Youth through Community-Based Prevention Marketing

ERIC Educational Resources Information Center

Bryant, Carol A.; Courtney, Anita H.; McDermott, Robert J.; Alfonso, Moya L.; Baldwin, Julie A.; Nickelson, Jen; Brown, Kelli R. McCormack; DeBate, Rita D.; Phillips, Leah M.; Thompson, Zachary; Zhu, Yiliang

2010-01-01

Background: Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age)…

Teaching Health Literacy Using Popular Television Programming: A Qualitative Pilot Study

ERIC Educational Resources Information Center

Primack, Brian A.; Wickett, Dustin J.; Kraemer, Kevin L.; Zickmund, Susan

2010-01-01

Background: Teaching of health and medical concepts in the K-12 curriculum may help improve health literacy. Purpose: The purpose of this project was to determine acceptability and preliminary efficacy of pilot implementation of a health literacy curriculum using brief clips from a popular television program. Methods: Participants included 55…

Implementing a School-Located Vaccination Program in Denver Public Schools

ERIC Educational Resources Information Center

Shlay, Judith C.; Rodgers, Sarah; Lyons, Jean; Romero, Scott; Vogt, Tara M.; McCormick, Emily V.

2015-01-01

Background: School-located vaccination (SLV) offers an opportunity to deliver vaccines to students, particularly those without a primary care provider. Methods: This SLV program offered 2 clinics at each of 20 elementary schools (influenza vaccine) and 3 clinics at each of 7 middle/preschool-eighth-grade schools (adolescent platform plus catch-up…

Use of Research-Based Information among Leaders of Public Health Agencies

ERIC Educational Resources Information Center

Toomey, Traci L.; Tramel, Sarah; Erickson, Darin J.; Lenk, Kathleen M.

2009-01-01

Background: Researchers have identified numerous policies and programs effective in reducing public health problems, yet many of these programs and policies have not been implemented throughout communities and states. Purpose: To assess the use of research-based information among leaders in the local public health system. Methods: We conducted a…

Implementation of a Study Skills Program for Entering At-Risk Medical Students

ERIC Educational Resources Information Center

Miller, Cynthia J.

2014-01-01

While the first year of medical school is challenging for all students, there may be specific issues for students from rural areas, economically disadvantaged backgrounds, ethnic minorities, or nontraditional age groups. A Summer Prematriculation Program (SPP) was created to prepare entering at-risk students for the demands of medical school. For…

Contextualizing Relationship Education and Adolescent Attitude toward Sexual Behavior: Considering Class Climate

ERIC Educational Resources Information Center

Morrison, Sandra U.; Adler-Baeder, Francesca; Bub, Kristen L.; Duke, Adrienne

2018-01-01

Background: Using data from a statewide relationship education (RE) program targeting a diverse adolescent sample, this study examined RE implementation in classroom environments. Objective: The purpose of this study was to explore (1) whether there is a beneficial RE program effect for change in individual attitudes toward sexual delay, (2)…

Process Evaluation of Two Participatory Approaches: Implementing Total Worker Health® Interventions in a Correctional Workforce

PubMed Central

Dugan, Alicia G.; Farr, Dana A.; Namazi, Sara; Henning, Robert A.; Wallace, Kelly N.; El Ghaziri, Mazen; Punnett, Laura; Dussetschleger, Jeffrey L.; Cherniack, Martin G.

2018-01-01

Background Correctional Officers (COs) have among the highest injury rates and poorest health of all the public safety occupations. The HITEC-2 (Health Improvement Through Employee Control-2) study uses Participatory Action Research (PAR) to design and implement interventions to improve health and safety of COs. Method HITEC-2 compared two different types of participatory program, a CO-only “Design Team” (DT) and “Kaizen Event Teams” (KET) of COs and supervisors, to determine differences in implementation process and outcomes. The Program Evaluation Rating Sheet (PERS) was developed to document and evaluate program implementation. Results Both programs yielded successful and unsuccessful interventions, dependent upon team-, facility-, organizational, state-, facilitator-, and intervention-level factors. Conclusions PAR in corrections, and possibly other sectors, depends upon factors including participation, leadership, continuity and timing, resilience, and financial circumstances. The new PERS instrument may be useful in other sectors to assist in assessing intervention success. PMID:27378470

From Competency List to Curriculum Implementation: A Case Study of Japan's First Online Master's Program for E-Learning Specialists Training

ERIC Educational Resources Information Center

Suzuki, Katsuaki

2009-01-01

This article describes the creation of a fully online master's program for e-learning specialist training. This program is the first of its kind in Japan. As background information, Japan's general trends in e-learning are described, including activities of the e-Learning Consortium Japan and National Institute of Multimedia in Education. Such…

Implementation of HIV and Tuberculosis Diagnostics: The Importance of Context

PubMed Central

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

2015-01-01

Background. Novel diagnostics have been widely applied across human immunodeficiency virus (HIV) and tuberculosis prevention and treatment programs. To achieve the greatest impact, HIV and tuberculosis diagnostic programs must carefully plan and implement within the context of a specific healthcare system and the laboratory capacity. Methods. A workshop was convened in Cape Town in September 2014. Participants included experts from laboratory and clinical practices, officials from ministries of health, and representatives from industry. Results. The article summarizes best practices, challenges, and lessons learned from implementation experiences across sub-Saharan Africa for (1) building laboratory programs within the context of a healthcare system; (2) utilizing experience of clinicians and healthcare partners in planning and implementing the right diagnostic; and (3) evaluating the effects of new diagnostics on the healthcare system and on patient health outcomes. Conclusions. The successful implementation of HIV and tuberculosis diagnostics in resource-limited settings relies on careful consideration of each specific context. PMID:26409272

Aviation Security: A Case for Risk-Based Passenger Screening

DTIC Science & Technology

2011-12-01

5 3. Threat Uncertainty ..............................................................................7 4. Increased Risk and Cost ...Airport Checkpoints .....................................131 ix 2. Technology Integration and Implementation Costs .....................131 3...Background Investigations and Sustaining Program Costs ........133 D. AREAS FOR FUTURE RESEARCH

Obesity Prevention in Early Child Care Settings: A Bistate (Minnesota and Wisconsin) Assessment of Best Practices, Implementation Difficulty, and Barriers

ERIC Educational Resources Information Center

Nanney, Marilyn S.; LaRowe, Tara L.; Davey, Cynthia; Frost, Natasha; Arcan, Chrisa; O'Meara, Joyce

2017-01-01

Background: Long-term evaluation studies reveal that high-quality early care and education (ECE) programs that include a lifestyle component predict later adult health outcomes. The purpose of this article is to characterize the nutrition and physical activity (PA) practices, including implementation difficulty and barriers, of licensed center-…

The First Years of Teaching: Background Papers and a Proposal.

ERIC Educational Resources Information Center

Griffin, Gary A., Ed.; Millies, Suzanne, Ed.

The papers in this volume were commissioned to provide information useful for planning, implementing, and assessing the impact of new teacher programs, such as the Illinois Initial Year of Teaching Program. These papers were presented at a conference held at the University of Chicago in September 1987 on the initial year of teaching to provide a…

A Comparison of Two Reading Programs on Third Grade Reading Achievement

ERIC Educational Resources Information Center

Miller, Tawana D.

2008-01-01

Background: The No Child Left Behind Act legislation requires both higher standards and higher success rates at the same time. Failure of students to learn to read adequately as shown by national and state test results and the need for continued school success had prompted education officials to implement two reading programs--Voyager Universal…

Assessing Effectiveness of Students Taking a Right Stand (STARS) Nashville Student Assistance Programs

ERIC Educational Resources Information Center

Kanu, Mohamed; Hepler, Nancy; Labi, Halima

2015-01-01

Background: Since 1984, Students Taking a Right Stand (STARS) Nashville has implemented Student Assistance Programs (SAPs) in the middle Tennessee area, to include 14 counties and 16 school districts. STARS Nashville serves K-12 with a focus in middle and high schools. Methods: The current study reviewed studies that utilized quasi-experimental…

Evaluating the Impact of a Connecticut Program to Reduce Availability of Unhealthy Competitive Food in Schools

ERIC Educational Resources Information Center

Long, Michael W.; Henderson, Kathryn E.; Schwartz, Marlene B.

2010-01-01

Background: This article seeks to inform state and local school food policies by evaluating the impact of Connecticut's Healthy Food Certification (HFC), a program which provides monetary incentives to school districts that choose to implement state nutrition standards for all foods sold to students outside reimbursable school meals. Methods: Food…

Special Education in the Natural Environment: A Training Manual in Providing Outdoor Education, Recreation and Camping for Children with Disabilities.

ERIC Educational Resources Information Center

Robb, Gary M.; And Others

The training manual for use with personnel concerned with outdoor education for the handicapped provides a guide to program development in the areas of background knowledge, skills and methods of outdoor education, individualized planning, and program evaluation. The five units are titled: "Defining,""Introducing,""Individualizing,""Implementing,"…

Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program

ERIC Educational Resources Information Center

Todorova, Irina L. G.; Tejada, Shirley; Castaneda-Sceppa, Carmen

2014-01-01

Background: Puerto Ricans are the second largest Hispanic group in the United States, and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. Purpose: To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being…

Implementation of CDC's School Health Index in 3 Midwest Middle Schools: Motivation for Change

ERIC Educational Resources Information Center

Sherwood-Puzzello, Catherine M.; Miller, Michelle; Lohrmann, David; Gregory, Patricia

2007-01-01

Background: The Centers for Disease Control and Prevention's School Health Index (SHI), a guide for completing a coordinated school-based program needs assessment relative to healthy eating, physical activity, a tobacco-free lifestyle, and prevention of other health risk behaviors and conditions, was used to assess current programming at 3…

Predicting Treatment Time with the Lidcombe Program: Replication and Meta-Analysis

ERIC Educational Resources Information Center

Kingston, Mary; Huber, Anna; Onslow, Mark; Jones, Mark; Packman, Ann

2003-01-01

Background: The benefits of treating stuttering close to onset have become obvious in recent years, and the Lidcombe Program has emerged as an effective and safe treatment method for children in their preschool years. The benefits of implementing the programme with young children, however, need to be weighed against the knowledge that many…

Employability Skills, the Student Path, and the Role of the Academic Library and Partners

ERIC Educational Resources Information Center

Tyrer, Gwyneth; Ives, Joanne; Corke, Charlotte

2013-01-01

This case study explores the introduction of a university wide employability program by the World of Work Careers Centre (WOWCC) at Liverpool John Moores University (LJMU). The article reports the background against which an employability program was implemented; the justification and growing demand for more emphasis on employability skills in…

Office of Student Financial Aid Quality Improvement Program: Design and Implementation Plan.

ERIC Educational Resources Information Center

Advanced Technology, Inc., Reston, VA.

The purpose and direction of the Office of Student Financial Aid (OSFA) quality improvement program are described. The background and context for the Pell Grant quality control (QC) design study and the meaning of QC are reviewed. The general approach to quality improvement consists of the following elements: a strategic approach that enables OSFA…

Determinants of Teacher Implementation of Youth Fitness Tests in School-Based Physical Education Programs

ERIC Educational Resources Information Center

Keating, Xiaofen Deng; Silverman, Stephen

2009-01-01

Background: Millions of American children are participating in fitness testing in school-based physical education (PE) programs. However, practitioners and researchers in the field of PE have questioned the need for regular or mandatory youth fitness testing. This was partly because a significant improvement in youth fitness and physical activity…

The Impact of a Patient Safety Program on Medical Error Reporting

DTIC Science & Technology

2005-05-01

307 The Impact of a Patient Safety Program on Medical Error Reporting Donald R. Woolever Abstract Background: In response to the occurrence of...a sentinel event—a medical error with serious consequences—Eglin U.S. Air Force (USAF) Regional Hospital developed and implemented a patient safety...communication, teamwork, and reporting. Objective: To determine the impact of a patient safety program on patterns of medical error reporting. Methods: This

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration

PubMed Central

Sullivan, Jennifer L.; Adjognon, Omonyêlé L.; Engle, Ryann L.; Shin, Marlena H.; Afable, Melissa K.; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

2018-01-01

Background: From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. Purpose: The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Methodology: Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. Results: The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. Discussion: This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Implications: Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges. PMID:28125459

Implementing the CDC’s Colorectal Cancer Screening Demonstration Program: Wisdom From the Field

PubMed Central

Rohan, Elizabeth A.; Boehm, Jennifer E.; DeGroff, Amy; Glover-Kudon, Rebecca; Preissle, Judith

2017-01-01

BACKGROUND Colorectal cancer, as the second leading cause of cancer-related deaths among men and women in the United States, represents an important area for public health intervention. Although colorectal cancer screening can prevent cancer and detect disease early when treatment is most effective, few organized public health screening programs have been implemented and evaluated. From 2005 to 2009, the Centers for Disease Control and Prevention funded 5 sites to participate in the Colorectal Cancer Screening Demonstration Program (CRCSDP), which was designed to reach medically underserved populations. METHODS The authors conducted a longitudinal, multiple case study to analyze program implementation processes. Qualitative methods included interviews with 100 stakeholders, 125 observations, and review of 19 documents. Data were analyzed within and across cases. RESULTS Several themes related to CRCSDP implementation emerged from the cross-case analysis: the complexity of colorectal cancer screening, the need for teamwork and collaboration, integration of the program into existing systems, the ability of programs to use wisdom at the local level, and the influence of social norms. Although these themes were explored independently from 1 another, interaction across themes was evident. CONCLUSIONS Colorectal cancer screening is clinically complex, and its screening methods are not well accepted by the general public; both of these circumstances have implications for program implementation. Using patient navigation, engaging in transdisciplinary teamwork, assimilating new programs into existing clinical settings, and deferring to local-level wisdom together helped to address complexity and enhance program implementation. In addition, public health efforts must confront negative social norms around colorectal cancer screening. PMID:23868482

Energy and Environment Guide to Action - Chapter 1: Introduction and Background

EPA Pesticide Factsheets

Introduces the Energy and Environment Guide to Action which documents best practices for designing and implementing state policies and the benefits of energy efficiency, renewable energy, and combined heat and power policies and programs.

Reforming Vocational Didactics by Implementing a New VET Teacher Education in Denmark: Tensions and Challenges Reflected in Interviews with Vocational College Teachers

ERIC Educational Resources Information Center

Duch, Henriette; Andreasen, Karen E.

2015-01-01

A new education program, Diploma of Vocational Pedagogy, has recently been implemented in Denmark to upskill vocational college teachers and improve didactics at VET colleges in general. Among many challenges, vocational college teachers have to adapt their pedagogy to a large number of students from backgrounds with no tradition for education.…

International Disability Educational Alliance (IDEAnet)

DTIC Science & Technology

2011-03-23

scientists who have graduated from the Field Epidemiology Training Program (FELTP) GUI: Graphical User Interface GIS : Global Implementation Solutions...how to participate in IDEAnet programs, and background information. 47 “Materials for Download ” is used here to denote materials that will be provided...for download and use by interested parties. The materials may include: written/pictorial instructions, articles, videos, images, and other materials

Societal and Educational Projections, Appendix A. Vol. II, A Plan for Managing the Development, Implementation and Operation of a Model Elementary Teacher Education Program.

ERIC Educational Resources Information Center

Corley, Clifford L.; Koch, Norman E.

The purpose of this paper is to identify and describe background information and possible indicators for future planning of elementary education, as a prerequisite to planning realistic education programs for early childhood and elementary school teachers. Developments considered include population growth, changing cultural characteristics,…

Transforming Tech Ed: The Advanced Technological Education Community Leads in Developing and Implementing Teaching Strategies

ERIC Educational Resources Information Center

Patton, Madeline

2015-01-01

After years of working in the background to build the capacity of two-year college science, technology, engineering and math (STEM) faculty and the skills of technicians, the Advanced Technological Education (ATE) program is gaining recognition as a source of STEM workforce expertise. The ATE program's effective mentoring of STEM educators and its…

Implementation of a Values Training Program in Physical Education and Sport: Perspectives from Teachers, Coaches, Students, and Athletes

ERIC Educational Resources Information Center

Koh, Koon Teck; Ong, Shu Wen; Camiré, Martin

2016-01-01

Background: Past research has shown that under the right conditions, youth can learn values through physical education and sport (PES). Although some programs have been developed using PES as a means to foster positive development, a limited amount of research has specifically addressed how stakeholders believe this type of material can be…

Translational Research in South Africa: Evaluating Implementation Quality Using a Factorial Design

ERIC Educational Resources Information Center

Caldwell, Linda L.; Smith, Edward A.; Collins, Linda M.; Graham, John W.; Lai, Mary; Wegner, Lisa; Vergnani, Tania; Matthews, Catherine; Jacobs, Joachim

2012-01-01

Background: HealthWise South Africa: Life Skills for Adolescents (HW) is an evidence-based substance use and sexual risk prevention program that emphasizes the positive use of leisure time. Since 2000, this program has evolved from pilot testing through an efficacy trial involving over 7,000 youth in the Cape Town area. Beginning in 2011, through…

Manual for computing bed load transport using BAGS (Bedload Assessment for Gravel-bed Streams) Software

Treesearch

John Pitlick; Yantao Cui; Peter Wilcock

2009-01-01

This manual provides background information and instructions on the use of a spreadsheet-based program for Bedload Assessment in Gravel-bed Streams (BAGS). The program implements six bed load transport equations developed specifically for gravel-bed rivers. Transport capacities are calculated on the basis of field measurements of channel geometry, reach-average slope,...

The Academic Impact of Enrollment in International Baccalaureate Diploma Programs: A Case Study of Chicago Public Schools

ERIC Educational Resources Information Center

Saavedra, Anna Rosefsky

2014-01-01

Background: In schools accredited as "IB World Schools" by the International Baccalaureate Organization (IBO), teachers use IB curriculum and pedagogy to teach a range of courses that are intended to prepare IB-enrolled students for college. Over the past 18 years, the number of U.S. schools that implement IB programs has increased…

Stakeholders' Perspectives towards the Use of the Comprehensive Health Assessment Program (CHAP) for Adults with Intellectual Disabilities in Manitoba

ERIC Educational Resources Information Center

Shooshtari, Shahin; Temple, Beverley; Waldman, Celeste; Abraham, Sneha; Ouellette-Kuntz, Héléne; Lennox, Nicholas

2017-01-01

Background: No standardized tool is used in Canada for comprehensive health assessments of adults with intellectual disabilities. This study was conducted to determine the feasibility of implementing the Comprehensive Health Assessment Program (CHAP) in Manitoba, Canada. Method: This was a qualitative study using a purposive sample of physicians,…

Reading Engagement in Social Studies: Exploring the Role of a Social Studies Literacy Intervention on Reading Comprehension, Reading Self-Efficacy, and Engagement in Middle School Students with Different Language Backgrounds

ERIC Educational Resources Information Center

Barber, Ana Taboada; Buehl, Michelle M.; Kidd, Julie K.; Sturtevant, Elizabeth G.; Nuland, Leila Richey; Beck, Jori

2015-01-01

The authors examined the role of an intervention designed to increase reading comprehension, reading self-efficacy beliefs, and engagement in social studies for middle school students of varying language backgrounds. Thirteen sixth- and seventh-grade teachers implemented the United States History for Engaged Reading (USHER) program with their…

Case studies of energy efficiency financing in the original five pilot states, 1993-1996

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

Farhar, B C; Collins, N E; Walsh, R W

1997-05-01

The purpose of this report is to document progress in state-level programs in energy efficiency financing programs that are linked with home energy rating systems. Case studies are presented of programs in five states using a federal pilot program to amortize the costs of home energy improvements. The case studies present background information, describe the states` program, list preliminary evaluation data and findings, and discuss problems and solution encountered in the programs. A comparison of experiences in pilot states will be used to provide guidelines for program implementers, federal agencies, and Congress. 5 refs.

Design and implementation of integrated solid wastes management pattern in industrial zones, case study of Shahroud, Iran

PubMed Central

2014-01-01

Background The aim of the study was to design and implementation of integrated solid wastes management pattern in Shahroud industrial zone, evaluates the results and determine possible performance problems. This cross - sectional study was carried out for 4 years in Shahroud industrial zone and the implementation process included:1- Qualitative and quantitative analysis of all solid waste generated in the city, 2- determine the current state of solid waste management in the zone and to identify programs conducted, 3- Design and implementation of integrated solid wastes management pattern including design and implementation of training programs, laws, penalties and incentives and explain and implement programs for all factories and 4- The monitoring of the implementation process and determine the results. Results Annually, 1,728 tons of solid wastes generated in the town including 1603 tons of industrial wastes and 125 tons of municipal wastes. By implementing this pattern, the two separated systems of collection and recycling of domestic and industrial wastes was launched in this zone. Also consistent with the goals, the amount of solid wastes generated and disposed in 2009 was 51.5 and 28.6 kg per 100 million Rials production, respectively. Conclusion Results showed that implementation of pattern of separated collection, training programs, capacity building, providing technical services, completing chain of industries and strengthening the cooperation between industrial estate management and industrial units could greatly reduce the waste management problems. PMID:24423020

3 Steps to Developing a Tribal Integrated Waste Management Plan (IWMP)

EPA Pesticide Factsheets

An Integrated Waste Management Plan (IWMP) is the blueprint of a comprehensive waste management program. The steps to developing an IWMP are collect background data, map out the tribal IWMP framework, and write and implement the tribal IWMP.

Healthcare technologies, quality improvement programs and hospital organizational culture in Canadian hospitals

PubMed Central

2013-01-01

Background Healthcare technology and quality improvement programs have been identified as a means to influence healthcare costs and healthcare quality in Canada. This study seeks to identify whether the ability to implement healthcare technology by a hospital was related to usage of quality improvement programs within the hospital and whether the culture within a hospital plays a role in the adoption of quality improvement programs. Methods A cross-sectional study of Canadian hospitals was conducted in 2010. The sample consisted of hospital administrators that were selected by provincial review boards. The questionnaire consisted of 3 sections: 20 healthcare technology items, 16 quality improvement program items and 63 culture items. Results Rasch model analysis revealed that a hierarchy existed among the healthcare technologies based upon the difficulty of implementation. The results also showed a significant relationship existed between the ability to implement healthcare technologies and the number of quality improvement programs adopted. In addition, culture within a hospital served a mediating role in quality improvement programs adoption. Conclusions Healthcare technologies each have different levels of difficulty. As a consequence, hospitals need to understand their current level of capability before selecting a particular technology in order to assess the level of resources needed. Further the usage of quality improvement programs is related to the ability to implement technology and the culture within a hospital. PMID:24119419

Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents

PubMed Central

Singh, Amika S; Chin A Paw, Marijke JM; Kremers, Stef PJ; Visscher, Tommy LS; Brug, Johannes; van Mechelen, Willem

2006-01-01

Background Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. Methods Applying the Intervention Mapping (IM) protocol, this paper describes the development, implementation, and evaluation of the Dutch Obesity Intervention in Teenagers (DOiT), a school-based intervention program aimed at the prevention of excessive weight gain. The intervention focussed on the following health behaviours: (1) reduction of the consumption of sugar-sweetened beverages, (2) reduction of energy intake derived from snacks, (3) decrease of levels of sedentary behaviour, and (4) increase of levels of physical activity (i.e. active transport behaviour and sports participation). The intervention program consisted of an individual classroom-based component (i.e. an educational program, covering 11 lessons of both biology and physical education classes), and an environmental component (i.e. encouraging and supporting changes at the school canteens, as well as offering additional physical education classes). We evaluated the effectiveness of the intervention program using a randomised controlled trial design. We assessed the effects of the intervention on body composition (primary outcome measure), as well as on behaviour, behavioural determinants, and aerobic fitness (secondary outcome measures). Furthermore, we conducted a process evaluation. Discussion The development of the DOiT-intervention resulted in a comprehensive school-based weight gain prevention program, tailored to the needs of Dutch adolescents from low socio-economic background. PMID:17173701

2+2 Electronics Technology. Looking Forward to the Future. A Model Secondary/Post-Secondary 2+2 Program To Prepare Students for Employment.

ERIC Educational Resources Information Center

Judson Independent School District, Converse, TX.

This document contains all pertinent information and essential background data necessary to implement the 2+2 electronics program at the high school level. An introduction describes development of the electronics technology 2+2 project that was a joint effort among San Antonio College and Judson, Northside, and North East Independent School…

Designing, Implementing, and Evaluating a Department-Wide Service-Learning Program for English Language Learners in Morocco

ERIC Educational Resources Information Center

Seilstad, Brian

2014-01-01

This article describes the theoretical and pedagogical background and results from the first semester of a service-learning program for English learners at a public Moroccan university and the local high school. This study fills a gap in the literature related to service-learning practice and outcomes in Morocco and the Arab world in general. The…

Intervening in the Professional Development of Science Teachers: The Colorado Science Teaching Enhancement Program. Interim Report of the Formative Evaluation of CO-STEP.

ERIC Educational Resources Information Center

Ellis, James D.; Maxwell, Donald E.

The purposes of the Colorado Science Teaching Enhancement Program (CO-STEP) are to improve the background in science content and the instructional skills of teachers in grades four through six throughout Colorado and to support the implementation of effective instruction. A network of six Teacher Development Centers in Colorado coordinate teacher…

Impact of the Garrett Lee Smith youth suicide prevention program on suicide mortality.

PubMed

Walrath, Christine; Garraza, Lucas Godoy; Reid, Hailey; Goldston, David B; McKeon, Richard

2015-05-01

We examined whether a reduction in youth suicide mortality occurred between 2007 and 2010 that could reasonably be attributed to Garrett Lee Smith (GLS) program efforts. We compared youth mortality rates across time between counties that implemented GLS-funded gatekeeper training sessions (the most frequently implemented suicide prevention strategy among grantees) and a set of matched counties in which no GLS-funded training occurred. A rich set of background characteristics, including preintervention mortality rates, was accounted for with a combination of propensity score-based techniques. We also analyzed closely related outcomes that we did not expect to be affected by GLS as control outcomes. Counties implementing GLS training had significantly lower suicide rates among the population aged 10 to 24 years the year after GLS training than similar counties that did not implement GLS training (1.33 fewer deaths per 100 000; P = .02). Simultaneously, we found no significant difference in terms of adult suicide mortality rates or nonsuicide youth mortality the year after the implementation. These results support the existence of an important reduction in youth suicide rates resulting from the implementation of GLS suicide prevention programming.

A comparison of common programming languages used in bioinformatics

PubMed Central

Fourment, Mathieu; Gillings, Michael R

2008-01-01

Background The performance of different programming languages has previously been benchmarked using abstract mathematical algorithms, but not using standard bioinformatics algorithms. We compared the memory usage and speed of execution for three standard bioinformatics methods, implemented in programs using one of six different programming languages. Programs for the Sellers algorithm, the Neighbor-Joining tree construction algorithm and an algorithm for parsing BLAST file outputs were implemented in C, C++, C#, Java, Perl and Python. Results Implementations in C and C++ were fastest and used the least memory. Programs in these languages generally contained more lines of code. Java and C# appeared to be a compromise between the flexibility of Perl and Python and the fast performance of C and C++. The relative performance of the tested languages did not change from Windows to Linux and no clear evidence of a faster operating system was found. Source code and additional information are available from Conclusion This benchmark provides a comparison of six commonly used programming languages under two different operating systems. The overall comparison shows that a developer should choose an appropriate language carefully, taking into account the performance expected and the library availability for each language. PMID:18251993

Enablers and barriers in delivery of a cancer exercise program: the Canadian experience

PubMed Central

Mina, D. Santa; Petrella, A.; Currie, K.L.; Bietola, K.; Alibhai, S.M.H.; Trachtenberg, J.; Ritvo, P.; Matthew, A.G.

2015-01-01

Background Exercise is an important therapy to improve well-being after a cancer diagnosis. Accordingly, cancer-exercise programs have been developed to enhance clinical care; however, few programs exist in Canada. Expansion of cancer-exercise programming depends on an understanding of the process of program implementation, as well as enablers and barriers to program success. Gaining knowledge from current professionals in cancer-exercise programs could serve to facilitate the necessary understanding. Methods Key personnel from Canadian cancer-exercise programs (n = 14) participated in semistructured interviews about program development and delivery. Results Content analysis revealed 13 categories and 15 subcategories, which were grouped by three organizing domains: Program Implementation, Program Enablers, and Program Barriers. ■ Program Implementation (5 categories, 8 subcategories) included Program Initiation (clinical care extension, research project expansion, program champion), Funding, Participant Intake (avenues of awareness, health and safety assessment), Active Programming (monitoring patient exercise progress, health care practitioner involvement, program composition), and Discharge and Follow-up Plan.■ Program Enablers (4 categories, 4 subcategories) included Patient Participation (personalized care, supportive network, personal control, awareness of benefits), Partnerships, Advocacy and Support, and Program Characteristics.■ Program Barriers (4 categories, 3 subcategories) included Lack of Funding, Lack of Physician Support, Deterrents to Participation (fear and shame, program location, competing interests), and Disease Progression and Treatment. Conclusions Interview results provided insight into the development and delivery of cancer-exercise programs in Canada and could be used to guide future program development and expansion in Canada. PMID:26715869

Bulgarians: Costumes.

ERIC Educational Resources Information Center

Kolar, Walter W.

This booklet presents background information and descriptions of Bulgarian national costumes. The document is part of an ethnic heritage unit intended for use by elementary and secondary social studies classroom teachers as they develop and implement cultural awareness educational programs on Bulgaria. Costumes from 11 Bulgarian regions are…

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

Tapping into a Billion Dollar Resource, SBIR/STTR

NASA Astrophysics Data System (ADS)

Mexcur, Paul; Kalshoven, James

2002-10-01

This presentation provides an overview of the Small Business Innovation Research (SBIR) and the Small Business Technology Transfer (STTR) Programs as implemented by the National Aeronautics and Space Administration (NASA). These programs, as mandated by Congress, provide an opportunity for small, high technology companies and research institutions to participate in Government sponsored research and development (R&D) efforts in key technology areas. This presentation describes the background and operation of these two programs and discusses what factors a business should consider in making the decision to participate.

Lessons Learned from the Implementation of Brighter Bites: A Food Co-Op to Increase Access to Fruits and Vegetables and Nutrition Education among Low-income Children and Their Families

ERIC Educational Resources Information Center

Sharma, Shreela V.; Chow, Joanne; Pomeroy, Michael; Raber, Margaret; Salako, David; Markham, Christine

2017-01-01

Background: Food co-op models have gained popularity as a mechanism for offering affordable, quality produce. We describe the challenges, successes, and lessons learned from implementation of a school-based program using a food co-op model combined with nutrition education to improve access to and intake of fresh fruits and vegetables among…

IMPLEMENTING NONPROFESSIONAL PROGRAMS IN HUMAN SERVICES. MANPOWER TRAINING SERIES.

ERIC Educational Resources Information Center

SCHMAIS, AARON

SPECIFIC PROCESSES FOR UTILIZING NONPROFESSIONAL EMPLOYEES IN HUMAN SERVICES ARE PRESENTED. THE BACKGROUND, CURRENT STATUS, AND PROBLEMS ARE DISCUSSED. THE ELEMENTS CONSIDERED ARE RECRUITMENT, SCREENING AND SELECTION, TRAINING, PLACEMENT, SUPERVISION, UPGRADING, AND EVALUATION. EXAMPLES OF NONPROFESSIONAL POSITIONS INCLUDE THE CASE AIDE IN SOCIAL…

Innovatively Supporting Teachers’ Implementation of School-Based Sex Education: Developing A Web-Based Coaching Intervention From Problem to Solution

PubMed Central

Kok, Gerjo; Meijer, Suzanne; Mevissen, Fraukje EF

2016-01-01

Background Full program implementation is crucial for effectiveness but is often overlooked or insufficiently considered during development of behavioral change interventions. For school-based health promotion programs, teachers are key players in program implementation, but teacher support in this phase is mostly limited to technical support and information. To ensure optimal implementation of the Dutch school-based sexual health program Long Live Love, a Web-based coaching website was developed to support teachers in completeness and fidelity of program implementation. Objective The aim of this paper is to provide insight into the process of systematic development of a Web-based coaching intervention to support teachers in their implementation of a school-based sexual health program. Methods The intervention mapping (IM) protocol was applied for the development of a theory- and evidence-based intervention. The IM process begins with (1) a needs assessment, followed by (2) the formulation of change objectives, (3) the selection of theory-based intervention methods and practical applications that take the parameters for effectiveness into consideration, (4) integration of practical applications into an organized program, (5) planning for adoption, implementation, and sustainability of the program, and finally, (6) generating an evaluation plan to measure program effectiveness. Results Teacher’s implementation behavior was characterized by inconsistently selecting parts of the program and not delivering (all) lessons as intended by program developers. Teachers, however, did not perceive this behavior as problematic, revealing the discrepancy between teacher’s actual and perceived need for support in delivering Long Live Love lessons with completeness and fidelity. Teachers did, however, acknowledge different difficulties they encountered which could potentially negatively influence the quality of implementation. With the IM protocol, this Web-based coaching intervention was developed based on a concept of unobtrusive coaching, by and for teachers, to bring about change in teachers’ implementation behavior. Conclusions This paper provides an example of a Web-based intervention to bring about behavioral change in a target group of intermediaries who lack intrinsic motivation for coaching and who’s perceptions differ from their actual problematic behavior. The IM protocol is a useful tool for guiding the scientific development of interventions and making them compatible with the needs and preferences of the target group. PMID:27405241

Participation of Students from Under-Represented Groups in Gifted Programs. A Planning Guide To Implement Gifted Rule 6A-6.03019, FAC, As Revised on 9-12-91.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Bureau of Education for Exceptional Students.

This planning guide is intended to facilitate flexibility in meeting the needs of under-represented groups in Florida programs for gifted students. An introduction defines these students (racial or ethnic minorities, limited English proficient, or from a low socioeconomic background), lists the required components of a district plan for increasing…

Factors Influencing Teachers’ Implementation of an Innovative Tobacco Prevention Curriculum for Multiethnic Youth: Project SPLASH

PubMed Central

Sy, Angela; Glanz, Karen

2013-01-01

BACKGROUND The effectiveness of school-based tobacco use prevention programs depends on proper implementation. This study examined factors associated with teachers’ implementation of a smoking prevention curriculum in a cluster randomized trial called Project SPLASH (Smoking Prevention Launch Among Students in Hawaii). METHODS A process evaluation was conducted and a cross-condition comparison used to examine whether teacher characteristics, teacher training, external facilitators and barriers, teacher attitudes, and curriculum attributes were associated with the dose of teacher implementation in the intervention and control arms of the study. Data were collected from a total of 62 middle school teachers in 20 public schools in Hawaii, during the 2000-2001 and 2001-2002 school years. Sources included teacher questionnaires and interviews. Chi-square test and t test revealed that implementation dose was related to teachers’ disciplinary backgrounds and skills and student enjoyment of the curriculum. RESULTS Content analysis, within case, and cross-case analyses of qualitative data revealed that implementing the curriculum in a yearlong class schedule and high teacher self-efficacy supported implementation, while high perceived curriculum complexity was associated with less complete implementation. CONCLUSIONS The results have implications for research, school health promotion practice, and the implementation of evidence-based youth tobacco use prevention curricula. PMID:18387026

Effect of six sigma program on the number of surgeries cancellation

PubMed Central

Gheysari, Esmat; Yousefi, Hojatollah; Soleymani, Hossain; Mojdeh, Soheila

2016-01-01

Background: Today, the rate of surgeries is increasing, but surgeries are canceled due to various reasons. Unexpected cancellation of surgeries not only results in disorder in the operating room schedule, but also causes stress for patients and their family and increases costs. We determined the number and causes of surgery cancellations and areas for improvement. Materials and Methods: This outcome evaluation of Six Sigma program was conducted on 850 cases after the implementation of the program and compared to that of 850 cases which received routine care before the program. Cases were selected through easy sampling during the study. Before the implementation, the number of cancellations was recorded daily and their reasons were investigated. Then, Six Sigma program was implemented in accordance with the reasons for each category and necessary steps were taken to prevent the cancellation of surgeries. Data were collected for 3 months using a three-section data collection form. For data analysis, distribution and relative frequency and chi-square test were used. Results: The three categories of patient, physician, and hospital system were identified as the main causes. The highest rate of cancellation was related to ENT surgeries (74.19%). No cancellations were made in orology surgeries. The implementation of the Six Sigma program caused a significant difference in surgery cancellation (P = 0.003); 31 (3.6%) cases of cancellation were reduced to 12 (1.4%) cases. Conclusions: The results showed that Six Sigma program is a pre-surgery care quality improvement program. Patient education and the implementation of the 6 sigma program can be effective in reducing the rate of cancellation of operations. PMID:27095994

A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial

PubMed Central

2011-01-01

Background Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD) program was not implemented optimally due to various barriers. To decrease these barriers and make implementation of the program more effective a combined implementation (CI) strategy was developed. In our study we will compare the effectiveness of this CI strategy with the usual educational (ED) strategy. Methods In this cluster randomized, single-blinded, controlled trial, each cluster consists of at least two occupational therapists, a manager, and a physician working at Dutch healthcare organizations that deliver community occupational therapy. Forty-five clusters, stratified by healthcare setting (nursing home, hospital, mental health service), have been allocated randomly to either the intervention group (CI strategy) or the control group (ED strategy). The study population consists of the professionals included in each cluster and community-dwelling people with dementia and their caregivers. The primary outcome measures are the use of community OT, the adherence of OTs to the COTiD program, and the cost effectiveness of implementing the COTiD program in outpatient care. Secondary outcome measures are patient and caregiver outcomes and knowledge of managers, physicians and OTs about the COTiD program. Discussion Implementation research is fairly new in the field of occupational therapy, making this a unique study. This study does not only evaluate the effects of the CI-strategy on professionals, but also the effects of professionals' degree of implementation on client and caregiver outcomes. Clinical trials registration NCT01117285 PMID:21450063

The Costs of Critical Care Telemedicine Programs

PubMed Central

Falk, Derik M.; Bonello, Robert S.; Kahn, Jeremy M.; Perencevich, Eli; Cram, Peter

2013-01-01

Background: Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. Methods: We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Results: Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. Conclusions: The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology. PMID:22797291

Effectiveness of Motor Skill Intervention Varies Based on Implementation Strategy

ERIC Educational Resources Information Center

Brian, Ali; Taunton, Sally

2018-01-01

Background: Young children from disadvantaged settings often present delays in fundamental motor skills (FMS). Young children can improve their FMS delays through developmentally appropriate motor skill intervention programming. However, it is unclear which pedagogical strategy is most effective for novice and expert instructors. Purpose: The…

Trends in Postdoctoral Dental Education.

ERIC Educational Resources Information Center

Weaver, Richard

1999-01-01

Presents trend data concerning the current number of programs and positions in postdoctoral dental education, and examines applicant trends in postdoctoral dental education, as background for examining needs and issues that will emerge as a mandatory year of postdoctoral dental education is implemented. Factors influencing student plans to pursue…

Technical Report on Tele-Communications.

ERIC Educational Resources Information Center

San Mateo County PACE Center, Redwood City, CA.

To provide background material for those interested in tele-communication in education and for those planning to implement such programs in their schools, a research study was conducted to gather information from a variety of sources including educational and technical experts, conference participation, visits to schools conducting projects, and…

41 CFR 128-1.8001 - Background.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Earthquake Hazards Reduction Act of 1977 (Act), 42 U.S.C. 7701, et seq., as amended, directs the Federal government to establish and maintain an effective earthquake hazards reduction program to reduce the risks to life and property from future earthquakes. Executive Order 12699 implements certain provisions of the...

41 CFR 128-1.8001 - Background.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Earthquake Hazards Reduction Act of 1977 (Act), 42 U.S.C. 7701, et seq., as amended, directs the Federal government to establish and maintain an effective earthquake hazards reduction program to reduce the risks to life and property from future earthquakes. Executive Order 12699 implements certain provisions of the...

41 CFR 128-1.8001 - Background.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Earthquake Hazards Reduction Act of 1977 (Act), 42 U.S.C. 7701, et seq., as amended, directs the Federal government to establish and maintain an effective earthquake hazards reduction program to reduce the risks to life and property from future earthquakes. Executive Order 12699 implements certain provisions of the...

41 CFR 128-1.8001 - Background.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Earthquake Hazards Reduction Act of 1977 (Act), 42 U.S.C. 7701, et seq., as amended, directs the Federal government to establish and maintain an effective earthquake hazards reduction program to reduce the risks to life and property from future earthquakes. Executive Order 12699 implements certain provisions of the...

41 CFR 128-1.8001 - Background.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Earthquake Hazards Reduction Act of 1977 (Act), 42 U.S.C. 7701, et seq., as amended, directs the Federal government to establish and maintain an effective earthquake hazards reduction program to reduce the risks to life and property from future earthquakes. Executive Order 12699 implements certain provisions of the...

The feasibility of a telephone coaching program on heart failure home management for family caregivers

PubMed Central

Piamjariyakul, Ubolrat; Smith, Carol E.; Russell, Christy; Werkowitch, Marilyn; Elyachar, Andrea

2012-01-01

Objectives To test the feasibility of delivery and evaluate the helpfulness of a coaching heart failure (HF) home management program for family caregivers. Background The few available studies on providing instruction for family caregivers are limited in content for managing HF home care and guidance for program implementation. Method This pilot study employed a mixed methods design. The measures of caregiver burden, confidence, and preparedness were compared at baseline and 3 months post-intervention. Descriptive statistics were used to summarize program costs and demographic data. Content analysis research methods were used to evaluate program feasibility and helpfulness. Results Caregiver (n=10) burden scores were significantly reduced and raw scores of confidence and preparedness for HF home management improved 3 months after the intervention. Content analyses of nurse and caregiver post-intervention data found caregivers rated the program as helpful and described how they initiated HF management skills based on the program. Conclusion The program was feasible to implement. These results suggest the coaching program should be further tested with a larger sample size to evaluate its efficacy. PMID:23116654

The transfer and implementation of an Aboriginal Australian wellbeing program: a grounded theory study

PubMed Central

2013-01-01

Background The concepts and standard practices of implementation, largely originating in developed countries, cannot necessarily be simply transferred into diverse cultural contexts. There has been relative inattention in the implementation science literature paid to the implementation of interventions targeting minority Indigenous populations within developed countries. This suggests that the implementation literature may be bypassing population groups within developed countries who suffer some of the greatest disadvantage. Within the context of Aboriginal Australian health improvement, this study considers the impact of political and cultural issues by examining the transfer and implementation of the Family Wellbeing program across 56 places over a 20-year period. Methods A theoretical model of program transfer was developed using constructivist-grounded theory methods. Data were generated by conducting in-depth interviews with 18 Aboriginal and non-Aboriginal research respondents who had been active in transferring the program. Data were categorised into higher order abstract concepts and the core impetus for and process of program transfer were identified. Results Organizations transferred the program by using it as a vehicle for supporting inside-out empowerment. The impetus to support inside-out empowerment referred to support for Aboriginal people's participation, responsibility for and control of their own affairs, and the associated ripple effects to family members, organizations, communities, and ultimately reconciliation with Australian society at large. Program transfer occurred through a multi-levelled process of embracing relatedness which included relatedness with self, others, and structural conditions; all three were necessary at both individual and organizational levels. Conclusions Similar to international implementation models, the model of supporting inside-out empowerment by embracing relatedness involved individuals, organizations, and interpersonal and inter-organizational networks. However, the model suggests that for minority Indigenous populations within developed countries, implementation approaches may require greater attention to the empowering nature of the intervention and its implementation, and multiple levels of relatedness by individuals and organizations with self, others, and the structural conditions. Key elements of the theoretical model provide a useful blueprint to inform the transfer of other empowerment programs to minority Indigenous and other disadvantaged populations on a case-by-case basis. PMID:24171867

Examining sustainability in a hospital setting: Case of smoking cessation

PubMed Central

2011-01-01

Background The Ottawa Model of Smoking Cessation (OMSC) is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded. Methods Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up) were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged. Results Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program. Conclusions Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during implementation may provide insight into issues affecting program sustainability, and foster development of a sustainability plan. Based on this study, we suggest that sustainability plans should focus on enhancing interactions between the health problem, program features, and stakeholder influence. PMID:21917156

Coverage of Nutrition Interventions Intended for Infants and Young Children Varies Greatly across Programs: Results from Coverage Surveys in 5 Countries.

PubMed

Leyvraz, Magali; Aaron, Grant J; Poonawala, Alia; van Liere, Marti J; Schofield, Dominic; Myatt, Mark; Neufeld, Lynnette M

2017-05-01

Background: The efficacy of a number of interventions that include fortified complementary foods (FCFs) or other products to improve infant and young child feeding (IYCF) is well established. Programs that provide such products free or at a subsidized price are implemented in many countries around the world. Demonstrating the impact at scale of these programs has been challenging, and rigorous information on coverage and utilization is lacking. Objective: The objective of this article is to review key findings from 11 coverage surveys of IYCF programs distributing or selling FCFs or micronutrient powders in 5 countries. Methods: Programs were implemented in Ghana, Cote d'Ivoire, India, Bangladesh, and Vietnam. Surveys were implemented at different stages of program implementation between 2013 and 2015. The Fortification Assessment Coverage Toolkit (FACT) was developed to assess 3 levels of coverage (message: awareness of the product; contact: use of the product ≥1 time; and effective: regular use aligned with program-specific goals), as well as barriers and factors that facilitate coverage. Analyses included the coverage estimates, as well as an assessment of equity of coverage between the poor and nonpoor, and between those with poor and adequate child feeding practices. Results: Coverage varied greatly between countries and program models. Message coverage ranged from 29.0% to 99.7%, contact coverage from 22.6% to 94.4%, and effective coverage from 0.8% to 88.3%. Beyond creating awareness, programs that achieved high coverage were those with effective mechanisms in place to overcome barriers for both supply and demand. Conclusions: Variability in coverage was likely due to the program design, delivery model, quality of implementation, and product type. Measuring program coverage and understanding its determinants is essential for program improvement and to estimate the potential for impact of programs at scale. Use of the FACT can help overcome this evidence gap.

Coverage of Nutrition Interventions Intended for Infants and Young Children Varies Greatly across Programs: Results from Coverage Surveys in 5 Countries123

PubMed Central

Aaron, Grant J; Poonawala, Alia; van Liere, Marti J; Schofield, Dominic; Myatt, Mark

2017-01-01

Background: The efficacy of a number of interventions that include fortified complementary foods (FCFs) or other products to improve infant and young child feeding (IYCF) is well established. Programs that provide such products free or at a subsidized price are implemented in many countries around the world. Demonstrating the impact at scale of these programs has been challenging, and rigorous information on coverage and utilization is lacking. Objective: The objective of this article is to review key findings from 11 coverage surveys of IYCF programs distributing or selling FCFs or micronutrient powders in 5 countries. Methods: Programs were implemented in Ghana, Cote d’Ivoire, India, Bangladesh, and Vietnam. Surveys were implemented at different stages of program implementation between 2013 and 2015. The Fortification Assessment Coverage Toolkit (FACT) was developed to assess 3 levels of coverage (message: awareness of the product; contact: use of the product ≥1 time; and effective: regular use aligned with program-specific goals), as well as barriers and factors that facilitate coverage. Analyses included the coverage estimates, as well as an assessment of equity of coverage between the poor and nonpoor, and between those with poor and adequate child feeding practices. Results: Coverage varied greatly between countries and program models. Message coverage ranged from 29.0% to 99.7%, contact coverage from 22.6% to 94.4%, and effective coverage from 0.8% to 88.3%. Beyond creating awareness, programs that achieved high coverage were those with effective mechanisms in place to overcome barriers for both supply and demand. Conclusions: Variability in coverage was likely due to the program design, delivery model, quality of implementation, and product type. Measuring program coverage and understanding its determinants is essential for program improvement and to estimate the potential for impact of programs at scale. Use of the FACT can help overcome this evidence gap. PMID:28404839

Developing program theory for purveyor programs

PubMed Central

2013-01-01

Background Frequently, social interventions produce less for the intended beneficiaries than was initially planned. One possible reason is that ideas embodied in interventions are not self-executing and require careful and systematic translation to put into practice. The capacity of implementers to deliver interventions is thus paramount. Purveyor organizations provide external support to implementers to develop that capacity and to encourage high-fidelity implementation behavior. Literature on the theory underlying this type of program is not plentiful. Research shows that detailed, explicit, and agreed-upon program theory contributes to and encourages high-fidelity implementation behavior. The process of developing and depicting program theory is flexible and leaves the researcher with what might be seen as an overwhelming number of options. Methods This study was designed to develop and depict the program theory underlying the support services delivered by a South African purveyor. The purveyor supports seventeen local organizations in delivering a peer education program to young people as an HIV/AIDS prevention intervention. Purposive sampling was employed to identify and select study participants. An iterative process that involved site visits, a desktop review of program documentation, one-on-one unstructured interviews, and a subsequent verification process, was used to develop a comprehensive program logic model. Results The study resulted in a formalized logic model of how the specific purveyor is supposed to function; that model was accepted by all study participants. Conclusion The study serves as an example of how program theory of a ‘real life’ program can be developed and depicted. It highlights the strengths and weakness of this evaluation approach, and provides direction and recommendations for future research on programs that employ the purveyor method to disseminate interventions. PMID:23421855

"Kickin' Asthma": School-Based Asthma Education in an Urban Community

ERIC Educational Resources Information Center

Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B.

2008-01-01

Background: In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of "Kickin' Asthma", a school-based asthma…

Perceived Environmental Church Support and Physical Activity among Black Church Members

ERIC Educational Resources Information Center

Baruth, Meghan; Wilcox, Sara; Saunders, Ruth P.; Hooker, Steven P.; Hussey, James R.; Blair, Steven N.

2013-01-01

Background: Churches are an appealing setting for implementing health-related behavior change programs. Purpose: The objective of the study was to examine the relationship between perceived environmental church support for physical activity (PA) and PA behaviors. Method: Black church members from South Carolina ("n" = 309) wore an…

Quality/Performance Circles Three Years after Implementation.

ERIC Educational Resources Information Center

Ladwig, Dennis J.

An overview is provided of the development of quality/performance circles at Lakeshore Technical Institute (LTI), Wisconsin, and of the projects undertaken through the quality/performance circle program during its 3-year history. First, background information is provided on the use of quality circles in Japan and the United States, including…

Intervention Fidelity for a Complex Behaviour Change Intervention in Community Pharmacy Addressing Cardiovascular Disease Risk

ERIC Educational Resources Information Center

McNamara, K. P.; O'Reilly, S. L.; George, J.; Peterson, G. M.; Jackson, S. L.; Duncan, G.; Howarth, H.; Dunbar, J. A.

2015-01-01

Background: Delivery of cardiovascular disease (CVD) prevention programs by community pharmacists appears effective and enhances health service access. However, their capacity to implement complex behavioural change processes during patient counselling remains largely unexplored. This study aims to determine intervention fidelity by pharmacists…

Improving Student Preparedness and Retention--Perceptions of Staff at Two Universities

ERIC Educational Resources Information Center

Marr, David; Nicoll, Camilla; von Treuer, Kathryn; Kolar, Christina; Palermo, Josephine

2013-01-01

In 2010 the Australian government provided funding under the Higher Education Participation and Partnerships Program (HEPPP) to assist universities to achieve a 20 percent participation rate for students from lower socioeconomic backgrounds. This funding has allowed universities the opportunity to implement projects towards this end. This study…

Staff Development for the Social Studies Teacher.

ERIC Educational Resources Information Center

Dillon-Peterson, Elizabeth; Greenawald, G. Dale

The book identifies critical variables that influence the success or failure of staff development programs for social studies teachers and provides suggestions for planning and implementing effective inservice activities. It is based on interviews with 24 educators of diverse backgrounds and the authors' own practical field experiences as well as…

Collaborative School-Based Obesity Interventions: Lessons Learned from 6 Southern Districts

ERIC Educational Resources Information Center

Jain, Anjali; Langwith, Casey

2013-01-01

Background: Although studies have shown that school-based obesity interventions can be effective, little is known about how to translate and implement programs into real-world school settings. Methods: Semistructured interviews were conducted in spring 2012 with 19 key informants who participated in a multifaceted childhood obesity intervention…

Advantages of Coordinated School Health Portfolios: Documenting and Showcasing Achievements

ERIC Educational Resources Information Center

Shipley, Meagan; Lohrmann, David; Barnes, Priscilla; O'Neill, Jim

2013-01-01

Background: Thirteen school district teams from Michigan and Indiana participated in the Michiana Coordinated School Health Leadership Institute with the intent of Coordinated School Health Program (CSHP) implementation. The purpose of this study was to determine if portfolios served as an effective approach for documenting teams' accomplishments…

A School-to-Work Resource Guide: Focusing on Diversity.

ERIC Educational Resources Information Center

Maddy-Bernstein, Carolyn, Comp.; And Others

This guide, which is designed for educators who are developing, implementing, or seeking background information about school-to-work transition programs, contains descriptions of 222 of the most current (1990-present) resources for/about the school-to-work transition. The entries describing each resource are organized into four sections:…

The Spencer Research Training Grant at the Penn Graduate School of Education: Implementation and Effects

ERIC Educational Resources Information Center

Kecskemethy, Thomas A.

2008-01-01

Background/Context: The Research Training Grant (RTG) program at the University of Pennsylvania's Graduate School of Education aimed to create strong research training experiences for predissertation fellows through generous financial aid, mentored research apprenticeships, and cocurricular experiences. Collectively these offerings sought to…

Promising Instructional Practices for English Language Learners

ERIC Educational Resources Information Center

Prince, Johanna

2018-01-01

Aim/Purpose: The purpose of this exploratory case study was to understand how teachers, working with English Language Learners (ELLs), expanded their knowledge and instructional practices as they implemented a one-to-one iPad® program. Background: English Language Learners experience linguistic, cultural, and cognitive shifts that can be…

RE-AIM Analysis of a School-Based Nutrition Education Intervention in Kindergarteners

ERIC Educational Resources Information Center

Larsen, Andrew L.; Liao, Yue; Alberts, Janel; Huh, Jimi; Robertson, Trina; Dunton, Genevieve F.

2017-01-01

Background: Few nutrition interventions in kindergarten classes have been evaluated, and none has been tested for program effectiveness, implementation, and dissemination. Building a Healthy Me (BHM) is a nutrition intervention for kindergarteners that is classroom-based and includes a family component. This study evaluated the public health…

Implementation of School Policies to Prevent Youth Tobacco Use in Alabama

ERIC Educational Resources Information Center

Geiger, Brian F.; Vaid, Isam; Beeson, Diane; Riddle, Barry

2012-01-01

Background: Public health professionals must monitor the effectiveness of school policies and programs to prevent youth initiation, promote quitting, and eliminate secondhand smoke. This analysis of school tobacco policies was preliminary to release of a state tobacco prevention and control plan for 2010-2015. Methods: University health educators…

76 FR 56949 - Biomass Crop Assistance Program; Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

.... ACTION: Interim rule; correction. SUMMARY: The Commodity Credit Corporation (CCC) is amending the Biomass... funds in favor of the ``project area'' portion of BCAP. CCC is also correcting errors in the regulation... INFORMATION: Background CCC published a final rule on October 27, 2010 (75 FR 66202-66243) implementing BCAP...

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.

Merging home and health via contemporary care delivery: program management insights on a home telehealth project.

PubMed

Abraham, Chon; Rosenthal, David A

2008-01-01

This article discusses a home telehealth program that uses innovative informatics and telemedicine technologies to meet the needs of a Veterans Affairs Medical Center. We provide background information for the program inclusive of descriptions for the decision support system, patient selection process, and selected home telehealth technologies. Lessons learned based on interview data collected from the project team highlight issues regarding implementation and management of the program. Our goal is to provide useful information to other healthcare systems considering home telehealth as a contemporary option for care delivery.

Implementation and Evaluation of a Smartphone-Based Telemonitoring Program for Patients With Heart Failure: Mixed-Methods Study Protocol

PubMed Central

Ross, Heather J; Cafazzo, Joseph A; Laporte, Audrey; Seto, Emily

2018-01-01

Background Meta-analyses of telemonitoring for patients with heart failure conclude that it can lower the utilization of health services and improve health outcomes compared with the standard of care. A smartphone-based telemonitoring program is being implemented as part of the standard of care at a specialty care clinic for patients with heart failure in Toronto, Canada. Objective The objectives of this study are to (1) evaluate the impact of the telemonitoring program on health service utilization, patient health outcomes, and their ability to self-care; (2) identify the contextual barriers and facilitators of implementation at the physician, clinic, and institutional level; (3) describe patient usage patterns to determine adherence and other behaviors in the telemonitoring program; and (4) evaluate the costs associated with implementation of the telemonitoring program from the perspective of the health care system (ie, public payer), hospital, and patient. Methods The evaluation will use a mixed-methods approach. The quantitative component will include a pragmatic pre- and posttest study design for the impact and cost analyses, which will make use of clinical data and questionnaires administered to at least 108 patients at baseline and 6 months. Furthermore, outcome data will be collected at 1, 12, and 24 months to explore the longitudinal impact of the program. In addition, quantitative data related to implementation outcomes and patient usage patterns of the telemonitoring system will be reported. The qualitative component involves an embedded single case study design to identify the contextual factors that influenced the implementation. The implementation evaluation will be completed using semistructured interviews with clinicians, and other program staff at baseline, 4 months, and 12 months after the program start date. Interviews conducted with patients will be triangulated with usage data to explain usage patterns and adherence to the system. Results The telemonitoring program was launched in August 2016 and patient enrollment is ongoing. Conclusions The methods described provide an example for conducting comprehensive evaluations of telemonitoring programs. The combination of impact, implementation, and cost evaluations will inform the quality improvement of the existing program and will yield insights into the sustainability of smartphone-based telemonitoring programs for patients with heart failure within a specialty care setting. PMID:29724704

Developing an active implementation model for a chronic disease management program

PubMed Central

Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter

2013-01-01

Background Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council’s model for complex interventions and the Chronic Care Model. Methods We used the Medical Research Council’s five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. Results The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council’s model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial (results reported elsewhere). Conclusion The combination of the theoretical model for complex interventions and the Chronic Care Model and the chosen specific implementation strategies proved feasible for a practice-based active implementation model for a chronic-disease-management-program for COPD. Using the Medical Research Council’s model added transparency to the design phase which further facilitated the process of implementing the program. Trial registration: http://www.clinicaltrials.gov/(NCT01228708). PMID:23882169

An intervention to improve program implementation: findings from a two-year cluster randomized trial of Assets-Getting To Outcomes

PubMed Central

2013-01-01

Background Studies have shown that communities have not always been able to implement evidence-based prevention programs with quality and achieve outcomes demonstrated by prevention science. Implementation support interventions are needed to bridge this gap between science and practice. The purpose of this article is to present two-year outcomes from an evaluation of the Assets Getting To Outcomes (AGTO) intervention in 12 Maine communities engaged in promoting Developmental Assets, a positive youth development approach to prevention. AGTO is an implementation support intervention that consists of: a manual of text and tools; face-to-face training, and onsite technical assistance, focused on activities shown to be associated with obtaining positive results across any prevention program. Methods This study uses a nested and cross-sectional, cluster randomized controlled design. Participants were coalition members and program staff from 12 communities in Maine. Each coalition nominated up to five prevention programs to participate. At random, six coalitions and their respective 30 programs received the two-year AGTO intervention and the other six maintained routine operations. The study assessed prevention practitioner capacity (efficacy and behaviors), practitioner exposure to and use of AGTO, practitioner perceptions of AGTO, and prevention program performance. Capacity of coalition members and performance of their programs were compared between the two groups across the baseline, one-, and two-year time points. Results We found no significant differences between AGTO and control group’s prevention capacity. However, within the AGTO group, significant differences were found between those with greater exposure to and use of AGTO. Programs that received the highest number of technical assistance hours showed the most program improvement. Conclusions This study is the first of its kind to show that use of an implementation support intervention-AGTO -yielded improvements in practitioner capacity and consequently in program performance on a large sample of practitioners and programs using a randomized controlled design. ClinicalTrials.gov identifier NCT00780338 PMID:23924279

Office ergonomics programs. A case study of North American corporations.

PubMed

Moore, J S

1997-12-01

Subject matter experts from 13 North American corporations provided detailed descriptions of the historical development and the current components and operations of their office ergonomics programs. Results were summarized across corporations and presented for the following programmatic topics: backgrounds of key people, initial awareness and preliminary needs assessment, program development, program implementation, program monitoring and evaluation, program components, education and training, workstation and job analysis, early identification of cases, case management, and alternate office environments. The subject matter experts also provided comments about the strengths of their programs, their advice to others, and lessons they learned. These observations suggested the need for an office ergonomics program, and possibly other occupational health programs, to fit into a corporation's culture and capitalize on its infrastructure. Most corporations used multidisciplinary task forces or teams to develop their programs. Communication, which included training, awareness, advertising, and feedback, was also an important issue. Flexibility and simplicity were important attributes of these programs. It is hoped that this descriptive information will be helpful to some occupational health managers interested in or concerned about managerial perspectives and skills related to the development and implementation of programs within their own corporations.

Implementation issues for consumer-directed programs: comparing views of policy experts, consumers, and representatives.

PubMed

Simon-Rusinowitz, Lori; Marks, Lori N; Loughlin, Dawn M; Desmond, Sharon M; Mahoney, Kevin J; Zacharias, B Lee; Squillace, Marie R; Allison, Ann Marie

2002-01-01

An increasing number of aging community providers and consumers support consumer-direction (CD) in long-term care services. In regard to devolution, consumer-direction goes beyond the usual approach of shifting responsibilities from the federal government to state governments to bring programs "closer to the people." Consumer-direction goes even further by placing resources directly in the hands of consumers. Yet, many questions remain unanswered regarding how to implement CD personal assistance services in general, and especially for older persons. This article describes the importance of examining views from multiple key stakeholders involved in implementing CD programs. We report on three background studies that have informed the Cash and Counseling Demonstration and Evaluation (CCDE) design and implementation-policy expert interviews as well as surveys and focus groups with consumers and representatives. As a fourth data source, we drew upon experiences in designing the CCDE and initial results from the first year of implementation. Each of the three studies on its own provided essential information for planning the CCDE. However, when we examined the studies together, and added CCDE design and implementation experiences, views expressed by the different stakeholders formed a type of multi-perspective "dialogue" that expanded our knowledge about implementing CD services. We hope this increased knowledge will help expand the availability of such services for consumers of any age who want to direct their own care.

KALI - An environment for the programming and control of cooperative manipulators

NASA Technical Reports Server (NTRS)

Hayward, Vincent; Hayati, Samad

1988-01-01

A design description is given of a controller for cooperative robots. The background and motivation for multiple arm control are discussed. A set of programming primitives which permit a programmer to specify cooperative tasks are described. Motion primitives specify asynchronous motions, master/slave motions, and cooperative motions. In the context of cooperative robots, trajectory generation issues are discussed and the authors' implementation briefly described. The relations between programming and control in the case of multiple robots are examined. The allocation of various tasks among a multiprocessor computer is described.

Experience with Designing and Implementing a Bundled Payment Program for Total Hip Replacement

PubMed Central

Whitcomb, Winthrop F.; Lagu, Tara; Krushell, Robert J.; Lehman, Andrew P.; Greenbaum, Jordan; McGirr, Joan; Pekow, Penelope S.; Calcasola, Stephanie; Benjamin, Evan; Mayforth, Janice; Lindenauer, Peter K.

2015-01-01

Background Bundled payments, also known as episode-based payments, are intended to contain health care costs and promote quality. In 2011 a bundled payment pilot program for total hip replacement was implemented by an integrated health care delivery system in conjunction with a commercial health plan subsidiary. In July 2015 the Centers for Medicare & Medicaid Services (CMS) proposed the Comprehensive Care for Joint Replacement Model to test bundled payment for hip and knee replacement. Methods Stakeholders were identified and a structure for program development and implementation was created. An Oversight Committee provided governance over a Clinical Model Subgroup and a Financial Model Subgroup. Results The pilot program included (1) a clinical model of care encompassing the period from the preoperative evaluation through the third postoperative visit, (2) a pricing model, (3) a program to share savings, and (4) a patient engagement and expectation strategy. Compared to 32 historical controls— patients treated before bundle implementation—45 post-bundle-implementation patients with total hip replacement had a similar length of hospital stay (3.0 versus 3.4 days, p = .24), higher rates of discharge to home or home with services than to a rehabilitation facility (87% versus 63%), similar adjusted median total payments ($22,272 versus $22,567, p = .43), and lower median posthospital payments ($704 versus $1,121, p = .002), and were more likely to receive guideline-consistent care (99% versus 95%, p = .05). Discussion The bundled payment pilot program was associated with similar total costs, decreased posthospital costs, fewer discharges to rehabilitation facilities, and improved quality. Successful implementation of the program hinged on buy-in from stakeholders and close collaboration between stakeholders and the clinical and financial teams. PMID:26289235

Lessons Learned From a Community-Based Participatory Research Mental Health Promotion Program for American Indian Youth.

PubMed

Langdon, Sarah E; Golden, Shannon L; Arnold, Elizabeth Mayfield; Maynor, Rhonda F; Bryant, Alfred; Freeman, V Kay; Bell, Ronny A

2016-05-01

Background American Indian (AI) youth have the highest rates of suicide among racial/ethnic minority groups in the United States. Community-based strategies are essential to address this issue, and community-based participatory research (CBPR) offers a model to engage AI communities in mental health promotion programming. Objectives This article describes successes and challenges of a CBPR, mixed-method project, The Lumbee Rite of Passage (LROP), an academic-community partnership to develop and implement a suicide prevention program for Lumbee AI youth in North Carolina. Method LROP was conducted in two phases to (1) understand knowledge and perceptions of existing mental health resources and (2) develop, implement, and evaluate a cultural enrichment program as a means of suicide prevention. Discussion/Results LROP implemented an effective community-academic partnership by (1) identifying and understanding community contexts, (2) maintaining equitable partnerships, and (3) implementing a culturally tailored research design targeting multilevel changes to support mental health. Strategies formed from the partnership alleviated challenges in each of these key CBPR concept areas. Conclusions LROP highlights how a CBPR approach contributes to positive outcomes and identifies opportunities for future collaboration in a tribal community. Using culturally appropriate CBPR strategies is critical to achieving sustainable, effective programs to improve mental health of AI youth. © 2016 Society for Public Health Education.

A Hybrid Effectiveness-Implementation Trial of an Evidence-Based Exercise Intervention for Breast Cancer Survivors

PubMed Central

Beidas, Rinad S.; Paciotti, Breah; Barg, Fran; Branas, Andrea R.; Brown, Justin C.; Glanz, Karen; DeMichele, Angela; DiGiovanni, Laura; Salvatore, Domenick

2014-01-01

Background The primary aims of this hybrid Type 1 effectiveness-implementation trial were to quantitatively assess whether an evidence-based exercise intervention for breast cancer survivors, Strength After Breast Cancer, was safe and effective in a new setting and to qualitatively assess barriers to implementation. Methods A cohort of 84 survivors completed measurements related to limb volume, muscle strength, and body image at baseline, 67 survivors completed measurements 12 months later. Qualitative methods were used to understand barriers to implementation experienced by referring oncology clinicians and physical therapists who delivered the program. Results Similar to the efficacy trial, the revised intervention demonstrated safety with regard to lymphedema, and led to improvements in lymphedema symptoms, muscular strength, and body image. Comparison of effects in the effectiveness trial to effects in the efficacy trial revealed larger strength increases in the efficacy trial than in the effectiveness trial (P < .04), but few other differences were found. Qualitative implementation data suggested significant barriers around intervention characteristics, payment, eligibility criteria, the referral process, the need for champions (ie, advocates), and the need to adapt during implementation of the intervention, which should be considered in future dissemination and implementation efforts. Conclusions This trial successfully demonstrated that a physical therapy led strength training program for breast cancer survivors can be implemented in a community setting while retaining the effectiveness and safety of the clinical trial. However, during the translation process, strategies to reduce barriers to implementation are required. This new program can inform larger scale dissemination and implementation efforts. PMID:25749601

Effectiveness of a role-play simulation program involving the sbar technique: A quasi-experimental study.

PubMed

Yu, Mi; Kang, Kyung Ja

2017-06-01

Accurate, skilled communication in handover is of high priority in maintaining patients' safety. Nursing students have few chances to practice nurse-to-doctor handover in clinical training, and some have little knowledge of what constitutes effective handover or lack confidence in conveying information. This study aimed to develop a role-play simulation program involving the Situation, Background, Assessment, Recommendation technique for nurse-to-doctor handover; implement the program; and analyze its effects on situation, background, assessment, recommendation communication, communication clarity, handover confidence, and education satisfaction in nursing students. Non-equivalent control-group pretest-posttest quasi-experimental. A convenience sample of 62 senior nursing students from two Korean universities. The differences in SBAR communication, communication clarity, handover confidence, and education satisfaction between the control and intervention groups were measured before and after program participation. The intervention group showed higher Situation, Background, Assessment, Recommendation communication scores (t=-3.05, p=0.003); communication clarity scores in doctor notification scenarios (t=-5.50, p<0.001); and Situation, Background, Assessment, Recommendation education satisfaction scores (t=-4.94, p<0.001) relative to those of the control group. There was no significant difference in handover confidence between groups (t=-1.97, p=0.054). The role-play simulation program developed in this study could be used to promote communication skills in nurse-to-doctor handover and cultivate communicative competence in nursing students. Copyright © 2017. Published by Elsevier Ltd.

"They Were Only Joking": Efforts to Decrease LGBTQ Bullying and Harassment in Seattle Public Schools

ERIC Educational Resources Information Center

Hillard, Pamela; Love, Lisa; Franks, Heather M.; Laris, B. A.; Coyle, Karin K.

2014-01-01

Background: Seattle Public Schools has implemented policies and programs to increase safety, family involvement, and student achievement for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. This case study examines students' perceptions of bullying and harassment in the school environment, and teacher intervention when these…

Roles of the State Asthma Program in Implementing Multicomponent, School-Based Asthma Interventions

ERIC Educational Resources Information Center

Hester, Laura L.; Wilce, Maureen A.; Gill, Sarah A.; Disler, Sheri L.; Collins, Pamela; Crawford, Gregory

2013-01-01

Background: Asthma is a leading chronic childhood disease in the United States and a major contributor to school absenteeism. Evidence suggests that multicomponent, school-based asthma interventions are a strategic way to address asthma among school-aged children. The Centers for Disease Control and Prevention (CDC) encourages the 36 health…

Connections: Developing Skills for the Family of the Young Special Child, 0-5. [and] A Coordinators Guide.

ERIC Educational Resources Information Center

Mendoza, Jeanne; And Others

The program is intended to increase skills in parents of young handicapped children. The coordinator's guide traces the background and development of the parent involvement materials, presents suggestions for workshop planning and actual implementation, and discusses training approaches for developing small group facilitation skills. The companion…

The Miami-Dade Juvenile Assessment Center National Demonstration Project

ERIC Educational Resources Information Center

Walters, Wansley; Dembo, Richard; Beaulaurier, Richard; Cocozza, Joseph; De La Rosa, Mario; Poythress, Norman; Skowyra, Kathy; Veysey, Bonita M.

2005-01-01

The Miami-Dade Juvenile Assessment Center National Demonstration Project (NDP) is serving as a national model for the transformation of front end services in the juvenile justice system in a unique sociocultural setting.We discuss the background and vision of the NDP, its implementation and accomplishments in six major program areas: (1)…

Promoting Social and Emotional Development in Deaf Children. The PATHS Project.

ERIC Educational Resources Information Center

Greenberg, Mark T.; Kusche, Carol A.

This book explains the background and rationale for the PATHS (Promoting Alternative THinking Strategies) curriculum, reports the results of 4 years of research on its use with children who are deaf, and explores theoretical and practical concerns in the implementation of school-based mental health promotion programs. It emphasizes the crucial…

School Personnel Experiences in Notifying Parents about Their Child's Risk for Suicide: Lessons Learned

ERIC Educational Resources Information Center

Nadeem, Erum; Santiago, Catherine DeCarlo; Kataoka, Sheryl H.; Chang, Vickie Y.; Stein, Bradley D.

2016-01-01

Background: Schools across the nation are increasingly implementing suicide prevention programs that involve training school staff and connecting students and their families to appropriate services. However, little is known about how parents are engaged in such efforts. Methods: This qualitative study examined school staff perspectives on parent…

Strategies for Implementing School-Located Influenza Vaccination of Children: A Systematic Literature Review

ERIC Educational Resources Information Center

Cawley, John; Hull, Harry F.; Rousculp, Matthew D.

2010-01-01

Background: The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccinations for all children 6 months to 18 years of age, which includes school-aged children. Influenza immunization programs may benefit schools by reducing absenteeism. Methods: A systematic literature review of PubMed, PsychLit, and Dissertation Abstracts…

K-12 School Food Service Staff Training Interventions: A Review of the Literature

ERIC Educational Resources Information Center

Stephens, Lacy; Shanks, Carmen Byker

2015-01-01

Background: School food service professionals are vital to implementing national nutrition standards in school meal programs. Appropriate and effective training for these professionals may be one key to producing healthful meals that students are excited to eat and also meet United States Department of Agriculture (USDA) nutrient guidelines. A…

A Comprehensive Wellness Program for Veterinary Medical Education: Design and Implementation at North Carolina State University

ERIC Educational Resources Information Center

Royal, Kenneth; Flammer, Keven; Borst, Luke; Huckle, Jeffrey; Barter, Hillary; Neel, Jennifer

2017-01-01

Research in veterinary medical education has illustrated the challenges students face with respect to mental and emotional wellness, lack of attention to physical health, and limited opportunities to meaningfully engage with persons from different backgrounds. In response, the North Carolina State University College of Veterinary Medicine has…

School-Based Health Promotion Initiative Increases Children's Physical Activity

ERIC Educational Resources Information Center

Cluss, Patricia; Lorigan, Devin; Kinsky, Suzanne; Nikolajski, Cara; McDermott, Anne; Bhat, Kiran B.

2016-01-01

Background: Childhood obesity increases health risk, and modest physical activity can impact that risk. Schools have an opportunity to help children become more active. Purpose: This study implemented a program offering extra school-day activity opportunities in a rural school district where 37% of students were obese or overweight in 2005 and…

Linking Agent's Tool Kit. Part Two: Selected Background Readings. Consortium Report Series.

ERIC Educational Resources Information Center

Ford, John J., III, Ed.; Hergert, Leslie F., Ed.

The second part of a 3-part guide developed as a resource for people involved in the selection and implementation of new programs in school settings, this collection of articles covers such topics as consultation, educational change, and linking processes. The following readings are included: "Behavior of Innovative Personnel," by Gary…

Building a Language-Focused Curriculum for the Preschool Classroom. Volume I: A Foundation for Lifelong Communication.

ERIC Educational Resources Information Center

Rice, Mabel L., Ed.; Wilcox, Kim A., Ed.

Drawing on the successfully implemented practices used at the Language Acquisition Preschool at the University of Kansas, this comprehensive resource provides the theoretical background and practical framework needed to create an effective language intervention program at the preschool level. The book is intended for professionals seeking to…

A Placement Test for Computer Science: Design, Implementation, and Analysis

ERIC Educational Resources Information Center

Nugent, Gwen; Soh, Leen-Kiat; Samal, Ashok; Lang, Jeff

2006-01-01

An introductory CS1 course presents problems for educators and students due to students' diverse background in programming knowledge and exposure. Students who enroll in CS1 also have different expectations and motivations. Prompted by the curricular guidelines for undergraduate programmes in computer science released in 2001 by the ACM/IEEE, and…

Go Slow Whoa Meal Patterns: Cafeteria Staff and Teacher Perceptions of Effectiveness in "Winning with Wellness" Schools

ERIC Educational Resources Information Center

Slawson, Deborah L.; Southerland, Jodi; Lowe, Elizabeth F.; Dalton, William T.; Pfortmiller, Deborah T.; Schetzina, Karen

2013-01-01

Background: School-based interventions hold promise for child obesity prevention. Implemented as a part of the "Winning with Wellness" obesity prevention project, the "Go Slow Whoa" meal pattern (GSW) was designed to promote healthier foods in school cafeterias. This investigation determined perceived program effectiveness and…

Supreme Court Highlights. Bill of Rights in Action, Vol. X, No. 3.

ERIC Educational Resources Information Center

Clark, Todd, Ed.

The student-oriented newsletter provides learning activities, background information, resources, teaching techniques, case studies, and other sources to help high school teachers develop, plan, and implement a course on the Supreme Court in a legal education program. The first chapter examines the role of the Supreme Court in American life,…

Structure to utilize interventionists' implementation experiences of a family-based behavioral weight management program to enhance the dissemination of the standardized intervention: The TODAY study.

PubMed

Chadwick, Jennifer Q; Van Buren, Dorothy J; Morales, Elisa; Timpson, Alexandra; Abrams, Ericka L; Syme, Amy; Preske, Jeff; Mireles, Gerardo; Anderson, Barbara; Grover, Nisha; Laffel, Lori

2017-08-01

Background For a 2- to 6-year period, interventionists for the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) randomized clinical trial delivered a family-based, behavioral weight-loss program (the TODAY Lifestyle Program) to 234 youth with type 2 diabetes. Interventionists held at least a bachelor's degree in psychology, social work, education, or health-related field and had experience working with children and families, especially from diverse ethnic and socioeconomic backgrounds. This article describes the administrative and organizational structure of the lifestyle program and how the structure facilitated collaboration among study leadership and lifestyle interventionists on the tailoring of the program to best suit the needs of the trial's diverse patient population. Methods During the pilot phase and throughout the duration of the trial, the interventionists' experiences in delivering the intervention were collected in a variety of ways including membership on study committees, survey responses, session audio recordings, and feedback during in-person trainings. Results The experiences of interventionists conveyed to study leadership through these channels resulted in decisions to tailor the lifestyle intervention's delivery location and ways to supplement the standardized educational materials to better address the needs of a diverse patient population. Conclusion The methods used within the TODAY study to encourage and utilize interventionists' experiences while implementing the lifestyle program may be useful to the design of future multi-site, clinical trials seeking to tailor behavioral interventions in a standardized, and culturally and developmentally sensitive manner.

A Policy Analysis of the implementation of a Reproductive Health Vouchers Program in Kenya

PubMed Central

2012-01-01

Background Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Methods Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. Results The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. Conclusions OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government’s role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies. PMID:22823923

Strengthening Self-efficacy through Supportive Mentoring

NASA Astrophysics Data System (ADS)

Haacker, R.

2015-12-01

The geosciences have had a chronic problem of underrepresentation of students from diverse ethnic, cultural, gender and socio-economic backgrounds. As a community we need to strengthen our support of young scientists from all backgrounds to sustain their enthusiasm and ensure their success in our field. Investing in mentoring programs that empower students and young professionals is one of the best ways to do so. The Significant Opportunities in Atmospheric Research and Science (SOARS) program, now entering its 20th year, has successfully developed and tested several mentoring models. The personalized, caring and consistent support is one of the key elements of the program's success; since its inception, 90% of SOARS participants have entered graduate school, research or science related careers after graduation. Many of our alumni who are now faculty apply the same mentoring strategies to build self-esteem and perseverance in their students. This presentation will cover the design and implementation of our four mentoring strategies, and provide insights on potential challenges, training aspects and impact assessment. The mentoring strategies include: 1) Multi-faceted, long-term mentoring of undergraduate and graduate students from diverse backgrounds. 2) Empowering advanced students to serve as peer mentors and role models. 3) Training faculty and professional scientists from all backgrounds to become mentors who are aware of diversity issues. 4) Providing mentor training for partner programs and laboratories. All four strategies have contributed to the creation of a mentoring culture in the geosciences.

Impact of Antimicrobial Stewardship on Physician Practice in a Geriatric Facility

PubMed Central

Kassett, Nina; Sham, Rosalind; Aleong, Rosanne; Yang, Daisy; Kirzner, Michael; Craft, Aidlee

2016-01-01

Background There is a paucity of literature describing the implementation of antimicrobial stewardship programs (ASPs) in long-term care (LTC) facilities. The current study evaluated the impact of an ASP that was implemented across a geriatric facility, which included an inpatient specialty hospital and an LTC facility. The program included prospective audits with feedback, multidisciplinary education, information technology interventions, and guideline development. Objective To investigate the impact of the ASP on physicians’ prescribing practices in this geriatric facility. Methods Utilization data for antibiotics commonly used to treat urinary tract infections were retrieved for the period September 1, 2011, to August 31, 2013. The study examined whether there were significant changes in overall antibiotic use, ciprofloxacin use, and physician prescribing behaviour after program implementation in September 2012. Results There was no significant change in the total number of antibiotic prescriptions for urinary tract infections in the hospital or the LTC facility after ASP implementation. Significant reductions were seen in the average days of therapy initially prescribed and the actual days of therapy after ASP implementation in the LTC facility but not the hospital. Across both facilities, significant reductions were seen in the number of ciprofloxacin prescriptions. Conclusions The current study showed that an ASP can affect physicians’ antibiotic prescribing behaviour and antibiotic usage in an LTC environment. PMID:28123192

“Because we all trust and care about each other”: Exploring Tensions Translating a Theater-based HIV Prevention Intervention into a New Context

PubMed Central

Mouw, Mary Sherwyn; Taboada, Arianna; Steinert, Scarlett; Willis, Stephanie; Lightfoot, Alexandra F.

2016-01-01

Background A theater-based HIV prevention intervention developed in urban California was piloted with a new partnership in North Carolina. Objectives To describe the experience of translating a complex program with an enhanced partnership approach; barriers and facilitators of implementation in the new setting; and challenges and benefits of interdisciplinary, collaborative interventions. Methods We gathered perspectives of local stakeholders involved in program implementation through process evaluation interviews and focus groups with undergraduates, a college instructor, school district administrators, and high school teachers. Results Implementing the intervention in a new setting proved feasible and successful; however, mistaken assumptions and unrecognized similarities about teaching priorities, philosophies, and values produced latent tensions amongst stakeholder groups, and were a limiting factor in partnership functioning. Conclusions Implementing a cross-disciplinary intervention in a new setting is best achieved through a local community-engaged process, with active involvement of relevant stakeholders. We suggest strategies to strengthen community partnerships cooperating in implementation of complex, context-tailored interventions. PMID:27346770

Enhancing STEM Education through Cubesats: Using Satellite Integration as a Teaching Tool at a Non-Tech School

NASA Astrophysics Data System (ADS)

Bernardes, S.; Cotten, D. L.

2016-12-01

University-based satellite programs have been successfully used as a platform for teaching STEM related fields, bringing tremendous benefits to graduate and undergraduate education. Considering their infrastructure and curricula, tech schools have traditionally been considered logical candidates for hosting such programs. More recently, with the dissemination of small satellites initiatives, non-tech schools have been presented the opportunity of developing satellite design and implementation programs. This work reports on the experiences and challenges associated with implementing a satellite program at the University of Georgia (UGA), a non-tech university. With funding from the Air Force Research Laboratory's (AFRL) University Nanosat Program (UNP) and NASA's Undergraduate Student Instrument Project (USIP) a team of undergraduates at UGA has recently been tasked with building two small satellites and helping to create a Small Satellite Research Laboratory (SSRL) at the university. Unique features of the satellite program at UGA include its team of students from a broad range of backgrounds and departments (Engineering, Computer Science, Art, Business, and Geography) and the previous exposure of many of these students to synergistic technologies, including arduino and unmanned aerial systems. We show how informal exposure to those technologies and willingness of students to focus on areas outside of their field of study can benefit from the implementation of satellite programs. In this regard, we report on methods and techniques used to find and recruit driven and knowledgeable students to work in a high paced field such as satellite system integration. We show how students and faculty from multiple departments have collaborated to reach a common, far reaching goal and describe our proposed methods to evaluate and measure educational goals based around SSRL and its projects. We also present the challenges associated with the lack of a developed engineering program, including our solutions to a shortage of equipment and expertise regarding building satellite systems and a satellite laboratory. Finally, we our outreach methods, including K-12, and share our experience and successes finding industry partners, considering an absence of background in the field and prior collaborations.

Transitioning a Large Scale HIV/AIDS Prevention Program to Local Stakeholders: Findings from the Avahan Transition Evaluation

PubMed Central

Bennett, Sara; Singh, Suneeta; Rodriguez, Daniela; Ozawa, Sachiko; Singh, Kriti; Chhabra, Vibha; Dhingra, Neeraj

2015-01-01

Background Between 2009–2013 the Bill and Melinda Gates Foundation transitioned its HIV/AIDS prevention initiative in India from being a stand-alone program outside of government, to being fully government funded and implemented. We present an independent prospective evaluation of the transition. Methods The evaluation drew upon (1) a structured survey of transition readiness in a sample of 80 targeted HIV prevention programs prior to transition; (2) a structured survey assessing institutionalization of program features in a sample of 70 targeted intervention (TI) programs, one year post-transition; and (3) case studies of 15 TI programs. Findings Transition was conducted in 3 rounds. While the 2009 transition round was problematic, subsequent rounds were implemented more smoothly. In the 2011 and 2012 transition rounds, Avahan programs were well prepared for transition with the large majority of TI program staff trained for transition, high alignment with government clinical, financial and managerial norms, and strong government commitment to the program. One year post transition there were significant program changes, but these were largely perceived positively. Notable negative changes were: limited flexibility in program management, delays in funding, commodity stock outs, and community member perceptions of a narrowing in program focus. Service coverage outcomes were sustained at least six months post-transition. Interpretation The study suggests that significant investments in transition preparation contributed to a smooth transition and sustained service coverage. Notwithstanding, there were substantive program changes post-transition. Five key lessons for transition design and implementation are identified. PMID:26327591

Health coaching in primary care: a feasibility model for diabetes care

PubMed Central

2014-01-01

Background Health coaching is a new intervention offering a one-on-one focused self-management support program. This study implemented a health coaching pilot in primary care clinics in Eastern Ontario, Canada to evaluate the feasibility and acceptability of integrating health coaching into primary care for patients who were either at risk for or diagnosed with diabetes. Methods We implemented health coaching in three primary care practices. Patients with diabetes were offered six months of support from their health coach, including an initial face-to-face meeting and follow-up by email, telephone, or face-to-face according to patient preference. Feasibility was assessed through provider focus groups and qualitative data analysis methods. Results All three sites were able to implement the program. A number of themes emerged from the focus groups, including the importance of physician buy-in, wide variation in understanding and implementing of the health coach role, the significant impact of different systems of team communication, and the significant effect of organizational structure and patient readiness on Health coaches’ capacity to perform their role. Conclusions It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention. PMID:24708783

Stages to Saturn

NASA Technical Reports Server (NTRS)

Bilstein, Roger E.

1996-01-01

Part one of this report is intended to bring back into focus some of the facts, circumstances, and background of space exploration. A recapitulation of the flight of Apollo 11, the first lunar landing missions, provides an opportunity to introduce some of the hardware and nomenclature of the Apollo-Saturn program. An historical overview of rocketry, including the main threads of Saturn's origins, provides a background for the scope and boldness of Apollo 11 and the Saturn adventure. The management structure developed by NASA to implement the Apollo-Saturn missions is described in some detail.

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Test implementation of a school-oriented drug prevention program “Study without Drugs”: pre- and post-testing for effectiveness

PubMed Central

2014-01-01

Background In this article, the test implementation of a school-oriented drug prevention program “Study without Drugs” is discussed. The aims of this study were to determine the results of the process evaluation and to determine whether the proposed school-oriented drug prevention program during a pilot project was effective for the participating pupils. Methods Sixty second-grade pupils at a junior high school in Paramaribo, Suriname participated in the test implementation. They were divided into two classes. For the process evaluation the students completed a structured questionnaire focusing on content and teaching method after every lesson. Lessons were qualified with a score from 0–10. The process was also evaluated by the teachers through structured interviews. Attention was paid to reach, dose delivered, dose received, fidelity, connection, achieved effects/observed behaviors, areas for improvement, and lesson strengths. The effect evaluation was conducted by using the General Liniair Model (repeated measure). The research (-design) was a pre-experimental design with pre-and post-test. Results No class or sex differences were detected among the pupils with regard to the assessment of content, methodology, and qualification of the lessons. Post-testing showed that participating pupils obtained an increased knowledge of drugs, their drug-resisting skills were enhanced, and behavior determinants (attitude, subjective norm, self-efficacy, and intention) became more negative towards drugs. Conclusions From the results of the test implementation can be cautiously concluded that the program “Study without Drugs” may yield positive results when applied in schools). Thus, this pilot program can be considered a step towards the development and implementation of an evidence-based school-oriented program for pupils in Suriname. PMID:24920468

ThermoData Engine (TDE): software implementation of the dynamic data evaluation concept. 9. Extensible thermodynamic constraints for pure compounds and new model developments.

PubMed

Diky, Vladimir; Chirico, Robert D; Muzny, Chris D; Kazakov, Andrei F; Kroenlein, Kenneth; Magee, Joseph W; Abdulagatov, Ilmutdin; Frenkel, Michael

2013-12-23

ThermoData Engine (TDE) is the first full-scale software implementation of the dynamic data evaluation concept, as reported in this journal. The present article describes the background and implementation for new additions in latest release of TDE. Advances are in the areas of program architecture and quality improvement for automatic property evaluations, particularly for pure compounds. It is shown that selection of appropriate program architecture supports improvement of the quality of the on-demand property evaluations through application of a readily extensible collection of constraints. The basis and implementation for other enhancements to TDE are described briefly. Other enhancements include the following: (1) implementation of model-validity enforcement for specific equations that can provide unphysical results if unconstrained, (2) newly refined group-contribution parameters for estimation of enthalpies of formation for pure compounds containing carbon, hydrogen, and oxygen, (3) implementation of an enhanced group-contribution method (NIST-Modified UNIFAC) in TDE for improved estimation of phase-equilibrium properties for binary mixtures, (4) tools for mutual validation of ideal-gas properties derived through statistical calculations and those derived independently through combination of experimental thermodynamic results, (5) improvements in program reliability and function that stem directly from the recent redesign of the TRC-SOURCE Data Archival System for experimental property values, and (6) implementation of the Peng-Robinson equation of state for binary mixtures, which allows for critical evaluation of mixtures involving supercritical components. Planned future developments are summarized.

Development of criteria used to establish a background environmental monitoring station

DOE PAGES

Fritz, Brad G.; Barnett, J. Matthew; Snyder, Sandra F.; ...

2015-03-02

It is generally considered necessary to measure concentrations of contaminants-of-concern at a background location when conducting atmospheric environmental surveillance. This is because it is recognized that measurements of background concentrations can enhance interpretation of environmental monitoring data. Despite the recognized need for background measurements, there is little published guidance available that describes how to identify an appropriate atmospheric background monitoring location. This paper develops generic criteria that can guide the decision making process for identifying suitable locations for background atmospheric monitoring station. Detailed methods for evaluating some of these criteria are also provided and a case study for establishment ofmore » an atmospheric background surveillance station as part of an environmental surveillance program is described. While the case study focuses on monitoring for radionuclides, the approach is equally valid for any airborne constituent being monitored. The case study shows that implementation of the developed criteria can result in a good, defensible choice for a background atmospheric monitoring location.« less

Dual peer mentoring program for undergraduate medical students: exploring the perceptions of mentors and mentees

PubMed Central

Abdolalizadeh, Parya; Pourhassan, Saeed; Gandomkar, Roghayeh; Heidari, Farrokh; Sohrabpour, Amir Ali

2017-01-01

Background: Despite the advantages of dual peer mentoring, there are a few reports of implementing and evaluating such programs for medical students. This study aimed at exploring the perceptions of mentors and mentees about the dual peer mentoring program for the first year undergraduate medical students of Tehran University of Medical Sciences. Methods: This qualitative study was conducted at the end of the first year of implementing the mentoring program. All mentees and mentors were invited to participate in focus group discussions. Data were analyzed using a qualitative content analysis. Results: All mentors (n= 12) and a group of mentees (n= 21) participated in focus group discussion sessions. We provided a variety of supports for the mentees including academic and psychosocial support and positive relationship; as a result, some developments occurred to the mentors We also explored participants’ views on some unique aspects of the program such as student-authorized, dual mentoring, and role model sessions. Conclusion: Our participants found the mentoring program beneficial in various academic achievements and psychosocial supports for both the mentors and the mentees. Dual peer mentoring program can be an alternative to school administered programs. PMID:28638809

Dual peer mentoring program for undergraduate medical students: exploring the perceptions of mentors and mentees.

PubMed

Abdolalizadeh, Parya; Pourhassan, Saeed; Gandomkar, Roghayeh; Heidari, Farrokh; Sohrabpour, Amir Ali

2017-01-01

Background: Despite the advantages of dual peer mentoring, there are a few reports of implementing and evaluating such programs for medical students. This study aimed at exploring the perceptions of mentors and mentees about the dual peer mentoring program for the first year undergraduate medical students of Tehran University of Medical Sciences. Methods: This qualitative study was conducted at the end of the first year of implementing the mentoring program. All mentees and mentors were invited to participate in focus group discussions. Data were analyzed using a qualitative content analysis. Results: All mentors ( n= 12 ) and a group of mentees ( n= 21 ) participated in focus group discussion sessions. We provided a variety of supports for the mentees including academic and psychosocial support and positive relationship; as a result, some developments occurred to the mentors We also explored participants' views on some unique aspects of the program such as student-authorized, dual mentoring, and role model sessions. Conclusion: Our participants found the mentoring program beneficial in various academic achievements and psychosocial supports for both the mentors and the mentees. Dual peer mentoring program can be an alternative to school administered programs.

Addressing Chronic Disease Within Supportive Housing Programs

PubMed Central

Henwood, Benjamin F.; Stanhope, Victoria; Brawer, Rickie; Weinstein, Lara Carson; Lawson, James; Stwords, Edward; Crossan, Cornelius

2015-01-01

Background Tenants of supportive housing have a high burden of chronic health conditions. Objectives To examine the feasibility of developing a tenant-involved health promotion initiative within a “housing first” agency using a community-based participatory research (CBPR) framework. Methods Qualitative analyses of nine research capacity-building group meetings and fifteen individual pre- and post-interviews with those who completed a chronic disease self-management program, resulting in the development of several themes. Results Tenants of supportive housing successfully partnered with health care providers to implement a chronic disease self-management program, noting that “health care becomes ‘relevant’ with housing.” Conclusions Supportive housing organizations are well-situated to implement health promotion initiatives. Such publicly subsidized housing that is accompanied by comprehensive supports must also include self-management training to help people overcome both internal and external barriers to addressing chronic health needs. PMID:23543023

Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review

PubMed Central

Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

2016-01-01

Background and aim: Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. Methods: We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. Results: We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists’ perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Conclusion: Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers. PMID:26878037

Implementing and Evaluating a Multicomponent Inpatient Diabetes Management Program: Putting Research into Practice

PubMed Central

Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M.; Golden, Sherita Hill

2013-01-01

Background Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes Overall the average patient-day–weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives. PMID:22649859

Cook It Up! A community-based cooking program for at-risk youth: overview of a food literacy intervention

PubMed Central

2011-01-01

Background In Canada, there are limited occasions for youth, and especially at-risk youth, to participate in cooking programs. The paucity of these programs creates an opportunity for youth-focused cooking programs to be developed, implemented, and evaluated with the goal of providing invaluable life skills and food literacy to this potentially vulnerable group. Thus, an 18-month community-based cooking program for at-risk youth was planned and implemented to improve the development and progression of cooking skills and food literacy. Findings This paper provides an overview of the rationale for and implementation of a cooking skills intervention for at-risk youth. The manuscript provides information about the process of planning and implementing the intervention as well as the evaluation plan. Results of the intervention will be presented elsewhere. Objectives of the intervention included the provision of applied food literacy and cooking skills education taught by local chefs and a Registered Dietitian, and augmented with fieldtrips to community farms to foster an appreciation and understanding of food, from 'gate to plate'. Eight at-risk youth (five girls and three boys, mean age = 14.6) completed the intervention as of November 2010. Pre-test cooking skills assessments were completed for all participants and post-test cooking skills assessments were completed for five of eight participants. Post intervention, five of eight participants completed in-depth interviews about their experience. Discussion The Cook It Up! program can provide an effective template for other agencies and researchers to utilize for enhancing existing programs or to create new applied cooking programs for relevant vulnerable populations. There is also a continued need for applied research in this area to reverse the erosion of cooking skills in Canadian society. PMID:22085523

Representing and comparing protein structures as paths in three-dimensional space

PubMed Central

Zhi, Degui; Krishna, S Sri; Cao, Haibo; Pevzner, Pavel; Godzik, Adam

2006-01-01

Background Most existing formulations of protein structure comparison are based on detailed atomic level descriptions of protein structures and bypass potential insights that arise from a higher-level abstraction. Results We propose a structure comparison approach based on a simplified representation of proteins that describes its three-dimensional path by local curvature along the generalized backbone of the polypeptide. We have implemented a dynamic programming procedure that aligns curvatures of proteins by optimizing a defined sum turning angle deviation measure. Conclusion Although our procedure does not directly optimize global structural similarity as measured by RMSD, our benchmarking results indicate that it can surprisingly well recover the structural similarity defined by structure classification databases and traditional structure alignment programs. In addition, our program can recognize similarities between structures with extensive conformation changes that are beyond the ability of traditional structure alignment programs. We demonstrate the applications of procedure to several contexts of structure comparison. An implementation of our procedure, CURVE, is available as a public webserver. PMID:17052359

Evaluation of a peer mentoring program for early career gerontological nursing faculty and its potential for application to other fields in nursing and health sciences

PubMed Central

Brody, Abraham A.; Edelman, Linda; Siegel, Elena O.; Foster, Victoria; Bailey, Donald E.; Bryant, Ashley Leak; Bond, Stewart M.

2018-01-01

Background As the retirement rate of senior nursing faculty increases, the need to implement new models for providing mentorship to early career academics will become key to developing and maintaining an experienced faculty. Purpose This evaluation of a peer mentorship program for predoctoral and postdoctoral gerontological nurses examined its efficacy, utility, and potential for improvement. Methods A web-based survey was developed, implemented, and completed by 22 mentees and 17 mentors (71% and 61% response rates, respectively) as part of the evaluation. Discussion The peer mentorship program was found to be valuable by both mentors (64.7%) and mentees (72.7%) in helping mentees further develop their careers and networks and providing mentors with supported mentorship experience. Conclusion The peer mentorship program could serve as a model for other professional organizations, academic institutions, and consortiums to enhance and extend the formal vertical mentorship provided to early academic career individuals. PMID:27156778

Survey of Needs and Expectations for Academic Advising in a Hong Kong University

ERIC Educational Resources Information Center

Cheung, Rhonda Y. S.; Siu, Andrew M. H.; Shek, Daniel T. L.

2017-01-01

Universities in Hong Kong implemented a new 4-year undergraduate curriculum in 2012, and many initiated academic advising programs to help students from different academic backgrounds and with various levels of preparedness to review their options and manage challenges in college. For this study, we administered a questionnaire survey to discover…

Health Promotion Efforts as Predictors of Physical Activity in Schools: An Application of the Diffusion of Innovations Model

ERIC Educational Resources Information Center

Glowacki, Elizabeth M.; Centeio, Erin E.; Van Dongen, Daniel J.; Carson, Russell L.; Castelli, Darla M.

2016-01-01

Background: Implementing a comprehensive school physical activity program (CSPAP) effectively addresses public health issues by providing opportunities for physical activity (PA). Grounded in the Diffusion of Innovations model, the purpose of this study was to identify how health promotion efforts facilitate opportunities for PA. Methods: Physical…

Improving Responsiveness to Intervention in a Virtual Publically Supported Program: An Action Research

ERIC Educational Resources Information Center

Kerr, Rachel A.

2014-01-01

The purpose of this action research study was to design, implement, analyze, and evaluate a series of interventions to increase the elementary teachers' utilization of the RtI process. Another purpose of the study was to determine the teachers' background knowledge and perceptions about the Responsiveness to Intervention (RtI) process at the…

Teaching Information & Technology Skills: The Big6[TM] in Secondary Schools.

ERIC Educational Resources Information Center

Eisenberg, Michael B.; Berkowitz, Robert E.

This companion volume to a previous work focusing on the Big6 Approach in elementary schools provides secondary school classroom teachers, teacher-librarians, and technology teachers with the background and tools necessary to implement an integrated Big6 program. The first part of this book explains the Big6 approach and the rationale behind it.…

Behaviors and Knowledge of Healthcorps New York City High School Students: Nutrition, Mental Health, and Physical Activity

ERIC Educational Resources Information Center

Heo, Moonseong; Irvin, Erica; Ostrovsky, Natania; Isasi, Carmen; Blank, Arthur E.; Lounsbury, David W.; Fredericks, Lynn; Yom, Tiana; Ginsberg, Mindy; Hayes, Shawn; Wylie-Rosett, Judith

2016-01-01

Background: HealthCorps provides school wellness programming using curricula to promote changes in nutrition, mental health, and physical activity behaviors. The research objective was to evaluate effects of implementing its curricula on nutrition, mental health, and physical activity knowledge and behavior. Methods: Pre- and postsurvey data were…

Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review

ERIC Educational Resources Information Center

Price, Cayla; Cohen, Deborah; Pribis, Peter; Cerami, Jean

2017-01-01

Background: Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. Methods: A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature…

Forming Values in the Media Age. Sourcebook for Media Literacy Education in Catholic Schools and Parishes.

ERIC Educational Resources Information Center

O'Brien, Kevin

This sourcebook provides background materials and teaching suggestions for Catholic Church educators implementing a media literacy program. The six chapters are: Chapter 1, "Why Media Literacy?," recognizes the Catholic Church's challenge and a call for critical consciousness. Chapter 2, "The Four Principles of Media Literacy," is subdivided into:…

We Need to "Catch Them before They Fall": Response to Intervention and Elementary Emergent Bilinguals

ERIC Educational Resources Information Center

López, Minda Morren; Mendoza, Marie Arnold

2013-01-01

The authors of this case study examine response to intervention (RTI) implementation with Emergent Bilinguals in a large urban district. As participants noted, it is not appropriate to assess, instruct, and intervene with students through a one-size-fits-all approach. Instead, multiple factors such as language background, program participation,…

The Education of English Language Learners in Arizona: A History of Underachievement

ERIC Educational Resources Information Center

Garcia, Eugene E.; Lawton, Kerry; Diniz De Figueriedo, Eduardo H.

2012-01-01

Background: The state of Arizona has recently mandated the Structured English Immersion Model (SEI) in the state's public schools, and as a result the local flexibility that existed regarding the choice of program models for ELLs has ended. In the school year 2008-09, these regulations were made even more restrictive after the implementation of…

Promoting Uptake of the HPV Vaccine: The Knowledge and Views of School Staff

ERIC Educational Resources Information Center

Rose, Sally B.; Lanumata, Tolotea; Lawton, Beverley A.

2011-01-01

Background: School-based human papillomavirus (HPV)/cervical cancer vaccination programs have been implemented widely, but few studies have investigated the knowledge and views of school staff about this new vaccine. Methods: Prior to the introduction of the HPV vaccine in 2009, we surveyed staff at 14 socioeconomically diverse schools to assess…

A Study of Arizona's Teachers of English Language Learners

ERIC Educational Resources Information Center

Rios-Aguilar, Cecilia; Gonzalez Canche, Manuel S.; Moll, Luis C.

2012-01-01

Background/Context: In September 2007, the Arizona State Board of Education adopted the Structured English Immersion (SEI) model proposed by the Arizona English Language Learner (ELL) Task Force.During the 2008-2009 academic year, it required all school districts to implement the SEI model.The SEI program, best known as the 4-hour English Language…

Dynaflow User’s Guide

DTIC Science & Technology

1988-11-01

264 ANALYSIS RESTART. ............. ..... ....... 269 1.0 TITLE CARD. .............. ............. 271 2.0 CONTROL CARDS...stress soil model will provide a tool for such analysis of waterfront structures. To understand the significance of liquefaction, it is important to note...Implementing this effective stress soil model into a finite element computer program would allow analysis of soil and structure together. TECHNICAL BACKGROUND

Self-Efficacy and Social Support Mediate the Relationship between Internal Health Locus of Control and Health Behaviors in College Students

ERIC Educational Resources Information Center

Marr, Joni; Wilcox, Sara

2015-01-01

Background: Internal health locus of control has been associated with positive health outcomes and behaviors. Understanding the mechanisms of this relationship are key to designing and implementing effective health behavior intervention programs. Purpose: The purpose was to examine whether self-efficacy and social support mediate the relationship…

Implementation of Systematic Instruction to Increase Client Engagement in a Day Habilitation Program

ERIC Educational Resources Information Center

Crites, Steven A.; Howard, Barbara H.

2011-01-01

Background: Individuals with severe disability exiting school are likely to be enrolled in day activity and sheltered workshops at least as often as in supported employment. Such facilities are often staffed by paraprofessionals who may not have the skills to engage clients in meaningful activities. This article describes a 3-phase staff training…

Employers Talk about Building a School-to-Work System: Voices from the Field.

ERIC Educational Resources Information Center

Wills, Joan L., Ed.

This document contains background information on the school-to-work (STW) movement and 20 essays written by employers and intermediaries involved in STW program planning and implementation. Four points are highlighted: (1) it takes time to assemble an STW system; (2) the number of students participating in structured work-based learning remains…

Strength and Comprehensiveness of District School Wellness Policies Predict Policy Implementation at the School Level

ERIC Educational Resources Information Center

Schwartz, Marlene B.; Henderson, Kathryn E.; Falbe, Jennifer; Novak, Sarah A.; Wharton, Christopher M.; Long, Michael W.; O'Connell, Meghan L.; Fiore, Susan S.

2012-01-01

Background: In 2006, all local education agencies in the United States participating in federal school meal programs were required to establish school wellness policies. This study documented the strength and comprehensiveness of 1 state's written district policies using a coding tool, and tested whether these traits predicted school-level…

West Valley demonstration project: Implementation of the kerosene mitigation plan

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

Blickwedehl, R.R.; Goodman, J.; Valenti, P.J.

1987-05-01

An aggressive program was implemented to mitigate the migration of radioactive kerosene believed to have originated from the West Valley NRC-Licensed Disposal Area (NDA) disposal trenches designated as SH-10 and SH-11 (Special Holes 10 and 11). This report provides a historical background of the events leading to the migration problem, the results of a detailed investigation to determine the location and source of the kerosene migration, the remediation plan to mitigate the migration, and the actions taken to successfully stabilize the kerosene. 7 refs., 19 figs., 1 tab.

Randomized Controlled Trial of Nuevo Amanecer: A Peer-delivered Stress Management Intervention for Spanish-speaking Latinas with Breast Cancer

PubMed Central

Nápoles, Anna María; Santoyo-Olsson, Jasmine; Ortiz, Carmen; Gregorich, Steven; Lee, Howard E.; Duron, Ysabel; Graves, Kristi; Luce, Judith A.; McGuire, Peggy; Díaz-Méndez, Marynieves; Stewart, Anita L.

2014-01-01

Background Latinas with breast cancer suffer symptom and psychosocial health disparities. Effective interventions have not been developed for or tested in this population. Purpose We describe community-based participatory research methods used to develop and implement the Nuevo Amanecer program, a culturally tailored, peer-delivered cognitive-behavioral stress management intervention for low-income Spanish-speaking Latinas with breast cancer, and unique considerations in implementing a randomized controlled trial to test the program in community settings. Methods We applied an implementation science framework to delineate the methodological phases used to develop and implement the Nuevo Amanecer program and trial, emphasizing community engagement processes. Results In phase 1, we established project infrastructure: academic and community Co-Principal Investigators, community partners, community advisory board, steering committee, and funding. In phase 2, we identified three program inputs: formative research, a community best practices model, and an evidence-based intervention tested in non-Latinas. In phase 3, we created the new program by integrating and adapting intervention components from the three sources, making adaptations to accommodate low-literacy, Spanish language, cultural factors, community context, and population needs. In phase 4, we built community capacity for the program and trial by training field staff (recruiters and interventionists embedded in community sites), compensating field staff, and creating a system for identifying potential participants. In phase 5, we implemented and monitored the program and trial. Engaging community partners in all phases has resulted in a new, culturally tailored program that is suitable for newly diagnosed Latinas with breast cancer and a trial that is acceptable and supported by community and clinical partners. Lessons Learned Engagement of community-based organizations and cancer survivors as research partners and hiring recruiters and interventionists from the community were critical to successful implementation in community settings. Having culturally and linguistically competent research staff with excellent interpersonal skills facilitated implementation. Facilitating and maintaining excellent communication among community partners was imperative to troubleshoot implementation issues. Randomization was challenging due to community concerns about assigning women to a control group. Patient privacy regulations and the need for extensive outreach to establish relationships between community partners and clinical sites hampered initial recruitment. Limitations These were resource-intensive processes to develop and implement the program that need to be compared to less intensive alternatives. Conclusions Engaging community members in design and implementation of community-based programs and trials enhances cultural appropriateness and congruence with the community context. If the randomized trial demonstrates that the intervention is effective, it will fill a gap in evidence-based programs to address ethnic disparities in quality of life among Spanish-speaking Latinas with breast cancer. PMID:24577971

Implementation and Outcomes of a Comprehensive Type 2 Diabetes Program in Rural Guatemala

PubMed Central

Flood, David; Mux, Sandy; Martinez, Boris; García, Pablo; Douglas, Kate; Goldberg, Vera; Lopez, Waleska

2016-01-01

Background The burden of chronic, non-communicable diseases such as diabetes is growing rapidly in low- and middle-income countries. Implementing management programs for diabetes and other chronic diseases for underserved populations is thus a critical global health priority. However, there is a notable dearth of shared programmatic and outcomes data from diabetes treatment programs in these settings. Program Description We describe our experiences as a non-governmental organization designing and implementing a type 2 diabetes program serving Maya indigenous people in rural Guatemala. We detail the practical challenges and solutions we have developed to build and sustain diabetes programming in this setting. Methods We conduct a retrospective chart review from our electronic medical record to evaluate our program’s performance. We generate a cohort profile, assess cross-sectional indicators using a framework adapted from the literature, and report on clinical longitudinal outcomes. Results A total of 142 patients were identified for the chart review. The cohort showed a decrease in hemoglobin A1C from a mean of 9.2% to 8.1% over an average of 2.1 years of follow-up (p <0.001). The proportions of patients meeting glycemic targets were 53% for hemoglobin A1C < 8% and 32% for the stricter target of hemoglobin A1C < 7%. Conclusion We first offer programmatic experiences to address a gap in resources relating to the practical issues of designing and implementing global diabetes management interventions. We then present clinical data suggesting that favorable diabetes outcomes can be attained in poor areas of rural Guatemala. PMID:27583362

The Vietnam Multicomponent Collaborative Care for Depression Program: Development of Depression Care for Low- and Middle-Income Nations

PubMed Central

Ngo, Victoria K.; Weiss, Bahr; Lam, Trung; Dang, Thanh; Nguyen, Tam; Nguyen, Mai Hien

2014-01-01

In this article, we discuss the Vietnam Multicomponent Collaborative Care for Depression Program, which was designed to provide evidence-based depression care services in low-resource, non-Western settings such as Vietnam. The article provides the program development background; the social, economic, and political context in which the program was developed; and the structure and content of the program and their underlying rationale in the context of rural Vietnam. Although the program was found to be acceptable, feasible, and effective in reducing depression outcomes, we did face challenges in implementation, which are outlined in this article. Key challenges included cultural factors (e.g., a lack of recognition of depression as a health-related entity amenable to professional treatment, relatively low levels of psychological mindedness useful for understanding of psychological interventions) and health system (e.g., lack of mental health specialists, overburdened health providers unfamiliar with behavioral interventions) factors. We discuss the strategies we employed to resolve these challenges and our successes and failures therein. We conclude with recommendations for others interested in implementing similar programs in low- and middle-income countries settings. PMID:25568593

Central station market development strategies for photovoltaics

NASA Technical Reports Server (NTRS)

1980-01-01

Federal market development strategies designed to accelerate the market penetration of central station applications of photovoltaic energy system are analyzed. Since no specific goals were set for the commercialization of central station applications, strategic principles are explored which, when coupled with specific objectives for central stations, can produce a market development implementation plan. The study includes (1) background information on the National Photovoltaic Program, photovoltaic technology, and central stations; (2) a brief market assessment; (3) a discussion of the viewpoints of the electric utility industry with respect to solar energy; (4) a discussion of commercialization issues; and (5) strategy principles. It is recommended that a set of specific goals and objectives be defined for the photovoltaic central station program, and that these goals and objectives evolve into an implementation plan that identifies the appropriate federal role.

Central station market development strategies for photovoltaics

NASA Astrophysics Data System (ADS)

1980-11-01

Federal market development strategies designed to accelerate the market penetration of central station applications of photovoltaic energy system are analyzed. Since no specific goals were set for the commercialization of central station applications, strategic principles are explored which, when coupled with specific objectives for central stations, can produce a market development implementation plan. The study includes (1) background information on the National Photovoltaic Program, photovoltaic technology, and central stations; (2) a brief market assessment; (3) a discussion of the viewpoints of the electric utility industry with respect to solar energy; (4) a discussion of commercialization issues; and (5) strategy principles. It is recommended that a set of specific goals and objectives be defined for the photovoltaic central station program, and that these goals and objectives evolve into an implementation plan that identifies the appropriate federal role.

Typology of delivery quality: latent profile analysis of teacher engagement and delivery techniques in a school-based prevention intervention, keepin’ it REAL curriculum

PubMed Central

Shin, YoungJu; Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Krieger, Janice L.

2014-01-01

Enhancing the delivery quality of school-based, evidence-based prevention programs is one key to ensuring uniform program effects on student outcomes. Program evaluations often focus on content dosage when implementing prevention curricula, however, less is known about implementation quality of prevention content, especially among teachers who may or may not have a prevention background. The goal of the current study is to add to the scholarly literature on implementation quality for a school-based substance use prevention intervention. Twenty-five schools in Ohio and Pennsylvania implemented the original keepin’ REAL (kiR) substance use prevention curriculum. Each of the 10, 40–45 min lessons of the kiR curriculum was video recorded. Coders observed and rated a random sample of 276 videos reflecting 78 classes taught by 31 teachers. Codes included teachers’ delivery techniques (e.g. lecture, discussion, demonstration and role play) and engagement with students (e.g. attentiveness, enthusiasm and positivity). Based on the video ratings, a latent profile analysis was run to identify typology of delivery quality. Five profiles were identified: holistic approach, attentive teacher-orientated approach, enthusiastic lecture approach, engaged interactive learning approach and skill practice-only approach. This study provides a descriptive typology of delivery quality while implementing a school-based substance use prevention intervention. PMID:25274721

“There’s No Touching in Pharmacy”: Training Pharmacists for Australia’s First Pharmacist Immunization Pilot

PubMed Central

Lau, Esther T L; Rochin, Michelle E; DelDot, Megan; Glass, Beverley D; Nissen, Lisa M

2017-01-01

Background Vaccination is a safe, efficient, and cost-effective means of preventing, controlling, and eradicating many life-threatening infections and diseases. Globally, the World Health Organization estimates that vaccination saves between 2 million and 3 million lives annually. However, low immunization rates are a significant public health concern. Individual factors, along with the vaccination process and system, have been reported as perceived barriers and challenges to immunization. Lack of time, on the part of both health care professionals and patients, has also been reported as a key factor influencing patterns of immunization. Despite the accessibility of pharmacists in community pharmacies in Australia, and initiatives by other countries to introduce pharmacist vaccination services, pharmacists in Australia had not previously delivered this service. The Queensland Pharmacist Immunisation Pilot (QPIP), initially implemented for the 2014 influenza season and later expanded, as QPIP2, to include other vaccines, allowed Australian pharmacists to vaccinate for the first time. Objectives To develop, implement, and evaluate a training program for pharmacists undertaking vaccination services in community pharmacies in Australia. Methods Background content was developed and delivered through 2 online modules. Pharmacists were required to successfully answer a series of multiple-choice questions related to the background reading before attending a face-to-face workshop. The workshop provided practical training in injection skills and anaphylaxis management. Participants were also asked to evaluate the training program. Results Of the 339 pharmacists who completed the training program, 286 (84%) provided an evaluation. Participants were satisfied with the training, as indicated by consistently high scores on the “overall satisfaction” question (mean 4.65/5 for the QPIP and QPIP2 training combined). Participants described the background reading as relevant to their practice and stated that it met their expectations. They also valued the opportunity to practise injections on each other during the face-to-face workshop, and this aspect was noted as a key component of the training. Conclusions QPIP demonstrated that a pharmacist-specific training program could produce competent and confident immunizers and could be used to “retrofit” the profession, to facilitate delivery of vaccination services in Australia. PMID:28894312

Enhance®Fitness Dissemination and Implementation,: 2010-2015: A Scoping Review.

PubMed

Petrescu-Prahova, Miruna G; Eagen, Thomas J; Fishleder, Sarah L; Belza, Basia

2017-03-01

Physical activity has many benefits for older adult physical and mental health. Enhance ® Fitness (EF) is an evidence-based group exercise program delivered by community-based organizations. The purpose of this study was to review recent evidence on the dissemination and implementation of EF. A scoping review of qualitative and quantitative studies with EF as main focus was conducted. CINAHL, PubMed, PubMed Central, SCOPUS, Web of Science, PsycINFO, and Google Scholar were searched between October and November 2015 for data-based studies on EF published in 2010-2015. Two team members abstracted each paper independently using a data abstraction tool. Results were summarized using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Seventeen publications met inclusion criteria. EF has reached and is effective across a broad population base, including individuals with low SES and diverse ethnic/racial backgrounds. EF participation may be associated with reduced risk for falls requiring medical care, and is associated with fewer hospital admissions. Analyses of medical cost savings from EF participation and program implementation costs suggest economic benefits of EF implementation for communities. Organization-level maintenance is facilitated by program-specific and organizational factors, such as instructor training and funding. Individual-level maintenance is facilitated by program structure, absence of pain, and increased quality of life. More-rigorous evidence is needed about the association between participation in EF and conditions such as falls. Evaluation of program fidelity, adaptations, and sustainability is limited; more-systematic examination across population groups and types of organizations would help ensure older adults continue to benefit from EF participation. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Playing Fair: The Contribution of High-Functioning Recess to Overall School Climate in Low-Income Elementary Schools

ERIC Educational Resources Information Center

London, Rebecca A.; Westrich, Lisa; Stokes-Guinan, Katie; McLaughlin, Milbrey

2015-01-01

Background: Recess is a part of the elementary school day with strong implications for school climate. Positive school climate has been linked to a host of favorable student outcomes, from attendance to achievement. We examine 6 low-income elementary schools' experiences implementing a recess-based program designed to provide safe, healthy,…

Implementation of Low-Fat, Low-Sugar, and Portion-Controlled Nutrition Guidelines in Competitive Food Venues of Maine Public High Schools

ERIC Educational Resources Information Center

Whatley Blum, Janet E.; Davee, Anne-Marie; Devore, Rachel L.; Beaudoin, Christina M.; Jenkins, Paul L.; Kaley, Lori A.; Wigand, Debra A.

2007-01-01

Background: The prevalence of childhood "overweight" and "at risk for overweight" has become a major public health concern. School food environments can affect key nutritional risk factors, especially in high schools where foods of poor nutrient value are pervasive in a la carte and vending programs. This study examines a la…

CMOS-array design-automation techniques

NASA Technical Reports Server (NTRS)

Feller, A.; Lombardt, T.

1979-01-01

Thirty four page report discusses design of 4,096-bit complementary metal oxide semiconductor (CMOS) read-only memory (ROM). CMOSROM is either mask or laser programable. Report is divided into six sections; section one describes background of ROM chips; section two presents design goals for chip; section three discusses chip implementation and chip statistics; conclusions and recommendations are given in sections four thru six.

The Role of Ethnicity in School-Based Obesity Intervention for School-Aged Children: A Pilot Evaluation

ERIC Educational Resources Information Center

Karczewski, Sabrina A.; Carter, Jocelyn S.; DeCator, Draycen D.

2016-01-01

Background: Rates of obesity have risen disproportionately for ethnic minority youth in the United States. School-based programs may be the most comprehensive and cost-effective way to implement primary prevention in children. In this study we evaluated the effect of a school-based obesity prevention on the outcome of body mass index percentile…

ICT Coordinators' TPACK-Based Leadership Knowledge in Their Roles as Agents of Change

ERIC Educational Resources Information Center

Avidov-Ungar, Orit; Shamir-Inbal, Tamar

2017-01-01

Aim/Purpose: The aim of the study is to examine what ICT coordinators perceive as the main elements of knowledge needed to implement ICT successfully into school culture. Background: For the past few years, Israel's Ministry of Education has been running a national program of adapting the education system to the 21st century skills. Key teachers…

Applying the School Health Index to a Nationally Representative Sample of Schools: Update for 2006

ERIC Educational Resources Information Center

Brener, Nancy D.; Pejavara, Anu; McManus, Tim

2011-01-01

Background: The School Health Index (SHI) is a tool designed to help schools assess the extent to which they are implementing practices included in the research-based guidelines and strategies for school health and safety programs developed by the Centers for Disease Control and Prevention (CDC). CDC previously analyzed data from the 2000 School…

Placing Students at the Center: The Whole School, Whole Community, Whole Child Model

ERIC Educational Resources Information Center

Morse, Linda L.; Allensworth, Diane D.

2015-01-01

Background: Students are the heart of the Whole School, Whole Community, Whole Child (WSCC) model. Students are the recipients of programs and services to ensure that they are healthy, safe, engaged, supported, and challenged and also serve as partners in the implementation and dissemination of the WSCC model. Methods: A review of the number of…

Company-College Links: Examples of What Works--A University Advisory Council Report.

ERIC Educational Resources Information Center

American Council of Life Insurance, Washington, DC. Education and Community Services.

A report is presented of a meeting sponsored by the University Advisory Council of the American Council of Life Insurance on company-college links. A brief outline is presented of each of five innovative programs developed and implemented by business groups and colleges. As background to the projects, attention is also directed to some of the main…

Increasing the Participation of Parents of Elementary School Students in Parent Education Activities through Development and Implementation of an Alternative Delivery System.

ERIC Educational Resources Information Center

Walker, Thomas

This practicum report describes a program intended to increase parent participation by improved information delivery at an elementary school. Background study of the school and community indicated approximately a 25% turnover rate of new families and students. Attendance at parent education workshops and school orientation tours before program…

Monterrey, La Ciudad Dorada/Monterrey, The Golden City. Curriculum Projects. Fulbright-Hays Summer Seminars Abroad Program, 2002 (Mexico).

ERIC Educational Resources Information Center

Quintyne, Susan

This curriculum project is designed for high school classes in Spanish, social studies, or global studies. The project's lesson plan lists materials needed; poses seven key questions about Mexico and Monterrey; outlines background notes on Mexico; and provides a detailed, step-by-step procedure for classroom implementation during three days. Also…

Accelerating Research Impact in a Learning Health Care System

PubMed Central

Elwy, A. Rani; Sales, Anne E.; Atkins, David

2017-01-01

Background: Since 1998, the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI) has supported more rapid implementation of research into clinical practice. Objectives: With the passage of the Veterans Access, Choice and Accountability Act of 2014 (Choice Act), QUERI further evolved to support VHA’s transformation into a Learning Health Care System by aligning science with clinical priority goals based on a strategic planning process and alignment of funding priorities with updated VHA priority goals in response to the Choice Act. Design: QUERI updated its strategic goals in response to independent assessments mandated by the Choice Act that recommended VHA reduce variation in care by providing a clear path to implement best practices. Specifically, QUERI updated its application process to ensure its centers (Programs) focus on cross-cutting VHA priorities and specify roadmaps for implementation of research-informed practices across different settings. QUERI also increased funding for scientific evaluations of the Choice Act and other policies in response to Commission on Care recommendations. Results: QUERI’s national network of Programs deploys effective practices using implementation strategies across different settings. QUERI Choice Act evaluations informed the law’s further implementation, setting the stage for additional rigorous national evaluations of other VHA programs and policies including community provider networks. Conclusions: Grounded in implementation science and evidence-based policy, QUERI serves as an example of how to operationalize core components of a Learning Health Care System, notably through rigorous evaluation and scientific testing of implementation strategies to ultimately reduce variation in quality and improve overall population health. PMID:27997456

Measurement of high altitude air quality using aircraft

NASA Technical Reports Server (NTRS)

Rudey, R. A.; Perkins, P. J.

1973-01-01

The minor atmospheric constituents associated with and affected by aircraft exhaust emissions at altitudes from 6 to 20 km will be monitored in flight programs presently being implemented. Preliminary in situ data are available from flight tests of dedicated instruments to be used in these programs. A Global Atmospheric Sampling Program using Boeing 747 airliners was determined to be feasible in studies conducted by airlines and airframe companies. Worldwide monitoring in the troposphere and the lower stratosphere is planned. Stratospheric air sampling on a more local basis will be done with a U2 aircraft. Measuring system evaluations and improvements have been required to detect the low background levels.

Measurement of high-altitude air quality using aircraft.

NASA Technical Reports Server (NTRS)

Rudey, R. A.; Perkins, P. J.

1973-01-01

The minor atmospheric constituents associated with and affected by aircraft exhaust emissions at altitudes from 6 to 20 km will be monitored in flight programs presently being implemented. Preliminary in situ data are available from flight tests of dedicated instruments to be used in these programs. A Global Atmospheric Sampling Program using Boeing 747 airliners was determined to be feasible in studies conducted by airlines and airframe companies. Worldwide monitoring in the troposphere and the lower stratosphere is planned. Stratospheric air sampling on a more local basis will be done with a U2 aircraft. Measuring system evaluations and improvements have been required to detect the low background levels.

Practical Issues in Developing a Culturally Tailored Physical Activity Promotion Program for Chinese and Korean American Midlife Women: A Pilot Study

PubMed Central

Chee, Wonshik; Kim, Sangmi; Chu, Tsung-Lan; Ji, Xiaopeng; Zhang, Jingwen; Chee, Eunice; Im, Eun-Ok

2016-01-01

Background With advances in computer technologies, Web-based interventions are widely accepted and welcomed by health care providers and researchers. Although the benefits of Web-based interventions on physical activity promotion have been documented, the programs have rarely targeted Asian Americans, including Asian American midlife women. Subsequently, culturally competent Web-based physical activity programs for Asian Americans may be necessary. Objective The purpose of our study was to explore practical issues in developing and implementing a culturally competent Web-based physical activity promotion program for 2 groups of Asian American women—Chinese American and Korean American midlife women—and to provide implications for future research. Methods While conducting the study, the research team members wrote individual memos on issues and their inferences on plausible reasons for the issues. The team had group discussions each week and kept the minutes of the discussions. Then, the memos and minutes were analyzed using a content analysis method. Results We identified practical issues in 4 major idea categories: (1) bilingual translators’ language orientations, (2) cultural sensitivity requirement, (3) low response rate, interest, and retention, and (4) issues in implementation logistics. Conclusions Based on the issues, we make several suggestions for the use of bilingual translators, motivational strategies, and implementation logistics. PMID:27872035

Adaptation, Implementation Plan, and Evaluation of an Online Tobacco Cessation Training Program for Health Care Professionals in Three Spanish-Speaking Latin American Countries: Protocol of the Fruitful Study

PubMed Central

Company, Assumpta; Guillen, Olga; Margalef, Mercè; Arrien, Martha Alicia; Sánchez, Claudia; Cáceres de León, Paula

2017-01-01

Background Tobacco cessation training programs to treat tobacco dependence have measureable effects on patients’ smoking. Tobacco consumption in low- and middle-income countries (LMICs) is high and slowly decreasing, but these countries usually lack measures to face the epidemic, including tobacco cessation training programs for health professionals and organizations. Based on a previous online smoking cessation training program for hospital workers in Spain, the Fruitful Study aims to increase smoking cessation knowledge, attitudes, self-confidence, and performance interventions among health care professionals of three Spanish-speaking low- and middle-income Latin American and Caribbean (LAC) countries. Objective The purpose of this paper is to describe the methodology and evaluation strategy of the Fruitful Study intended to adapt, implement, and test the effectiveness of an online, evidence-based tobacco cessation training program addressed to health professionals from Bolivia, Guatemala, and Paraguay. Methods This study will use a mixed-methods design with a pre-post evaluation (quantitative approach) and in-depth interviews and focus groups (qualitative approach). The main outcomes will be (1) participants’ attitudes, knowledge, and behaviors before and after the training; and (2) the level of implementation of tobacco control policies within the hospitals before and after the training. Results To date, adaptation of the materials, study enrollment, and training activities have been completed. During the adaptation, the main mismatches were language background and content adaptation. Several aids were developed to enable students’ training enrollment, including access to computers, support from technicians, and reminders to correctly complete the course. Follow-up data collection is in progress. We have enrolled 281 hospital workers. Results are expected at the beginning of 2017 and will be reported in two follow-up papers: one about the formative evaluation and the other about the summative evaluation. Conclusions There is a need to learn more about the cultural and content elements that should be modified when an online tobacco cessation training program is adapted to new contexts. Special attention should be given to the personal and material resources that could make the implementation possible. Results from the Fruitful Study may offer a new approach to adapting programs to LMICs in order to offer education solutions with the use of emerging and growing communication technologies. ClinicalTrial Clinicaltrials.gov NCT02718872; https://clinicaltrials.gov/ct2/show/NCT02718872 (Archived by WebCite at http://www.webcitation.org/6mjihsgE2) PMID:28128731

Determinants for the effectiveness of implementing an occupational therapy intervention in routine dementia care

PubMed Central

2013-01-01

Background A multifaceted implementation (MFI) strategy was used to implement an evidence-based occupational therapy program for people with dementia (COTiD program). This strategy was successful in increasing the number of referrals, but not in improving occupational therapists’ (OTs) adherence. Therefore, a process evaluation was conducted to identify factors that influenced the effectiveness of the MFI strategy. Methods A mixed-method approach of qualitative and quantitative research was used to evaluate the implementation process. The MFI strategy as planned and as executed were reported and evaluated based on the framework of Hulscher et al. (2003; 2006). Data on OTs attitudes and expected barriers were collected at baseline from 94 OTs using a 19-item questionnaire. Data on the experiences were collected after finishing the implementation using focus groups with OTs and telephone interviews with physicians and managers. For quantitative data, frequencies and correlations were calculated and qualitative data were analyzed using inductive content analysis. Results The implementation strategy as executed had a stronger focus than planned on increasing OTs promotional skills due to an initial lack of referrals. This resulted in less attention for increasing OTs’ skills in using the COTiD program as initially intended. At baseline, OTs had a positive attitude toward the program, however, 75% did not feel experienced enough and only 14.3% felt competent in using the program. Focus groups and interviews revealed various determinants that influenced implementation. Most managers were positive about the program. However, the degree of operational support of managers for OTs regarding the implementation was not always adequate. Managers stated that a well-defined place for occupational therapy within the dementia care network was lacking although this was perceived necessary for successful implementation. Several physicians perceived psychosocial interventions not to be in their area of expertise or not their responsibility. All professionals perceived inter-professional collaboration to be a facilitator for effective implementation, and general practitioners were perceived as key partners in this collaboration. However, collaboration was not always optimal. OTs indicated that increasing the referral rate was most effective when promoting OT via other disciplines within a physician’s network. Conclusion Our data suggests that a first step in successful implementation should be to make sure that individual and organizational barriers are resolved. In addition, implementation should be network-based and encourage inter-professional collaboration. Initial promotion of COTiD should focus on physicians that have a positive attitude toward non-pharmacological interventions. PMID:24195975

The Texas Medication Algorithm Project Patient and Family Education Program: a consumer-guided initiative.

PubMed

Toprac, M G; Rush, A J; Conner, T M; Crismon, M L; Dees, M; Hopkins, C; Rowe, V; Shon, S P

2000-07-01

Educating patients with mental illness and their families about the illness and its treatment is essential to successful medication (disease) management. Specifically, education provides patients and families with the background they need to participate in treatment planning and implementation as full "partners" with clinicians. Thus, education increases the probability that appropriate and accurate treatment decisions will be made and that a treatment regimen will be followed. The Texas Medication Algorithm Project (TMAP) has incorporated these concepts into its philosophy of care and accordingly created a Patient and Family Education Program (PFEP) to complement the utilization of medication algorithms for the treatment of schizophrenic, bipolar, and major depressive disorders. This article describes how a team of mental health consumers, advocates, and professionals developed and implemented the PFEP. In keeping with the TMAP philosophy of care, consumers were true partners in the program's development and implementation. They not only created several components of the program and incorporated the consumer perspective, but they also served as program trainers and advocates. Initially, PFEP provides basic and subsequently more in-depth information about the illness and its treatment, including such topics as symptom monitoring and management and self-advocacy with one's treatment team. It includes written, pictorial, videotaped, and other media used in a phased manner by clinicians and consumer educators, in either individual or group formats.

A mixed methods multiple case study of implementation as usual in children’s social service organizations: study protocol

PubMed Central

2013-01-01

Background Improving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care. It is likely that efforts to identify, develop, and refine implementation strategies will be more successful if they are informed by relevant stakeholders and are responsive to the strengths and limitations of the contexts and implementation processes identified in usual care settings. This study will describe: the types of implementation strategies used; how organizational leaders make decisions about what to implement and how to approach the implementation process; organizational stakeholders’ perceptions of different implementation strategies; and the potential influence of organizational culture and climate on implementation strategy selection, implementation decision-making, and stakeholders’ perceptions of implementation strategies. Methods/design This study is a mixed methods multiple case study of seven children’s social service organizations in one Midwestern city in the United States that compose the control group of a larger randomized controlled trial. Qualitative data will include semi-structured interviews with organizational leaders (e.g., CEOs/directors, clinical directors, program managers) and a review of documents (e.g., implementation and quality improvement plans, program manuals, etc.) that will shed light on implementation decision-making and specific implementation strategies that are used to implement new programs and practices. Additionally, focus groups with clinicians will explore their perceptions of a range of implementation strategies. This qualitative work will inform the development of a Web-based survey that will assess the perceived effectiveness, relative importance, acceptability, feasibility, and appropriateness of implementation strategies from the perspective of both clinicians and organizational leaders. Finally, the Organizational Social Context measure will be used to assess organizational culture and climate. Qualitative, quantitative, and mixed methods data will be analyzed and interpreted at the case level as well as across cases in order to highlight meaningful similarities, differences, and site-specific experiences. Discussion This study is designed to inform efforts to develop more effective implementation strategies by fully describing the implementation experiences of a sample of community-based organizations that provide mental health services to youth in one Midwestern city. PMID:23961701

Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region

PubMed Central

Kalolo, Albino; Radermacher, Ralf; Stoermer, Manfred; Meshack, Menoris; De Allegri, Manuela

2015-01-01

Background Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI) schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses. Objective In this paper, we describe a process evaluation protocol aimed at opening the ‘black box’ to evaluate the implementation processes of the Redesigned Community Health Fund (CHF) program in the Dodoma region of Tanzania. Design The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review), and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. Discussion This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes. PMID:26679408

Activities of the Oil Implementation Task Force; Contracts for field projects and supporting research on enhanced oil recovery, July--September 1990

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

Tiedemann, H.A.

1991-05-01

The report contains a general introduction and background to DOE's revised National Energy Strategy Advanced Oil Recovery Program and activities of the Oil Implementation Task Force; a detailed synopsis of the symposium, including technical presentations, comments and suggestions; a section of technical information on deltaic reservoirs; and appendices containing a comprehensive listing of references keyed to general deltaic and geological aspects of reservoirs and those relevant to six selected deltaic plays. Enhanced recovery processes include chemical floodings, gas displacement, thermal recovery, geoscience, and microbial recovery.

Improving the Nurse–Family Partnership in Community Practice

PubMed Central

Donelan-McCall, Nancy; O’Brien, Ruth; MacMillan, Harriet; Jack, Susan; Jenkins, Thomas; Dunlap, Wallace P.; O’Fallon, Molly; Yost, Elly; Thorland, Bill; Pinto, Francesca; Gasbarro, Mariarosa; Baca, Pilar; Melnick, Alan; Beeber, Linda

2013-01-01

BACKGROUND: Evidence-based preventive interventions are rarely final products. They have reached a stage of development that warrant public investment but require additional research and development to strengthen their effects. The Nurse-Family Partnership (NFP), a program of nurse home visiting, is grounded in findings from replicated randomized controlled trials. OBJECTIVE: Evidence-based programs require replication in accordance with the models tested in the original randomized controlled trials in order to achieve impacts comparable to those found in those trials, and yet they must be changed in order to improve their impacts, given that interventions require continuous improvement. This article provides a framework and illustrations of work our team members have developed to address this tension. METHODS: Because the NFP is delivered in communities outside of research contexts, we used quantitative and qualitative research to identify challenges with the NFP program model and its implementation, as well as promising approaches for addressing them. RESULTS: We describe a framework used to address these issues and illustrate its use in improving nurses’ skills in retaining participants, reducing closely spaced subsequent pregnancies, responding to intimate partner violence, observing and promoting caregivers’ care of their children, addressing parents’ mental health problems, classifying families’ risks and strengths as a guide for program implementation, and collaborating with indigenous health organizations to adapt and evaluate the program for their populations. We identify common challenges encountered in conducting research in practice settings and translating findings from these studies into ongoing program implementation. CONCLUSIONS: The conduct of research focused on quality improvement, model improvement, and implementation in NFP practice settings is challenging, but feasible, and holds promise for improving the impact of the NFP. PMID:24187112

Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships

PubMed Central

Matovu, Joseph K.B.; Wanyenze, Rhoda K.; Mawemuko, Susan; Wamuyu-Maina, Gakenia; Bazeyo, William; Olico-Okui; Serwadda, David

2011-01-01

Background Around the world, health professionals and program managers are leading and managing public and private health organizations with little or no formal management and leadership training and experience. Objective To describe an innovative 2-year, long-term apprenticeship Fellowship training program implemented by Makerere University School of Public Health (MakSPH) to strengthen capacity for leadership and management of HIV/AIDS programs in Uganda. Implementation process The program, which began in 2002, is a 2-year, full-time, non-degree Fellowship. It is open to Ugandan nationals with postgraduate training in health-related disciplines. Enrolled Fellows are attached to host institutions implementing HIV/AIDS programs and placed under the supervision of host institution and academic mentors. Fellows spend 75% of their apprenticeship at the host institutions while the remaining 25% is dedicated to didactic short courses conducted at MakSPH to enhance their knowledge base. Achievements Overall, 77 Fellows have been enrolled since 2002. Of the 57 Fellows who were admitted between 2002 and 2008, 94.7% (54) completed the Fellowship successfully and 50 (92.3%) are employed in senior leadership and management positions in Uganda and internationally. Eighty-eight percent of those employed (44/54) work in institutions registered in Uganda, indicating a high level of in-country retention. Nineteen of the 20 Fellows who were admitted between 2009 and 2010 are still undergoing training. A total of 67 institutions have hosted Fellows since 2002. The host institutions have benefited through staff training and technical expertise from the Fellows as well as through grant support to Fellows to develop and implement innovative pilot projects. The success of the program hinges on support from mentors, stakeholder involvement, and the hands-on approach employed in training. Conclusion The Fellowship Program offers a unique opportunity for hands-on training in HIV/AIDS program leadership and management for both Fellows and host institutions. PMID:21364774

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

Alliance for a Healthier Generation's Competitive Beverage and Food Guidelines: Do Elementary School Administrators Know about Them and Do They Report Implementing Them?

ERIC Educational Resources Information Center

Ohri-Vachaspati, Punam; Turner, Lindsey; Chaloupka, Frank J.

2012-01-01

Background: The availability of competitive foods in schools is a modifiable factor in efforts to prevent childhood obesity. The Alliance for a Healthier Generation launched the Healthy Schools Program in 2006 to encourage schools to create healthier food environments, including the adoption of nutritional guidelines for competitive beverages and…

Effects of a Community-Based Lifestyle Intervention on Change in Physical Activity among Economically Disadvantaged Adults with Prediabetes

ERIC Educational Resources Information Center

Hays, Laura M.; Hoen, Helena M.; Slaven, James E.; Finch, Emily A.; Marrero, David G.; Saha, Chandan; Ackermann, Ronald T.

2016-01-01

Background: Moderate weight loss and physical activity (PA) can prevent or delay type 2 diabetes however there is a need for innovative, effective programs to promote PA in high-risk individuals. Purpose: We examined the effect of a group-based adaption of the DPP lifestyle intervention implemented in partnership with the YMCA (YDPP) on changes in…

PREP inside and out: marriage education for inmates.

PubMed

Einhorn, Lindsey; Williams, Tamara; Stanley, Scott; Wunderlin, Nicole; Markman, Howard; Eason, Joanne

2008-09-01

Although research has demonstrated that marriage education has positive effects on relationship quality, little is known about how such services impact relationships where one partner is incarcerated. The current study implemented an adapted version of the Prevention and Relationship Enhancement Program (PREP Inside and Out) for inmates in Oklahoma correctional facilities. Inmates, with or without their partners, participated in the 12-hour program. The impact of the program was investigated on a range of relationship variables including satisfaction with relationship, dedication, confidence, communication skills, friendship, and negative interactions as reported by the inmate partner. Participants reported substantial gains in all variables and in overall satisfaction with their relationship after completing the program, regardless of their gender and racial/ethnic background. Implications for future marriage education programs and research in prisons are discussed.

The magnetosphere, ionosphere, and atmosphere as a system - Dynamics Explorer 5 years later

NASA Technical Reports Server (NTRS)

Hoffman, R. A.

1988-01-01

The Dynamics Explorer (DE) program summarizes its accomplishments during the first 5 years since the launch of the two DE satellites. This introduction to six review articles provides background information and a brief history of the program, especially citing the contributions of many people to its development. The principal investigators who had primary responsibility to implement the program are listed, together with the instruments they provided. Orbital information and approaches and constraints to data acquisition are explained. The brief description of the ground data processing and analysis system provides information on access to data catalogs and data sets. Each review article is then placed in the context of the categories of scientific objectives of the program.

Predictors of Success for Electronic Health Record Implementation in Small Physician Practices

PubMed Central

Ancker, J.S.; Singh, M.P.; Thomas, R.; Edwards, A.; Snyder, A.; Kashyap, A.; Kaushal, R.

2013-01-01

Background The federal government is promoting adoption of electronic health records (EHRs) through financial incentives for EHR use and implementation support provided by regional extension centers. Small practices have been slow to adopt EHRs. Objectives Our objective was to measure time to EHR implementation and identify factors associated with successful implementation in small practices receiving financial incentives and implementation support. This study is unique in exploiting quantitative implementation time data collected prospectively as part of routine project management. Methods This mixed-methods study includes interviews of key informants and a cohort study of 544 practices that had worked with the Primary Care Information Project (PCIP), a publicly funded organization that since 2007 has subsidized EHRs and provided implementation support similar to that supplied by the new regional extension centers. Data from a project management database were used for a cohort study to assess time to implementation and predictors of implementation success. Results Four hundred and thirty practices (79%) implemented EHRs within the analysis period, with a median project time of 24.7 weeks (95% CI: 23.3 – 26.4). Factors associated with implementation success were: fewer providers, practice sites, and patients; fewer Medicaid and uninsured patients; having previous experience with scheduling software; enrolling in 2010 rather than earlier; and selecting an integrated EHR plus practice management product rather than two products. Interviews identified positive attitude toward EHRs, resources, and centralized leadership as additional practice-level predictors of success. Conclusions A local initiative similar to current federal programs successfully implemented EHRs in primary care practices by offsetting software costs and providing implementation assistance. Nevertheless, implementation success was affected by practice size and other characteristics, suggesting that the federal programs can reduce barriers to EHR implementation but may not eliminate them. PMID:23650484

Interventions for prevention of childhood obesity in primary care: a qualitative study

PubMed Central

Bourgeois, Nicole; Brauer, Paula; Simpson, Janis Randall; Kim, Susie; Haines, Jess

2016-01-01

Background: Preventing childhood obesity is a public health priority, and primary care is an important setting for early intervention. Authors of a recent national guideline have identified a need for effective primary care interventions for obesity prevention and that parent perspectives on interventions are notably absent from the literature. Our objective was to determine the perspectives of primary care clinicians and parents of children 2-5 years of age on the implementation of an obesity prevention intervention within team-based primary care to inform intervention implementation. Methods: We conducted focus groups with interprofessional primary care clinicians (n = 40) and interviews with parents (n = 26). Participants were asked about facilitators and barriers to, and recommendations for implementing a prevention program in primary care. Data were recorded and transcribed, and we used directed content analysis to identify major themes. Results: Barriers existed to addressing obesity-related behaviours in this age group and included a gap in well-child primary care between ages 18 months and 4-5 years, lack of time and sensitivity of the topic. Trust and existing relationships with primary care clinicians were facilitators to program implementation. Offering separate programs for parents and children, and addressing both general parenting topics and obesity-related behaviours were identified as desirable. Interpretation: Despite barriers to addressing obesity-related behaviours within well-child primary care, both clinicians and parents expressed interest in interventions in primary care settings. Next steps should include pilot studies to identify feasible strategies for intervention implementation. PMID:27398363

A Nursing Workforce Diversity Project: Strategies for Recruitment, Retention, Graduation, and NCLEX-RN Success.

PubMed

Murray, Ted A; Pole, David C; Ciarlo, Erica M; Holmes, Shearon

2016-01-01

The purpose of this article is to describe a collaborative project designed to recruit and retain students from underrepresented minorities and disadvantaged backgrounds into nursing education. Ethnic minorities remain underrepresented in the nursing workforce in comparison to the general population. The numbers of minorities enrolled in nursing education programs are insufficient to meet the health care workforce diversity needs of the future. High school students were provided with a preprofessional education program to prepare them for admission into a nursing program. Retention strategies were implemented for newly admitted and enrolled nursing education students. Twenty-one high school students enrolled in a nursing education program. The students enrolled in the nursing education program graduated and passed the licensure examination. Early recruitment and multiprong retention programs can be successful in diversifying the registered nurse workforce.

Design and implementation of an air monitoring program in support of a brownfields redevelopment program

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

Maisel, B.E.; Hunt, G.T.; Devaney, R.J. Jr.

EPA`s Brownfields Economic Redevelopment Initiative has sparked renewal of industrial and commercial parcels otherwise idled or under-utilized because of real or perceived environmental contamination. In certain cases, restoring such parcels to productive economic use requires a redevelopment effort protective of human health and welfare through minimizing offsite migration of environmental contaminants during cleanup, demolition and remediation activities. To support these objectives, an air monitoring program is often required as an integral element of a comprehensive brownfields redevelopment effort. This paper presents a strategic framework for design and execution of an ambient air monitoring program in support of a brownfields remediationmore » effort ongoing in Lawrence, MA. Based on site characterization, the program included sample collection and laboratory analysis of ambient air samples for polychlorinated biphenyls (PCBs), polychlorinated dibenzodioxins and polychlorinated dibenzofurans (PCDDs/PCDFs), total suspended particulate (TSP), inhalable particulate (PM10), and lead. The program included four monitoring phases, identified as background, wintertime, demolition/remediation and post-demolition. Air sampling occurred over a 16 month period during 1996--97, during which time nine sampling locations were utilized to produce approximately 1,500 ambient air samples. Following strict data review and validation procedures, ambient air data interpretation focused on the following: evaluation of upwind/downwind sample pairs, comparison of ambient levels to existing regulatory standards, relation of ambient levels to data reported in the open literature, and, determination of normal seasonal variations in existing background burden, comparison of ambient levels measured during site activity to background levels.« less

[Chronic Disease Self-management Support for People with a Migrant Background: towards a Peer-led Group Program to Improve Equity in Health].

PubMed

Zanoni, S; Gabriel, E; Salis Gross, C; Deppeler, M; Haslbeck, J

2018-03-01

Limited health literacy and language skills are barriers for people with a migrant background (PMB) to access health information and healthcare services, in particular for those living with chronic conditions. During the introduction of a peer-led Stanford chronic disease self-management course in Switzerland, special interest in the program as well as motivation of PMB was observed. In response, we examined if the program can be implemented in German for people with limited language skills. This explorative study is part of the evaluation study on introducing the adapted Stanford program in Switzerland and German-speaking Europe. Following the principles of Grounded Theory, semi-structured focus group and individual interviews were conducted with course participants, leaders and coordinators (n=30) and analyzed thematically. The focus was on the feasibility, satisfaction and course content. In principle, the program seems to have positive value for PMB, may work for them in German, have high relevance for everyday life and give an impetus for social integration. The need for and extent of modification of the program for PMB has to be further explored in order to make it more accessible for vulnerable groups. © Georg Thieme Verlag KG Stuttgart · New York.

Fading vision: knowledge translation in the implementation of a public health policy intervention

PubMed Central

2013-01-01

Background In response to several high profile public health crises, public health renewal is underway in Canada. In the province of British Columbia, the Ministry of Health initiated a collaborative evidence-informed process involving a steering committee of representatives from the six health authorities. A Core Functions (CF) Framework was developed, identifying 21 core public health programs. For each core program, an evidence review was conducted and a model core program paper developed. These documents were distributed to health authorities to guide development of their own renewed public health services. The CF implementation was conceptualized as an embedded knowledge translation process. A CF coordinator in each health authority was to facilitate a gap analysis and development of a performance improvement plan for each core program, and post these publically on the health authority website. Methods Interviews (n = 19) and focus groups (n = 8) were conducted with a total of 56 managers and front line staff from five health authorities working in the Healthy Living and Sexually Transmitted Infection Prevention core programs. All interviews and focus groups were digitally recorded, transcribed and verified by the project coordinator. Five members of the research team used NVivo 9 to manage data and conducted a thematic analysis. Results Four main themes emerged concerning implementation of the CF Framework generally, and the two programs specifically. The themes were: ‘you’ve told me what, now tell me how’; ‘the double bind’; ‘but we already do that’; and the ‘selling game.’ Findings demonstrate the original vision of the CF process was lost in the implementation process and many participants were unaware of the CF framework or process. Conclusions Results are discussed with respect to a well-known framework on the adoption, assimilation, and implementation of innovations in health services organizations. Despite attempts of the Ministry of Health and the Steering Committee to develop and implement a collaborative, evidence-informed policy intervention, there were several barriers to the realization of the vision for core public health functions implementation, at least in the early stages. In neglecting the implementation process, it seems unlikely that the expected benefits of the public health renewal process will be realized. PMID:23734672

Community-based implementation and effectiveness in a randomized trial of a risk reduction intervention for HIV-serodiscordant couples: study protocol

PubMed Central

2014-01-01

Background The HIV/AIDS epidemic continues to disproportionately affect African American communities in the US, particularly those located in urban areas. Despite the fact that HIV is often transmitted from one sexual partner to another, most HIV prevention interventions have focused only on individuals, rather than couples. This five-year study investigates community-based implementation, effectiveness, and sustainability of ‘Eban II,’ an evidence-based risk reduction intervention for African-American heterosexual, serodiscordant couples. Methods/design This hybrid implementation/effectiveness implementation study is guided by organizational change theory as conceptualized in the Texas Christian University Program Change Model (PCM), a model of phased organizational change from exposure to adoption, implementation, and sustainability. The primary implementation aims are to assist 10 community-based organizations (CBOs) to implement and sustain Eban II; specifically, to partner with CBOs to expose providers to the intervention; facilitate its adoption, implementation and sustainment; and to evaluate processes and determinants of implementation, effectiveness, fidelity, and sustainment. The primary effectiveness aim is to evaluate the effect of Eban II on participant (n = 200 couples) outcomes, specifically incidents of protected sex and proportion of condom use. We will also determine the cost-effectiveness of implementation, as measured by implementation costs and potential cost savings. A mixed methods evaluation will examine implementation at the agency level; staff members from the CBOs will complete baseline measures of organizational context and climate, while key stakeholders will be interviewed periodically throughout implementation. Effectiveness of Eban II will be assessed using a randomized delayed enrollment (waitlist) control design to evaluate the impact of treatment on outcomes at posttest and three-month follow-up. Multi-level hierarchical modeling with a multi-level nested structure will be used to evaluate the effects of agency- and couples-level characteristics on couples-level outcomes (e.g., condom use). Discussion This study will produce important information regarding the value of the Eban II program and a theory-guided implementation process and tools designed for use in implementing Eban II and other evidence-based programs in demographically diverse, resource-constrained treatment settings. Trial registration NCT00644163 PMID:24950708

Windows to the Universe: Earth Science Enterprise Education Program

NASA Technical Reports Server (NTRS)

2004-01-01

Over the past year, Windows to the Universe has continued a multifaceted program of support to the Earth Science Enterprise Education program. Areas of activity include continued maintenance of the W2U website and user traffic analysis, development of new and revised content and activities on the website, implementation of new tools to facilitate website development and maintenance, response to users questions and comments, professional development for educators through workshops at the National Science Teachers Association meetings and at NCAR, and dissemination of information about the project through materials distribution at NSTAs, AGUs, AMS and other venues. This report provides some background on the project and summarizes progress for the third and final year of the project.

NURD: an implementation of a new method to estimate isoform expression from non-uniform RNA-seq data

PubMed Central

2013-01-01

Background RNA-Seq technology has been used widely in transcriptome study, and one of the most important applications is to estimate the expression level of genes and their alternative splicing isoforms. There have been several algorithms published to estimate the expression based on different models. Recently Wu et al. published a method that can accurately estimate isoform level expression by considering position-related sequencing biases using nonparametric models. The method has advantages in handling different read distributions, but there hasn’t been an efficient program to implement this algorithm. Results We developed an efficient implementation of the algorithm in the program NURD. It uses a binary interval search algorithm. The program can correct both the global tendency of sequencing bias in the data and local sequencing bias specific to each gene. The correction makes the isoform expression estimation more reliable under various read distributions. And the implementation is computationally efficient in both the memory cost and running time and can be readily scaled up for huge datasets. Conclusion NURD is an efficient and reliable tool for estimating the isoform expression level. Given the reads mapping result and gene annotation file, NURD will output the expression estimation result. The package is freely available for academic use at http://bioinfo.au.tsinghua.edu.cn/software/NURD/. PMID:23837734

Mod-2 wind turbine project assessment and cluster test plans

NASA Technical Reports Server (NTRS)

Gordon, L. H.

1982-01-01

An assessment of the Mod-2 Wind Turbine project is presented based on initial goals and present results. Specifically, the Mod-2 background, project flow, and a chronology of events/results leading to Mod-2 acceptance is presented. After checkout/acceptance of the three operating turbines, NASA/LeRC will continue management of a two year test program performed at the DOE Goodnoe Hills test site. This test program is expected to yield data necessary for the continued development and optimization of wind energy systems. These test activities, the implementation of, and the results to date are also presented.

Implementing facility-based kangaroo mother care services: lessons from a multi-country study in Africa

PubMed Central

2014-01-01

Background Some countries have undertaken programs that included scaling up kangaroo mother care. The aim of this study was to systematically evaluate the implementation status of facility-based kangaroo mother care services in four African countries: Malawi, Mali, Rwanda and Uganda. Methods A cross-sectional, mixed-method research design was used. Stakeholders provided background information at national meetings and in individual interviews. Facilities were assessed by means of a standardized tool previously applied in other settings, employing semi-structured key-informant interviews and observations in 39 health care facilities in the four countries. Each facility received a score out of a total of 30 according to six stages of implementation progress. Results Across the four countries 95 per cent of health facilities assessed demonstrated some evidence of kangaroo mother care practice. Institutions that fared better had a longer history of kangaroo mother care implementation or had been developed as centres of excellence or had strong leaders championing the implementation process. Variation existed in the quality of implementation between facilities and across countries. Important factors identified in implementation are: training and orientation; supportive supervision; integrating kangaroo mother care into quality improvement; continuity of care; high-level buy in and support for kangaroo mother care implementation; and client-oriented care. Conclusion The integration of kangaroo mother care into routine newborn care services should be part of all maternal and newborn care initiatives and packages. Engaging ministries of health and other implementing partners from the outset may promote buy in and assist with the mobilization of resources for scaling up kangaroo mother care services. Mechanisms for monitoring these services should be integrated into existing health management information systems. PMID:25001366

Columbia River Basin Fish and Wildlife Program Work Plan for Fiscal Year 1989.

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

United States. Bonneville Power Administration. Division of Fish and Wildlife.

1988-11-01

The FY 1989 Columbia River Basin Fish and Wildlife Program Work Plan (Work Plan) presents Bonneville Power Administration's plans for implementing the Columbia River Basin Fish and Wildlife Program (Program) in FY 1989. The Work Plan focuses on individual Action Items found in the 1987 Program for which Bonneville Power Administration (BPA) has determined that it has authority and responsibility to implement. Each of the entries in the Work Plan includes objectives, background, and progress to date in achieving those objectives, and a summary of plans for implementation in FY 1989. Most Action Items are implemented through one or moremore » BPA-funded projects. Each Action Item entry is followed by a list of completed, ongoing, and planned projects, along with objectives, results, schedules, and milestones for each project. The FY 1989 Work Plan emphasizes continuation of 113 projects, most of which involve protection, mitigation, or enhancement of anadromous fishery resources. BPA also plans to start 20 new projects in FY 1989. The number of ongoing FY 1988 projects to be continued in FY 1989 and the number of new projects planned to start in FY 1989 are based on current (September 7, 1988) procurement expectations. Several projects presently in BPA's procurement process are expected to be contracted by September 30, 1988, the last day of FY 1988. Although these projects have not yet started, they have been listed in the Work Plan as ongoing FY 1988 projects, based on projected start dates in late September 1988. Throughout the Work Plan, those projects with projected start dates in September 1988 have been noted.« less

swga: a primer design toolkit for selective whole genome amplification.

PubMed

Clarke, Erik L; Sundararaman, Sesh A; Seifert, Stephanie N; Bushman, Frederic D; Hahn, Beatrice H; Brisson, Dustin

2017-07-15

Population genomic analyses are often hindered by difficulties in obtaining sufficient numbers of genomes for analysis by DNA sequencing. Selective whole-genome amplification (SWGA) provides an efficient approach to amplify microbial genomes from complex backgrounds for sequence acquisition. However, the process of designing sets of primers for this method has many degrees of freedom and would benefit from an automated process to evaluate the vast number of potential primer sets. Here, we present swga , a program that identifies primer sets for SWGA and evaluates them for efficiency and selectivity. We used swga to design and test primer sets for the selective amplification of Wolbachia pipientis genomic DNA from infected Drosophila melanogaster and Mycobacterium tuberculosis from human blood. We identify primer sets that successfully amplify each against their backgrounds and describe a general method for using swga for arbitrary targets. In addition, we describe characteristics of primer sets that correlate with successful amplification, and present guidelines for implementation of SWGA to detect new targets. Source code and documentation are freely available on https://www.github.com/eclarke/swga . The program is implemented in Python and C and licensed under the GNU Public License. ecl@mail.med.upenn.edu. Supplementary data are available at Bioinformatics online. © The Author(s) 2017. Published by Oxford University Press.

A Dynamic Clamp on Every Rig

PubMed Central

2017-01-01

Abstract The dynamic clamp should be a standard part of every cellular electrophysiologist’s toolbox. That it is not, even 25 years after its introduction, comes down to three issues: money, the disruption that adding dynamic clamp to an existing electrophysiology rig entails, and the technical prowess required of experimenters. These have been valid and limiting issues in the past, but no longer. Technological advances associated with the so-called maker movement render them moot. We demonstrate this by implementing a fast (∼100 kHz) dynamic clamp system using an inexpensive microcontroller (Teensy 3.6). The overall cost of the system is less than USD$100, and assembling it requires no prior electronics experience. Modifying it—for example, to add Hodgkin–Huxley-style conductances—requires no prior programming experience. The system works together with existing electrophysiology data acquisition systems (for Macintosh, Windows, and Linux); it does not attempt to supplant them. Moreover, the process of assembling, modifying, and using the system constitutes a useful pedagogical exercise for students and researchers with no background but an interest in electronics and programming. We demonstrate the system’s utility by implementing conductances as fast as a transient sodium conductance and as complex as the Ornstein–Uhlenbeck conductances of the “point conductance” model of synaptic background activity. PMID:29085905

Implementation of a Systematic Accountability Framework in 2014 to Improve the Performance of the Nigerian Polio Program

PubMed Central

Tegegne, Sisay G.; MKanda, Pascal; Yehualashet, Yared G.; Erbeto, Tesfaye B.; Touray, Kebba; Nsubuga, Peter; Banda, Richard; Vaz, Rui G.

2016-01-01

Background. An accountability framework is a central feature of managing human and financial resources. One of its primary goals is to improve program performance through close monitoring of selected priority activities. The principal objective of this study was to determine the contribution of a systematic accountability framework to improving the performance of the World Health Organization (WHO)–Nigeria polio program staff, as well as the program itself. Methods. The effect of implementation of the accountability framework was evaluated using data on administrative actions and select process indicators associated with acute flaccid paralysis (AFP) surveillance, routine immunization, and polio supplemental immunization activities. Data were collected in 2014 during supportive supervision, using Magpi software (a company that provides service to collect data using mobile phones). A total of 2500 staff were studied. Results. Data on administrative actions and process indicators from quarters 2–4 in 2014 were compared. With respect to administrative actions, 1631 personnel (74%) received positive feedback (written or verbal commendation) in quarter 4 through the accountability framework, compared with 1569 (73%) and 1152 (61%) during quarters 3 and 2, respectively. These findings accorded with data on process indicators associated with AFP surveillance and routine immunization, showing statistically significant improvements in staff performance at the end of quarter 4, compared with other quarters. Conclusions. Improvements in staff performance and process indicators were observed for the WHO-Nigeria polio program after implementation of a systematic accountability framework. PMID:26823334

Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context

PubMed Central

Shakeel, Saad; Newhouse, Ian; Malik, Ali; Heckman, George

2015-01-01

Background Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the ‘feasibility’ of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. Method Six electronic databases were searched by two independent researchers for randomized controlled trials that targeted long-term care residents and included exercise as an independent component of the intervention. Results A total of 39 studies were included in this review. A majority of these interventions were led by physiotherapist(s), carried out three times per week for 30–45 minutes per session. However, a few group-based interventions that were led by long-term care staff, volunteers, or trained non-exercise specialists were identified that also required minimal equipment. Conclusion This systematic review has identified ‘feasible’ physical activity and falls prevention programs that required minimal investment in staff and equipment, and demonstrated positive outcomes. Implementation of such programs represents cost-effective means of providing long-term care residents with meaningful gains in physical, psychological, and social health. PMID:26180563

Effectiveness of a Core-Competency–based Program on Residents’ Learning and Experience

PubMed Central

Charles, Lesley; Triscott, Jean; Dobbs, Bonnie; Tian, Peter George; Babenko, Oksana

2016-01-01

Background The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency–based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency–based program on residents’ learning and their training experience as compared to residents trained using learning objectives. Methods The data from the 2007–2013 COE residents were used in the study, with nine and eight residents trained in the LO and CC programs, respectively. Residents’ learning was measured using preceptors’ evaluations of residents’ skills/abilities throughout the program (118 evaluations in total). Residents’ rating of training experience was measured using the Graduate’s Questionnaire which residents completed after graduation. Results For residents’ learning, overall, there was no significant difference between the two programs. However, when examined as a function of the four CanMEDS roles, there were significant increases in the CC residents’ scores for two of the CanMEDS roles: Communicator/Collaborator/Manager and Scholar compared to residents in the LO program. With respect to residents’ training experience, seven out of ten program components were rated by the CC residents higher than by the LO residents. Conclusion The implementation of a COE CC program appears to facilitate resident learning and training experience. PMID:27403213

[The German program for disease management guidelines. Background, methods, and development process].

PubMed

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika; Sänger, Sylvia; Heymans, Lothar; Thole, Henning; Trapp, Henrike; Lorenz, Wilfried; Selbmann, Hans-Konrad; Encke, Albrecht

2006-10-15

The Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 by the German Medical Association (umbrella organization of the German Chambers of Physicians) and joined by the Association of the Scientific Medical Societies (AWMF; umbrella organization of more than 150 professional societies) and by the National Association of Statutory Health Insurance Physicians (NASHIP) in 2003. The program provides a conceptual basis for disease management, focusing on high-priority health-care topics and aiming at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. It is organized by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the German DM-CPG Program is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health-care provision and facilitating the coordination of care for the individual patient through time and across interfaces. Within the last year, DM-CPGs have been published for asthma, chronic obstructive pulmonary disease, type 2 diabetes, and coronary heart disease. In addition, experts from national patient self-help groups have been developing patient guidance based upon the recommendations for health-care providers. The article describes background, methods, and tools of the DM-CPG Program, and is the first of a publication series dealing with innovative recommendations and aspects of the program.

Lessons learnt from pilot field test of a comprehensive advocacy program to support health promoting schools' project in Iran.

PubMed

Babazadeh, Towhid; Fathi, Behrouz; Shaghaghi, Abdolreza; Allahverdipour, Hamid

2017-01-01

Background: Health promoting schools (HPS) project is currently being used in Iran but many challenges still lie ahead. The present study aimed, to test feasibility of implementing a comprehensive advocacy program (CAP) to overcome the obstacles and problems associated with the consummation of school health programs based on the HPS framework. Methods: This quasi-experimental study was performed through recruiting all schools that were enrolled in the national HPS program and located in Jolfa as the intervention group and all of the schools situated in the East Azerbaijan province as control. In order to collect data, Iranian Ministry of Health's checklists and external audit guidelines for HPS were utilized. In addition, to plan a CAP required data for coordinating fund raising activities including current rules and regulations regarding implementation of local health promotion interventions were collected. Results: Findings of the study revealed that the implemented CAP had improved all HPS dimensions' mean score in the intervention group. The observed change in the pre- and post-test score in the intervention group was significant (P < 0.05). The intervention was also successful in encouraging signing of an agreement among the participated organizations to be committed to pursue the adopted policies in facilitation of progress towards full implementation of the local HPS project. Conclusion: Commencing changes in the recruited schools' structure through coordinated multi-level activities is feasible and this must be considered as a priority where contextual determinants exist to motivate progress towards providing healthier educational settings for school aged children in Iran.

Association between rural clinical clerkship and medical students’ intentions to choose rural medical work after graduation: A cross-sectional study in western China

PubMed Central

Zhu, Bin; Mao, Ying

2018-01-01

Background A large number of programs have been implemented in many countries to increase the healthcare workforce recruitment in rural and remote areas. Rural early exposure programs for medical students have been shown to be effective strategies. However, no related studies have been reported before in China. This study was carried out to determine the association between medical students’ participation in rural clinical clerkships and their intentions to choose rural medical work after graduation from western medical schools in China. Methods Based on a two-stage random sampling method, the cross-sectional survey was carried out in ten western provinces in China. A brief questionnaire filled in by medical students was used for data collection. A total of 4278 medical students participated in the study. The response rate was approximately 90.34%. Pearson’s chi-squared tests and binary logistic regression analyses were performed for data analyses. Results Approximately 52.0% of medical students disclosed intentions to work in rural medical institutions after graduation. Only one in five participants had experience with a rural clinical clerkship. Rural clinical clerkships were significantly associated with medical students’ intentions to work in rural medical institutions (OR: 1.24, 95%CI: 1.05–1.46); further analyses indicated that such clerkships only had a significant impact among the medical students with an urban background (OR: 2.10, 95%CI: 1.48–2.97). In terms of the sociodemographic characteristics, younger age, low level of parental education, majoring in general practice, and studying in low-level medical schools increased the odds of having intentions to engage in rural medical work among medical students; however, rural origins was the only positive univariate predictor. In addition, the predictors of intentions to choose rural medical work were different between medical students with a rural background and those with an urban background. Conclusions Rural clinical clerkship is likely to increase the odds of having intentions to work in rural medical institutions after graduation among medical students in western China, especially for those with an urban background. Related policy makers could consider developing compulsory rural clerkship programs and implement them among medical students to increase early rural exposure. PMID:29608624

School personnel experiences in notifying parents about their child’s risk for suicide: lessons learned

PubMed Central

Nadeem, Erum; Santiago, Catherine DeCarlo; Kataoka, Sheryl H.; Chang, Vickie Y.; Stein, Bradley D.

2015-01-01

BACKGROUND Schools across the nation are increasingly implementing suicide prevention programs that involve training school staff and connecting students and their families to appropriate services. However, little is known about how parents are engaged in such efforts. METHODS This qualitative study examined school staff perspectives on parent involvement in the implementation of a district-wide suicide prevention program by analyzing focus group and interview data gathered on the program implementation processes. Participants included middle school teachers, administrators, and other school personnel. RESULTS Study results revealed that in the immediate wake of a crisis or concern about suicide, school staff routinely contacted parents. However, substantial barriers prevent some students from receiving needed follow-up care (eg, lack of consistent follow-up, financial strain, parental stress, availability of appropriate services). Despite these challenges, school staff identified strategies that could better support parents before, during, and after the crisis. In particular, school-based services increased the success of mental health referrals. CONCLUSIONS Our study suggests that systematic post-crisis follow-up procedures are needed to improve the likelihood that students and families receive ongoing support. In particular, school-based services and home visits, training and outreach for parents, and formal training for school mental health staff on parent engagement may be beneficial in this context. PMID:26645415

Engaging Students in GeoPRISMS Science Planning: Preparing the Leaders of Tomorrow

NASA Astrophysics Data System (ADS)

Henning, A. T.; Benoit, M. H.; Marshall, J.; Goodliffe, A. M.; Morgan, J. K.; Bopp, C. J.

2011-12-01

GeoPRISMS is the legacy of the NSF MARGINS Program. It is a new decadal program, funded by NSF, committed to the amphibious study of the origin and evolution of continental margins through interdisciplinary, community-based investigations. MARGINS and GeoPRISMS have had notable success in fostering this team-based approach in graduate students who then continue on to become GeoPRISMS PIs. GeoPRISMS is enhancing its student outreach efforts through the development of a student symposium program, in which graduate students are invited to be more active participants in GeoPRISMS workshops, and are provided with valuable background and reference materials to enable them. This approach has been applied and updated at four GeoPRISMS workshops so far: two implementation workshops and two science planning workshops. Graduate students participated in the GeoPRISMS Rift Initiation and Evolution (RIE) implementation workshop in November 2010 and the Subduction Cycles and Deformation (SCD) workshop in January 2011, contributing to the overall design of the GeoPRISMS research program, and the selection of primary sites for study. In addition to participating in the regular meeting activities, students gave "pop-up" presentations to summarize their research and poster presentations and also worked together to develop their own draft implementation plan that was presented to the larger audience. Students responded positively to the experience of drafting their own implementation plans, which fostered a sense of community among participants and created an environment in which students felt comfortable speaking up during the meeting. Scientists attending the workshops were impressed by the students' draft implementation plans, as well as their work ethic and enthusiasm, and felt they made a very positive contribution to the workshops. Student feedback suggested providing students with a better understanding of the main scientific questions addressed at the meeting, as well as possible career paths. The sequestration of students during the workshop also raised concerns that they missed opportunities for broader community interactions. In Fall 2011, students participated in two symposia associated with the GeoPRISMS Alaska and Eastern North American Margin primary site planning workshops. The fall symposia followed a different model based on feedback from the first two workshops. A full day of activities took place prior to the workshop, including short presentations by experts in the field to provide background, a half-day field trip to enhance cohort-building, and student-only poster sessions and discussions. This approach allowed the students to participate fully in the meeting itself, with a stronger base of knowledge about the workshop topics and a larger network of colleagues.

The relationship between baseline Organizational Readiness to Change Assessment subscale scores and implementation of hepatitis prevention services in substance use disorders treatment clinics: a case study

PubMed Central

2010-01-01

Background The Organizational Readiness to Change Assessment (ORCA) is a measure of organizational readiness for implementing practice change in healthcare settings that is organized based on the core elements and sub-elements of the Promoting Action on Research Implementation in Health Services (PARIHS) framework. General support for the reliability and factor structure of the ORCA has been reported. However, no published study has examined the utility of the ORCA in a clinical setting. The purpose of the current study was to examine the relationship between baseline ORCA scores and implementation of hepatitis prevention services in substance use disorders (SUD) clinics. Methods Nine clinic teams from Veterans Health Administration SUD clinics across the United States participated in a six-month training program to promote evidence-based practices for hepatitis prevention. A representative from each team completed the ORCA evidence and context subscales at baseline. Results Eight of nine clinics reported implementation of at least one new hepatitis prevention practice after completing the six-month training program. Clinic teams were categorized by level of implementation-high (n = 4) versus low (n = 5)-based on how many hepatitis prevention practices were integrated into their clinics after completing the training program. High implementation teams had significantly higher scores on the patient experience and leadership culture subscales of the ORCA compared to low implementation teams. While not reaching significance in this small sample, high implementation clinics also had higher scores on the research, clinical experience, staff culture, leadership behavior, and measurement subscales as compared to low implementation clinics. Conclusions The results of this study suggest that the ORCA was able to measure differences in organizational factors at baseline between clinics that reported high and low implementation of practice recommendations at follow-up. This supports the use of the ORCA to describe factors related to implementing practice recommendations in clinical settings. Future research utilizing larger sample sizes will be essential to support these preliminary findings. PMID:20546584

Intervention mapping for development of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders

PubMed Central

Vermeulen, Sylvia J; Anema, Johannes R; Schellart, Antonius JM; van Mechelen, Willem; van der Beek, Allard J

2009-01-01

Background In the past decade in activities aiming at return-to-work (RTW), there has been a growing awareness to change the focus from sickness and work disability to recovery and work ability. To date, this process in occupational health care (OHC) has mainly been directed towards employees. However, within the working population there are two vulnerable groups: temporary agency workers and unemployed workers, since they have no workplace/employer to return to, when sick-listed. For this group there is a need for tailored RTW strategies and interventions. Therefore, this paper aims to describe the structured and stepwise process of development, implementation and evaluation of a theory- and practise-based participatory RTW program for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders (MSD). This program is based on the already developed and cost-effective RTW program for employees, sick-listed due to low back pain. Methods The Intervention Mapping (IM) protocol was used to develop a tailor-made RTW program for temporary agency workers and unemployed workers, sick-listed due to MSD. The Attitude-Social influence-self-Efficacy (ASE) model was used as a theoretical framework for determinants of behaviour regarding RTW of the sick-listed worker and development of the intervention. To ensure participation and facilitate successful adoption and implementation, important stakeholders were involved in all steps of program development and implementation. Results of semi-structured interviews and 'fine-tuning' meetings were used to design the final participatory RTW program. Results A structured stepwise RTW program was developed, aimed at making a consensus-based RTW implementation plan. The new program starts with identifying obstacles for RTW, followed by a brainstorm session in which the sick-listed worker and the labour expert of the Social Security Agency (SSA) formulate solutions/possibilities for suitable (therapeutic) work. This process is guided by an independent RTW coordinator to achieve consensus. Based on the resulting RTW implementation plan, to create an actual RTW perspective, a vocational rehabilitation agency is assigned to find a matching (therapeutic) workplace. The cost-effectiveness of this participatory RTW program will be evaluated in a randomised controlled trial. Conclusion IM is a promising tool for the development of tailor-made OHC interventions for the vulnerable working population. PMID:19573229

Adaptation and Feasibility Study of a Digital Health Program to Prevent Diabetes among Low-Income Patients: Results from a Partnership between a Digital Health Company and an Academic Research Team

PubMed Central

McDermott, Kelly; Tieu, Lina; Rios, Christina; Gibson, Eliza; Sweet, Cynthia Castro; Payne, Mike

2016-01-01

Background. The feasibility of digital health programs to prevent and manage diabetes in low-income patients has not been adequately explored. Methods. Researchers collaborated with a digital health company to adapt a diabetes prevention program for low-income prediabetes patients at a large safety net clinic. We conducted focus groups to assess patient perspectives, revised lessons for improved readability and cultural relevance to low-income and Hispanic patients, conducted a feasibility study of the adapted program in English and Spanish speaking cohorts, and implemented real-time adaptations to the program for commercial use and for a larger trial of in multiple safety net clinics. Results. The majority of focus group participants were receptive to the program. We modified the curriculum to a 5th-grade reading level and adapted content based on patient feedback. In the feasibility study, 54% of eligible contacted patients expressed interest in enrolling (n = 23). Although some participants' computer access and literacy made registration challenging, they were highly satisfied and engaged (80% logged in at least once/week). Conclusions. Underserved prediabetic patients displayed high engagement and satisfaction with a digital diabetes prevention program despite lower digital literacy skills. The collaboration between researchers and a digital health company enabled iterative improvements in technology implementation to address challenges in low-income populations. PMID:27868070

Promoting Success: A Professional Development Coaching Program for Interns in Medicine

PubMed Central

Palamara, Kerri; Kauffman, Carol; Stone, Valerie E.; Bazari, Hasan; Donelan, Karen

2015-01-01

Background Residency is an intense period. Challenges, including burnout, arise as new physicians develop their professional identities. Residency programs provide remediation, but emotional support for interns is often limited. Professional development coaching of interns, regardless of their performance, has not been reported. Objective Design, implement, and evaluate a program to support intern professional development through positive psychology coaching. Methods We implemented a professional development coaching program in a large residency program. The program included curriculum development, coach-intern interactions, and evaluative metrics. A total of 72 internal medicine interns and 26 internal medicine faculty participated in the first year. Interns and coaches were expected to meet quarterly; expected time commitments per year were 9 hours (per individual coached) for coaches, 5 1/2 hours for each individual coachee, and 70 hours for the director of the coaching program. Coaches and interns were asked to complete 2 surveys in the first year and to participate in qualitative interviews. Results Eighty-two percent of interns met with their coaches 3 or more times. Coaches and their interns assessed the program in multiple dimensions (participation, program and professional activities, burnout, coping, and coach-intern communication). Most of the interns (94%) rated the coaching program as good or excellent, and 96% would recommend this program to other residency programs. The experience of burnout was lower in this cohort compared with a prior cohort. Conclusions There is early evidence that a coaching program of interactions with faculty trained in positive psychology may advance intern development and partially address burnout. PMID:26692977

The Productive Ward Program™: A Two-Year Implementation Impact Review Using a Longitudinal Multilevel Study.

PubMed

Van Bogaert, Peter; Van Heusden, Danny; Verspuy, Martijn; Wouters, Kristien; Slootmans, Stijn; Van der Straeten, Johnny; Van Aken, Paul; White, Mark

2017-03-01

Aim To investigate the impact of the quality improvement program "Productive Ward - Releasing Time to Care™" using nurses' and midwives' reports of practice environment, burnout, quality of care, job outcomes, as well as workload, decision latitude, social capital, and engagement. Background Despite the requirement for health systems to improve quality and the proliferation of quality improvement programs designed for healthcare, the empirical evidence supporting large-scale quality improvement programs impacting patient satisfaction, staff engagement, and quality care remains sparse. Method A longitudinal study was performed in a large 600-bed acute care university hospital at two measurement intervals for nurse practice environment, burnout, and quality of care and job outcomes and three measurement intervals for workload, decision latitude, social capital, and engagement between June 2011 and November 2014. Results Positive results were identified in practice environment, decision latitude, and social capital. Less favorable results were identified in relation to perceived workload, emotional exhaustion. and vigor. Moreover, measures of quality of care and job satisfaction were reported less favorably. Conclusion This study highlights the need to further understand how to implement large-scale quality improvement programs so that they integrate with daily practices and promote "quality improvement" as "business as usual."

Addressing culture and context in humanitarian response: preparing desk reviews to inform mental health and psychosocial support.

PubMed

Greene, M Claire; Jordans, Mark J D; Kohrt, Brandon A; Ventevogel, Peter; Kirmayer, Laurence J; Hassan, Ghayda; Chiumento, Anna; van Ommeren, Mark; Tol, Wietse A

2017-01-01

Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners with crucial background information to improve their capacity to work efficiently and with maximum benefit. In this paper, we draw on experience implementing desk review guidance from the World Health Organization (WHO) and UNHCR, the United Nations Refugee Agency (2012) in four diverse humanitarian crises (earthquakes in Haiti and Nepal; forced displacement among Syrians and Congolese). We discuss critical parameters for the design and implementation of desk reviews, and discuss current challenges and future directions to improve mental health care and psychosocial support in humanitarian emergencies.

Senegal: Background and U.S. Relations

DTIC Science & Technology

2012-04-11

Politique et Révolution Passive. ‘Sopi’ or not ‘Sopi’?” Politique Africaine, December 2004. 12 See, for example, Abdou Latif Coulibaly, Contes et ...regional presence of violent extremist groups. Al Qaeda in the Islamic Maghreb (AQIM), an criminal- terrorist network with ties to Al Qaeda and roots...FTF_2010_Implementation_Plan_Senegal.pdf. 27 U.N. Development Program and Government of Senegal, Changement Climatique, Sécurité Alimentaire et Développement Humain

WIS Implementation Study Report. Volume 3. Background Information.

DTIC Science & Technology

1983-10-01

similar representations so that a single schema interpreter can serve in either environment. Examples of schema intepreters exist in all databases...Unfortunately, programs expect ing ;L VSA M file caninot accept a similar, non-VSAM file instead. In practice, a tile written using any of tire 6 film ...Thomas Kaczmarek USC/Information Sciences Institute 4676 Admiralty Way Marina del Rey, CA 90292 14 September 1983 247 PAiIECDIG PAMI &~A -NOT FILM

Moving from rhetoric to reality: adapting Housing First for homeless individuals with mental illness from ethno-racial groups

PubMed Central

2012-01-01

Background The literature on interventions addressing the intersection of homelessness, mental illness and race is scant. The At Home/Chez Soi research demonstration project is a pragmatic field trial investigating a Housing First intervention for homeless individuals with mental illness in five cities across Canada. A unique focus at the Toronto site has been the development and implementation of a Housing First Ethno-Racial Intensive Case Management (HF ER-ICM) arm of the trial serving 100 homeless individuals with mental illness from ethno-racial groups. The HF ER-ICM program combines the Housing First approach with an anti-racism/anti-oppression framework of practice. This paper presents the findings of an early implementation and fidelity evaluation of the HF ER-ICM program, supplemented by participant narrative interviews to inform our understanding of the HF ER-ICM program theory. Methods Descriptive statistics are used to describe HF ER-ICM participant characteristics. Focus group interviews, key informant interviews and fidelity assessments were conducted between November 2010 and January 2011, as part of the program implementation evaluation. In-depth qualitative interviews with HF ER-ICM participants and control group members were conducted between March 2010 and June 2011. All qualitative data were analysed using grounded theory methodology. Results The target population had complex health and social service needs. The HF ER-ICM program enjoyed a high degree of fidelity to principles of both anti-racism/anti-oppression practice and Housing First and comprehensively addressed the housing, health and sociocultural needs of participants. Program providers reported congruence of these philosophies of practice, and program participants valued the program and its components. Conclusions Adapting Housing First with anti-racism/anti-oppression principles offers a promising approach to serving the diverse needs of homeless people from ethno-racial groups and strengthening the service systems developed to support them. The use of fidelity and implementation evaluations can be helpful in supporting successful adaptations of programs and services. Trial registration Current Controlled Trials ISRCTN42520374 PMID:23031406

NASA's Lunar Impact Monitoring Program

NASA Technical Reports Server (NTRS)

Suggs, Robert M.; Cooke, William; Swift, Wesley; Hollon, Nicholas

2007-01-01

NASA's Meteoroid Environment Office nas implemented a program to monitor the Moon for meteoroid impacts from the Marshall Space Flight Center. Using off-the-shelf telescopes and video equipment, the moon is monitored for as many as 10 nights per month, depending on weather. Custom software automatically detects flashes which are confirmed by a second telescope, photometrically calibrated using background stars, and published on a website for correlation with other observations, Hypervelocity impact tests at the Ames Vertical Gun Facility have been performed to determine the luminous efficiency ana ejecta characteristics. The purpose of this research is to define the impact ejecta environment for use by lunar spacecraft designers of the Constellation (manned lunar) Program. The observational techniques and preliminary results will be discussed.

System safety checklist Skylab program report

NASA Technical Reports Server (NTRS)

Mcnail, E. M.

1974-01-01

Design criteria statement applicable to a wide variety of flight systems, experiments and other payloads, associated ground support equipment and facility support systems are presented. The document reflects a composite of experience gained throughout the aerospace industry prior to Skylab and additional experience gained during the Skylab Program. It has been prepared to provide current and future program organizations with a broad source of safety-related design criteria and to suggest methods for systematic and progressive application of the criteria beginning with preliminary development of design requirements and specifications. Recognizing the users obligation to shape the checklist to his particular needs, a summary of the historical background, rationale, objectives, development and implementation approach, and benefits based on Skylab experience has been included.

Limits, discovery and cut optimization for a Poisson process with uncertainty in background and signal efficiency: TRolke 2.0

NASA Astrophysics Data System (ADS)

Lundberg, J.; Conrad, J.; Rolke, W.; Lopez, A.

2010-03-01

A C++ class was written for the calculation of frequentist confidence intervals using the profile likelihood method. Seven combinations of Binomial, Gaussian, Poissonian and Binomial uncertainties are implemented. The package provides routines for the calculation of upper and lower limits, sensitivity and related properties. It also supports hypothesis tests which take uncertainties into account. It can be used in compiled C++ code, in Python or interactively via the ROOT analysis framework. Program summaryProgram title: TRolke version 2.0 Catalogue identifier: AEFT_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEFT_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: MIT license No. of lines in distributed program, including test data, etc.: 3431 No. of bytes in distributed program, including test data, etc.: 21 789 Distribution format: tar.gz Programming language: ISO C++. Computer: Unix, GNU/Linux, Mac. Operating system: Linux 2.6 (Scientific Linux 4 and 5, Ubuntu 8.10), Darwin 9.0 (Mac-OS X 10.5.8). RAM:˜20 MB Classification: 14.13. External routines: ROOT ( http://root.cern.ch/drupal/) Nature of problem: The problem is to calculate a frequentist confidence interval on the parameter of a Poisson process with statistical or systematic uncertainties in signal efficiency or background. Solution method: Profile likelihood method, Analytical Running time:<10 seconds per extracted limit.

Increasing Access for Economically Disadvantaged Students: The NSF/CSEM & S-STEM Programs at Louisiana State University

NASA Astrophysics Data System (ADS)

Wilson, Zakiya S.; Iyengar, Sitharama S.; Pang, Su-Seng; Warner, Isiah M.; Luces, Candace A.

2012-10-01

Increasing college degree attainment for students from disadvantaged backgrounds is a prominent component of numerous state and federal legislation focused on higher education. In 1999, the National Science Foundation (NSF) instituted the "Computer Science, Engineering, and Mathematics Scholarships" (CSEMS) program; this initiative was designed to provide greater access and support to academically talented students from economically disadvantaged backgrounds. Originally intended to provide financial support to lower income students, this NSF program also advocated that additional professional development and advising would be strategies to increase undergraduate persistence to graduation. This innovative program for economically disadvantaged students was extended in 2004 to include students from other disciplines including the physical and life sciences as well as the technology fields, and the new name of the program was Scholarships for Science, Technology, Engineering and Mathematics (S-STEM). The implementation of these two programs in Louisiana State University (LSU) has shown significant and measurable success since 2000, making LSU a Model University in providing support to economically disadvantaged students within the STEM disciplines. The achievement of these programs is evidenced by the graduation rates of its participants. This report provides details on the educational model employed through the CSEMS/S-STEM projects at LSU and provides a path to success for increasing student retention rates in STEM disciplines. While the LSU's experience is presented as a case study, the potential relevance of this innovative mentoring program in conjunction with the financial support system is discussed in detail.

"There's No Touching in Pharmacy": Training Pharmacists for Australia's First Pharmacist Immunization Pilot.

PubMed

Lau, Esther T L; Rochin, Michelle E; DelDot, Megan; Glass, Beverley D; Nissen, Lisa M

2017-01-01

Vaccination is a safe, efficient, and cost-effective means of preventing, controlling, and eradicating many life-threatening infections and diseases. Globally, the World Health Organization estimates that vaccination saves between 2 million and 3 million lives annually. However, low immunization rates are a significant public health concern. Individual factors, along with the vaccination process and system, have been reported as perceived barriers and challenges to immunization. Lack of time, on the part of both health care professionals and patients, has also been reported as a key factor influencing patterns of immunization. Despite the accessibility of pharmacists in community pharmacies in Australia, and initiatives by other countries to introduce pharmacist vaccination services, pharmacists in Australia had not previously delivered this service. The Queensland Pharmacist Immunisation Pilot (QPIP), initially implemented for the 2014 influenza season and later expanded, as QPIP2, to include other vaccines, allowed Australian pharmacists to vaccinate for the first time. To develop, implement, and evaluate a training program for pharmacists undertaking vaccination services in community pharmacies in Australia. Background content was developed and delivered through 2 online modules. Pharmacists were required to successfully answer a series of multiple-choice questions related to the background reading before attending a face-to-face workshop. The workshop provided practical training in injection skills and anaphylaxis management. Participants were also asked to evaluate the training program. Of the 339 pharmacists who completed the training program, 286 (84%) provided an evaluation. Participants were satisfied with the training, as indicated by consistently high scores on the "overall satisfaction" question (mean 4.65/5 for the QPIP and QPIP2 training combined). Participants described the background reading as relevant to their practice and stated that it met their expectations. They also valued the opportunity to practise injections on each other during the face-to-face workshop, and this aspect was noted as a key component of the training. QPIP demonstrated that a pharmacist-specific training program could produce competent and confident immunizers and could be used to "retrofit" the profession, to facilitate delivery of vaccination services in Australia.

How to improve patient retention in an antiretroviral treatment program in Ethiopia: a mixed-methods study

PubMed Central

2014-01-01

Background Patient retention, defined as continuous engagement of patients in care, is one of the crucial indicators for monitoring and evaluating the performance of antiretroviral treatment (ART) programs. It has been identified that suboptimal patient retention in care is one of the challenges of ART programs in many settings. ART programs have, therefore, been striving hard to identify and implement interventions that improve their suboptimal levels of retention. The objective of this study was to develop a framework for improving patient retention in care based on interventions implemented in health facilities that have achieved higher levels of retention in care. Methods A mixed-methods study, based on the positive deviance approach, was conducted in Ethiopia in 2011/12. Quantitative data were collected to estimate and compare the levels of retention in care in nine health facilities. Key informant interviews and focus group discussions were conducted to identify a package of interventions implemented in the health facilities with relatively higher or improving levels of retention. Results Retention in care in the Ethiopian ART program was found to be variable across health facilities. Among hospitals, the poorest performer had 0.46 (0.35, 0.60) times less retention than the reference; among health centers, the poorest performers had 0.44 (0.28, 0.70) times less retention than the reference. Health facilities with higher and improving patient retention were found to implement a comprehensive package of interventions: (1) retention promoting activities by health facilities, (2) retention promoting activities by community-based organizations, (3) coordination of these activities by case manager(s), and (4) patient information systems by data clerk(s). On the contrary, such interventions were either poorly implemented or did not exist in health facilities with lower retention in care. A framework to improve retention in care was developed based on the evidence found by applying the positive deviance approach. Conclusion A framework for improving retention in care of patients on ART was developed. We recommend that health facilities implement the framework, monitor and evaluate their levels of retention in care, and, if necessary, adapt the framework to their own contexts. PMID:24475889

Strategic Plan. Volume 1

NASA Technical Reports Server (NTRS)

2002-01-01

The purpose of this document is to present the strategic plan and associated organizational structure that the National Space Biomedical Research Institute (NSBRI) will utilize to achieve the defined mission and objectives provided by NASA. Much of the information regarding the background and establishment of the NSBRI by NASA has been provided in other documentation and will not be repeated in this Strategic Plan. This Strategic Plan is presented in two volumes. Volume I (this volume) begins with an Introduction (Section 2) that provides the Institute's NASA-defined mission and objectives, and the organizational structure adopted to implement these through three Strategic Programs: Countermeasure Research; Education, Training and Outreach; and Cooperative Research and Development. These programs are described in Sections 3 to 5. Each program is presented in a similar way, using four subsections: Goals and Objectives; Current Strategies; Gaps and Modifications; and Resource Requirements. Section 6 provides the administrative infrastructure and total budget required to implement the Strategic Programs and assures that they form a single cohesive plan. This plan will ensure continued success of the Institute for the next five years. Volume II of the Strategic Plan provides an in-depth analysis of the current and future strategic programs of the 12 current NSBRI teams, including their goals, objectives, mutual interactions and schedules.

Translational Research in South Africa: Evaluating Implementation Quality Using a Factorial Design

PubMed Central

Smith, Edward A.; Collins, Linda M.; Graham, John W.; Lai, Mary; Wegner, Lisa; Vergnani, Tania; Matthews, Catherine; Jacobs, Joachim

2012-01-01

Background HealthWise South Africa: Life Skills for Adolescents (HW) is an evidence-based substance use and sexual risk prevention program that emphasizes the positive use of leisure time. Since 2000, this program has evolved from pilot testing through an efficacy trial involving over 7,000 youth in the Cape Town area. Beginning in 2011, through 2015, we are undertaking a new study that expands HW to all schools in the Metro South Education District. Objective This paper describes a research study designed in partnership with our South African collaborators that examines three factors hypothesized to affect the quality and fidelity of HW implementation: enhanced teacher training; teacher support, structure and supervision; and enhanced school environment. Methods Teachers and students from 56 schools in the Cape Town area will participate in this study. Teacher observations are the primary means of collecting data on factors affecting implementation quality. These factors address the practical concerns of teachers and schools related to likelihood of use and cost-effectiveness, and are hypothesized to be “active ingredients” related to high-quality program implementation in real-world settings. An innovative factorial experimental design was chosen to enable estimation of the individual effect of each of the three factors. Results Because this paper describes the conceptualization of our study, results are not yet available. Conclusions The results of this study may have both substantive and methodological implications for advancing Type 2 translational research. PMID:22707870

INTEGRATION OF STRENGTH AND CONDITIONING PRINCIPLES INTO A REHABILITATION PROGRAM

PubMed Central

Lorenz, Daniel S.

2011-01-01

Background and Purpose: Rehabilitation and strength and conditioning are often seen as two separate entities in athletic injury recovery. Traditionally an athlete progresses from the rehabilitation environment under the care of a physical therapist and/or athletic trainer to the strength and conditioning coach for specific return to sport training. These two facets of return to sport are often considered to have separate goals. Initial goals of each are often different due to the timing of their implementation encompassing different stages of post-injury recovery. The initial focus of post injury rehabilitation includes alleviation of dysfunction, enhancement of tissue healing, and provision of a systematic progression of range-of-motion and strength. During the return to function phases, specific return to play goals are paramount. Understanding of specific principles and program parameters is necessary when designing and implementing an athlete's rehabilitation program. Communication and collaboration amongst all individuals caring for the athlete is a must. The purpose of this review is to outline the current evidence supporting utilization of training principles in athletic rehabilitation, as well as provide suggested implementation of such principles throughout different phases of a proposed rehabilitation program. Evidence Acquisition: The following electronic databases were used to identify research relevant to this clinical commentary: MEDLINE (from 1950–June 2011) and CINAHL (1982–June 2011), for all relevant journal articles written in English. Additional references were accrued by independent searching of references from relevant articles. Results: Currently evidence is lacking in the integration of strength and conditioning principles into the rehabilitation program for the injured athlete. Numerous methods are suggested for possible utilization by the clinician in practice to improve strength, power, speed, endurance, and metabolic capacity. Conclusion: Despite abundance of information on the implementation of training principles in the strength and conditioning field, investigation regarding the use of these principles in a properly designed rehabilitation program is lacking. PMID:21904701

NASA's Coordinated Efforts to Enhance STEM Education: Bringing NASA Science into the Library

NASA Astrophysics Data System (ADS)

Meinke, B. K.; Thomas, C.; Eyermann, S.; Mitchell, S.; LaConte, K.; Hauck, K.

2015-11-01

Libraries are community-centered, free-access venues serving learners of all ages and backgrounds. Libraries also recognize the importance of science literacy and strive to include science in their programming portfolio. Scientists and educators can partner with local libraries to advance mutual goals of connecting the public to Earth and Space Science. In this interactive Special Interest Group (SIG) discussion, representatives from the NASA Science Mission Directorate (SMD) Education and Public Outreach (EPO) community's library collaborations discussed the opportunities for partnership with public and school libraries; explored the resources, events, and programs available through libraries; explored NASA science programming and professional development opportunities available for librarians; and strategized about the types of support that librarians require to plan and implement programs that use NASA data and resources. We also shared successes, lessons learned, and future opportunities for incorporating NASA science programming into library settings.

Dockres: a computer program that analyzes the output of virtual screening of small molecules

PubMed Central

2010-01-01

Background This paper describes a computer program named Dockres that is designed to analyze and summarize results of virtual screening of small molecules. The program is supplemented with utilities that support the screening process. Foremost among these utilities are scripts that run the virtual screening of a chemical library on a large number of processors in parallel. Methods Dockres and some of its supporting utilities are written Fortran-77; other utilities are written as C-shell scripts. They support the parallel execution of the screening. The current implementation of the program handles virtual screening with Autodock-3 and Autodock-4, but can be extended to work with the output of other programs. Results Analysis of virtual screening by Dockres led to both active and selective lead compounds. Conclusions Analysis of virtual screening was facilitated and enhanced by Dockres in both the authors' laboratories as well as laboratories elsewhere. PMID:20205801

Colorectal Cancer Control Program Grantees’ Use of Evidence-Based Interventions

PubMed Central

Hannon, Peggy A.; Maxwell, Annette E.; Escoffery, Cam; Vu, Thuy; Kohn, Marlana; Leeman, Jennifer; Carvalho, Michelle L.; Pfeiffer, Debbie J.; Dwyer, Andrea; Fernandez, Maria E.; Vernon, Sally W.; Liang, Lily; DeGroff, Amy

2015-01-01

Background Colorectal cancer (CRC) screening is recommended for adults aged 50–75 years, yet screening rates are low, especially among the uninsured. The CDC initiated the Colorectal Cancer Control Program (CRCCP) in 2009 with the goal of increasing CRC screening rates to 80% by 2014. A total of 29 grantees (states and tribal organizations) receive CRCCP funding to (1) screen uninsured adults and (2) promote CRC screening at the population level. Purpose CRCCP encourages grantees to use one or more of five evidence-based interventions (EBIs) recommended by the Guide to Community Preventive Services. The purpose of the study was to evaluate grantees’ EBI use. Methods A web-based survey was conducted in 2011 measuring grantees’ use of CRC screening EBIs and identifying their implementation partners. Data were analyzed in 2012. Results Twenty-eight grantees (97%) completed the survey. Most respondents (96%) used small media. Fewer used client reminders (75%); reduction of structural barriers (50%); provider reminders (32%); or provider assessment and feedback (50%). Provider-oriented EBIs were rated as harder to implement than client-oriented EBIs. Grantees partnered with several types of organizations to implement EBIs, many with county- or state-wide reach. Conclusions Almost all grantees implement EBIs to promote CRC screening, but the EBIs that may have the greatest impact with CRC screening are implemented by fewer grantees in the first 2 years of the CRCCP. PMID:24139779

Antimicrobial stewardship program in a Malaysian district hospital: First year experience

PubMed Central

Sing, Diana Yap Fui; Boo, Yang Liang; Mukhlis, Roshalina; Chin, Pek Woon; Hoo, Fan Kee

2016-01-01

Backgrounds & Objective: Antimicrobial resistance is an alarming public health threat that requires urgent global solution. Implementation of antimicrobial stewardship program (ASP) is an essential practice element for healthcare institutions in gate-keeping judicious antimicrobial use. This study highlighted the development, first year experience, and result of the implementation of ASP utilizing persuasive and restrictive approaches in a Malaysian district hospital. Methods: An observational study was conducted between January 2015 to December 2015 on implementation of ASP among hospitalized inpatients age 12 years old and above. Results: Recommendations were provided for 60% of cases (110 patients) with the average acceptance rate of 83.33%. Majority of the interventions were to stop the antimicrobial therapy (30.3%), and the most common audited antimicrobials was Piperacillin/Tazobactam (25.5%), followed by Meropenem (11.82%), Amoxicillin/Clavulanate and Vancomycin (8.18%) respectively. The concordance rate towards authorization policy was increased in 2015 (71.59% of cases) as compared before the implementation of ASP in 2014 (60.6% of cases). Restrictive enforcement under ASP had been shown to improve significantly adherence rate towards antimicrobials authorization policy (p-value: 0.004). Conclusion: ASP was successfully implemented in a district hospital. Future studies on its clinical outcomes are important to evaluate its effectiveness as well as focus on the improvement to the pre-existing strategies and measures. PMID:27648056

A Quality Improvement Initiative to Increase Colorectal Cancer (CRC) Screening: Collaboration between a Primary Care Clinic and Research Team

PubMed Central

Green, Beverly B.; Fuller, Sharon; Anderson, Melissa L.; Mahoney, Christine; Mendy, Peter; Powell, Susan L.

2017-01-01

Background Multiple randomized controlled trials have demonstrated that mailed fecal testing programs are effective in increasing colorectal cancer screening participation. However, few healthcare organization in the US have Implemented such programs. Methods Stakeholders from one clinic in an integrated healthcare system in Washington State initiated collaboration with researchers with expertise in CRC screening, aiming to increase screening rates at their clinic. Age-eligible individuals who were overdue for CRC screening and had previously completed a fecal test were randomized to receive mailed fecal immunochemical test kits (FIT) at the start of the project (Early) or 6 months later (Late). Outcomes included comparing FIT completion at 6 months by randomization group, and overall CRC screening rates at 12 months. We also assessed implementation facilitators and challenges. Results Overall 2,421 FIT tests were mailed at a cost of $10,739. At 6 months, FIT completion was significantly higher among the Early compared to the Late group (62% vs.47%, p <0.001). By 12 months, after both groups had received mailings, 71% in each group had completed a FIT. The clinic’s overall CRC screening rate was 75.1% at baseline and 78.0% 12 months later. Key constructs associated with successful program implementation included strong stakeholder involvement, use of evidence-based strategies, simplicity, and low cost. Challenges included lack of a plan for maintaining the program. Discussion Collaboration between clinic stakeholders and researchers led to a successful project that rapidly increased CRC screening rates. However, institutional normalization of the program would be required to maintain it. PMID:29399669

Use of Joint Commission International Standards to Evaluate and Improve Pediatric Oncology Nursing Care in Guatemala

PubMed Central

Day, Sara W.; McKeon, Leslie M.; Garcia, Jose; Wilimas, Judith A.; Carty, Rita M.; de Alarcon, Pedro; Antillon, Federico; Howard, Scott C.

2017-01-01

Background Inadequate nursing care is a major impediment to development of effective programs for treatment of childhood cancer in low-income countries. When the International Outreach Program at St. Jude Children’s Research Hospital established partner sites in low-income countries, few nurses had pediatric oncology skills or experience. A comprehensive nursing program was developed to promote the provision of quality nursing care, and in this manuscript we describe the program’s impact on 20 selected Joint Commission International (JCI) quality standards at the National Pediatric Oncology Unit in Guatemala. We utilized JCI standards to focus the nursing evaluation and implementation of improvements. These standards were developed to assess public hospitals in low-income countries and are recognized as the gold standard of international quality evaluation. Methods We compared the number of JCI standards met before and after the nursing program was implemented using direct observation of nursing care; review of medical records, policies, procedures, and job descriptions; and interviews with staff. Results In 2006, only 1 of the 20 standards was met fully, 2 partially, and 17 not met. In 2009, 16 were met fully, 1 partially, and 3 not met. Several factors contributed to the improvement. The pre-program quality evaluation provided objective and credible findings and an organizational framework for implementing change. The medical, administrative, and nursing staff worked together to improve nursing standards. Conclusion A systematic approach and involvement of all hospital disciplines led to significant improvement in nursing care that was reflected by fully meeting 16 of 20 standards. PMID:23015363

Does Insurance Matter? Implementing Dialectical Behavior Therapy with Two Groups of Youth Engaged in Deliberate Self-Harm

PubMed Central

James, Sigrid; Freeman, Kim; Mayo, Danessa; Riggs, Matt; Morgan, Joshua P.; Schaepper, Mary Ann; Montgomery, Susanne B.

2014-01-01

This paper presents the outcomes of a Dialectical Behavior Treatment (DBT) program, implemented in intensive outpatient care with two groups of adolescents (n=55 and n=45), ages 12–18, who engaged in deliberate self-harm (DSH) but had different insurance/funding sources and risk backgrounds. This pre-post study examined variability in clinical functioning and treatment utilization between the two groups and investigated moderating risk factors. Findings support DBT’s effectiveness in improving clinical functioning for youth with DSH regardless of insurance type. However, lower rates of treatment completion among youth without private insurance call for extra engagement efforts to retain high-risk youth in DBT. PMID:25199812

How much can we gain from improved efficiency? An examination of performance of national HIV/AIDS programs and its determinants in low- and middle-income countries

PubMed Central

2012-01-01

Background The economic downturn exacerbates the inadequacy of resources for combating the worldwide HIV/AIDS pandemic and amplifies the need to improve the efficiency of HIV/AIDS programs. Methods We used data envelopment analysis (DEA) to evaluate efficiency of national HIV/AIDS programs in transforming funding into services and implemented a Tobit model to identify determinants of the efficiency in 68 low- and middle-income countries. We considered the change from the lowest quartile to the average value of a variable a "notable" increase. Results Overall, the average efficiency in implementing HIV/AIDS programs was moderate (49.8%). Program efficiency varied enormously among countries with means by quartile of efficiency of 13.0%, 36.4%, 54.4% and 96.5%. A country's governance, financing mechanisms, and economic and demographic characteristics influence the program efficiency. For example, if countries achieved a notable increase in "voice and accountability" (e.g., greater participation of civil society in policy making), the efficiency of their HIV/AIDS programs would increase by 40.8%. For countries in the lowest quartile of per capita gross national income (GNI), a notable increase in per capita GNI would increase the efficiency of AIDS programs by 45.0%. Conclusions There may be substantial opportunity for improving the efficiency of AIDS services, by providing more services with existing resources. Actions beyond the health sector could be important factors affecting HIV/AIDS service delivery. PMID:22443135

Sociocultural Tailoring of a Healthy Lifestyle Intervention to Reduce Cardiovascular Disease and Type 2 Diabetes Risk Among Latinos

PubMed Central

Martinez, Maria C.; Rayens, Mary Kay; Gokun, Yevgeniya; Meininger, Janet C.

2013-01-01

Background Suboptimal lifestyle factors in combination with genetic susceptibility contribute to cardiovascular disease and type 2 diabetes risk among Latinos. We describe a community–academic collaboration that developed and explored the feasibility of implementing a socioculturally tailored, healthy lifestyle intervention integrating genomics and family history education to reduce risk of cardiovascular disease and type 2 diabetes among Latinos. Community Context The community-based participatory research was conducted with communities in Kentucky, which has a rapidly growing Latino population. This growth underscores the need for socioculturally appropriate health resources. Methods Su Corazon, Su Vida (Your Heart, Your Life) is a Spanish-language, healthy lifestyle educational program to reduce cardiovascular disease and type 2 diabetes risk among Latinos. Twenty natural leaders from an urban Latino community in Kentucky participated in sociocultural tailoring of the program and development of a genomics and family history module. The tailored program was presented to 22 participants to explore implementation feasibility and assess appropriateness for community use. Preintervention and postintervention assessments of genomic knowledge and lifestyle behaviors and qualitative postintervention evaluations were conducted. Outcomes Postintervention improvements in health-promoting lifestyle choices and genomic knowledge specific to cardiovascular disease and type 2 diabetes suggested that the program may be effective in reducing risk. Feedback indicated the program was socioculturally acceptable and responsive to community needs. Interpretation These findings indicated that a tailored healthy lifestyle program integrating genomics and family history education was socioculturally appropriate and may feasibly be implemented to reduce cardiovascular disease and type 2 diabetes risk in a Latino community with limited health care resources. The project highlights contributions of community-based processes in tailoring interventions that are appropriate for community contexts. PMID:24286274

From design to implementation - The Joint Asia Diabetes Evaluation (JADE) program: A descriptive report of an electronic web-based diabetes management program

PubMed Central

2010-01-01

Background The Joint Asia Diabetes Evaluation (JADE) Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care. Methods The JADE Program uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver an evidence-based care and education protocol tailored to patients' risk profiles. With written informed consent from participating patients and care providers, all data are anonymized and stored in a databank to establish an Asian Diabetes Database for research and publication purpose. Results The JADE electronic portal (e-portal: http://www.jade-adf.org) is implemented as a Java application using the Apache web server, the mySQL database and the Cocoon framework. The JADE e-portal comprises a risk engine which predicts 5-year probability of major clinical events based on parameters collected during an annual comprehensive assessment. Based on this risk stratification, the JADE e-portal recommends a care protocol tailored to these risk levels with decision support triggered by various risk factors. Apart from establishing a registry for quality assurance and data tracking, the JADE e-portal also displays trends of risk factor control at each visit to promote doctor-patient dialogues and to empower both parties to make informed decisions. Conclusions The JADE Program is a prototype using information technology to facilitate implementation of a comprehensive care model, as recommended by the International Diabetes Federation. It also enables health care teams to record, manage, track and analyze the clinical course and outcomes of people with diabetes. PMID:20465815

Climate and health impacts of clean cookstove implementation programs in Africa

NASA Astrophysics Data System (ADS)

Lacey, F.; Marais, E. A.; Wiedinmyer, C.; Coffey, E.; Muvandimwe, D.; Hannigan, M.; Henze, D. K.

2016-12-01

In Africa, 77% of the population (646 million people in 2010) use solid fuels as the main cooking source. These cooking methods are often inefficient and result in significant burdens to both climate and human health, particularly for women and children. In order to fully understand the impacts of clean cookstove implementation programs, a better understanding of the background concentrations of aerosols, aerosol precursors, and ozone precursors are needed, along with improved information on the changes in emissions from transitions to newer technologies. Through the use of the GEOS-Chem adjoint model, we have calculated species-specific climate and health sensitivities using a range of African emissions estimates including EDGAR-HTAP and a more recent improved emissions inventory, DICE-Africa. These sensitivities account for the spatial heterogeneity of emissions with respect to their impacts and allow for efficient estimation of the impacts of various clean cookstove implementation emissions scenarios that are based on laboratory and field measurements of emissions factors, along with realistic adoption and usage rates from field surveys. The resulting estimates of premature deaths and global surface temperature change are then aggregated to the national scale in order to provide policy makers with improved information regarding the implementation of clean cookstoves throughout continental Africa.

Challenges and Potential Solutions for Big Data Implementations in Developing Countries

PubMed Central

Mayan, J.C; García, M.J.; Almerares, A.A.; Househ, M.

2014-01-01

Summary Background The volume of data, the velocity with which they are generated, and their variety and lack of structure hinder their use. This creates the need to change the way information is captured, stored, processed, and analyzed, leading to the paradigm shift called Big Data. Objectives To describe the challenges and possible solutions for developing countries when implementing Big Data projects in the health sector. Methods A non-systematic review of the literature was performed in PubMed and Google Scholar. The following keywords were used: “big data”, “developing countries”, “data mining”, “health information systems”, and “computing methodologies”. A thematic review of selected articles was performed. Results There are challenges when implementing any Big Data program including exponential growth of data, special infrastructure needs, need for a trained workforce, need to agree on interoperability standards, privacy and security issues, and the need to include people, processes, and policies to ensure their adoption. Developing countries have particular characteristics that hinder further development of these projects. Conclusions The advent of Big Data promises great opportunities for the healthcare field. In this article, we attempt to describe the challenges developing countries would face and enumerate the options to be used to achieve successful implementations of Big Data programs. PMID:25123719

Integrated teaching program using case-based learning

PubMed Central

Bhardwaj, Pankaj; Bhardwaj, Nikha; Mahdi, Farzana; Srivastava, J P; Gupta, Uma

2015-01-01

Background: At present, in a medical school, students are taught in different departments, subject-wise, without integration to interrelate or unify subjects and these results in compartmentalization of medical education, with no stress on case-based learning. Therefore, an effort was made to develop and adopt integrated teaching in order to have a better contextual knowledge among students. Methodology and Implementation: After the faculty orientation training, four “topic committees” with faculty members from different departments were constituted which decided and agreed on the content material to be taught, different methodologies to be used, along with the logical sequencing of the same for the purpose of implementation. Different teaching methodologies used, during the program, were didactic lectures, case stimulated sessions, clinical visits, laboratory work, and small group student's seminar. Results: After the implementation of program, the comparison between two batches as well as between topics taught with integrated learning program versus traditional method showed that students performed better in the topics, taught with integrated approach. Students rated “clinical visits” as very good methodology, followed by “case stimulated interactive sessions.” Students believed that they felt more actively involved, and their queries are better addressed with such interactive sessions. Conclusion: There is a very good perception of students toward integrated teaching. Students performed better if they are taught using this technique. Although majority of faculty found integrated teaching, as useful method of teaching, nevertheless extra work burden and interdepartmental coordination remained a challenging task. PMID:26380204

A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan

PubMed Central

Yokoo, Kyoko; Funaba, Yuuki; Fukushima, Sayo; Fukuhara, Rie; Uchida, Mieko; Aiba, Satoru; Doi, Miki; Nishimura, Akira; Hayakawa, Masahiro; Nishimura, Yutaka; Oohira, Mitsuko

2017-01-01

Background: Neonatal pain management guidelines have been released; however, there is insufficient systematic institutional support for the adoption of evidence-based pain management in Japan. Purpose: To evaluate the impact of a collaborative quality improvement program on the implementation of pain management improvements in Japanese neonatal intensive care units (NICUs). Methods: Seven Japanese level III NICUs participated in a neonatal pain management quality improvement program based on an Institute for Healthcare Improvement collaborative model. The NICUs developed evidence-based practice points for pain management and implemented these over a 12-month period. Changes were introduced through a series of Plan-Do-Study-Act cycles, and throughout the process, pain management quality indicators were tracked as performance measures. Jonckheere's trend test and the Cochran-Armitage test for trend were used to examine the changes in quality indicator implementations over time (baseline, 3 months, 6 months, and 12 months). Findings: Baseline pain management data from the 7 sites revealed substantial opportunities for improvement of pain management, and testing changes in the NICU setting resulted in measurable improvements in pain management. During the intervention phase, all participating sites introduced new pain assessment tools, and all sites developed electronic medical record forms to capture pain score, interventions, and infant responses to interventions. Implications for Practice: The use of collaborative quality improvement techniques played a key role in improving pain management in the NICUs. Implications for Research: Collaborative improvement programs provide an attractive strategy for solving evidence-practice gaps in the NICU setting. PMID:28114148

School-based violence prevention strategy: a pilot evaluation

PubMed Central

Thakore, Rachel V.; Apfeld, Jordan C.; Johnson, Ronald K.; Sathiyakumar, Vasanth; Jahangir, A. Alex; Sethi, Manish K.

2015-01-01

Abstract: Background: Violence has recently been reported among a primarily young, minority population in Nashville, Tennessee. School-based programs have been proven as effective methods of reducing violent behavior, beliefs, and actions that lead to violence among adolescents. Methods: Investigators implemented a rigorous search for an appropriate school-based violence prevention program for Metropolitan Nashville middle school students utilizing a systematic review and discussion group with victims of violence. 27 programs nation-wide were reviewed and 2 discussion groups with African American males under the age of 25 admitted to a level 1 trauma center for assault-related injuries were conducted. Our findings led to a single, evidence-based conflict resolution program. In conjunction with educators, we evaluated the program’s effectiveness in a pilot study in a Nashville middle school with high rates of violence. Results: 122 students completed the conflict resolution program and described their behavior and experiences with violence in a pre-test/post-test self-rate questionnaire. Results showed a significant decrease in violent behavior and an increase in students’ competencies to deal with violence (p less than 0.05). Conclusions: This study shows that a reduction in violent behavior and beliefs among middle school students can be achieved through the implementation of a targeted violence intervention program. A larger-scale intervention is needed to develop more conclusive evidence of effectiveness. PMID:24879077

Lessons Learned From Early Implementation of Option B+: The Elizabeth Glaser Pediatric AIDS Foundation Experience in 11 African Countries

PubMed Central

Mattingly, Meghan; Giphart, Anja; van de Ven, Roland; Chouraya, Caspian; Walakira, Moses; Boon, Alexandre; Mikusova, Silvia; Simonds, R. J.

2014-01-01

Background: “Option B+” is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+. Methods: This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies. Results: Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality. Discussion: Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation. PMID:25436817

Imi Ho'ola: an educational model for disadvantaged students at the University of Hawai''i School of Medicine.

PubMed

Judd, Nanette L K; Sakamoto, Karen K; Hishinuma, Earl S; DeCambra, Chessa; Malate, Agnes R

2007-03-01

This paper describes an educational model that provides opportunities in medicine to students from disadvantaged backgrounds that have a commitment to serve in areas of need, and it presents guidelines on how this model could be adapted to various settings. From 1973 to 2002, the Imi Ho'ola Program (Hawaiian for "Those Who Seek to Heal") of the University of Hawai'i John A. Burns School of Medicine (JABSOM) has provided opportunities in medicine to 379 students from disadvantaged backgrounds. In 1995-1996, Imi Ho'ola underwent a transformation from a pre-medical enrichment program to a post-baccalaureate program that included provisional acceptance and financial support into JABSOM for students who successfully completed the program. As a result, the acceptance rate increased from 47.6% to 98.0%. In addition to provisional acceptance to JABSOM and financial support, the program's educational model incorporates five components, the key factors of the program's success: 1) JABSOM commitment and the institutionalization of the program; 2) emphasis placed on a comprehensive approach and the implementation of a curriculum and learning process that are aligned with JABSOM curricula; 3) faculty and staff who support the instructional methodology and work as a team to address students' needs; 4) assessment of students and systematic feedback regarding individualized education plans and academic and non-academic progress; and 5) a positive learning environment for students. Guidelines are provided in this article for consideration in adapting this educational model to other academic settings.

Changing the Course of Geriatrics Education: An Evaluation of the First Cohort of Reynolds Geriatrics Education Programs

PubMed Central

Reuben, David B.; Bachrach, Peter S.; McCreath, Heather; Simpson, Deborah; Bragg, Elizabeth J.; Warshaw, Gregg A.; Snyder, Rani; Frank, Janet C.

2013-01-01

Background/Purpose To describe geriatric training initiatives implemented as a result of Reynolds Foundation grants awarded in 2001 (and concluding in 2005) and evaluate the resulting structure, process, and outcome changes Methods Cross-sectional survey of program directors at 10 academic institutions augmented by review of reports and secondary analyses of existing databases to identify structural and process measures of curriculum implementation, participation rates, and students’ responses to Association of American Medical Colleges Medical School Graduation Questionnaires about geriatrics training. Results All 10 institutions reported structural changes including newly developed or revised geriatric rotations or courses for their trainees. Most used online internet educational materials, sent students to new training venues, incorporated geriatric case discussions, implemented standardized patients, and utilized digital media. On average, each institution trained over 1,000 medical students, 500 residents, 100 faculty, and 700 non-faculty community physicians during the award period. Reynolds institutions also provided geriatrics training across 22 non-primary care disciplines. Eight schools implemented formal faculty development programs. By 2005, students at Reynolds-supported schools reported higher levels of geriatrics/gerontology education and more exposure to expert geriatric care by the attending faculty compared to students at non-Reynolds schools. Innovations and products were disseminated via journal publications, conference presentations, and POGOe (Portal of Geriatric Online Education). Conclusions The investment of extramural and institutional funds in geriatrics education has substantially influenced undergraduate, graduate, and practicing physician education at Reynolds-supported schools. The full impact of these programs on care of older persons will not be known until these trainees enter practice and educational careers. PMID:19704195

Implementation of Neurocritical Care Is Associated With Improved Outcomes in Traumatic Brain Injury.

PubMed

Sekhon, Mypinder S; Gooderham, Peter; Toyota, Brian; Kherzi, Navid; Hu, Vivien; Dhingra, Vinay K; Hameed, Morad S; Chittock, Dean R; Griesdale, Donald E

2017-07-01

Background Traditionally, the delivery of dedicated neurocritical care (NCC) occurs in distinct NCC units and is associated with improved outcomes. Institution-specific logistical challenges pose barriers to the development of distinct NCC units; therefore, we developed a consultancy NCC service coupled with the implementation of invasive multimodal neuromonitoring, within a medical-surgical intensive care unit. Our objective was to evaluate the effect of a consultancy NCC program on neurologic outcomes in severe traumatic brain injury patients. We conducted a single-center quasi-experimental uncontrolled pre- and post-NCC study in severe traumatic brain injury patients (Glasgow Coma Scale ≤8). The NCC program includes consultation with a neurointensivist and neurosurgeon and multimodal neuromonitoring. Demographic, injury severity metrics, neurophysiologic data, and therapeutic interventions were collected. Glasgow Outcome Scale (GOS) at 6 months was the primary outcome. Multivariable ordinal logistic regression was used to model the association between NCC implementation and GOS at 6 months. A total of 113 patients were identified: 76 pre-NCC and 37 post-NCC. Mean age was 39 years (standard deviation [SD], 2) and 87 of 113 (77%) patients were male. Median admission motor score was 3 (interquartile ratio, 1-4). Daily mean arterial pressure was higher (95 mmHg [SD, 10]) versus (88 mmHg [SD, 10], p<0.001) and daily mean core body temperature was lower (36.6°C [SD, 0.90]) versus (37.2°C [SD, 1.0], p=0.001) post-NCC compared with pre-NCC, respectively. Multivariable regression modelling revealed the NCC program was associated with a 2.5 increased odds (odds ratios, 2.5; 95% confidence interval, 1.1-5.3; p=0.022) of improved 6-month GOS. Implementation of a NCC program is associated with improved 6 month GOS in severe TBI patients.

Floating-Point Units and Algorithms for field-programmable gate arrays

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

Underwood, Keith D.; Hemmert, K. Scott

2005-11-01

The software that we are attempting to copyright is a package of floating-point unit descriptions and example algorithm implementations using those units for use in FPGAs. The floating point units are best-in-class implementations of add, multiply, divide, and square root floating-point operations. The algorithm implementations are sample (not highly flexible) implementations of FFT, matrix multiply, matrix vector multiply, and dot product. Together, one could think of the collection as an implementation of parts of the BLAS library or something similar to the FFTW packages (without the flexibility) for FPGAs. Results from this work has been published multiple times and wemore » are working on a publication to discuss the techniques we use to implement the floating-point units, For some more background, FPGAS are programmable hardware. "Programs" for this hardware are typically created using a hardware description language (examples include Verilog, VHDL, and JHDL). Our floating-point unit descriptions are written in JHDL, which allows them to include placement constraints that make them highly optimized relative to some other implementations of floating-point units. Many vendors (Nallatech from the UK, SRC Computers in the US) have similar implementations, but our implementations seem to be somewhat higher performance. Our algorithm implementations are written in VHDL and models of the floating-point units are provided in VHDL as well. FPGA "programs" make multiple "calls" (hardware instantiations) to libraries of intellectual property (IP), such as the floating-point unit library described here. These programs are then compiled using a tool called a synthesizer (such as a tool from Synplicity, Inc.). The compiled file is a netlist of gates and flip-flops. This netlist is then mapped to a particular type of FPGA by a mapper and then a place- and-route tool. These tools assign the gates in the netlist to specific locations on the specific type of FPGA chip used and constructs the required routes between them. The result is a "bitstream" that is analogous to a compiled binary. The bitstream is loaded into the FPGA to create a specific hardware configuration.« less

Zumba: From Secondary Physical Education Classes to Adulthood Workouts: Staying up to Date with the Growing Trends of Physical Activity in and out of the Schools

ERIC Educational Resources Information Center

Benham, Lindsey; Hall, Amber; Barney, David

2013-01-01

This article discusses the background of Zumba, the need for it as a result of its growing popularity, the national standards it supports, and the necessary steps that need to be taken to properly implement Zumba in physical education programs. When taking a closer look at the standards that Zumba supports, it is evident that Zumba can serve as a…

Advanced 3-V semiconductor technology assessment. [space communications

NASA Technical Reports Server (NTRS)

Nowogrodzki, M.

1983-01-01

Against a background of an extensive survey of the present state of the art in the field of III-V semiconductors for operation at microwave frequencies (or gigabit rate speeds), likely requirements of future space communications systems are identified, competing technologies and physical device limitations are discussed, and difficulties in implementing emerging technologies are projected. On the basis of these analyses, specific research and development programs required for the development of future systems components are recommended.

Predictable Programming on a Precision Timed Architecture

DTIC Science & Technology

2008-04-18

Application: A Video Game Figure 6: Structure of the Video Game Example Inspired by an example game sup- plied with the Hydra development board [17...we implemented a sim- ple video game in C targeted to our PRET architecture. Our example centers on rendering graphics and is otherwise fairly simple...background image. 13 Figure 10: A Screen Dump From Our Video Game Ultimately, each displayed pixel is one of only four col- ors, but the pixels in

Improving Charging-Breeding Simulations with Space-Charge Effects

NASA Astrophysics Data System (ADS)

Bilek, Ryan; Kwiatkowski, Ania; Steinbrügge, René

2016-09-01

Rare-isotope-beam facilities use Highly Charged Ions (HCI) for accelerators accelerating heavy ions and to improve measurement precision and resolving power of certain experiments. An Electron Beam Ion Trap (EBIT) is able to create HCI through successive electron impact, charge breeding trapped ions into higher charge states. CBSIM was created to calculate successive charge breeding with an EBIT. It was augmented by transferring it into an object-oriented programming language, including additional elements, improving ion-ion collision factors, and exploring the overlap of the electron beam with the ions. The calculation is enhanced with the effects of residual background gas by computing the space charge due to charge breeding. The program assimilates background species, ionizes and charge breeds them alongside the element being studied, and allows them to interact with the desired species through charge exchange, giving fairer overview of realistic charge breeding. Calculations of charge breeding will be shown for realistic experimental conditions. We reexamined the implementation of ionization energies, cross sections, and ion-ion interactions when charge breeding.

A case study exploring science competence and science confidence of middle school girls from marginalized backgrounds

NASA Astrophysics Data System (ADS)

Garcia, Yeni Violeta

The inclusion of learners from underrepresented background in biology field research experiences has not been widely explored in the literature. Increased access and equity to experiences for groups historically underrepresented in science, technology, engineering, and mathematics (STEM) has been identified as a priority for many, yet little is known about the components these experiences should have and what types of transformations participants undergo as a result of these experiences. This dissertation explored the systemic creation of an intervention purposely designed to serve middle school girls from underrepresented backgrounds, the implementation of such intervention, and effect on the girls' science competence and science confidence. El Espejo, Spanish for "The Mirror," was an ongoing field ecology research program for middle schools girls founded in 2009 at a local interdisciplinary learning center. Girls from all walks of life had the opportunity to be apprentice researchers and to work with scientists and science educators from the local community. All activities were strategically designed to promote student-led inquiry, career awareness, cultural awareness, and opportunities for research and mentorship for girls from underrepresented backgrounds. An increased understanding of if, how, and why this experience was perceived by the girls to be life changing was of importance to add to the conversations that seek ways to inspire and prepare this generation of students to be the next generation of scientists. The study built on systems theory, and on theories that were embedded in the participants' system: critical race theory, identity theory, and experiential learning theory, grounded in the context of the lived experiences of girls from underrepresented backgrounds. The girls' experiences were captured through journals, observer participant notes, photo-documentation, artifacts (posters, videos) created by the girls, and by using science perception tools as well as ecological knowledge tools to gage change in perceptions before and after the program. Research questions centered on understanding what key components were necessary to inspire and motivate the girls to ask questions about the natural world, exploring ecological knowledge as a component of scientific literacy, and on understanding science identity formation as an integrated process. Analyses of qualitative and quantitative data occurred through a systems lens to explore the intersection of experience, identity, place, science knowledge, and science perceptions for the girls in this environment. The findings indicate that the program was successful in changing the perceptions of science the girls had at the beginning of the program compared to the end of the program. The experience was overall successful as evidenced by the experiences, stories, and insights from the eight case studies examined in depth. All case study participants indicated a continued interest in science or a newly discovered interest in science related topics that they had not considered before the program. The pre-post content test was not indicative of the concepts the girls learned through the process of scientific inquiry. These findings have implications for the design, implementation, and evaluation of current and future interventions that seek to provide opportunities for underrepresented populations, for the facilitators, classroom teachers, parents, community members, and policy makers vested in providing a space where creation, innovation, and transformation of experience can take place. This is a pivotal undertaking to inspire and prepare girls from underrepresented backgrounds to be leaders in STEM.

Organizational factors associated with readiness to implement and translate a primary care based telemedicine behavioral program to improve blood pressure control: the HTN-IMPROVE study

PubMed Central

2013-01-01

Background Hypertension is prevalent and often sub-optimally controlled; however, interventions to improve blood pressure control have had limited success. Objectives Through implementation of an evidence-based nurse-delivered self-management phone intervention to facilitate hypertension management within large complex health systems, we sought to answer the following questions: What is the level of organizational readiness to implement the intervention? What are the specific facilitators, barriers, and contextual factors that may affect organizational readiness to change? Study design Each intervention site from three separate Veterans Integrated Service Networks (VISNs), which represent 21 geographic regions across the US, agreed to enroll 500 participants over a year with at least 0.5 full time equivalent employees of nursing time. Our mixed methods approach used a priori semi-structured interviews conducted with stakeholders (n = 27) including nurses, physicians, administrators, and information technology (IT) professionals between 2010 and 2011. Researchers iteratively identified facilitators and barriers of organizational readiness to change (ORC) and implementation. Additionally, an ORC survey was conducted with the stakeholders who were (n = 102) preparing for program implementation. Results Key ORC facilitators included stakeholder buy-in and improving hypertension. Positive organizational characteristics likely to impact ORC included: other similar programs that support buy-in, adequate staff, and alignment with the existing site environment; improved patient outcomes; is positive for the professional nurse role, and is evidence-based; understanding of the intervention; IT infrastructure and support, and utilization of existing equipment and space. The primary ORC barrier was unclear long-term commitment of nursing. Negative organizational characteristics likely to impact ORC included: added workload, competition with existing programs, implementation length, and limited available nurse staff time; buy-in is temporary until evidence shows improved outcomes; contacting patients and the logistics of integration into existing workflow is a challenge; and inadequate staffing is problematic. Findings were complementary across quantitative and qualitative analyses. Conclusions The model of organizational change identified key facilitators and barriers of organizational readiness to change and successful implementation. This study allows us to understand the needs and challenges of intervention implementation. Furthermore, examination of organizational facilitators and barriers to implementation of evidence-based interventions may inform dissemination in other chronic diseases. PMID:24010683

Implementation of Programmatic Quality and the Impact on Safety

NASA Technical Reports Server (NTRS)

Huls, Dale Thomas; Meehan, Kevin

2005-01-01

The purpose of this paper is to discuss the implementation of a programmatic quality assurance discipline within the International Space Station Program and the resulting impact on safety. NASA culture has continued to stress safety at the expense of quality when both are extremely important and both can equally influence the success or failure of a Program or Mission. Although safety was heavily criticized in the media after Colimbiaa, strong case can be made that it was the failure of quality processes and quality assurance in all processes that eventually led to the Columbia accident. Consequently, it is possible to have good quality processes without safety, but it is impossible to have good safety processes without quality. The ISS Program quality assurance function was analyzed as representative of the long-term manned missions that are consistent with the President s Vision for Space Exploration. Background topics are as follows: The quality assurance organizational structure within the ISS Program and the interrelationships between various internal and external organizations. ISS Program quality roles and responsibilities with respect to internal Program Offices and other external organizations such as the Shuttle Program, JSC Directorates, NASA Headquarters, NASA Contractors, other NASA Centers, and International Partner/participants will be addressed. A detailed analysis of implemented quality assurance responsibilities and functions with respect to NASA Headquarters, the JSC S&MA Directorate, and the ISS Program will be presented. Discussions topics are as follows: A comparison of quality and safety resources in terms of staffing, training, experience, and certifications. A benchmark assessment of the lessons learned from the Columbia Accident Investigation (CAB) Report (and follow-up reports and assessments), NASA Benchmarking, and traditional quality assurance activities against ISS quality procedures and practices. The lack of a coherent operational and sustaining quality assurance strategy for long-term manned space flight. An analysis of the ISS waiver processes and the Problem Reporting and Corrective Action (PRACA) process implemented as quality functions. Impact of current ISS Program procedures and practices with regards to operational safety and risk A discussion regarding a "defense-in-depth" approach to quality functions will be provided to address the issue of "integration vs independence" with respect to the roles of Programs, NASA Centers, and NASA Headquarters. Generic recommendations are offered to address the inadequacies identified in the implementation of ISS quality assurance. A reassessment by the NASA community regarding the importance of a "quality culture" as a component within a larger "safety culture" will generate a more effective and value-added functionality that will ultimately enhance safety.

Mothers’ experiences in the Nurse-Family Partnership program: a qualitative case study

PubMed Central

2012-01-01

Background Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers' experiences participating in the Nurse-Family Partnership (NFP) Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant's first birthday. Methods A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently. Results The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent. Conclusions Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers' perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers' unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation. PMID:22953748

The Milestones Passport: A Learner-Centered Application of the Milestone Framework to Prompt Real-Time Feedback in the Emergency Department

PubMed Central

Yarris, Lalena M.; Jones, David; Kornegay, Joshua G.; Hansen, Matthew

2014-01-01

Background In July 2013, emergency medicine residency programs implemented the Milestone assessment as part of the Next Accreditation System. Objective We hypothesized that applying the Milestone framework to real-time feedback in the emergency department (ED) could affect current feedback processes and culture. We describe the development and implementation of a Milestone-based, learner-centered intervention designed to prompt real-time feedback in the ED. Methods We developed and implemented the Milestones Passport, a feedback intervention incorporating subcompetencies, in our residency program in July 2013. Our primary outcomes were feasibility, including faculty and staff time and costs, number of documented feedback encounters in the first 2 months of implementation, and user-reported time required to complete the intervention. We also assessed learner and faculty acceptability. Results Development and implementation of the Milestones Passport required 10 hours of program coordinator time, 120 hours of software developer time, and 20 hours of faculty time. Twenty-eight residents and 34 faculty members generated 257 Milestones Passport feedback encounters. Most residents and faculty reported that the encounters required fewer than 5 minutes to complete, and 48% (12 of 25) of the residents and 68% (19 of 28) of faculty reported satisfaction with the Milestones Passport intervention. Faculty satisfaction with overall feedback in the ED improved after the intervention (93% versus 54%, P  =  .003), whereas resident satisfaction with feedback did not change significantly. Conclusions The Milestones Passport feedback intervention was feasible and acceptable to users; however, learner satisfaction with the Milestone assessment in the ED was modest. PMID:26279784

Voluntary Medical Male Circumcision: A Framework Analysis of Policy and Program Implementation in Eastern and Southern Africa

PubMed Central

Dickson, Kim E.; Tran, Nhan T.; Samuelson, Julia L.; Njeuhmeli, Emmanuel; Cherutich, Peter; Dick, Bruce; Farley, Tim; Ryan, Caroline; Hankins, Catherine A.

2011-01-01

Background Following confirmation of the effectiveness of voluntary medical male circumcision (VMMC) for HIV prevention, the World Health Organization and the Joint United Nations Programme on HIV/AIDS issued recommendations in 2007. Less than 5 y later, priority countries are at different stages of program scale-up. This paper analyzes the progress towards the scale-up of VMMC programs. It analyzes the adoption of VMMC as an additional HIV prevention strategy and explores the factors may have expedited or hindered the adoption of policies and initial program implementation in priority countries to date. Methods and Findings VMMCs performed in priority countries between 2008 and 2010 were recorded and used to classify countries into five adopter categories according to the Diffusion of Innovations framework. The main predictors of VMMC program adoption were determined and factors influencing subsequent scale-up explored. By the end of 2010, over 550,000 VMMCs had been performed, representing approximately 3% of the target coverage level in priority countries. The “early adopter” countries developed national VMMC policies and initiated VMMC program implementation soon after the release of the WHO recommendations. However, based on modeling using the Decision Makers' Program Planning Tool (DMPPT), only Kenya appears to be on track towards achievement of the DMPPT-estimated 80% coverage goal by 2015, having already achieved 61.5% of the DMPPT target. None of the other countries appear to be on track to achieve their targets. Potential predicators of early adoption of male circumcision programs include having a VMMC focal person, establishing a national policy, having an operational strategy, and the establishment of a pilot program. Conclusions Early adoption of VMMC policies did not necessarily result in rapid program scale-up. A key lesson is the importance of not only being ready to adopt a new intervention but also ensuring that factors critical to supporting and accelerating scale-up are incorporated into the program. The most successful program had country ownership and sustained leadership to translate research into a national policy and program. Please see later in the article for the Editors' Summary PMID:22140368

Film/chemistry selection for the earth resources technology satellite /ERTS/ ground data handling system

NASA Technical Reports Server (NTRS)

Shaffer, R. M.

1973-01-01

A detailed description is given of the methods of choose the duplication film and chemistry currently used in the NASA-ERTS Ground Data Handling System. The major ERTS photographic duplication goals are given as background information to justify the specifications for the desirable film/chemistry combination. Once these specifications were defined, a quantitative evaluation program was designed and implemented to determine if any recommended combinations could meet the ERTS laboratory specifications. The specifications include tone reproduction, granularity, MTF and cosmetic effects. A complete description of the techniques used to measure the test response variables is given. It is anticipated that similar quantitative techniques could be used on other programs to determine the optimum film/chemistry consistent with the engineering goals of the program.

Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study

PubMed Central

Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

2016-01-01

Background American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. Objective We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet’s potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. Methods This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths’ perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using previously established measures. Results Sites had sufficient computer access and Internet connectivity to implement the 6 programs with adequate fidelity; however, variable bandwidth (ranging from 0.24 to 93.5 megabits per second; mean 25.6) and technical issues led some sites to access programs via back-up modalities (eg, uploading the programs from a Universal Serial Bus drive). The number of youth providing engagement ratings varied by program (n=40-191; 48-60% female, 85-90% self-identified AI/AN). Across programs, youth rated the programs as easy to use (68-91%), trustworthy (61-89%), likeable (59-87%), and impactful (63-91%). Most youth understood the words in the programs (60-83%), although some needed hints to complete the programs (16-49%). Overall, 37-66% of the participants would recommend the programs to a classmate, and 62-87% found the programs enjoyable when compared to other school lessons. Conclusions Findings demonstrate the potential of the Internet to enhance the reach and implementation of evidence-based health promotion programs, and to engage AI/AN youth. Provision of back-up modalities is recommended to address possible connectivity or technical issues. The dissemination of Internet-based health promotion programs may be a promising strategy to address health disparities for this underserved population. Trial Registration Clinicaltrials.gov NCT01303575; https://clinicaltrials.gov/ct2/show/NCT01303575 (Archived by WebCite at http://www.webcitation.org/6m7DO4g7c) PMID:27872037

CoCoa: a software tool for estimating the coefficient of coancestry from multilocus genotype data.

PubMed

Maenhout, Steven; De Baets, Bernard; Haesaert, Geert

2009-10-15

Phenotypic data collected in breeding programs and marker-trait association studies are often analyzed by means of linear mixed models. In these models, the covariance between the genetic background effects of all genotypes under study is modeled by means of pairwise coefficients of coancestry. Several marker-based coancestry estimation procedures allow to estimate this covariance matrix, but generally introduce a certain amount of bias when the examined genotypes are part of a breeding program. CoCoa implements the most commonly used marker-based coancestry estimation procedures and as such, allows to select the best fitting covariance structure for the phenotypic data at hand. This better model fit translates into an increased power and improved type I error control in association studies and an improved accuracy in phenotypic prediction studies. The presented software package also provides an implementation of the new Weighted Alikeness in State (WAIS) estimator for use in hybrid breeding programs. Besides several matrix manipulation tools, CoCoa implements two different bending heuristics, in case the inverse of an ill-conditioned coancestry matrix estimate is needed. The software package CoCoa is freely available at http://webs.hogent.be/cocoa. Source code, manual, binaries for 32 and 64-bit Linux systems and an installer for Microsoft Windows are provided. The core components of CoCoa are written in C++, while the graphical user interface is written in Java.

Design and implementation of a patient navigation system in rural Nepal: Improving patient experience in resource-constrained settings.

PubMed

Raut, Anant; Thapa, Poshan; Citrin, David; Schwarz, Ryan; Gauchan, Bikash; Bista, Deepak; Tamrakar, Bibhu; Halliday, Scott; Maru, Duncan; Schwarz, Dan

2015-12-01

Patient navigation programs have shown to be effective across multiple settings in guiding patients through the care delivery process. Limited experience and literature exist, however, for such programs in rural and resource-constrained environments. Patients living in such settings frequently have low health literacy and substantially lower social status than their providers. They typically have limited experiences interfacing with formalized healthcare systems, and, when they do, their experience can be unpleasant and confusing. At a district hospital in rural far-western Nepal, we designed and implemented a patient navigation system that aimed to improve patients' subjective care experience. First, we hired and trained a team of patient navigators who we recruited from the local area. Their responsibility is exclusively to demonstrate compassion and to guide patients through their care process. Second, we designed visual cues throughout our hospital complex to assist in navigating patients through the buildings. Third, we incorporated the patient navigators within the management and communications systems of the hospital care team, and established standard operating procedures. We describe here our experiences and challenges in designing and implementing a patient navigator program. Such patient-centered systems may be relevant at other facilities in Nepal and globally where patient health literacy is low, patients come from backgrounds of substantial marginalization and disempowerment, and patient experience with healthcare facilities is limited. Copyright © 2015 Elsevier Inc. All rights reserved.

Healthier School Environment Leads to Decreases in Childhood Obesity – The Kearney Nebraska Story

PubMed Central

Heelan, Kate A.; Bartee, R. Todd; Nihiser, Allison; Sherry, Bettylou

2016-01-01

Background Schools play a role in addressing childhood obesity by implementing healthy eating and physical activity strategies. The primary aim of this case study was to describe prevalence of overweight and obesity among elementary school students in a rural Mid-western community between 2006 and 2012. The secondary aim was to use a novel approach called “population dose” to retrospectively evaluate the impact dose of each strategy implemented and its estimated potential population level impact on changes in overweight and obesity. Methods Weight and height were directly measured annually beginning in January 2006 to assess weight status, using body mass index (kg·m2), for all kindergarten – fifth grade students (N ≈ 2,400 per year). Multiple evidence-based strategies were implemented in nine schools to increase physical activity and healthy eating behaviors. BMI reporting and revised school meal programs were implemented district-wide. Comprehensive school physical activity programs (CSPAP), school food environment, and supportive/promotional strategies were implemented at individual schools. Results The absolute change in prevalence of obesity (BMI ≥ 95th percentile) decreased from 16.4% to 13.9%, indicating a 15.2% relative change in prevalence of obesity in 6 years. There was an inverse relationship between the number of strategies implemented and prevalence of overweight and obesity over time. Conclusions District and school-level approaches have the potential to impact childhood obesity. Schools can successfully implement strategies to address overweight and obesity, but the extent of implementation between schools may vary. Population dose analysis can be used to estimate impact of clusters of strategies to address overweight/obesity. PMID:26440386

Development of an interprofessional program for cardiovascular prevention in primary care: A participatory research approach

PubMed Central

Goudreau, Johanne; Hudon, Éveline; Lussier, Marie-Thérèse; Bareil, Céline; Duhamel, Fabie; Lévesque, Lise; Turcotte, Alain; Lalonde, Gilles

2014-01-01

Background: The chronic care model provides a framework for improving the management of chronic diseases. Participatory research could be useful in developing a chronic care model–based program of interventions, but no one has as yet offered a description of precisely how to apply the approach. Objectives: An innovative, structured, multi-step participatory process was applied to select and develop (1) chronic care model–based interventions program to improve cardiovascular disease prevention that can be adapted to a particular regional context and (2) a set of indicators to monitor its implementation. Methods: Primary care clinicians (n = 16), administrative staff (n = 2), patients and family members (n = 4), decision makers (n = 5), researchers, and a research coordinator (n = 7) took part in the process. Additional primary care actors (n = 26) validated the program. Results: The program targets multimorbid patients at high or moderate risk of cardiovascular disease with uncontrolled hypertension, dyslipidemia or diabetes. It comprises interprofessional follow-up coordinated by case-management nurses, in which motivated patients are referred in a timely fashion to appropriate clinical and community resources. The program is supported by clinical tools and includes training in motivational interviewing. A set of 89 process and clinical indicators were defined. Conclusion: Through a participatory process, a contextualized interventions program to optimize cardiovascular disease prevention and a set of quality indicators to monitor its implementation were developed. Similar approach might be used to develop other health programs in primary care if program developers are open to building on community strengths and priorities. PMID:26770705

Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC)

PubMed Central

2013-01-01

Background Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals’ perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. Methods The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign (‘Ask 3 Questions’); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. Results A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: ‘coherence,’ ‘cognitive participation,’ ‘collective action,’ and ‘reflexive monitoring.’ Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose (‘coherence’). Shared decision making was facilitated when teams engaged in developing and delivering interventions (‘cognitive participation’), and when those interventions fit with existing skill sets and organizational priorities (‘collective action’) resulting in demonstrable improvements to practice (‘reflexive monitoring’). The implementation process uncovered diverse and conflicting attitudes toward shared decision making; ‘coherence’ was often missing. Conclusions The study showed that implementation of shared decision making is more complex than the delivery of patient decision support interventions to patients, a portrayal that often goes unquestioned. Normalizing shared decision making requires intensive work to ensure teams have a shared understanding of the purpose of involving patients in decisions, and undergo the attitudinal shifts that many health professionals feel are required when comprehension goes beyond initial interpretations. Divergent views on the value of engaging patients in decisions remain a significant barrier to implementation. PMID:24006959

Enhancing Dissemination, Implementation, and Improvement Science in CTSAs through Regional Partnerships

PubMed Central

Brown, Arleen F.; Vassar, Stefanie D.; Sankaré, Ibrahima C.; Martinez, Arturo B.; Kubicek, Katrina; Kuo, Tony; Mahajan, Anish; Gould, Michael; Mittman, Brian S.

2015-01-01

Abstract Background and Importance Challenges in healthcare policy and practice have stimulated interest in dissemination and implementation science. The Institute of Medicine Committee on the Clinical Translational Science Award (CTSA) program recommended expanding the CTSA program's investment and activity in this domain. Guidance is needed to facilitate successful growth of DII science infrastructure, activity and impacts. Objectives Several CTSAs in Southern California collaborated to identify and respond to local challenges and opportunities to expand dissemination, implementation and improvement research by strengthening capacity and relationships between DII researchers and community, health system, and population health partners. Main outcomes Planning and outreach by the Southern California CTSAs increased awareness and interest in DII research and generated recommendations for growth. Recommendations include: increasing strong partnerships with healthcare and population health systems to guide policy research agendas and collaborative DII science; promoting multi‐sector partnerships that involve researchers and delivery systems throughout DII processes; bringing together multiple disciplines; and addressing national and international barriers as well as opportunities in DII science. Implications CTSAs through regional collaboration can increase their contributions to improved community health via skill‐building, partnership development and enhanced outreach to local healthcare and public health agencies and delivery systems. PMID:26602191

Using Deep Learning Algorithm to Enhance Image-review Software for Surveillance Cameras

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

Cui, Yonggang; Thomas, Maikael A.

We propose the development of proven deep learning algorithms to flag objects and events of interest in Next Generation Surveillance System (NGSS) surveillance to make IAEA image review more efficient. Video surveillance is one of the core monitoring technologies used by the IAEA Department of Safeguards when implementing safeguards at nuclear facilities worldwide. The current image review software GARS has limited automated functions, such as scene-change detection, black image detection and missing scene analysis, but struggles with highly cluttered backgrounds. A cutting-edge algorithm to be developed in this project will enable efficient and effective searches in images and video streamsmore » by identifying and tracking safeguards relevant objects and detect anomalies in their vicinity. In this project, we will develop the algorithm, test it with the IAEA surveillance cameras and data sets collected at simulated nuclear facilities at BNL and SNL, and implement it in a software program for potential integration into the IAEA’s IRAP (Integrated Review and Analysis Program).« less

The Vanderbilt Professional Nursing Practice Program, part 3: managing an advancement process.

PubMed

Steaban, Robin; Fudge, Mitzie; Leutgens, Wendy; Wells, Nancy

2003-11-01

Consistency of performance standards across multiple clinical settings is an essential component of a credible advancement system. Our advancement process incorporates a central committee, composed of nurses from all clinical settings within the institution, to ensure consistency of performance in inpatient, outpatient, and procedural settings. An analysis of nurses advanced during the first 18 months of the program indicates that performance standards are applicable to nurses in all clinical settings. The first article (September 2003) in this 3-part series described the foundation for and the philosophical background of the Vanderbilt Professional Nursing Practice Program (VPNPP), the career advancement program underway at Vanderbilt University Medical Center. Part 2 described the development of the evaluation tools used in the VPNPP, the implementation and management of this new system, program evaluation, and improvements since the program's inception. The purpose of this article is to review the advancement process, review the roles of those involved in the process, and to describe outcomes and lessons learned.

Peer education: a successful strategy with some constraints.

PubMed

Baldo, M

1998-01-01

The use of peer education programs to promote sexual health has been widely accepted because of the potential of such programs to be implemented in a cost-effective manner in various settings and because peers are considered more convincing than outsiders. In addition, the thousands of people who have received training to become peer educators constitute a new generation of social work and health professionals who are not embarrassed by sexuality. Problems encountered by peer health education programs include sustainability of volunteers and funding, difficulty in assessing the impact of a program (especially cost-effectiveness), and the lack of appropriate monitoring and evaluation indicators. Given the large turnover of peer educators and the resources needed to provide week-long residential training courses, new methods of training are needed that are less labor intensive and more cost effective. Another problem is that many facilitators of peer health education programs lack a background in health promotion, and sometimes peer education programs for similar audiences compete or send contradictory messages because of a lack of coordination.

Multicenter External Quality Assessment Program for PCR Detection of Mycobacterium ulcerans in Clinical and Environmental Specimens

PubMed Central

Eddyani, Miriam; Lavender, Caroline; de Rijk, Willem Bram; Bomans, Pieter; Fyfe, Janet; de Jong, Bouke; Portaels, Françoise

2014-01-01

Background Mycobacterium ulcerans is the causative agent of Buruli ulcer (BU), a necrotizing disease of the skin, soft tissue and bone. PCR is increasingly used in the diagnosis of BU and in research on the mode of transmission and environmental reservoir of M. ulcerans. Methodology/Principal Findings The aim of this study was to evaluate the performance of laboratories in detecting M. ulcerans using molecular tests in clinical and environmental samples by implementing sequential multicenter external quality assessment (EQA) programs. The second round of the clinical EQA program revealed somewhat improved performance. Conclusions/Significance Ongoing EQA programs remain essential and continued participation in future EQA programs by laboratories involved in the molecular testing of clinical and environmental samples for M. ulcerans for diagnostic and research purposes is strongly encouraged. Broad participation in such EQA programs also benefits the harmonization of quality in the BU research community and enhances the credibility of advances made in solving the transmission enigma of M. ulcerans. PMID:24586755

A Summer Prematriculation Program: Bridging the Gap for Disadvantaged Underrepresented Minority Students Interested in a Nursing Career.

PubMed

Norris, Tommie L; Wicks, Mona N; Cowan, Patricia A; Davison, Erwin Story

2016-08-01

The nursing and health care workforce needs diverse clinicians who can provide culturally competent and high-quality care to an increasingly diverse U.S. Achieving this goal requires creating learning environments that foster the success of disadvantaged underrepresented minority (URM) students seeking nursing careers. This 4-week summer prematriculation program introduced 33 URM individuals from disadvantaged backgrounds to nursing as a career through financial support, academic enrichment, and social support to enhance nursing program admission success. Federal guidelines were used to establish URM and economically disadvantaged status. To date, one third of program participants have been admitted to nursing programs. Fundamental reforms in pre-college education systems, such as the evidence-based strategies implemented in our summer prematriculation program, may be needed to achieve a diverse, culturally competent workforce that can help eliminate persistent health and health care disparities. [J Nurs Educ. 2016;55(8):471-475.]. Copyright 2016, SLACK Incorporated.

What is actually measured in process evaluations for worksite health promotion programs: a systematic review

PubMed Central

2013-01-01

Background Numerous worksite health promotion program (WHPPs) have been implemented the past years to improve employees’ health and lifestyle (i.e., physical activity, nutrition, smoking, alcohol use and relaxation). Research primarily focused on the effectiveness of these WHPPs. Whereas process evaluations provide essential information necessary to improve large scale implementation across other settings. Therefore, this review aims to: (1) further our understanding of the quality of process evaluations alongside effect evaluations for WHPPs, (2) identify barriers/facilitators affecting implementation, and (3) explore the relationship between effectiveness and the implementation process. Methods Pubmed, EMBASE, PsycINFO, and Cochrane (controlled trials) were searched from 2000 to July 2012 for peer-reviewed (randomized) controlled trials published in English reporting on both the effectiveness and the implementation process of a WHPP focusing on physical activity, smoking cessation, alcohol use, healthy diet and/or relaxation at work, targeting employees aged 18-65 years. Results Of the 307 effect evaluations identified, twenty-two (7.2%) published an additional process evaluation and were included in this review. The results showed that eight of those studies based their process evaluation on a theoretical framework. The methodological quality of nine process evaluations was good. The most frequently reported process components were dose delivered and dose received. Over 50 different implementation barriers/facilitators were identified. The most frequently reported facilitator was strong management support. Lack of resources was the most frequently reported barrier. Seven studies examined the link between implementation and effectiveness. In general a positive association was found between fidelity, dose and the primary outcome of the program. Conclusions Process evaluations are not systematically performed alongside effectiveness studies for WHPPs. The quality of the process evaluations is mostly poor to average, resulting in a lack of systematically measured barriers/facilitators. The narrow focus on implementation makes it difficult to explore the relationship between effectiveness and implementation. Furthermore, the operationalisation of process components varied between studies, indicating a need for consensus about defining and operationalising process components. PMID:24341605

Designing and Piloting a Program to Provide Water Filters and Improved Cookstoves in Rwanda

PubMed Central

Barstow, Christina K.; Ngabo, Fidele; Rosa, Ghislaine; Majorin, Fiona; Boisson, Sophie; Clasen, Thomas; Thomas, Evan A.

2014-01-01

Background In environmental health interventions addressing water and indoor air quality, multiple determinants contribute to adoption. These may include technology selection, technology distribution and education methods, community engagement with behavior change, and duration and magnitude of implementer engagement. In Rwanda, while the country has the fastest annual reduction in child mortality in the world, the population is still exposed to a disease burden associated with environmental health challenges. Rwanda relies both on direct donor funding and coordination of programs managed by international non-profits and health sector businesses working on these challenges. Methods and Findings This paper describes the design, implementation and outcomes of a pilot program in 1,943 households across 15 villages in the western province of Rwanda to distribute and monitor the use of household water filters and improved cookstoves. Three key program design criteria include a.) an investment in behavior change messaging and monitoring through community health workers, b.) free distributions to encourage community-wide engagement, and c.) a private-public partnership incentivized by a business model designed to encourage “pay for performance”. Over a 5-month period of rigorous monitoring, reported uptake was maintained at greater than 90% for both technologies, although exclusive use of the stove was reported in only 28.5% of households and reported water volume was 1.27 liters per person per day. On-going qualitative monitoring suggest maintenance of comparable adoption rates through at least 16 months after the intervention. Conclusion High uptake and sustained adoption of a water filter and improved cookstove was measured over a five-month period with indications of continued comparable adoption 16 months after the intervention. The design attributes applied by the implementers may be sufficient in a longer term. In particular, sustained and comprehensive engagement by the program implementer is enabled by a pay-for-performance business model that rewards sustained behavior change. PMID:24676210

Performance evaluation of the essential dimensions of the primary health care services in six localities of Bogota–Colombia: a cross-sectional study

PubMed Central

2013-01-01

Background The high segmentation and fragmentation in the provision of services are some of the main problems of the Colombian health system. In 2004 the district government of Bogota decided to implement a Primary Health Care (PHC) strategy through the Home Health program. PHC was conceived as a model for transforming health care delivery within the network of the first-level public health care facilities. This study aims to evaluate the performance of the essential dimensions of the PHC strategy in six localities geographically distributed throughout Bogotá city. Methods The rapid assessment tool to measure PHC performance, validated in Brazil, was applied. The perception of participants (users, professionals, health managers) in public health facilities where the Home Health program was implemented was compared with the perception of participants in private health facilities not implementing the program. A global performance index and specific indices for each primary care dimension were calculated. A multivariate logistic regression analysis was conducted to determine possible associations between the performance of the PHC dimensions and the self-perceived health status of users. Results The global performance index was rated as good for all participants interviewed. In general, with the exception of professionals, the differences in most of the essential dimensions seemed to favor public health care facilities where the Home Health program was implemented. The weakest dimensions were the family focus and community orientation—rated as critical by users; the distribution of financial resources—rated as critical by health managers; and, accessibility—rated as intermediate by users. Conclusions The overall findings suggest that the Home Health program could be improving the performance of the network of the first-level public health care facilities in some PHC essential dimensions, but significant efforts to achieve its objectives and raise its visibility in the community are required. PMID:23947574

Teaching Humanities at the National University of la Plata, Argentina.

PubMed

Acuña, Leopoldo E

2003-10-01

In this article the author begins by giving a brief history of medical education in Argentina, then provides some background information on the National University of La Plata. He describes two major initiatives at La Plata: a new and pioneering admission policy (implemented in 1993) and a change in the number of hours and years in the curriculum. He then looks back to the introduction in 1976 of La Plata's medical humanities program. Over its 20 year existence, the program has undergone a number of changes in response both to students' interests and financial concerns. The revised humanities curriculum now consists of four elective courses: medicine and literature, anthropology, history of medicine, and "medical kalology" (which focuses on music and dance). Unfortunately, the program, while it has been well received by both students and faculty and has inspired programs at other Argentinean schools, is threatened by Argentina's economic crisis.

DNDO Report

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

Liegey, Lauren Rene; Wilcox, Trevor; Mckinney, Gregg Walter

2015-08-07

My internship program was the Domestic Nuclear Detection Office Summer Internship Program. I worked at Los Alamos National Laboratory with Trevor A. Wilcox and Gregg W. McKinney in the NEN-5 group. My project title was “MCNP Physical Model Interoperability & Validation”. The goal of my project was to write a program to predict the solar modulation parameter for dates in the future and then implement it into MCNP6. This update to MCNP6 can be used to calculate the background more precisely, which is an important factor in being able to detect Special Nuclear Material. We will share our work inmore » a published American Nuclear Society (ANS) paper, an ANS presentation, and a LANL student poster session. Through this project, I gained skills in programming, computing, and using MCNP. I also gained experience that will help me decide on a career or perhaps obtain employment in the future.« less

ACTS Operational Performance Review: September 1995

NASA Technical Reports Server (NTRS)

Krawczyk, Richard J.

1996-01-01

The Advanced Communications Technology Satellite (ACTS) utilized a proven spacecraft bus with a payload that qualified new technologies to provide a wide range of on-orbit demonstrations. A comprehensive development, qualification and ground test program was implemented to reduce technology risks. Since launch in September, 1993, and insertion into its geostationary slot ACTS has accumulated over 16,000 hours of successful operation. This paper briefly reviews the technology development background then provides a summary of the operational performance observed for the spacecraft bus and communication payload subsystems and units.

The planned Alaska SAR Facility - An overview

NASA Technical Reports Server (NTRS)

Carsey, Frank; Weeks, Wilford

1987-01-01

The Alaska SAR Facility (ASF) is described in an overview fashion. The facility consists of three major components, a Receiving Ground System, a SAR Processing System and an Analysis and Archiving System; the ASF Program also has a Science Working Team and the requisite management and operations systems. The ASF is now an approved and fully funded activity; detailed requirements and science background are presented for the facility to be implemented for data from the European ERS-1, the Japanese ERS-1 and Radarsat.

Building a Culture of Continuous Improvement and Employee Engagement Using a Daily Management System Part 1: Overview.

PubMed

Maurer, Marsha; Canacari, Elena; Eng, Kimberly; Foley, Jane; Phelan, Cynthia; Sulmonte, Kimberlyann; Wandel, Jane

2018-03-01

A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or workflow and to address them on a daily basis. Through DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 1 describes the background and organizing framework of the program.

The effects of yoga practice in school physical education on children's motor abilities and social behavior

PubMed Central

Folleto, Júlia C; Pereira, Keila RG; Valentini, Nadia Cristina

2016-01-01

Background: In recent years, yoga programs in childhood have been implemented in schools, to promote the development for children. Aim: To investigate the effects of yoga program in physical education classes on the motor abilities and social behavior parameters of 6–8-year-old children. Methods: The study included 16 children from the 1st grade of a public elementary school in the South of Brazil. The children participated in a 12-week intervention, twice weekly, with 45 min each session. To assess children's performance, we used the Bruininks-Oseretsky Test of Motor Proficiency - Second Edition, the flexibility test (sit and reach – Eurofit, 1988), the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children and semi-structured interviews with children, parents, and classroom’ teacher. Data were analyzed with Wilcoxon test and level of significance was 5%. Results: The yoga program was well accepted by children, children also demonstrated significant and positive changes in overall motor abilities scores (balance, strength, and flexibility). In addition, the interviews reported changing in social behavior and the use of the knowledge learned in the program in contexts outside of school. Conclusion: These findings suggest that the implementation of yoga practice in physical education lessons contributed to children's development. PMID:27512323

Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation.

PubMed

Hadjistavropoulos, Thomas; Williams, Jaime; Kaasalainen, Sharon; Hunter, Paulette V; Savoie, Maryse L; Wickson-Griffiths, Abigail

2016-01-01

Background. Although feasible protocols for pain assessment and management in long-term care (LTC) have been developed, these have not been implemented on a large-scale basis. Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so. Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted. Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain. Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices. Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

Association between rural clinical clerkship and medical students' intentions to choose rural medical work after graduation: A cross-sectional study in western China.

PubMed

Liu, Jinlin; Zhu, Bin; Mao, Ying

2018-01-01

A large number of programs have been implemented in many countries to increase the healthcare workforce recruitment in rural and remote areas. Rural early exposure programs for medical students have been shown to be effective strategies. However, no related studies have been reported before in China. This study was carried out to determine the association between medical students' participation in rural clinical clerkships and their intentions to choose rural medical work after graduation from western medical schools in China. Based on a two-stage random sampling method, the cross-sectional survey was carried out in ten western provinces in China. A brief questionnaire filled in by medical students was used for data collection. A total of 4278 medical students participated in the study. The response rate was approximately 90.34%. Pearson's chi-squared tests and binary logistic regression analyses were performed for data analyses. Approximately 52.0% of medical students disclosed intentions to work in rural medical institutions after graduation. Only one in five participants had experience with a rural clinical clerkship. Rural clinical clerkships were significantly associated with medical students' intentions to work in rural medical institutions (OR: 1.24, 95%CI: 1.05-1.46); further analyses indicated that such clerkships only had a significant impact among the medical students with an urban background (OR: 2.10, 95%CI: 1.48-2.97). In terms of the sociodemographic characteristics, younger age, low level of parental education, majoring in general practice, and studying in low-level medical schools increased the odds of having intentions to engage in rural medical work among medical students; however, rural origins was the only positive univariate predictor. In addition, the predictors of intentions to choose rural medical work were different between medical students with a rural background and those with an urban background. Rural clinical clerkship is likely to increase the odds of having intentions to work in rural medical institutions after graduation among medical students in western China, especially for those with an urban background. Related policy makers could consider developing compulsory rural clerkship programs and implement them among medical students to increase early rural exposure.

Positive youth development programs for adolescents with greater psychosocial needs: evaluation based on program implementers.

PubMed

Shek, Daniel T L; Ng, Catalina S M; Law, Moon Y M

2017-02-01

As program implementers' views are seldom included in program evaluation and there are few related studies in different Chinese communities, this study examined the perceptions of the program implementers who implemented the Tier 2 Program of the P.A.T.H.S. Program in Hong Kong. The Tier 2 Program was designed to promote the development of adolescents with greater psychosocial needs. In the community-based P.A.T.H.S. Project, 400 program implementers completed a subjective outcome evaluation form (Form D) for program implementers. Consistent with the previous findings, program implementers generally held positive views towards the program, implementers, and program effectiveness and their views towards these three domains did not differ across grades. In line with the hypotheses, perceived program quality and perceived implementer quality predicted program effectiveness. The present findings provided an alternative perspective showing that the Tier 2 Program was well received by the program implementers and they regarded the program to be beneficial to the program participants.

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

PubMed Central

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

2008-01-01

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

Reductions in Sepsis Mortality and Costs After Design and Implementation of a Nurse-Based Early Recognition and Response Program

PubMed Central

Jones, Stephen L.; Ashton, Carol M.; Kiehne, Lisa; Gigliotti, Elizabeth; Bell-Gordon, Charyl; Disbot, Maureen; Masud, Faisal; Shirkey, Beverly A.; Wray, Nelda P.

2016-01-01

Background Sepsis is a leading cause of death, but evidence suggests that early recognition and prompt intervention can save lives. In 2005 Houston Methodist Hospital prioritized sepsis detection and management in its ICU. In late 2007, because of marginal effects on sepsis death rates, the focus shifted to designing a program that would be readily used by nurses and ensure early recognition of patients showing signs suspicious for sepsis, as well as the institution of prompt, evidence-based interventions to diagnose and treat it. Methods The intervention had four components: organizational commitment and data-based leadership; development and integration of an early sepsis screening tool into the electronic health record; creation of screening and response protocols; and education and training of nurses. Twice-daily screening of patients on targeted units was conducted by bedside nurses; nurse practitioners initiated definitive treatment as indicated. Evaluation focused on extent of implementation, trends in inpatient mortality, and, for Medicare beneficiaries, a before-after (2008–2011) comparison of outcomes and costs. A federal grant in 2012 enabled expansion of the program. Results By year 3 (2011) 33% of inpatients were screened (56,190 screens in 9,718 unique patients), up from 10% in year 1 (2009). Inpatient sepsis-associated death rates decreased from 29.7% in the preimplementation period (2006–2008) to 21.1% after implementation (2009–2014). Death rates and hospital costs for Medicare beneficiaries decreased from preimplementation levels without a compensatory increase in discharges to postacute care. Conclusion This program has been associated with lower inpatient death rates and costs. Further testing of the robustness and exportability of the program is under way. PMID:26484679

Integrating team resource management program into staff training improves staff’s perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan

PubMed Central

2014-01-01

Background The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. Methods We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. Results During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Conclusion Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation. PMID:25115403

Changes in medicine course curricula in Brazil encouraged by the Program for the Promotion of Medical School Curricula (PROMED)

PubMed Central

Souza, Patrícia Alves de; Zeferino, Angélica Maria Bicudo; Ros, Marco Da Aurélio

2008-01-01

Background The Program for the Promotion of Changes in Medical School Curricula (PROMED) was developed by the Brazilian Ministries of Health and Education. The objective of this program was to finance the implementation of changes to the curricula of medical schools directed towards the Brazilian national healthcare system (SUS). This paper reports research carried out together with the coordinators responsible for the PROMED of each medical school approved, in which interviews were used to evaluate whether this financial support succeeded in stimulating changes. The aim of this study was to evaluate the impact of this program three years after implementation in the universities that received funding. Methods The 19 course coordinators of the medical schools in which the PROMED project was implemented were interviewed using a questionnaire containing 12 questions for qualitative analysis. This paper focuses partially on the reports of the results of this qualitative analysis. Laurence Bardin's. Results The universities interviewed were found to have some common concerns: the decoupling of basic and professional training difficulties in achieving proximity to the network of services; insufficient funding; and the emphasis of most teachers being on teaching hospitals and specialization. These findings indicate that the direction of curriculum reform (PROMED) is toward providing a targeted training for this system. Conclusion The interviewees were aware that this program would trigger future changes in all aspects of healthcare and represents an ongoing challenge to the academic field. PROMED provided the momentum for change in the nature of medical training in Brazil and was seen as powerful enough to override other processes and as a basis for guidance regarding the methodology, pedagogical approach and scenarios of practical experience. PMID:19038043

Methodology of the Comprehensive Program on Prevention and Control of Overweight and Obesity in Iranian Children and Adolescents: The IRAN-Ending Childhood Obesity (IRAN-ECHO) Program

PubMed Central

Sayyari, Ali-Akbar; Abdollahi, Zahra; Ziaodini, Hassan; Olang, Beheshteh; Fallah, Hossein; Salehi, Forouzan; Heidari-Beni, Motahar; Imanzadeh, Farid; Abasalti, Zahra; Fozouni, Fereshteh; Jafari, Sakineh; Lashkarlouki, Farhad; Sahebdel, Mahnoush; Siadati, Arash; Aslani, Hamideh; Hosseini, Mostafa; Goodarzi, Azam; Yngve, Agneta; Kelishadi, Roya

2017-01-01

Background: The World Health Organization program on Ending Childhood Obesity (WHO-ECHO) has developed a comprehensive and integrated package of recommendations to address childhood obesity. The present study, entitled IRAN-ECHO, was designed and implemented in the framework of the WHO-ECHO program. Methods: The IRAN-ECHO program is implementing multicomponent interventions by considering life course dimensions. The program has two parts: a population approach and an individual approach. The population approach considers different periods in life, including prenatal, infancy, childhood, and adolescence, as well as family and society. The individual approach targets those children or adolescents with overweight or obesity; this part is conducted as a referral system that is now integrated in the current national health system. As part of the population approach, a quasi-experimental study was conducted in six provinces to compare the status before and after implementing parts of the interventions. By intersectoral collaboration with different organizations, multicomponent interventions are conducted for different age groups. Results: The IRAN-ECHO program is being conducted in six provinces, and will be considered in all provinces in the near future. Its main effects could be assessed in future years. Part of this program that was conducted as a quasi-experimental survey comprised 7149 students and showed that a high percentage of students had acceptable knowledge about adverse health effects of overweight and obesity. However, the knowledge about the low nutritional value of unhealthy snacks such as potato chips, puffs, industrial juices, and carbonated drinks was not appropriate. Many participants had the undesirable attitude of skipping one of the main meals when attempting to lose weight. Conclusions: The IRAN-ECHO program is presenting the feasibility of conducting the WHO-ECHO recommendations in Iran. The scope of potential policy recommendations to decrease childhood obesity is extensive and includes various elements. This program considers multisectoral interventions through population and individual approaches. The multicomponent interventions of this program address the obesogenic environment by considering the life course dimensions. It is expected that, by its life course interventions, it could help in primordial and primary prevention of noncommunicable diseases. PMID:29416836

Development and implementation of a workshop to enhance the effectiveness of mentors working with diverse mentees in HIV research.

PubMed

Gandhi, Monica; Fernandez, Alicia; Stoff, David M; Narahari, Swathi; Blank, Michael; Fuchs, Jonathan; Evans, Clyde H; Kahn, James S; Johnson, Mallory O

2014-08-01

Abstract A growing body of evidence highlights the importance of competent mentoring in academic research in the field of HIV, particularly for early stage investigators from diverse, underrepresented backgrounds. We describe the development and implementation of a 2-day intensive workshop to train mid-level and senior-level investigators conducting HIV-related clinical and translational research across multiple academic institutions on more effective mentoring, with an emphasis on techniques to foster mentees of diversity. The workshop was focused on training mentors in techniques designed to improve the effectiveness of the mentor-mentee relationship, and included didactic presentations, interactive discussions, and small-group problem-based learning activities. Mid-level or senior-level faculty involved or planning to be involved in significant mentorship activities related to HIV research were eligible. Surveys and formal actions plans allowed for workshop evaluation and laid the groundwork for subsequent workshops. Twenty-six faculty from 16 U.S.-based institutions participated, with good representation across discipline, gender, and race/ethnicity. The sessions were highly rated and discussions and evaluations revealed important barriers and facilitators to mentoring, challenges and solutions related to mentoring mentees from diverse backgrounds, and specific tools to enhance mentoring effectiveness. The Mentoring the Mentors training program for HIV researchers focusing on early career investigators of diversity was the first of its kind and was well attended, was rated highly, and provided guidance for improving the program in the future. This training program fills an important gap in the HIV researcher community and offers guidance for training mentors interested in diversity issues in settings outside of HIV.

Development and Implementation of a Workshop to Enhance the Effectiveness of Mentors Working with Diverse Mentees in HIV Research

PubMed Central

Fernandez, Alicia; Stoff, David M.; Narahari, Swathi; Blank, Michael; Fuchs, Jonathan; Evans, Clyde H.; Kahn, James S.; Johnson, Mallory O.

2014-01-01

Abstract A growing body of evidence highlights the importance of competent mentoring in academic research in the field of HIV, particularly for early stage investigators from diverse, underrepresented backgrounds. We describe the development and implementation of a 2-day intensive workshop to train mid-level and senior-level investigators conducting HIV-related clinical and translational research across multiple academic institutions on more effective mentoring, with an emphasis on techniques to foster mentees of diversity. The workshop was focused on training mentors in techniques designed to improve the effectiveness of the mentor–mentee relationship, and included didactic presentations, interactive discussions, and small-group problem-based learning activities. Mid-level or senior-level faculty involved or planning to be involved in significant mentorship activities related to HIV research were eligible. Surveys and formal actions plans allowed for workshop evaluation and laid the groundwork for subsequent workshops. Twenty-six faculty from 16 U.S.-based institutions participated, with good representation across discipline, gender, and race/ethnicity. The sessions were highly rated and discussions and evaluations revealed important barriers and facilitators to mentoring, challenges and solutions related to mentoring mentees from diverse backgrounds, and specific tools to enhance mentoring effectiveness. The Mentoring the Mentors training program for HIV researchers focusing on early career investigators of diversity was the first of its kind and was well attended, was rated highly, and provided guidance for improving the program in the future. This training program fills an important gap in the HIV researcher community and offers guidance for training mentors interested in diversity issues in settings outside of HIV. PMID:24735004

Evaluation of a workplace intervention to promote commuter cycling: A RE-AIM analysis

PubMed Central

2013-01-01

Background Originating from the interdisciplinary collaboration between public health and the transportation field a workplace intervention to promote commuter cycling, ‘Bike to Work: cyclists are rewarded’, was implemented. The intervention consisted of two cycling contests, an online loyalty program based on earning ‘cycling points’ and the dissemination of information through folders, newsletters, posters and a website. The study purpose was to evaluate the dissemination efforts of the program and to gain insights in whether free participation could persuade small and middle-sized companies to sign up. Methods The RE-AIM framework was used to guide the evaluation. Two months after the start of the intervention a questionnaire was send to 4880 employees. At the end of the intervention each company contact person (n = 12) was interviewed to obtain information on adoption, implementation and maintenance. Comparison analyses between employees aware and unaware of the program were conducted using independent-samples t-tests for quantitative data and chi-square tests for qualitative data. Difference in commuter cycling frequency was assessed using an ANOVA test. Non-parametric tests were used for the comparison analyses between the adopting and non-adopting companies. Results In total seven of the twelve participating companies adopted the program and all adopting companies implemented all intervention components. No significant differences were found in the mean number of employees (p = 0.15) or in the type of business sector (p = 0.92) between adopting and non-adopting companies. Five out of seven companies had the intention to continue the program. At the individual level, a project awareness of 65% was found. Employees aware of the program had a significantly more positive attitude towards cycling and reported significantly more commuter cycling than those unaware of the program (both p < 0.001). Participation was mainly because of health and environmental considerations. Conclusions The results of the dissemination study are promising. The adoption and implementation rates indicate that the ‘Bike to Work: cyclists are rewarded’ program seems to be a feasible workplace intervention. At the individual level, a higher score of commuter cycling was found among the employees aware of the program. Nevertheless, more evidence regarding long term effectiveness and sustainability of the intervention is needed. PMID:23773476

Canadian Otolaryngology - Head and Neck Surgery clerkship curricula: evolving toward tomorrow’s learners

PubMed Central

2013-01-01

Background Increasing focus is being placed on Clerkship curriculum design and implementation in light of new undergraduate medical education research and accreditation standards. Canadian Otolaryngology-Head and Neck Surgery (OTOHNS) Clerkship programs are continually but independently evolving towards a common goal of improving Clerkship curriculum. Methods An electronic survey was sent to undergraduate OTOHNS directors at all Canadian medical schools (n = 17) examining their Clerkship curricula. Themes included Clerkship format, teaching methods, faculty support and development, program strengths, and barriers. Results Survey response rate was 76%. All responding schools had OTOHNS Clerkship programs ranging in type (mandatory, selective or elective) and length (<1 to 4 weeks). Learning modalities varied. Electronic learning tools were identified as increasingly important to curriculum delivery. Common strengths included wide clinical exposure and one-on-one mentoring. Multiple challenges were identified in curriculum implementation and evaluation. All schools expressed interest in developing national standards, objectives and e-learning resources. Conclusions Significant variation exists in OTOHNS Clerkship experiences between Canadian medical schools. Many schools perceive barriers of insufficient time, space and curriculum standardization. Interested Canadian OTOHNS educators are eager to collaborate to improve the collective OTOHNS Clerkship experience. PMID:23663703

Social network diagnostics: a tool for monitoring group interventions

PubMed Central

2013-01-01

Background Many behavioral interventions designed to improve health outcomes are delivered in group settings. To date, however, group interventions have not been evaluated to determine if the groups generate interaction among members and how changes in group interaction may affect program outcomes at the individual or group level. Methods This article presents a model and practical tool for monitoring how social ties and social structure are changing within the group during program implementation. The approach is based on social network analysis and has two phases: collecting network measurements at strategic intervention points to determine if group dynamics are evolving in ways anticipated by the intervention, and providing the results back to the group leader to guide implementation next steps. This process aims to initially increase network connectivity and ultimately accelerate the diffusion of desirable behaviors through the new network. This article presents the Social Network Diagnostic Tool and, as proof of concept, pilot data collected during the formative phase of a childhood obesity intervention. Results The number of reported advice partners and discussion partners increased during program implementation. Density, the number of ties among people in the network expressed as a percentage of all possible ties, increased from 0.082 to 0.182 (p < 0.05) in the advice network, and from 0.027 to 0.055 (p > 0.05) in the discussion network. Conclusions The observed two-fold increase in network density represents a significant shift in advice partners over the intervention period. Using the Social Network Tool to empirically guide program activities of an obesity intervention was feasible. PMID:24083343

Implementing Preventive Chemotherapy through an Integrated National Neglected Tropical Disease Control Program in Mali

PubMed Central

Dembélé, Massitan; Bamani, Sanoussi; Dembélé, Robert; Traoré, Mamadou O.; Goita, Seydou; Traoré, Mamadou Namory; Sidibe, Abdoul Karim; Sam, Letitia; Tuinsma, Marjon; Toubali, Emily; MacArthur, Chad; Baker, Shawn K.; Zhang, Yaobi

2012-01-01

Background Mali is endemic for all five targeted major neglected tropical diseases (NTDs). As one of the five ‘fast-track’ countries supported with the United States Agency for International Development (USAID) funds, Mali started to integrate the activities of existing disease-specific national control programs on these diseases in 2007. The ultimate objectives are to eliminate lymphatic filariasis, onchocerciasis and trachoma as public health problems and to reduce morbidity caused by schistosomiasis and soil-transmitted helminthiasis through regular treatment to eligible populations, and the specific objectives were to achieve 80% program coverage and 100% geographical coverage yearly. The paper reports on the implementation of the integrated mass drug administration and the lessons learned. Methodology/Principal Findings The integrated control program was led by the Ministry of Health and coordinated by the national NTD Control Program. The drug packages were designed according to the disease endemicity in each district and delivered through various platforms to eligible populations involving the primary health care system. Treatment data were recorded and reported by the community drug distributors. After a pilot implementation of integrated drug delivery in three regions in 2007, the treatment for all five targeted NTDs was steadily scaled up to 100% geographical coverage by 2009, and program coverage has since been maintained at a high level: over 85% for lymphatic filariasis, over 90% for onchocerciasis and soil-transmitted helminthiasis, around 90% in school-age children for schistosomiasis, and 76–97% for trachoma. Around 10 million people have received one or more drug packages each year since 2009. No severe cases of adverse effects were reported. Conclusions/Significance Mali has scaled up the drug treatment to national coverage through integrated drug delivery involving the primary health care system. The successes and lessons learned in Mali can be valuable assets to other countries starting up their own integrated national NTD control programs. PMID:22448294

A controlled investigation of continuing pain education for long-term care staff

PubMed Central

Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Bello-Haas, Vanina Dal; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra MG; Carleton, R Nicholas; Hunter, Paulette V; Lix, Lisa M

2013-01-01

BACKGROUND: The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. OBJECTIVES: To investigate the effectiveness of an expert-based continuing education program in pain assessment/management for LTC staff. METHODS: Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes/beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. RESULTS: Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. CONCLUSIONS: Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers. PMID:23457681

Health promotion programs related to the Athens 2004 Olympic and Para Olympic games

PubMed Central

Soteriades, Elpidoforos S; Hadjichristodoulou, Christos; Kremastinou, Jeni; Chelvatzoglou, Fotini C; Minogiannis, Panagiotis S; Falagas, Matthew E

2006-01-01

Background The Olympic Games constitute a first-class opportunity to promote athleticism and health messages. Little is known, however on the impact of Olympic Games on the development of health-promotion programs for the general population. Our objective was to identify and describe the population-based health-promotion programs implemented in relation to the Athens 2004 Olympic and Para Olympic Games. Methods A cross-sectional survey of all stakeholders of the Games, including the Athens 2004 Organizing Committee, all ministries of the Greek government, the National School of Public Health, all municipalities hosting Olympic events and all official private sponsors of the Games, was conducted after the conclusion of the Games. Results A total of 44 agencies were surveyed, 40 responded (91%), and ten (10) health-promotion programs were identified. Two programs were implemented by the Athens 2004 Organizing Committee, 2 from the Greek ministries, 2 from the National School of Public Health, 1 from municipalities, and 3 from official private sponsors of the Games. The total cost of the programs was estimated at 943,000 Euros; a relatively small fraction (0.08%) of the overall cost of the Games. Conclusion Greece has made a small, however, significant step forward, on health promotion, in the context of the Olympic Games. The International Olympic Committee and the future hosting countries, including China, are encouraged to elaborate on this idea and offer the world a promising future for public health. PMID:16504120

Evaluation of a large-scale weight management program using the consolidated framework for implementation research (CFIR)

PubMed Central

2013-01-01

Background In the United States, as in many other parts of the world, the prevalence of overweight/obesity is at epidemic proportions in the adult population and even higher among Veterans. To address the high prevalence of overweight/obesity among Veterans, the MOVE!® weight management program was disseminated nationally to Veteran Affairs (VA) medical centers. The objective of this paper is two-fold: to describe factors that explain the wide variation in implementation of MOVE!; and to illustrate, step-by-step, how to apply a theory-based framework using qualitative data. Methods Five VA facilities were selected to maximize variation in implementation effectiveness and geographic location. Twenty-four key stakeholders were interviewed about their experiences in implementing MOVE!. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection and analysis of qualitative data. Constructs that most strongly influence implementation effectiveness were identified through a cross-case comparison of ratings. Results Of the 31 CFIR constructs assessed, ten constructs strongly distinguished between facilities with low versus high program implementation effectiveness. The majority (six) were related to the inner setting: networks and communications; tension for change; relative priority; goals and feedback; learning climate; and leadership engagement. One construct each, from intervention characteristics (relative advantage) and outer setting (patient needs and resources), plus two from process (executing and reflecting) also strongly distinguished between high and low implementation. Two additional constructs weakly distinguished, 16 were mixed, three constructs had insufficient data to assess, and one was not applicable. Detailed descriptions of how each distinguishing construct manifested in study facilities and a table of recommendations is provided. Conclusions This paper presents an approach for using the CFIR to code and rate qualitative data in a way that will facilitate comparisons across studies. An online Wiki resource (http://www.wiki.cfirwiki.net) is available, in addition to the information presented here, that contains much of the published information about the CFIR and its constructs and sub-constructs. We hope that the described approach and open access to the CFIR will generate wide use and encourage dialogue and continued refinement of both the framework and approaches for applying it. PMID:23663819

Implementation of patient education at first and second dispensing of statins in Dutch community pharmacies: the sequel of a cluster randomized trial

PubMed Central

2011-01-01

Background As a result of the previous part of this trial, many patients with cardiovascular disease were expected to receive a statin for the first time. In order to provide these patients with comprehensive information on statins, as recommended by professional guidance, education at first and second dispensing of statins had to be implemented. This study was designed to assess the effectiveness of an intensive implementation program targeted at pharmacy project assistants on the frequency of providing education at first dispensing (EAFD) and education at second dispensing (EASD) of statins in community pharmacies. Methods The participating community pharmacies were clustered on the basis of local collaboration, were numbered by a research assistant and subsequently an independent statistician performed a block randomization, in which the cluster size (number of pharmacies in each cluster) was balanced. The pharmacies in the control group received a written manual on the implementation of EAFD and EASD; the pharmacies in the intervention group received intensive support for the implementation. The impact of the intensive implementation program on the implementation process and on the primary outcomes was examined in a random coefficient logistic regression model, which took into account that patients were grouped within pharmacy clusters. Results Of the 37 pharmacies in the intervention group, 17 pharmacies (50%) provided EAFD and 12 pharmacies (35.3%) provided EASD compared to 14 pharmacies (45.2%, P = 0.715) and 12 pharmacies (38.7%, P = 0.899), respectively, of the 34 pharmacies in the control group. In the intervention group a total of 72 of 469 new statin users (15.4%) received education and 49 of 393 patients with a second statin prescription (12.5%) compared to 78 of 402 new users (19.4%, P = 0.944) and 35 of 342 patients with a second prescription (10.2%, P = 0.579) in the control group. Conclusion The intensive implementation program did not increase the frequency of providing EAFD and EASD of statins in community pharmacies. Trial Registration clinicaltrials.gov NCT00509717 PMID:22087850

Therapists' Use of the Graded Repetitive Arm Supplementary Program (GRASP) Intervention: A Practice Implementation Survey Study

PubMed Central

McMahon, Naoimh E.; Watkins, Caroline L.; Eng, Janice J.

2014-01-01

Background Only a small percentage of research is ever successfully translated into practice. The Graded Repetitive Arm Supplementary Program (GRASP) is a stroke rehabilitation intervention that anecdotally has had rapid translation from research to clinical practice. This study was conducted to explore the characteristics of this practice implementation. Objectives The aims of this study were: (1) to explore the extent of practice implementation of GRASP in the United Kingdom; (2) using an implementation framework, to explore UK therapists' opinions of implementing GRASP; and (3) if GRASP is found to be used in the United Kingdom, to investigate differences in opinions between therapists who are using GRASP in practice and those who are not. Design A cross-sectional study design was used. Methods Data were collected via an online questionnaire. Participants in this study were members of the College of Occupational Therapy Specialist Section Neurological Practice and the Association of Chartered Physiotherapists Interested in Neurology. Results Of the 274 therapists who responded to the survey, 61 (22.3%) had experience of using GRASP, 114 (41.6%) knew of GRASP but had never used it, and 99 (36.1%) had never heard of GRASP. Therapists displayed positive opinions toward the implementation of a manual with graded progressions of structured upper limb exercises for people after stroke. Opinions were different between therapists who had used GRASP and those who had not. Limitations The findings of this study may be limited by response bias. Conclusions GRASP is a relatively new stroke rehabilitation intervention that has made impressive translation into the knowledge and practice of UK therapists. Therapists' opinions would suggest that GRASP is both an acceptable and feasible intervention and has the potential to be implemented by a greater number of therapists in a range of settings. PMID:24505098

WebStruct and VisualStruct: Web interfaces and visualization for Structure software implemented in a cluster environment.

PubMed

Jayashree, B; Rajgopal, S; Hoisington, D; Prasanth, V P; Chandra, S

2008-09-24

Structure, is a widely used software tool to investigate population genetic structure with multi-locus genotyping data. The software uses an iterative algorithm to group individuals into "K" clusters, representing possibly K genetically distinct subpopulations. The serial implementation of this programme is processor-intensive even with small datasets. We describe an implementation of the program within a parallel framework. Speedup was achieved by running different replicates and values of K on each node of the cluster. A web-based user-oriented GUI has been implemented in PHP, through which the user can specify input parameters for the programme. The number of processors to be used can be specified in the background command. A web-based visualization tool "Visualstruct", written in PHP (HTML and Java script embedded), allows for the graphical display of population clusters output from Structure, where each individual may be visualized as a line segment with K colors defining its possible genomic composition with respect to the K genetic sub-populations. The advantage over available programs is in the increased number of individuals that can be visualized. The analyses of real datasets indicate a speedup of up to four, when comparing the speed of execution on clusters of eight processors with the speed of execution on one desktop. The software package is freely available to interested users upon request.

Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence

PubMed Central

Manlove, Jennifer; Fish, Heather; Moore, Kristin Anderson

2015-01-01

Background US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs), highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome). We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use). Conclusion Future efforts should conduct replications of existing program evaluations, identify implementation components linked to impacts, rigorously evaluate programs that appear promising, and expand the evidence base on programs that impact hormonal and long-acting contraceptive method use. PMID:25897271

Meta-Modeling: A Knowledge-Based Approach to Facilitating Model Construction and Reuse

NASA Technical Reports Server (NTRS)

Keller, Richard M.; Dungan, Jennifer L.

1997-01-01

In this paper, we introduce a new modeling approach called meta-modeling and illustrate its practical applicability to the construction of physically-based ecosystem process models. As a critical adjunct to modeling codes meta-modeling requires explicit specification of certain background information related to the construction and conceptual underpinnings of a model. This information formalizes the heretofore tacit relationship between the mathematical modeling code and the underlying real-world phenomena being investigated, and gives insight into the process by which the model was constructed. We show how the explicit availability of such information can make models more understandable and reusable and less subject to misinterpretation. In particular, background information enables potential users to better interpret an implemented ecosystem model without direct assistance from the model author. Additionally, we show how the discipline involved in specifying background information leads to improved management of model complexity and fewer implementation errors. We illustrate the meta-modeling approach in the context of the Scientists' Intelligent Graphical Modeling Assistant (SIGMA) a new model construction environment. As the user constructs a model using SIGMA the system adds appropriate background information that ties the executable model to the underlying physical phenomena under investigation. Not only does this information improve the understandability of the final model it also serves to reduce the overall time and programming expertise necessary to initially build and subsequently modify models. Furthermore, SIGMA's use of background knowledge helps eliminate coding errors resulting from scientific and dimensional inconsistencies that are otherwise difficult to avoid when building complex models. As a. demonstration of SIGMA's utility, the system was used to reimplement and extend a well-known forest ecosystem dynamics model: Forest-BGC.

The Joint Effects of Background Selection and Genetic Recombination on Local Gene Genealogies

PubMed Central

Zeng, Kai; Charlesworth, Brian

2011-01-01

Background selection, the effects of the continual removal of deleterious mutations by natural selection on variability at linked sites, is potentially a major determinant of DNA sequence variability. However, the joint effects of background selection and genetic recombination on the shape of the neutral gene genealogy have proved hard to study analytically. The only existing formula concerns the mean coalescent time for a pair of alleles, making it difficult to assess the importance of background selection from genome-wide data on sequence polymorphism. Here we develop a structured coalescent model of background selection with recombination and implement it in a computer program that efficiently generates neutral gene genealogies for an arbitrary sample size. We check the validity of the structured coalescent model against forward-in-time simulations and show that it accurately captures the effects of background selection. The model produces more accurate predictions of the mean coalescent time than the existing formula and supports the conclusion that the effect of background selection is greater in the interior of a deleterious region than at its boundaries. The level of linkage disequilibrium between sites is elevated by background selection, to an extent that is well summarized by a change in effective population size. The structured coalescent model is readily extendable to more realistic situations and should prove useful for analyzing genome-wide polymorphism data. PMID:21705759

The joint effects of background selection and genetic recombination on local gene genealogies.

PubMed

Zeng, Kai; Charlesworth, Brian

2011-09-01

Background selection, the effects of the continual removal of deleterious mutations by natural selection on variability at linked sites, is potentially a major determinant of DNA sequence variability. However, the joint effects of background selection and genetic recombination on the shape of the neutral gene genealogy have proved hard to study analytically. The only existing formula concerns the mean coalescent time for a pair of alleles, making it difficult to assess the importance of background selection from genome-wide data on sequence polymorphism. Here we develop a structured coalescent model of background selection with recombination and implement it in a computer program that efficiently generates neutral gene genealogies for an arbitrary sample size. We check the validity of the structured coalescent model against forward-in-time simulations and show that it accurately captures the effects of background selection. The model produces more accurate predictions of the mean coalescent time than the existing formula and supports the conclusion that the effect of background selection is greater in the interior of a deleterious region than at its boundaries. The level of linkage disequilibrium between sites is elevated by background selection, to an extent that is well summarized by a change in effective population size. The structured coalescent model is readily extendable to more realistic situations and should prove useful for analyzing genome-wide polymorphism data.

Suicide prevention for youth - a mental health awareness program: lessons learned from the Saving and Empowering Young Lives in Europe (SEYLE) intervention study

PubMed Central

2012-01-01

Background The Awareness program was designed as a part of the EU-funded Saving and Empowering Young Lives in Europe (SEYLE) intervention study to promote mental health of adolescents in 11 European countries by helping them to develop problem-solving skills and encouraging them to self-recognize the need for help as well as how to help peers in need. Methods For this descriptive study all coordinators of the SEYLE Awareness program answered an open-ended evaluation questionnaire at the end of the project implementation. Their answers were synthesized and analyzed and are presented here. Results The results show that the program cultivated peer understanding and support. Adolescents not only learned about mental health by participating in the Awareness program, but the majority of them also greatly enjoyed the experience. Conclusions Recommendations for enhancing the successes of mental health awareness programs are presented. Help and cooperation from schools, teachers, local politicians and other stakeholders will lead to more efficacious future programs. PMID:22971152

Guarding against emerging epidemics: addressing HIV and AIDS among culturally and linguistically diverse communities in NSW.

PubMed

McMahon, Tadgh; Moreton, Renee J; Luisi, Barbara N

2010-01-01

In Australia, people from culturally and linguistically diverse backgrounds, largely born in low- and middle-income countries, accounted for 24% of HIV notifications in the period 2004-2008. NSW has one of the most culturally diverse communities in Australia and is also the most popular destination for both permanent and temporary migrants. Consequently people from culturally and linguistically diverse backgrounds have recently been recognised as a priority in the NSW HIV/AIDS Strategy. The National Health and Medical Research Council provides a cultural competency framework for re-orienting public health and health promotion programs to better meet the needs of these communities. It is being applied to re-orientate the HIV response in NSW. Examples of how this framework can be implemented are provided.

Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach

PubMed Central

Ammendolia, Carlo; Cassidy, David; Steensta, Ivan; Soklaridis, Sophie; Boyle, Eleanor; Eng, Stephanie; Howard, Hamer; Bhupinder, Bains; Côté, Pierre

2009-01-01

Background Despite over 2 decades of research, the ability to prevent work-related low back pain (LBP) and disability remains elusive. Recent research suggests that interventions that are focused at the workplace and incorporate the principals of participatory ergonomics and return-to-work (RTW) coordination can improve RTW and reduce disability following a work-related back injury. Workplace interventions or programs to improve RTW are difficult to design and implement given the various individuals and environments involved, each with their own unique circumstances. Intervention mapping provides a framework for designing and implementing complex interventions or programs. The objective of this study is to design a best evidence RTW program for occupational LBP tailored to the Ontario setting using an intervention mapping approach. Methods We used a qualitative synthesis based on the intervention mapping methodology. Best evidence from systematic reviews, practice guidelines and key articles on the prognosis and management of LBP and improving RTW was combined with theoretical models for managing LBP and changing behaviour. This was then systematically operationalized into a RTW program using consensus among experts and stakeholders. The RTW Program was further refined following feedback from nine focus groups with various stakeholders. Results A detailed five step RTW program was developed. The key features of the program include; having trained personnel coordinate the RTW process, identifying and ranking barriers and solutions to RTW from the perspective of all important stakeholders, mediating practical solutions at the workplace and, empowering the injured worker in RTW decision-making. Conclusion Intervention mapping provided a useful framework to develop a comprehensive RTW program tailored to the Ontario setting. PMID:19508728

Core curricula for postdoctoral dental students: recent problems, potential solutions, and a model for the future.

PubMed

Iacopino, Anthony M; Taft, Thomas B

2007-11-01

Development of common core curricula for the graduate advanced education/specialty programs in dental schools presents significant challenges. Similarities in graduate education accreditation standards justify such an approach, yet a core curriculum is difficult to achieve for a variety of reasons including scheduling constraints and the capacity of a common, single pathway curriculum to address the specific educational needs of postgraduate students in different disciplines. Additionally, many dental schools are experiencing severe shortages of qualified faculty to provide graduate program instruction. There are no previous reports regarding graduate core curricula and the definition/delivery of such core curricula in advanced education programs in dentistry although there are several reports in the medical literature that support the educational value of a unified core curriculum implemented in a modular format. Graduate curricula are typically designed to provide residents with advanced education/training beyond what is acquired during their predoctoral dental school experience. Advanced education programs must emphasize knowledge and skills that are discipline-specific; however, there is a large amount of common foundational material within the early phases of these programs. Dental schools have attempted to identify and present this common material within the context of an organized shared set of courses/seminars where residents from each advanced education program are scheduled simultaneously. However, there have been problems with the implementation of a shared core curricula including the following: 1) dissimilar educational backgrounds/abilities among residents; 2) relevance of material to all residents; 3) lack of central management; 4) scheduling conflicts; and 5) lack of adequate and consistent program evaluation. In an attempt to resolve these problems, a new comprehensive graduate core curriculum was implemented at the Marquette University School of Dentistry in 2000. This core curriculum was designed to 1) be user-friendly; 2) allow flexibility; 3) meet specific programmatic/accreditation needs for each advanced education program; and 4) provide assessment tools for continuous resident feedback and curriculum improvement. Assessment data obtained from residents, faculty, and program directors indicate that this approach has been successful and has transformed graduate education at Marquette. Thus, this model may prove useful for other institutions seeking to refine or develop graduate core curricula.

Genetic characterization of measles viruses isolated in Turkey during 2000 and 2001

PubMed Central

Korukluoglu, Gulay; Liffick, Stephanie; Guris, Dalya; Kobune, Fumio; Rota, Paul A; Bellini, William J; Ceylan, Ali; Ertem, Meliksah

2005-01-01

Background Molecular epidemiologic studies have made significant contributions to measles surveillance activities by helping to identify source and transmission pathways of the virus. This report describes the genetic characterization of wild-type measles viruses isolated in Turkey in 2000 and 2001. Results Wild-type measles viruses were isolated from 24 cases from five provinces in Turkey during 2001. The viruses were analyzed using the standard genotyping protocols. All isolates were classified as genotype D6, the same genotype that was identified in Turkey in previous outbreaks during 1998. Conclusion Turkey has begun implementation of a national program to eliminate measles by 2010. Therefore, this baseline genotype data will provide a means to monitor the success of the elimination program. PMID:16029506

Real-time implementation of a multispectral mine target detection algorithm

NASA Astrophysics Data System (ADS)

Samson, Joseph W.; Witter, Lester J.; Kenton, Arthur C.; Holloway, John H., Jr.

2003-09-01

Spatial-spectral anomaly detection (the "RX Algorithm") has been exploited on the USMC's Coastal Battlefield Reconnaissance and Analysis (COBRA) Advanced Technology Demonstration (ATD) and several associated technology base studies, and has been found to be a useful method for the automated detection of surface-emplaced antitank land mines in airborne multispectral imagery. RX is a complex image processing algorithm that involves the direct spatial convolution of a target/background mask template over each multispectral image, coupled with a spatially variant background spectral covariance matrix estimation and inversion. The RX throughput on the ATD was about 38X real time using a single Sun UltraSparc system. A goal to demonstrate RX in real-time was begun in FY01. We now report the development and demonstration of a Field Programmable Gate Array (FPGA) solution that achieves a real-time implementation of the RX algorithm at video rates using COBRA ATD data. The approach uses an Annapolis Microsystems Firebird PMC card containing a Xilinx XCV2000E FPGA with over 2,500,000 logic gates and 18MBytes of memory. A prototype system was configured using a Tek Microsystems VME board with dual-PowerPC G4 processors and two PMC slots. The RX algorithm was translated from its C programming implementation into the VHDL language and synthesized into gates that were loaded into the FPGA. The VHDL/synthesizer approach allows key RX parameters to be quickly changed and a new implementation automatically generated. Reprogramming the FPGA is done rapidly and in-circuit. Implementation of the RX algorithm in a single FPGA is a major first step toward achieving real-time land mine detection.

Findings from the Community Health Intervention Program in South Carolina: Implications for Reducing Cancer-Related Health Disparities

PubMed Central

McCracken, James Lyndon; Friedman, Daniela B.; Brandt, Heather M.; Adams, Swann Arp; Xirasagar, Sudha; Ureda, John R.; Mayo, Rachel M.; Comer, Kimberly; Evans, Miriam; Fedrick, Delores; Talley, Jacqueline; Broderick, Madeline; Hebert, James R.

2013-01-01

BACKGROUND The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities and reduce the cancer burden among high-risk populations across the state. The mini-grants project implemented evidence-based health interventions tailored to the specific needs of each community. OBJECTIVE To support the SC-CPCRN’s goals of moving toward greater dissemination and implementation of evidence-based programs in the community to improve public health, prevent disease, and reduce the cancer burden. METHODS Three community-based organizations were awarded $10,000 each to implement one of the National Cancer Institute’s evidence-based interventions. Each group had 12 months to complete their project. SC-CPCRN investigators and staff provided guidance, oversight, and technical assistance for each project. Grantees provided regular updates and reports to their SC-CPCRN liaisons to capture vital evaluation information. RESULTS The intended CHIP mini-grant target population reach was projected to be up to 880 participants combined. Actual combined reach of the three projects reported upon completion totaled 1,072 individuals. The majority of CHIP participants were African-American females. Participants ranged in age from 19 to 81 years. Evaluation results showed an increase in physical activity, dietary improvements, and screening participation. CONCLUSIONS The success of the initiative was the result of a strong community-university partnership built on trust. Active two-way communication and an honest open dialogue created an atmosphere for collaboration. Communities were highly motivated. All team members shared a common goal of reducing cancer-related health disparities and building greater public health capacity across the state. PMID:23645547

Promoting Tobacco Cessation and Smoke-Free Workplaces Through Community Outreach Partnerships in Puerto Rico

PubMed Central

Díaz-Toro, Elba C.; Fernández, Maria E.; Correa-Fernández, Virmarie; Calo, William A.; Ortiz, Ana Patricia; Mejía, Luz M.; Mazas, Carlos A.; Santos-Ortiz, María del Carmen; Wetter, David W.

2014-01-01

Background Puerto Rico (PR) has a lower smoking prevalence than the United States (14.8% vs. 21.2%, respectively); nevertheless, the five leading causes of death are associated with smoking. There is a need to implement evidence-based tobacco control strategies in PR. Objectives The Outreach Pilot Program (OPP) was designed to engage communities, health professionals, and researchers in a network to advance health promotion activities and research to increase the use of the PR Quitline (PRQ) among smokers and promoting policies in support of smoke-free workplaces. Methods Using community-based participatory research (CBPR) methods, the OPP mobilized a network of community and academic partners to implement smoking cessation activities including referrals to the PRQ, adoption of evidence-based smoking cessation programs, and promotion of smoke-free legislation. Results Eighty organizations participated in the OPP. Collaborators implemented activities that supported the promotion of the PRQ and smoke-free workplaces policy and sponsored yearly trainings, including tobacco control conferences. From 2005 to 2008, physician referrals to the PRQ increased from 2.6% to 7.2%. The number of annual smokers receiving cessation services through the PRQ also increased from 703 to 1,086. The OPP shepherded a rigorous smoke-free law through participation in the development, promotion, and implementation of the smoke-free workplaces legislation as well as the creation of the PR Tobacco Control Strategic Plan, launched in 2006. Conclusions This project demonstrates the feasibility of developing a successful and sustainable community-based outreach program model that enlists the participation of academic researchers, community organizations, and health care providers as partners to promote tobacco control. PMID:25152097

The impact of patient support programs on adherence, clinical, humanistic, and economic patient outcomes: a targeted systematic review

PubMed Central

Ganguli, Arijit; Clewell, Jerry; Shillington, Alicia C

2016-01-01

Background Patient support programs (PSPs), including medication management and counseling, have the potential to improve care in chronic disease states with complex therapies. Little is known about the program’s effects on improving clinical, adherence, humanistic, and cost outcomes. Purpose To conduct a targeted review describing medical conditions in which PSPs have been implemented; support delivery components (eg, face-to-face, phone, mail, and internet); and outcomes associated with implementation. Data sources MEDLINE – 10 years through March 2015 with supplemental handsearching of reference lists. Study selection English-language trials and observational studies of PSPs providing at minimum, counseling for medication management, measurement of ≥1 clinical outcome, and a 3-month follow-up period during which outcomes were measured. Data extraction Program characteristics and related clinical, adherence, humanistic, and cost outcomes were abstracted. Study quality and the overall strength of evidence were reviewed using standard criteria. Data synthesis Of 2,239 citations, 64 studies met inclusion criteria. All targeted chronic disease processes and the majority (48 [75%]) of programs offered in-clinic, face-to-face support. All but 9 (14.1%) were overseen by allied health care professionals (eg, nurses, pharmacists, paraprofessionals). Forty-one (64.1%) reported at least one significantly positive clinical outcome. The most frequent clinical outcome impacted was adherence, where 27 of 41 (66%) reported a positive outcome. Of 42 studies measuring humanistic outcomes (eg, quality of life, functional status), 27 (64%) reported significantly positive outcomes. Only 15 (23.4%) programs reported cost or utilization-related outcomes, and, of these, 12 reported positive impacts. Conclusion The preponderance of evidence suggests a positive impact of PSPs on adherence, clinical and humanistic outcomes. Although less often measured, health care utilization and costs are also reduced following PSP implementation. Further research is needed to better quantify which support programs, delivery methods, and components offer the greatest value for any particular medical condition. PMID:27175071

Meeting international standards: a cultural approach in implementing the mini-CEX effectively in Indonesian clerkships.

PubMed

Suhoyo, Yoyo; Schönrock-Adema, Johanna; Rahayu, Gandes Retno; Kuks, Jan B M; Cohen-Schotanus, Janke

2014-10-01

Abstract Background: Medical schools all over the world try to adapt their programs to meet international standards. However, local culture might hamper innovation attempts. To describe challenges in implementing the mini-CEX in Indonesia and investigate its effect on students' clinical competence. The study was conducted in the Internal Medicine and Neurology departments of the Universitas Gadjah Mada, Indonesia. Implementing the mini-CEX into the existing curriculum, while taking the Indonesian culture into account, implied a shift from group to individual feedback. We compared students' final clinical competence before (Internal Medicine n = 122, Neurology n = 183) and after (n = 183 and 186, respectively) the implementation of the mini-CEX, using a modified Objective Structured Long Examination Record (OSLER). The Mann-Whitney test was used to analyze the data. We took power distance and individualism into account to facilitate the implementation process. After implementing the mini-CEX, the OSLER results were significant higher in Internal Medicine (p < 0.05). However, no differences were found in Neurology. By managing the innovation process carefully and taking culture and local context into account, the mini-CEX can be implemented without changing the underlying concept. The shift from group to individual feedback seems to have a positive effect on student learning.

One-Year Results of the BeweegKuur Lifestyle Intervention Implemented in Dutch Primary Healthcare Settings.

PubMed

Schutte, Bianca A M; Haveman-Nies, Annemien; Preller, Liesbeth

2015-01-01

Background. Lifestyle interventions focusing on healthy diet and physical activity (PA) are effective in reducing health risks in controlled research settings. The aim of this study was to investigate the one-year results of the BeweegKuur lifestyle intervention implemented nationwide in Netherlands for people with a weight-related health risk. Materials and Methods. Data were requested from all 160 locations participating in the BeweegKuur. In a one group pretest/posttest study, one-year changes in health outcome variables and time spent on physical activity were tested with dependent t-tests. Associations between one-year changes in weight and waist circumference and sociodemographic factors and uptake of the program were analysed with ANOVA. Results. Data for 517 participants from 47 locations were available for analysis. One year after the intervention, weight reduced by 2.9 kg (95% CI -3.3;, -2.5), waist circumference by 4.3 cm (-4.9; -3.7), and blood glucose by 0.5 mmol/L (-0.8; -0.3). Physical activity increased significantly. Higher uptake of the program was associated with a larger decrease in waist circumference. Conclusion. The results of the study suggest that lifestyle interventions implemented in real-life primary healthcare settings with tailor-made supervision can contribute meaningfully to primary prevention.

Training medical students in human rights: a fifteen-year experience in Geneva

PubMed Central

Chastonay, Philippe; Zesiger, Véronique; Ferreira, Jackeline; Mpinga, Emmanuel Kabengele

2012-01-01

Background Training health professionals in the field of human rights has long been advocated by the United Nations. Over the past decade some medical schools have introduced health and human rights courses, yet by far not all. This paper describes the objectives and the content of the Health and Human Rights program developed at the Faculty of Medicine, University of Geneva. Methods The health and human rights program was developed through the identification of the course objectives, contents, and educational modalities using consensus techniques, and through a step by step implementation procedure integrating multiple evaluation processes. Results Defined objectives included the familiarization with the concepts, instruments and mechanisms of human rights, the links between health and human rights, and the role of health professionals in promoting human rights. The content ultimately adopted focused on the typology of human rights, their mechanisms of protection, their instruments, as well as social inequalities and vulnerable groups of the population. The implementation proceeded through a step by step approach. Evaluation showed high satisfaction of students, good achievement of learning objectives, and some academic and community impact. Conclusions High interest of students for a human rights course is encouraging. Furthermore, the community projects initiated and implemented by students may contribute to the social responsibility of the academic institution. PMID:26451186

The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis (OA): a knowledge translation (KT) randomized controlled trial (RCT): Part I: The Uptake of the Ottawa Panel clinical practice guidelines (CPGs)

PubMed Central

2012-01-01

Background The implementation of evidence based clinical practice guidelines on self-management interventions to patients with chronic diseases is a complex process. A multifaceted strategy may offer an effective knowledge translation (KT) intervention to promote knowledge uptake and improve adherence in an effective walking program based on the Ottawa Panel Evidence Based Clinical Practice Guidelines among individuals with moderate osteoarthritis (OA). Methods A single-blind, randomized control trial was conducted. Patients with mild to moderate (OA) of the knee (n=222) were randomized to one of three KT groups: 1) Walking and Behavioural intervention (WB) (18 males, 57 females) which included the supervised community-based aerobic walking program combined with a behavioural intervention and an educational pamphlet on the benefits of walking for OA; 2) Walking intervention (W) (24 males, 57 females) wherein participants only received the supervised community-based aerobic walking program intervention and the educational pamphlet; 3) Self-directed control (C) (32 males, 52 females) wherein participants only received the educational pamphlet. One-way analyses of variance were used to test for differences in quality of life, adherence, confidence, and clinical outcomes among the study groups at each 3 month assessment during the 12-month intervention period and 6-month follow-up period. Results Short-term program adherence was greater in WB compared to C (p<0.012) after 3 months. No statistical significance (p> 0.05) was observed for long-term adherence (6 to 12 months), and total adherence between the three groups. The three knowledge translation strategies demonstrated equivalent long-term results for the implementation of a walking program for older individuals with moderate OA. Lower dropout rates as well as higher retention rates were observed for WB at 12 and 18 months. Conclusion The additional knowledge translation behavioural component facilitated the implementation of clinical practice guidelines on walking over a short-term period. More studies are needed to improve the long-term walking adherence or longer guidelines uptake on walking among participants with OA. Particular attention should be taken into account related to patient’s characteristic and preference. OA can be managed through the implementation of a walking program based on clinical practice guidelines in existing community-based walking clubs as well as at home with the minimal support of an exercise therapist or a trained volunteer. Trial Registration Current Controlled Trials IRSCTNO9193542 PMID:23061875

The dynamic of tuberculosis case finding in the era of the public–private mix strategy for tuberculosis control in Central Java, Indonesia

PubMed Central

Reviono, Reviono; Setianingsih, Wahyu; Damayanti, Kusmadewi Eka; Ekasari, Ratna

2017-01-01

ABSTRACT Background: The public–private mix (PPM) strategy has strengthened tuberculosis care and control in many countries. Indonesia, a country with a high tuberculosis burden, has a low tuberculosis case detection rate (CDR), despite PPM implementation in 2003. The PPM in Indonesia involves primary healthcare centers, hospitals, and specialized chest clinics. The long-term impact of the strategy is unknown. Objective: We aimed to explore the case detection achievements of the tuberculosis program since PPM implementation in Central Java in 2003. Methods: This retrospective cohort study covered the period 1 January 2000 to 31 December 2014. The data from tuberculosis patients treated in all health facilities in Central Java implementing directly observed treatment short-course, recorded via a standardized form, were analyzed after being validated by the Office of Health of Central Java Province. We evaluated the CDR, case notification rate, and total number of cases, using linear regression to analyze the temporal trends of those indicators in the phases of PPM implementation. Results: The CDR increased during the initial phase (2000–2005), decreased during the mid-phase (2006–2009), and increased slightly during the late phase (2010–2014), ranging from 13 to 61.72. These trends were observed despite a steady increase in the number of participating healthcare facilities. The regression analysis showed that the CDR of referral institutions contributed the most to the total CDR of Central Java Province. Many of the smear-negative tuberculosis cases recorded at primary healthcare centers may have been smear positive; this probable misclassification could have been partially avoided if more specific and sensitive diagnostic tools were available. Conclusions: The CDR remains below the national target (70%). Early awareness of a negative trend in certain program indicators is important to ensure program sustainability. Careful observation of the indicator pattern will secure the long-term success of the program. PMID:28766465

State of the Art and Challenges of Radio Spectrum Monitoring in China

NASA Astrophysics Data System (ADS)

Lu, Q. N.; Yang, J. J.; Jin, Z. Y.; Chen, D. Z.; Huang, M.

2017-10-01

This paper provides an overview of radio spectrum monitoring in China. First, research background, the motivation is described and then train of thought, the prototype system, and the accomplishments are presented. Current radio spectrum monitoring systems are man-machine communication systems, which are unable to detect and process the radio interference automatically. In order to realize intelligent radio monitoring and spectrum management, we proposed an Internet of Things-based spectrum sensing approach using information system architecture and implemented a pilot program; then some very interesting results were obtained.

Continental Scientific Drilling and Exploration Act. Introduced in the Senate, Ninety-Ninth Congress, Second Session, September 19, 1986

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

Not Available

1986-01-01

The Senate Committee on Energy and Natural Resources report on S. 1026 recommends without amendment the bill which directs the Secretaries of the Interior and the National Science Foundation to cooperate in implementing the Continental Scientific Drilling Program (CSDP). The purpose of the CSDP is to enhance the knowledge and understanding of the composition, structure, dynamics, and evolution of the continental crust, including how such processes affect natural phenomena. The report includes background and the need for the legislation and summarizes the four sections.

A normative price for a manufactured product: The SAMICS methodology. Volume 2: Analysis

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.

1979-01-01

The Solar Array Manufacturing Industry Costing Standards provide standard formats, data, assumptions, and procedures for determining the price a hypothetical solar array manufacturer would have to be able to obtain in the market to realize a specified after-tax rate of return on equity for a specified level of production. The methodology and its theoretical background are presented. The model is sufficiently general to be used in any production-line manufacturing environment. Implementation of this methodology by the Solar Array Manufacturing Industry Simultation computer program is discussed.

Healthy eating and active living for diabetes in primary care networks (HEALD-PCN): rationale, design, and evaluation of a pragmatic controlled trial for adults with type 2 diabetes

PubMed Central

2012-01-01

Background While strong and consistent evidence supports the role of lifestyle modification in the prevention and management of type 2 diabetes (T2DM), the best strategies for program implementation to support lifestyle modification within primary care remain to be determined. The objective of the study is to evaluate the implementation of an evidence-based self- management program for patients with T2DM within a newly established primary care network (PCN) environment. Method Using a non-randomized design, participants (total N = 110 per group) will be consecutively allocated in bi-monthly blocks to either a 6-month self-management program lead by an Exercise Specialist or to usual care. Our primary outcome is self-reported physical activity and pedometer steps. Discussion The present study will assess whether a diabetes self-management program lead by an Exercise Specialist provided within a newly emerging model of primary care and linked to available community-based resources, can lead to positive changes in self-management behaviours for adults with T2DM. Ultimately, our work will serve as a platform upon which an emerging model of primary care can incorporate effective and efficient chronic disease management practices that are sustainable through partnerships with local community partners. Clinical Trials Registration ClinicalTrials.gov identifier: NCT00991380 PMID:22712881

Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

PubMed Central

Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

2016-01-01

Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

Bench to Bedside: The Effectiveness of a Professional Development Program Focused on Biomedical Sciences and Action Research

PubMed Central

Barnes, Marianne B.; Barnes, Lehman W.; Cooper, Lou Ann; Bokor, Julie R.; Koroly, Mary Jo

2017-01-01

A three-year, National Institutes of Health-funded residential project at a southeastern research university immersed 83 secondary science teachers in a summer institute called “Bench to Bedside.” Teachers were provided with knowledge, skills, experiences, and incentives to improve their science teaching and increase their awareness of scientific processes, technologies, and careers by examining the translational medicine continuum of basic to clinical research. This was done with the help of medical school researchers, clinical personnel, biotechnology entrepreneurs, program mentors, and prior year participants. A critical component of the institute was the preparation and implementation of an action research project that reflected teachers’ newly acquired knowledge and skills. Action research proposals were critiqued by project team members and feedback provided prior to action research implementation in schools during the following year. Teachers shared their action research with colleagues and project team at a symposium and online as a critical step in networking the teachers. Results of a mixed methods program evaluation strategy indicate that the program produced significant gains in teachers’ confidence to explain advanced biosciences topics, development of action research skills, and formation of a statewide biosciences network of key stakeholders. Constraints of time, variation in teacher content and action research background, technology availability, and school-related variables, among others, are discussed. PMID:29733086

[Development of a program theory as a basis for the evaluation of a dementia special care unit].

PubMed

Adlbrecht, Laura; Bartholomeyczik, Sabine; Mayer, Hanna

2018-06-01

Background: An existing dementia special care unit should be evaluated. In order to build a sound foundation of the evaluation a deep theoretical understanding of the implemented intervention is needed, which has not been explicated yet. One possibility to achieve this is the development of a program theory. Aim: The aim is to present a method to develop a program theory for the existing living and care concept of the dementia special care unit, which is used in a larger project to evaluate the concept theory-drivenly. Method: The evaluation is embedded in the framework of van Belle et al. (2010) and an action model and a change model (Chen, 2015) is created. For the specification of the change model the contribution analysis (Mayne, 2011) is applied. Data were collected in workshops with the developers and the nurses of the dementia special care unit and a literature research concerning interventions and outcomes was carried out. The results were synthesized in a consens workshop. Results: The action model describes the interventions of the dementia special care unit, the implementers, the organization and the context. The change model compromises the mechanisms through which interventions achieve outcomes. Conclusions: The results of the program theory can be employed to choose data collection methods and instruments for the evaluation. On the basis of the results of the evaluation the program theory can be refined and adapted.

Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa

PubMed Central

Amoussouhoui, Arnaud Setondji; Wadagni, Anita Carolle; Johnson, Roch Christian; Aoulou, Paulin; Agbo, Inès Elvire; Houezo, Jean-Gabin; Boyer, Micah; Nichter, Mark

2018-01-01

Background Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin’s most endemic districts previously served by centralized hospital-based care. Methodology/Principal findings We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. Conclusions/Significance This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control. PMID:29529087

Human Papillomavirus Vaccine as an Anti-cancer Vaccine: Collaborative Efforts to Promote HPV Vaccine in the National Comprehensive Cancer Control Program

PubMed Central

Townsend, Julie S.; Steele, C. Brooke; Hayes, Nikki; Bhatt, Achal; Moore, Angela R.

2018-01-01

Background Widespread use of the HPV vaccine has the potential to reduce incidence from HPV-associated cancers. However, vaccine uptake among adolescents remains well below the Healthy People 2020 targets. The Centers for Disease Control and Prevention (CDC)’s National Comprehensive Cancer Control Program awardees (NCCCP) are well positioned to work with immunization programs to increase vaccine uptake. Methods CDC’s chronic disease management information system was queried for objectives and activities associated with HPV vaccine that were reported by NCCCP awardees from 2013 – 2016 as part of program reporting requirements. A content analysis was conducted on the query results to categorize interventions according to strategies outlined in The Guide to Community Preventive Services and the 2014 President’s Cancer Panel report. Results Sixty-two percent of NCCCP awardees had planned or implemented at least one activity since 2013 to address low HPV vaccination coverage in their jurisdictions. Most NCCCP awardees (86%) reported community education activities, while 65% reported activities associated with provider education. Systems-based strategies such as client reminders or provider assessment and feedback were each reported by less than 25% of NCCCP awardees. Conclusion Many NCCCP awardees report planning or implementing activities to address low HPV vaccination coverage, often in conjunction with state immunization programs. NCCCP awardees can play a role in increasing HPV vaccination coverage through their cancer prevention and control expertise and access to partners in the health care community. PMID:28263672

Developing, Implementing, and Evaluating a Formal Pharmacist Mentorship Program

PubMed Central

Nieuwstraten, Carmine; Huh, Alice; Liu, Gwen; Davis, Karen; Dolovich, Lisa

2011-01-01

Background: Mentoring is associated with positive professional and personal outcomes. However, there are few published data on mentoring programs for pharmacists. Objective: To develop and evaluate a mentorship program for hospital pharmacists that was implemented at St Joseph’s Healthcare Hamilton, in Hamilton, Ontario, by identifying the benefits and challenges that participants experienced and determining whether the program provided the necessary skills for a successful mentoring relationship. Methods: A descriptive pilot study was performed between June 2007 and November 2008. Focus groups and self-administered questionnaires were conducted at two time points (after 3–4 months and at the end of the study period). The focus groups were conducted separately for mentors and mentees. Data were summarized by predefined categories. Quantitative data from the questionnaires were summarized as medians, minimums, and maximums, and qualitative survey data were transcribed and reviewed. Results: Three mentors were each paired with a mentee. The mentees identified an average of 4 learning objectives. All of the mentees reported improvements in their self-perceived level of competency and skill within the mentoring relationship and their confidence in their ability to perform the functions of a hospital pharmacist. The job satisfaction of both mentors and mentees improved. Reported challenges were related to scheduling and documentation. Mentors and mentees reported high levels of overall satisfaction with the program, at both of the evaluation time points. Participants spent less than 60 min/week each on mentoring activities. Conclusions: Both mentors and mentees benefited from the mentoring relationship. PMID:22479041

Challenges of postgraduate critical care nursing program in Iran.

PubMed

Dehghan Nayeri, Nahid; Shariat, Esmaeil; Tayebi, Zahra; Ghorbanzadeh, Majid

2017-01-01

Background: The main philosophy of postgraduate preparation for working in critical care units is to ensure the safety and quality of patients' care. Increasing the complexity of technology, decision-making challenges and the high demand for advanced communication skills necessitate the need to educate learners. Within this aim, a master's degree in critical care nursing has been established in Iran. Current study was designed to collect critical care nursing students' experiences as well as their feedback to the field critical care nursing. Methods: This study used qualitative content analysis through in-depth semi-structured interviews. Graneheim and Lundman method was used for data analysis. Results: The results of the total 15 interviews were classified in the following domains: The vision of hope and illusion; shades of grey attitude; inefficient program and planning; inadequacy to run the program; and multiple outcomes: Far from the effectiveness. Overall findings indicated the necessity to review the curriculum and the way the program is implemented. Conclusion: The findings of this study provided valuable information to improve the critical care-nursing program. It also facilitated the next review of the program by the authorities.

Social networks and implementation of evidence-based practices in public youth-serving systems: a mixed-methods study

PubMed Central

2011-01-01

Background The present study examines the structure and operation of social networks of information and advice and their role in making decisions as to whether to adopt new evidence-based practices (EBPs) among agency directors and other program professionals in 12 California counties participating in a large randomized controlled trial. Methods Interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welfare departments. Grounded-theory analytic methods were used to identify themes related to EBP adoption and network influences. A web-based survey collected additional quantitative information on members of information and advice networks of study participants. A mixed-methods approach to data analysis was used to create a sociometric data set (n = 176) for examination of associations between advice seeking and network structure. Results Systems leaders develop and maintain networks of information and advice based on roles, responsibility, geography, and friendship ties. Networks expose leaders to information about EBPs and opportunities to adopt EBPs; they also influence decisions to adopt EBPs. Individuals in counties at the same stage of implementation accounted for 83% of all network ties. Networks in counties that decided not to implement a specific EBP had no extra-county ties. Implementation of EBPs at the two-year follow-up was associated with the size of county, urban versus rural counties, and in-degree centrality. Collaboration was viewed as critical to implementing EBPs, especially in small, rural counties where agencies have limited resources on their own. Conclusions Successful implementation of EBPs requires consideration and utilization of existing social networks of high-status systems leaders that often cut across service organizations and their geographic jurisdictions. Trial Registration NCT00880126 PMID:21958674

Economic Evaluation of Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventive Services Task Force

PubMed Central

Li, Rui; Qu, Shuli; Zhang, Ping; Chattopadhyay, Sajal; Gregg, Edward W.; Albright, Ann; Hopkins, David; Pronk, Nicolaas P.

2016-01-01

Background Diabetes is a highly prevalent and costly disease. Studies indicate that combined diet and physical activity promotion programs can prevent type 2 diabetes among persons at increased risk. Purpose To systematically evaluate the evidence on cost, cost-effectiveness, and cost-benefit estimates of diet and physical activity promotion programs. Data Sources Cochrane Library, EMBASE, MEDLINE, PsycINFO, Sociological Abstracts, Web of Science, EconLit, and CINAHL through 7 April 2015. Study Selection English-language studies from high-income countries that provided data on cost, cost-effectiveness, or cost-benefit ratios of diet and physical activity promotion programs with at least 2 sessions over at least 3 months delivered to persons at increased risk for type 2 diabetes. Data Extraction Dual abstraction and assessment of relevant study details. Data Synthesis Twenty-eight studies were included. Costs were expressed in 2013 U.S. dollars. The median program cost per participant was $653. Costs were lower for group-based programs (median, $417) and programs implemented in community or primary care settings (median, $424) than for the U.S. DPP (Diabetes Prevention Program) trial and the DPP Outcomes Study ($5881). Twenty-two studies assessed the incremental cost-effectiveness ratios (ICERs) of the programs. From a health system perspective, 16 studies reported a median ICER of $13 761 per quality-adjusted life-year (QALY) saved. Group-based programs were more cost-effective (median, $1819 per QALY) than those that used individual sessions (median, $15 846 per QALY). No cost-benefit studies were identified. Limitation Information on recruitment costs and cost-effectiveness of translational programs implemented in community and primary care settings was limited. Conclusion Diet and physical activity promotion programs to prevent type 2 diabetes are cost-effective among persons at increased risk. Costs are lower when programs are delivered to groups in community or primary care settings. Primary Funding Source None. PMID:26167962

Voluntary Medical Male Circumcision: Logistics, Commodities, and Waste Management Requirements for Scale-Up of Services

PubMed Central

Edgil, Dianna; Stankard, Petra; Forsythe, Steven; Rech, Dino; Chrouser, Kristin; Adamu, Tigistu; Sakallah, Sameer; Thomas, Anne Goldzier; Albertini, Jennifer; Stanton, David; Dickson, Kim Eva; Njeuhmeli, Emmanuel

2011-01-01

Background The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President’s Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. Methods and Findings This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. Conclusions Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in “Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa.” Program planners and policy makers should consider the significant contribution of supply chain and waste management to VMMC program costs as they determine future resource needs for VMMC programs. Please see later in the article for the Editors' Summary PMID:22140363

Impact of a provincial asthma guidelines continuing medical education project: The Ontario Asthma Plan of Action’s Provider Education in Asthma Care Project

PubMed Central

Lougheed, M Diane; Moosa, Dilshad; Finlayson, Shelagh; Hopman, Wilma M; Quinn, Mallory; Szpiro, Kim; Reisman, Joseph

2007-01-01

BACKGROUND: The Ontario Ministry of Health and Long-Term Care funded the Ontario Lung Association to develop and implement a continuing medical education program to promote implementation of the Canadian asthma guidelines in primary care. OBJECTIVES: To determine baseline knowledge, preferred learning format, satisfaction with the program and reported impact on practice patterns. METHODS: A 3 h workshop was developed that combined didactic presentations and small group case discussions. Outcome measures included a workshop evaluation, baseline assessment of asthma management knowledge and three-month postreflective evaluations. RESULTS: One hundred thirty-seven workshops were delivered to 2783 primary care providers (1313 physicians, 1470 allied health) between September 2002 and March 2005. Of the 2133 participants, 1007 physicians and 1126 allied health professionals submitted workshop evaluations. Most (98%) of the attendees indicated they would recommend the workshop to a colleague. The majority preferred the combination of didactic lecture plus interactive case discussions. A subset of physicians provided consent to use these data for research (n=298 pediatric and 288 adult needs assessments; n=349 postreflective evaluations). Important needs identified included appropriate medication for chronic asthma and development of written action plans. On the postreflective evaluations, 88.7% remained very satisfied, 95.5% reported increased confidence, 91.9% reported an influence on practice and 67.2% reported using a written action plan. CONCLUSIONS: This continuing medical education program addresses identified needs of primary care providers. Participants reported improvements in asthma care, including prescribing practices, use of spirometry and written action plans. Similar programs should be considered as part of multifaceted asthma guidelines dissemination and implementation initiatives in other provinces and nationally. PMID:17372639

MCMC-ODPR: Primer design optimization using Markov Chain Monte Carlo sampling

PubMed Central

2012-01-01

Background Next generation sequencing technologies often require numerous primer designs that require good target coverage that can be financially costly. We aimed to develop a system that would implement primer reuse to design degenerate primers that could be designed around SNPs, thus find the fewest necessary primers and the lowest cost whilst maintaining an acceptable coverage and provide a cost effective solution. We have implemented Metropolis-Hastings Markov Chain Monte Carlo for optimizing primer reuse. We call it the Markov Chain Monte Carlo Optimized Degenerate Primer Reuse (MCMC-ODPR) algorithm. Results After repeating the program 1020 times to assess the variance, an average of 17.14% fewer primers were found to be necessary using MCMC-ODPR for an equivalent coverage without implementing primer reuse. The algorithm was able to reuse primers up to five times. We compared MCMC-ODPR with single sequence primer design programs Primer3 and Primer-BLAST and achieved a lower primer cost per amplicon base covered of 0.21 and 0.19 and 0.18 primer nucleotides on three separate gene sequences, respectively. With multiple sequences, MCMC-ODPR achieved a lower cost per base covered of 0.19 than programs BatchPrimer3 and PAMPS, which achieved 0.25 and 0.64 primer nucleotides, respectively. Conclusions MCMC-ODPR is a useful tool for designing primers at various melting temperatures at good target coverage. By combining degeneracy with optimal primer reuse the user may increase coverage of sequences amplified by the designed primers at significantly lower costs. Our analyses showed that overall MCMC-ODPR outperformed the other primer-design programs in our study in terms of cost per covered base. PMID:23126469

Critical realism: a practical ontology to explain the complexities of smoking and tobacco control in different resource settings

PubMed Central

Oladele, Dunsi; Clark, Alexander M.; Richter, Solina; Laing, Lory

2013-01-01

Background This paper presents critical realism (CR) as an innovative system for research in tobacco prevention and control. CR argues that underlying mechanisms are considered and explored to ensure effective implementation of any program/policy or intervention. Any intervention or program/policy that is transposed from one country to another or one setting to another is complex. Methods The research was undertaken and analyzed through a critical ethnography lens using CR as a philosophical underpinning. The study relied upon the following components: original fieldwork in Nigeria including participant observation of smokers, in-depth interviews and focus groups with smokers, and in-depth interviews with health professionals working in the area of tobacco control in Nigeria. Results Findings from this small ethnographic study in Nigeria, suggest that Critical Realism holds promise for addressing underlying mechanism that links complex influences on smoking. Conclusion This paper argues that understanding the underlying mechanisms associated with smoking in different societies will enable a platform for effective implementation of tobacco control policies that work in various settings. PMID:23561029

National machine guarding program: Part 1. Machine safeguarding practices in small metal fabrication businesses

PubMed Central

Yamin, Samuel C.; Brosseau, Lisa M.; Xi, Min; Gordon, Robert; Most, Ivan G.; Stanley, Rodney

2015-01-01

Background Metal fabrication workers experience high rates of traumatic occupational injuries. Machine operators in particular face high risks, often stemming from the absence or improper use of machine safeguarding or the failure to implement lockout procedures. Methods The National Machine Guarding Program (NMGP) was a translational research initiative implemented in conjunction with two workers' compensation insures. Insurance safety consultants trained in machine guarding used standardized checklists to conduct a baseline inspection of machine‐related hazards in 221 business. Results Safeguards at the point of operation were missing or inadequate on 33% of machines. Safeguards for other mechanical hazards were missing on 28% of machines. Older machines were both widely used and less likely than newer machines to be properly guarded. Lockout/tagout procedures were posted at only 9% of machine workstations. Conclusions The NMGP demonstrates a need for improvement in many aspects of machine safety and lockout in small metal fabrication businesses. Am. J. Ind. Med. 58:1174–1183, 2015. © 2015 The Authors. American Journal of Industrial Medicine published by Wiley Periodicals, Inc. PMID:26332060

The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research

PubMed Central

2012-01-01

Background The introduction of evidence-based programs and practices into healthcare settings has been the subject of an increasing amount of research in recent years. While a number of studies have examined initial implementation efforts, less research has been conducted to determine what happens beyond that point. There is increasing recognition that the extent to which new programs are sustained is influenced by many different factors and that more needs to be known about just what these factors are and how they interact. To understand the current state of the research literature on sustainability, our team took stock of what is currently known in this area and identified areas in which further research would be particularly helpful. This paper reviews the methods that have been used, the types of outcomes that have been measured and reported, findings from studies that reported long-term implementation outcomes, and factors that have been identified as potential influences on the sustained use of new practices, programs, or interventions. We conclude with recommendations and considerations for future research. Methods Two coders identified 125 studies on sustainability that met eligibility criteria. An initial coding scheme was developed based on constructs identified in previous literature on implementation. Additional codes were generated deductively. Related constructs among factors were identified by consensus and collapsed under the general categories. Studies that described the extent to which programs or innovations were sustained were also categorized and summarized. Results Although "sustainability" was the term most commonly used in the literature to refer to what happened after initial implementation, not all the studies that were reviewed actually presented working definitions of the term. Most study designs were retrospective and naturalistic. Approximately half of the studies relied on self-reports to assess sustainability or elements that influence sustainability. Approximately half employed quantitative methodologies, and the remainder employed qualitative or mixed methodologies. Few studies that investigated sustainability outcomes employed rigorous methods of evaluation (e.g., objective evaluation, judgement of implementation quality or fidelity). Among those that did, a small number reported full sustainment or high fidelity. Very little research has examined the extent, nature, or impact of adaptations to the interventions or programs once implemented. Influences on sustainability included organizational context, capacity, processes, and factors related to the new program or practice themselves. Conclusions Clearer definitions and research that is guided by the conceptual literature on sustainability are critical to the development of the research in the area. Further efforts to characterize the phenomenon and the factors that influence it will enhance the quality of future research. Careful consideration must also be given to interactions among influences at multiple levels, as well as issues such as fidelity, modification, and changes in implementation over time. While prospective and experimental designs are needed, there is also an important role for qualitative research in efforts to understand the phenomenon, refine hypotheses, and develop strategies to promote sustainment. PMID:22417162

Demand-side management glossary

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

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

Demand-side management glossary. Final report

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

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

Worksite Cancer Prevention Activities in the National Comprehensive Cancer Control Program

PubMed Central

Nahmias, Zachary; Townsend, Julie S.; Neri, Antonio; Stewart, Sherri L.

2016-01-01

Background Workplaces are one setting for cancer control planners to reach adults at risk for cancer and other chronic diseases. However, the extent to which Centers for Disease Control and Prevention-funded National Comprehensive Cancer Control Programs (NCCCP) implement interventions in the workplace setting is not well characterized. Methods We conducted a qualitative content analysis of program action plans submitted by NCCCP grantees from 2013–2015 to identify and describe cancer prevention objectives and interventions in the workplace setting. Results Nearly half of NCCCP action reports contained at least one cancer prevention objective or intervention in the workplace setting. Common interventions included education about secondhand smoke exposure in the workplace, and the importance of obtaining colorectal cancer screening. Conclusion Workplace interventions were relatively common among NCCCP action plans, and serve as one way to address low percentages of CRC screening, and reduce risk for obesity- and tobacco-related cancers. PMID:26874944

Matching by linear programming and successive convexification.

PubMed

Jiang, Hao; Drew, Mark S; Li, Ze-Nian

2007-06-01

We present a novel convex programming scheme to solve matching problems, focusing on the challenging problem of matching in a large search range and with cluttered background. Matching is formulated as metric labeling with L1 regularization terms, for which we propose a novel linear programming relaxation method and an efficient successive convexification implementation. The unique feature of the proposed relaxation scheme is that a much smaller set of basis labels is used to represent the original label space. This greatly reduces the size of the searching space. A successive convexification scheme solves the labeling problem in a coarse to fine manner. Importantly, the original cost function is reconvexified at each stage, in the new focus region only, and the focus region is updated so as to refine the searching result. This makes the method well-suited for large label set matching. Experiments demonstrate successful applications of the proposed matching scheme in object detection, motion estimation, and tracking.

"The largest Lean transformation in the world": the implementation and evaluation of lean in Saskatchewan healthcare.

PubMed

Kinsman, Leigh; Rotter, Thomas; Stevenson, Katherine; Bath, Brenna; Goodridge, Donna; Harrison, Liz; Dobson, Roy; Sari, Nazmi; Jeffery, Cathy; Bourassa, Carrie; Westhorp, Gill

2014-01-01

The Saskatchewan Ministry of Health has committed to a multi-million dollar investment toward the implementation of Lean methodology across the province's healthcare system. Originating as a production line discipline (the Toyota Production System), Lean has evolved to encompass process improvements including inventory management, waste reduction and quality improvement techniques. With an initial focus on leadership, strategic alignment, training and the creation of a supportive infrastructure (Lean promotion offices), the goal in Saskatchewan is a whole health system transformation that produces "better health, better value, better care, and better teams." Given the scope and scale of the initiative and the commitment of resources, it is vital that a comprehensive, longitudinal evaluation plan be implemented to support ongoing decision-making and program design. The nature of the initiative also offers a unique opportunity to contribute to health quality improvement science by advancing our understanding of the implementation and evaluation of complex, large-scale healthcare interventions. The purpose of this article is to summarize the background to Lean in Saskatchewan and the proposed evaluation methods. Copyright © 2014 Longwoods Publishing.

Sustainability of school-located influenza vaccination programs in Florida

PubMed Central

Tran, Cuc H.; Brew, Joe; Johnson, Nicholas; Ryan, Kathleen A.; Martin, Brittany; Cornett, Catherine; Caron, Brad; Duncan, R. Paul; Small, Parker A.; Myers, Paul D.; Morris, J. Glenn

2018-01-01

Background School-located influenza vaccination (SLIV) programs are a promising strategy for increasing vaccination coverage among schoolchildren. However, questions of economic sustainability have dampened enthusiasm for this approach in the United States. We evaluated SLIV sustainability of a health department led, county-wide SLIV program in Alachua County, Florida. Based on Alachua’s outcome data, we modeled the sustainability of SLIV programs statewide using two different implementation costs and at different vaccination rates, reimbursement amount, and Vaccines for Children (VFC) coverage. Methods Mass vaccination clinics were conducted at 69 Alachua County schools in 2013 using VFC (for Medicaid and uninsured children) and non-VFC vaccines. Claims were processed after each clinic and submitted to insurance providers for reimbursement ($5 Medicaid and $47.04 from private insurers). We collected programmatic expenditures and volunteer hours to calculate fixed and variable costs for two different implementation costs (with or without in-kind costs included). We project program sustainability for Florida using publicly available county-specific student populations and health insurance enrollment data. Results Approximately 42% (n = 12,853) of pre-kindergarten – 12th grade students participated in the SLIV program in Alachua. Of the 13,815 doses provided, 58% (8042) were non-VFC vaccine. Total implementation cost was $14.95/dose or $7.93/dose if “in-kind” costs were not included. The program generated a net surplus of $24,221, despite losing $4.68 on every VFC dose provided to Medicaid and uninsured children. With volunteers, 99% of Florida counties would be sustainable at a 50% vaccination rate and average reimbursement amount of $3.25 VFC and $37 non-VFC. Without volunteers, 69% of counties would be sustainable at 50% vaccination rate if all VFC recipients were on Medicaid and its reimbursement increased from $5 to $10 (amount private practices receive). Conclusions and relevance Key factors that contributed to the sustainability and success of an SLIV program are: targeting privately insured children and reducing administration cost through volunteers. Counties with a high proportion of VFC eligible children may not be sustainable without subsidies at $5 Medicaid reimbursement. PMID:27126875

Disease management projects and the Chronic Care Model in action: baseline qualitative research

PubMed Central

2012-01-01

Background Disease management programs, especially those based on the Chronic Care Model (CCM), are increasingly common in the Netherlands. While disease management programs have been well-researched quantitatively and economically, less qualitative research has been done. The overall aim of the study is to explore how disease management programs are implemented within primary care settings in the Netherlands; this paper focuses on the early development and implementation stages of five disease management programs in the primary care setting, based on interviews with project leadership teams. Methods Eleven semi-structured interviews were conducted at the five selected sites with sixteen professionals interviewed; all project directors and managers were interviewed. The interviews focused on each project’s chosen chronic illness (diabetes, eating disorders, COPD, multi-morbidity, CVRM) and project plan, barriers to development and implementation, the project leaders’ action and reactions, as well as their roles and responsibilities, and disease management strategies. Analysis was inductive and interpretive, based on the content of the interviews. After analysis, the results of this research on disease management programs and the Chronic Care Model are viewed from a traveling technology framework. Results This analysis uncovered four themes that can be mapped to disease management and the Chronic Care Model: (1) changing the health care system, (2) patient-centered care, (3) technological systems and barriers, and (4) integrating projects into the larger system. Project leaders discussed the paths, both direct and indirect, for transforming the health care system to one that addresses chronic illness. Patient-centered care was highlighted as needed and a paradigm shift for many. Challenges with technological systems were pervasive. Project leaders managed the expenses of a traveling technology, including the social, financial, and administration involved. Conclusions At the sites, project leaders served as travel guides, assisting and overseeing the programs as they traveled from the global plans to local actions. Project leaders, while hypothetically in control of the programs, in fact shared control of the traveling of the programs with patients, clinicians, and outside consultants. From this work, we can learn what roadblocks and expenses occur while a technology travels, from a project leader’s point of view. PMID:22578251

Urban family physician plan in Iran: challenges of implementation in Kerman

PubMed Central

Dehnavieh, Reza; Kalantari, Ali Reza; Jafari Sirizi, Mohammad

2015-01-01

Background: The Family Physician Plan has recently been implemented in three provinces of Iran on a pilot basis and is going to be implemented throughout Iran in the future. Through a qualitative design, this study aims to determine probable implementation challenges of Family Physician Plan in Kerman. Methods: This study was conducted in Kerman in 2013. Data were collected through interviews with 21 experts in the field. Sampling continued until data saturation level was achieved. All interviews were recorded and then analyzed, and main themes and subgroups were extracted from them based on a framework analysis model. Results: most prevalent establishment challenges of Family Physician Plan were classified into policy-making, financial supply, laws and resources. Conclusion: The urban Family Physician Plan can be carried out more effectively by implementing this plan step by step, highlighting the relationships between the related organizations, using new payment mechanisms e.g Per Capita, DRG, make national commitment and proper educational programs for providers, development the health electronic Record, justifying providers and community about advantages of this plan, clarifying regulatory status about providers' Duties and most importantly considering a specific funding source. PMID:26913266

Bioenvironmental Engineering: An Interdisciplinary Approach to Training Environmental Engineers at Rutgers University

NASA Astrophysics Data System (ADS)

Uchrin, Christoph; Krogmann, Uta; Gimenez, Daniel

2010-05-01

It is becoming increasingly apparent that environmental problems have become extremely complex, involving inter- and multidisciplinary expertise. Furthermore, the nature of environmental episodes requires practitioners who are flexible in designing appropriate solution approaches. As a result, there is a high demand for environmental engineering graduates in the professional sector as well as graduate schools. At Rutgers University, we have designed and are now delivering an undergraduate curriculum that melds a strong background in basic and applied sciences with a rigorous sequence of design oriented engineering courses, all focused on producing graduates who view the environment in a holistic sense, rather than a narrow, medium oriented manner. Since the implementation of the program in 2004 student numbers have doubled and half of the students graduate with honors. The undergraduate program is complemented by the new Environmental Engineering option of the Graduate Program in Environmental Sciences. The undergraduate program and the graduate option are served by a highly committed faculty of seven full-time members and one part-time member.

Coverage of Large-Scale Food Fortification of Edible Oil, Wheat Flour, and Maize Flour Varies Greatly by Vehicle and Country but Is Consistently Lower among the Most Vulnerable: Results from Coverage Surveys in 8 Countries123

PubMed Central

Aaron, Grant J; Friesen, Valerie M; Jungjohann, Svenja; Garrett, Greg S; Myatt, Mark

2017-01-01

Background: Large-scale food fortification (LSFF) of commonly consumed food vehicles is widely implemented in low- and middle-income countries. Many programs have monitoring information gaps and most countries fail to assess program coverage. Objective: The aim of this work was to present LSFF coverage survey findings (overall and in vulnerable populations) from 18 programs (7 wheat flour, 4 maize flour, and 7 edible oil programs) conducted in 8 countries between 2013 and 2015. Methods: A Fortification Assessment Coverage Toolkit (FACT) was developed to standardize the assessments. Three indicators were used to assess the relations between coverage and vulnerability: 1) poverty, 2) poor dietary diversity, and 3) rural residence. Three measures of coverage were assessed: 1) consumption of the vehicle, 2) consumption of a fortifiable vehicle, and 3) consumption of a fortified vehicle. Individual program performance was assessed based on the following: 1) achieving overall coverage ≥50%, 2) achieving coverage of ≥75% in ≥1 vulnerable group, and 3) achieving equity in coverage for ≥1 vulnerable group. Results: Coverage varied widely by food vehicle and country. Only 2 of the 18 LSFF programs assessed met all 3 program performance criteria. The 2 main program bottlenecks were a poor choice of vehicle and failure to fortify a fortifiable vehicle (i.e., absence of fortification). Conclusions: The results highlight the importance of sound program design and routine monitoring and evaluation. There is strong evidence of the impact and cost-effectiveness of LSFF; however, impact can only be achieved when the necessary activities and processes during program design and implementation are followed. The FACT approach fills an important gap in the availability of standardized tools. The LSFF programs assessed here need to be re-evaluated to determine whether to further invest in the programs, whether other vehicles are appropriate, and whether other approaches are needed. PMID:28404836

Coverage of Large-Scale Food Fortification of Edible Oil, Wheat Flour, and Maize Flour Varies Greatly by Vehicle and Country but Is Consistently Lower among the Most Vulnerable: Results from Coverage Surveys in 8 Countries.

PubMed

Aaron, Grant J; Friesen, Valerie M; Jungjohann, Svenja; Garrett, Greg S; Neufeld, Lynnette M; Myatt, Mark

2017-05-01

Background: Large-scale food fortification (LSFF) of commonly consumed food vehicles is widely implemented in low- and middle-income countries. Many programs have monitoring information gaps and most countries fail to assess program coverage. Objective: The aim of this work was to present LSFF coverage survey findings (overall and in vulnerable populations) from 18 programs (7 wheat flour, 4 maize flour, and 7 edible oil programs) conducted in 8 countries between 2013 and 2015. Methods: A Fortification Assessment Coverage Toolkit (FACT) was developed to standardize the assessments. Three indicators were used to assess the relations between coverage and vulnerability: 1 ) poverty, 2 ) poor dietary diversity, and 3 ) rural residence. Three measures of coverage were assessed: 1 ) consumption of the vehicle, 2 ) consumption of a fortifiable vehicle, and 3 ) consumption of a fortified vehicle. Individual program performance was assessed based on the following: 1 ) achieving overall coverage ≥50%, 2) achieving coverage of ≥75% in ≥1 vulnerable group, and 3 ) achieving equity in coverage for ≥1 vulnerable group. Results: Coverage varied widely by food vehicle and country. Only 2 of the 18 LSFF programs assessed met all 3 program performance criteria. The 2 main program bottlenecks were a poor choice of vehicle and failure to fortify a fortifiable vehicle (i.e., absence of fortification). Conclusions: The results highlight the importance of sound program design and routine monitoring and evaluation. There is strong evidence of the impact and cost-effectiveness of LSFF; however, impact can only be achieved when the necessary activities and processes during program design and implementation are followed. The FACT approach fills an important gap in the availability of standardized tools. The LSFF programs assessed here need to be re-evaluated to determine whether to further invest in the programs, whether other vehicles are appropriate, and whether other approaches are needed.

Public health program capacity for sustainability: a new framework

PubMed Central

2013-01-01

Background Public health programs can only deliver benefits if they are able to sustain activities over time. There is a broad literature on program sustainability in public health, but it is fragmented and there is a lack of consensus on core constructs. The purpose of this paper is to present a new conceptual framework for program sustainability in public health. Methods This developmental study uses a comprehensive literature review, input from an expert panel, and the results of concept-mapping to identify the core domains of a conceptual framework for public health program capacity for sustainability. The concept-mapping process included three types of participants (scientists, funders, and practitioners) from several public health areas (e.g., tobacco control, heart disease and stroke, physical activity and nutrition, and injury prevention). Results The literature review identified 85 relevant studies focusing on program sustainability in public health. Most of the papers described empirical studies of prevention-oriented programs aimed at the community level. The concept-mapping process identified nine core domains that affect a program’s capacity for sustainability: Political Support, Funding Stability, Partnerships, Organizational Capacity, Program Evaluation, Program Adaptation, Communications, Public Health Impacts, and Strategic Planning. Concept-mapping participants further identified 93 items across these domains that have strong face validity—89% of the individual items composing the framework had specific support in the sustainability literature. Conclusions The sustainability framework presented here suggests that a number of selected factors may be related to a program’s ability to sustain its activities and benefits over time. These factors have been discussed in the literature, but this framework synthesizes and combines the factors and suggests how they may be interrelated with one another. The framework presents domains for public health decision makers to consider when developing and implementing prevention and intervention programs. The sustainability framework will be useful for public health decision makers, program managers, program evaluators, and dissemination and implementation researchers. PMID:23375082

The implementation effectiveness of the ‘Strengthen your ankle’ smartphone application for the prevention of ankle sprains: design of a randomized controlled trial

PubMed Central

2014-01-01

Background Ankle sprains continue to pose a significant burden to the individual athlete, as well as to society as a whole. However, despite ankle sprains being the single most common sports injury and despite an active approach by various Dutch organisations in implementing preventive measures, large-scale community uptake of these preventive measures, and thus actual prevention of ankle sprains, is lagging well behind. In an attempt to bridge this implementation gap, the Dutch Consumer Safety Institute VeiligheidNL developed a freely available interactive App (‘Strenghten your ankle’ translated in Dutch as: ‘Versterk je enkel; available for iOS and Android) that contains - next to general advice on bracing and taping - a proven cost-effective neuromuscular program. The ‘Strengthen your ankle’ App has not been evaluated against the ‘regular’ prevention approach in which the neuromuscular program is advocated through written material. The aim of the current project is to evaluate the implementation value of the ‘Strengthen your ankle’ App as compared to the usual practice of providing injured athletes with written materials. In addition, as a secondary outcome measure, the cost-effectiveness will be assessed against usual practice. Methods/Design The proposed study will be a randomised controlled trial. After stratification for medical caregiver, athletes will be randomised to two study groups. One group will receive a standardized eight-week proprioceptive training program that has proven to be cost-effective to prevent recurrent ankle injuries, consisting of a balance board (machU/ MSG Europe BVBA), and a traditional instructional booklet. The other group will receive the same exercise program and balance board. However, for this group the instructional booklet is exchanged by the interactive ‘Strengthen your ankle’ App. Discussion This trial is the first randomized controlled trial to study the implementation effectiveness of an App for proprioceptive balance board training program in comparison to a traditional printed instruction booklet, with the recurrence of ankle sprains among athletes as study outcome. Results of this study could possibly lead to changes in practical guidelines on the treatment of ankle sprains and in the use of mobile applications for injury prevention. Results will become available in 2014. Trial registration The Netherlands National Trial Register NTR4027. The NTR is part of the WHO Primary Registries. PMID:24393146

Adopting an Evidence-Based Lifestyle Physical Activity Program: Dissemination Study Design and Methods.

PubMed

Dunn, Andrea L; Buller, David B; Dearing, James W; Cutter, Gary; Guerra, Michele; Wilcox, Sara; Bettinghaus, Erwin P

2012-06-01

BACKGROUND: There is a scarcity of research studies that have examined academic-commercial partnerships to disseminate evidence-based physical activity programs. Understanding this approach to dissemination is essential because academic-commercial partnerships are increasingly common. Private companies have used dissemination channels and strategies to a degree that academicians have not, and declining resources require academicians to explore these partnerships. PURPOSE: This paper describes a retrospective case-control study design including the methods, demographics, organizational decision-making, implementation rates, and marketing strategy for Active Living Every Day (ALED), an evidence-based lifestyle physical activity program that has been commercially available since 2001. Evidence-based public health promotion programs rely on organizations and targeted sectors to disseminate these programs although relatively little is known about organizational-level and sector-level influences that lead to their adoption and implementation. METHODS: Cases (n=154) were eligible if they had signed an ALED license agreement with Human Kinetics (HK), publisher of the program's textbooks and facilitator manuals, between 2001 and 2008. Two types of controls were matched (2:2:1) and stratified by sector and region. Active controls (Control 1; n=319) were organizations that contacted HK to consider adopting ALED. Passive controls (Control 2; n=328) were organizations that received unsolicited marketing materials and did not initiate contact with HK. We used Diffusion of Innovations Theory (DIT) constructs as the basis for developing the survey of cases and controls. RESULTS: Using the multi-method strategy recommended by Dillman, a total of n=801 cases and controls were surveyed. Most organizations were from the fitness sector followed by medical, nongovernmental, governmental, educational, worksite and other sectors with significantly higher response rates from government, educational and medical sectors compared with fitness and other sectors, (p=0.02). More cases reported being involved in the decision to adopt ALED (p<0.0001). Data indicate that a low percentage of controls had ever heard of ALED despite repeated marketing and offering other types of physical activity programs and services. Finally, slightly over half of the adopters reported they had actually implemented the ALED program. CONCLUSION: Dissemination research requires new perspectives and designs to produce valid insights about the results of dissemination efforts. This study design, survey methods and theoretically-based questions can serve as a useful model for other evidence-based public health interventions that are marketed by commercial publishers to better understand key issues related to adoption and implementation of evidence-based programs.

Comparing estimates of child mortality reduction modelled in LiST with pregnancy history survey data for a community-based NGO project in Mozambique

PubMed Central

2011-01-01

Background There is a growing body of evidence that integrated packages of community-based interventions, a form of programming often implemented by NGOs, can have substantial child mortality impact. More countries may be able to meet Millennium Development Goal (MDG) 4 targets by leveraging such programming. Analysis of the mortality effect of this type of programming is hampered by the cost and complexity of direct mortality measurement. The Lives Saved Tool (LiST) produces an estimate of mortality reduction by modelling the mortality effect of changes in population coverage of individual child health interventions. However, few studies to date have compared the LiST estimates of mortality reduction with those produced by direct measurement. Methods Using results of a recent review of evidence for community-based child health programming, a search was conducted for NGO child health projects implementing community-based interventions that had independently verified child mortality reduction estimates, as well as population coverage data for modelling in LiST. One child survival project fit inclusion criteria. Subsequent searches of the USAID Development Experience Clearinghouse and Child Survival Grants databases and interviews of staff from NGOs identified no additional projects. Eight coverage indicators, covering all the project’s technical interventions were modelled in LiST, along with indicator values for most other non-project interventions in LiST, mainly from DHS data from 1997 and 2003. Results The project studied was implemented by World Relief from 1999 to 2003 in Gaza Province, Mozambique. An independent evaluation collecting pregnancy history data estimated that under-five mortality declined 37% and infant mortality 48%. Using project-collected coverage data, LiST produced estimates of 39% and 34% decline, respectively. Conclusions LiST gives reasonably accurate estimates of infant and child mortality decline in an area where a package of community-based interventions was implemented. This and other validation exercises support use of LiST as an aid for program planning to tailor packages of community-based interventions to the epidemiological context and for project evaluation. Such targeted planning and assessments will be useful to accelerate progress in reaching MDG4 targets. PMID:21501454

Parallel mutual information estimation for inferring gene regulatory networks on GPUs

PubMed Central

2011-01-01

Background Mutual information is a measure of similarity between two variables. It has been widely used in various application domains including computational biology, machine learning, statistics, image processing, and financial computing. Previously used simple histogram based mutual information estimators lack the precision in quality compared to kernel based methods. The recently introduced B-spline function based mutual information estimation method is competitive to the kernel based methods in terms of quality but at a lower computational complexity. Results We present a new approach to accelerate the B-spline function based mutual information estimation algorithm with commodity graphics hardware. To derive an efficient mapping onto this type of architecture, we have used the Compute Unified Device Architecture (CUDA) programming model to design and implement a new parallel algorithm. Our implementation, called CUDA-MI, can achieve speedups of up to 82 using double precision on a single GPU compared to a multi-threaded implementation on a quad-core CPU for large microarray datasets. We have used the results obtained by CUDA-MI to infer gene regulatory networks (GRNs) from microarray data. The comparisons to existing methods including ARACNE and TINGe show that CUDA-MI produces GRNs of higher quality in less time. Conclusions CUDA-MI is publicly available open-source software, written in CUDA and C++ programming languages. It obtains significant speedup over sequential multi-threaded implementation by fully exploiting the compute capability of commonly used CUDA-enabled low-cost GPUs. PMID:21672264

“Working to shape what society's expectations of us should be”: Philip Morris' societal alignment strategy

PubMed Central

Yang, J S; Malone, R E

2009-01-01

Background A key element of Philip Morris's (PM's) corporate social responsibility initiatives is “societal alignment”, defined as “strategies and programs to meet society's expectations of a responsible tobacco company”. This study explored the genesis and implementation of Philip Morris' (PM) societal alignment efforts. Methods The study retrieved and analysed approximately 375 previously undisclosed PM documents now available electronically. Using an iterative process, the study categorised themes and prepared a case analysis. Results Beginning in 1999, PM sought to become “societally aligned” by identifying expectations of a responsible tobacco company through public opinion research and developing and publicising programs to meet those expectations. Societal alignment was undertaken within the US and globally to ensure an environment favourable to PM's business objectives. Despite PM's claims to be “changing”, however, societal alignment in practice was highly selective. PM responded to public “expectations” largely by retooling existing positions and programs, while entirely ignoring other expectations that might have interfered with its business goals. It also appears that convincing employees of the value and authenticity of societal alignment was difficult. Conclusions As implementation of the Framework Convention on Tobacco Control proceeds, tobacco control advocates should closely monitor development of such “alignment” initiatives and expose the motivations and contradictions they reveal. PMID:18845623

Assessment of eight HPV vaccination programs implemented in lowest income countries

PubMed Central

2012-01-01

Background Cervix cancer, preventable, continues to be the third most common cancer in women worldwide, especially in lowest income countries. Prophylactic HPV vaccination should help to reduce the morbidity and mortality associated with cervical cancer. The purpose of the study was to describe the results of and key concerns in eight HPV vaccination programs conducted in seven lowest income countries through the Gardasil Access Program (GAP). Methods The GAP provides free HPV vaccine to organizations and institutions in lowest income countries. The HPV vaccination programs were entirely developed, implemented and managed by local institutions. Institutions submitted application forms with institution characteristics, target population, communication delivery strategies. After completion of the vaccination campaign (3 doses), institutions provided a final project report with data on doses administered and vaccination models. Two indicators were calculated, the program vaccination coverage and adherence. Qualitative data were also collected in the following areas: government and community involvement; communication, and sensitization; training and logistics resources, and challenges. Results A total of eight programs were implemented in seven countries. The eight programs initially targeted a total of 87,580 girls, of which 76,983 received the full 3-dose vaccine course, with mean program vaccination coverage of 87.8%; the mean adherence between the first and third doses of vaccine was 90.9%. Three programs used school-based delivery models, 2 used health facility-based models, and 3 used mixed models that included schools and health facilities. Models that included school-based vaccination were most effective at reaching girls aged 9-13 years. Mixed models comprising school and health facility-based vaccination had better overall performance compared with models using just one of the methods. Increased rates of program coverage and adherence were positively correlated with the number of vaccination sites. Qualitative key insights from the school models showed a high level of coordination and logistics to facilitate vaccination administration, a lower risk of girls being lost to follow-up and vaccinations conducted within the academic year limit the number of girls lost to follow-up. Conclusion Mixed models that incorporate both schools and health facilities appear to be the most effective at delivering HPV vaccine. This study provides lessons for development of public health programs and policies as countries go forward in national decision-making for HPV vaccination. PMID:22621342

Internet-based computer technology on radiotherapy.

PubMed

Chow, James C L

2017-01-01

Recent rapid development of Internet-based computer technologies has made possible many novel applications in radiation dose delivery. However, translational speed of applying these new technologies in radiotherapy could hardly catch up due to the complex commissioning process and quality assurance protocol. Implementing novel Internet-based technology in radiotherapy requires corresponding design of algorithm and infrastructure of the application, set up of related clinical policies, purchase and development of software and hardware, computer programming and debugging, and national to international collaboration. Although such implementation processes are time consuming, some recent computer advancements in the radiation dose delivery are still noticeable. In this review, we will present the background and concept of some recent Internet-based computer technologies such as cloud computing, big data processing and machine learning, followed by their potential applications in radiotherapy, such as treatment planning and dose delivery. We will also discuss the current progress of these applications and their impacts on radiotherapy. We will explore and evaluate the expected benefits and challenges in implementation as well.

Practice-Based Learning and Improvement for Institutions: A Case Report

PubMed Central

Kirk, Susan E.; Howell, R. Edward

2010-01-01

Background In 2006, the University of Virginia became one of the first academic medical institutions to be placed on probation, after the Accreditation Council for Graduate Medical Education (ACGME) Institutional Review Committee implemented a new classification system for institutional reviews. Intervention After University of Virginia reviewed its practices and implemented needed changes, the institution was able to have probation removed and full accreditation restored. Whereas graduate medical education committees and designated institutional officials are required to conduct internal reviews of each ACGME–accredited program midway through its accreditation cycle, no similar requirement exists for institutions. Learning As we designed corrective measures at the University of Virginia, we realized that regularly scheduled audits of the entire institution would have prevented the accumulation of deficiencies. We suggest that institutional internal reviews be implemented to ensure that the ACGME institutional requirements for graduate medical education are met. This process represents practice-based learning and improvement at the institutional level and may prevent other institutions from receiving unfavorable accreditation decisions. PMID:22132290

Impact of an Educational Program to Reduce Healthcare Resources in Community-Acquired Pneumonia: The EDUCAP Randomized Controlled Trial

PubMed Central

Simonetti, Antonella; Jiménez-Martínez, Emilio; Molero, Lorena; González-Samartino, Maribel; Castillo, Elena; Juvé-Udina, María-Eulalia; Alcocer, María-Jesús; Hernández, Carme; Buera, María-Pilar; Roel, Asunción; Abad, Emilia; Zabalegui, Adelaida; Ricart, Pilar; Gonzalez, Anna; Isla, Pilar; Dorca, Jordi; Garcia-Vidal, Carolina

2015-01-01

Background Additional healthcare visits and rehospitalizations after discharge are frequent among patients with community-acquired pneumonia (CAP) and have a major impact on healthcare costs. We aimed to determine whether the implementation of an individualized educational program for hospitalized patients with CAP would decrease subsequent healthcare visits and readmissions within 30 days of hospital discharge. Methods A multicenter, randomized trial was conducted from January 1, 2011 to October 31, 2014 at three hospitals in Spain. We randomly allocated immunocompetent adults patients hospitalized for CAP to receive either an individualized educational program or conventional information before discharge. The educational program included recommendations regarding fluid intake, adherence to drug therapy and preventive vaccines, knowledge and management of the disease, progressive adaptive physical activity, and counseling for alcohol and smoking cessation. The primary trial endpoint was a composite of the frequency of additional healthcare visits and rehospitalizations within 30 days of hospital discharge. Intention-to-treat analysis was performed. Results We assigned 102 patients to receive the individualized educational program and 105 to receive conventional information. The frequency of the composite primary end point was 23.5% following the individualized program and 42.9% following the conventional information (difference, -19.4%; 95% confidence interval, -6.5% to -31.2%; P = 0.003). Conclusions The implementation of an individualized educational program for hospitalized patients with CAP was effective in reducing subsequent healthcare visits and rehospitalizations within 30 days of discharge. Such a strategy may help optimize available healthcare resources and identify post-acute care needs in patients with CAP. Trial Registration Controlled-Trials.com ISRCTN39531840 PMID:26460907

Assessing Opportunities to Enhance Comprehensive Health Promotion and Wellness Programming in a State Community College System.

PubMed

Linnan, Laura A; Arandia, Gabriela; Naseer, Carolyn; Li, Jiang; Pomerantz, Meg; Diehl, Sandra J

2017-01-01

BACKGROUND North Carolina has the third largest community college system in the nation and reaches residents in all 100 counties. Few studies have focused on the health of employees who work at these institutions. We assessed the current status of and interest in supporting health promotion efforts among North Carolina Community College System members. METHODS North Carolina Community College System presidents completed a brief 15-item survey assessing support for and interest in offering health promotion programs. Wellness coordinators completed a 60-item questionnaire assessing current health promotion programming and organizational, environmental, and policy supports for health promotion efforts. Onsite interviews with a sub-sample of Wellness coordinators offered insights into important implementation considerations. We examined differences by campus size with Fisher's exact test. RESULTS All 58 presidents (100%) and 51 wellness coordinators (88%) completed surveys. Ten percent of colleges offered comprehensive employee health promotion programming. Most offered physical activity (70.6%), tobacco cessation (51.0%), weight loss/management (49.0%), and/or nutrition counseling (47.1%). Larger colleges were more likely to offer programming and environmental support. Nearly all presidents (89.7%) believed it is "very" or "extremely" important to offer health promotion programs to employees, and most (84%) were interested in promoting health through a university partnership. LIMITATIONS Despite very high survey response rates from presidents and wellness coordinators at each community college, onsite interviews were only done at select campuses, limiting the generalizability and scope of conclusions derived from interview data. CONCLUSION Community colleges in North Carolina are promising settings for promoting employee health. Findings identify resources, barriers, and technical assistance that could facilitate greater adoption and implementation of programs. ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Successful implementation of a wellness and tobacco cessation curriculum in psychosocial rehabilitation clubhouses

PubMed Central

2011-01-01

Background Tobacco remains a seemingly intractable problem for individuals living with severe and persistent mental illness. This study evaluated the implementation, technical assistance, and perceived impact of a model curriculum ("Learning About Healthy Living") to promote wellness and motivation to quit tobacco use in psychosocial rehabilitation clubhouses. Methods We used semi-structured interviews (n = 9) with clubhouse staff (n = 12) and a survey of participating clubhouse members (n = 271) in nine clubhouses. Results Fifty-eight percent of clubhouse participants completed surveys. Results showed tobacco users open to tobacco-free policies (62%) and perceiving more discussions about quitting tobacco with healthcare providers (69%). Analyses of staff interviews and member surveys revealed four key themes: (1) the curriculum was successfully implemented and appreciated; (2) technical assistance kept implementation on track; (3) adding wellness content and interactive components should enhance the curriculum; and, (4) the curriculum advanced other healthful policies and practices. Conclusions Mental health settings are important locations for implementing programs to address tobacco use. In this real-world implementation of a model curriculum in psychosocial rehabilitation clubhouses, the curriculum tested well, was feasible and well-received, and suggests potential impact on tobacco use outcomes. Revision, dissemination, and a randomized controlled trial evaluation of the model curriculum should now occur. PMID:21917179

The Feasibility and Acceptability of a Web-Based Alcohol Management Intervention in Community Sports Clubs: A Cross-Sectional Study

PubMed Central

Wolfenden, Luke; Wiggers, John; Tindall, Jenny; Yoong, Sze Lin; Lecathelinais, Christophe; Gillham, Karen; Sherker, Shauna; Rowland, Bosco; McLaren, Nicola; Kingsland, Melanie

2017-01-01

Background The implementation of comprehensive alcohol management strategies can reduce excessive alcohol use and reduce the risk of alcohol-related harm at sporting venues. Supporting sports venues to implement alcohol management strategies via the Web may represent an effective and efficient means of reducing harm caused by alcohol in this setting. However, the feasibility and acceptability of such an approach is unknown. Objective This study aimed to identify (1) the current access to and use of the Web and electronic devices by sports clubs; (2) the perceived usefulness, ease of use, and intention to use a Web-based program to support implementation of alcohol management policies in sports clubs; (3) the factors associated with intention to use such a Web-based support program; and (4) the specific features of such a program that sports clubs would find useful. Methods A cross-sectional survey was conducted with club administrators of community football clubs in the state of New South Wales, Australia. Perceived usefulness, ease of use and intention to use a hypothetical Web-based alcohol management support program was assessed using the validated Technology Acceptance Model (TAM) instrument. Associations between intention to use a Web-based program and club characteristics as well as perceived ease of use and usefulness was tested using Fisher’s exact test and represented using relative risk (RR) for high intention to use the program. Results Of the 73 football clubs that were approached to participate in the study, 63 consented to participate and 46 were eligible and completed the survey. All participants reported having access to the Web and 98% reported current use of electronic devices (eg, computers, iPads/tablets, smartphones, laptops, televisions, and smartboards). Mean scores (out of a possible 7) for the TAM constructs were high for intention to use (mean 6.25, SD 0.87), perceived ease of use (mean 6.00, SD 0.99), and perceived usefulness (mean 6.17, SD 0.85). Intention to use the Web-based alcohol management program was significantly associated with perceived ease of use (P=.02, RR 1.4, CI 1.0-2.9), perceived usefulness (P=.03, RR 1.5, CI 1.0-6.8) and club size (P=.02, RR 0.8, CI 0.5-0.9). The most useful features of such a program included the perceived ability to complete program requirements within users’ own time, complete program accreditation assessment and monitoring online, develop tailored action plans, and receive email reminders and prompts to complete action. Conclusions A Web-based alcohol management approach to support sports clubs in the implementation of recommended alcohol management policies appears both feasible and acceptable. Future research should aim to determine if such intended use leads to actual use and club implementation of alcohol management policies. PMID:28666977

Effective Tools and Resources from the MAVEN Education and Public Outreach Program

NASA Astrophysics Data System (ADS)

Mason, T.

2015-12-01

Since 2010, NASA's Mars Atmosphere and Volatile Evolution (MAVEN) Education and Public Outreach (E/PO) team has developed and implemented a robust and varied suite of projects, serving audiences of all ages and diverse backgrounds from across the country. With a program designed to reach formal K-12 educators and students, afterschool and summertime communities, museum docents, journalists, and online audiences, we have incorporated an equally varied approach to developing tools, resources, and evaluation methods to specifically reach each target population and to determine the effectiveness of our efforts. This poster will highlight some of the tools and resources we have developed to share the complex science and engineering of the MAVEN mission, as well as initial evaluation results and lessons-learned from each of our E/PO projects.

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

Enhanced Graphics for Extended Scale Range

NASA Technical Reports Server (NTRS)

Hanson, Andrew J.; Chi-Wing Fu, Philip

2012-01-01

Enhanced Graphics for Extended Scale Range is a computer program for rendering fly-through views of scene models that include visible objects differing in size by large orders of magnitude. An example would be a scene showing a person in a park at night with the moon, stars, and galaxies in the background sky. Prior graphical computer programs exhibit arithmetic and other anomalies when rendering scenes containing objects that differ enormously in scale and distance from the viewer. The present program dynamically repartitions distance scales of objects in a scene during rendering to eliminate almost all such anomalies in a way compatible with implementation in other software and in hardware accelerators. By assigning depth ranges correspond ing to rendering precision requirements, either automatically or under program control, this program spaces out object scales to match the precision requirements of the rendering arithmetic. This action includes an intelligent partition of the depth buffer ranges to avoid known anomalies from this source. The program is written in C++, using OpenGL, GLUT, and GLUI standard libraries, and nVidia GEForce Vertex Shader extensions. The program has been shown to work on several computers running UNIX and Windows operating systems.

Educational Approaches When Implementing the Next Generation Science Standards

NASA Astrophysics Data System (ADS)

Dwyer, Brian

This paper overviews the history of science education from the launch of Sputnik through reform movements and associated legislation to the most recent Next Generation Science Standards (NGSS). The paper also considers stakeholder groups that would need to be involved if NGSS is to be implemented properly, including teachers, parents and unions. Each group holds a responsibility within a school system that needs to be addressed from a practical standpoint to increase the likelihood of the effective adoption of the Next Generation Science Standards. This paper provides background and program information about the Next Generation Science Standards (NGSS). It also considers the educational, philosophical, and instructional approach known as inquiry which is strongly advocated by NGSS and explores where and how other well-studied instructional approaches might have a place within an inquiry-based classroom.

Policies and Programs to Facilitate Access to Targeted Cancer Therapies in Thailand

PubMed Central

Sruamsiri, Rosarin; Ross-Degnan, Dennis; Lu, Christine Y.; Chaiyakunapruk, Nathorn; Wagner, Anita K.

2015-01-01

Background Increasing access to clinically beneficial targeted cancer medicines is a challenge in every country due to their high cost. We describe the interplay of innovative policies and programs involving multiple stakeholders to facilitate access to these medicines in Thailand, as well as the utilization of selected targeted therapies over time. Methods We selected two medicines on the 2013 Thai national list of essential medicines (NLEM) [letrozole and imatinib] and three unlisted medicines for the same indications [trastuzumab, nilotinib and dasatinib]. We created timelines of access policies and programs for these products based on scientific and grey literature. Using IMS Health sales data, we described the trajectories of sales volumes of the study medicines between January 2001 and December 2012. We compared estimated average numbers of patients treated before and after the implementation of policies and programs for each product. Results Different stakeholders implemented multiple interventions to increase access to the study medicines for different patient populations. During 2007–2009, the Thai Government created a special NLEM category with different coverage requirements for payers and issued compulsory licenses; payers negotiated prices with manufacturers and engaged in pooled procurement; pharmaceutical companies expanded patient assistance programs and lowered prices in different ways. Compared to before the interventions, estimated numbers of patients treated with each medicine increased significantly afterwards: for letrozole from 645 (95% CI 366–923) to 3683 (95% CI 2,748–4,618); for imatinib from 103 (95% CI 72–174) to 350 (95% CI 307–398); and for trastuzumab from 68 (95% CI 45–118) to 412 (95% CI 344–563). Conclusions Government, payers, and manufacturers implemented multi-pronged approaches to facilitate access to targeted cancer therapies for the Thai population, which differed by medicine. Routine monitoring is needed to assess clinical and economic impacts of these strategies in the health system. PMID:25798948

The process of developing and implementing a telephone-based peer support program for postpartum depression: evidence from two randomized controlled trials

PubMed Central

2014-01-01

Background A randomized controlled trial evaluated the effect of telephone-based peer support on preventing postpartum depression (PPD) among high-risk mothers. The results indicated that support provided by peer volunteers may be an effective preventative strategy. The purpose of this paper is to outline the process of developing, implementing, maintaining, and evaluating the peer support program that we used in this PPD prevention trial. Methods The peer support program had been used successfully in a pilot trial and a previous breastfeeding peer support trial. Based on our experience and lessons learned, we developed a 4-phase, 12-step approach so that the peer support model could be copied and used by different health providers in various settings. We will use the PPD prevention trial to demonstrate the suggested steps. Results The trial aim to prevent the onset of PPD was established. Peer volunteers who previously experienced and recovered from self-reported PPD were recruited and attended a four-hour training session. Volunteers were screened and those identified as appropriate to provide support to postpartum mothers were selected. Women who scored more than 9 on the Edinburgh Postnatal Depression Scale within the first two weeks after childbirth were recruited to participate in the trial and proactive, individualized, telephone-based peer support (mother-to-mother) was provided to those randomized to the intervention group. Peer volunteers maintained the intervention, supported other volunteers, and evaluated the telephone-based support program. Possible negative effects of the intervention were assessed. An in-depth assessment of maternal perspectives of the program at 12 weeks postpartum was performed. Conclusions The 4-phase, 12-step approach delineated in this paper provides clear and concise guidelines for health professionals to follow in creating and implementing community-based, peer-support interventions with the potential to prevent PPD. Trial registration Current Controlled Trials ISRCTN68337727. PMID:24742217

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

PubMed

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

2017-12-01

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

The Healthy Class of 2010: Utilization of the School Health Index to Build Collaboration Between a University and an Urban School District

PubMed Central

Fryer, Craig S.; Reed, Ernestine A.; Thomas, Stephen B.

2014-01-01

BACKGROUND Insufficient attention has been paid to the process of conducting the Centers for Disease Control and Prevention’s School Health Index (SHI) to promote collaboration between universities and urban school districts when developing adolescent health promotion initiatives. This article provides an overview of the real world contextual challenges and opportunities this type of collaboration can pose. METHODS The SHI and selected collaboration principles were used to facilitate partnership and increase stakeholder buy-in, which led to developing and implementing an eight year health promotion campaign, The Healthy Class of 2010 (HC 2010). RESULTS The focus on planning brought together key stakeholders and allowed for HC 2010 programming to take place despite the competing demands on the schools. The SHI allowed for input from stakeholders to develop campaign activities and inform school- and district-wide policy. Universities and school districts desiring to develop and implement school-based, adolescent health promotion programs should: 1) identify the hierarchical structure of the school district; 2) establish credibility for the program and the university staff; 3) emphasize the benefits to all partners; 4) maintain a cooperative partnership with teachers and administrators; 5) appreciate the need for planning; and, 6) provide as many resources as possible to on an already overburdened school system. CONCLUSIONS Promoting healthy behaviors among students is an important part of the fundamental mission of schools. HC 2010 underscored the significance of collaboration using the SHI in the development and implementation of this health promotion campaign with input from students, teachers, administrators and university partners. PMID:22070509

Factors affecting evidence-based decision making in local health departments.

PubMed

Sosnowy, Collette D; Weiss, Linda J; Maylahn, Christopher M; Pirani, Sylvia J; Katagiri, Nancy J

2013-12-01

Data indicating the extent to which evidence-based decision making (EBDM) is used in local health departments (LHDs) are limited. This study aims to determine use of decision-making processes by New York State LHD leaders and upper-level staff and identify facilitators and barriers to the use of EBDM in LHDs. The New York Public Health Practice-Based Research Network implemented a mixed-methods study in 31 LHDs. There were 20 individual interviews; five small-group interviews (two or three participants each); and two focus groups (eight participants each) conducted with people who had decision-making authority. Information was obtained about each person's background and position, decision-making responsibilities, how decisions are made within their LHD, knowledge and experience with EBDM, use of each step of the EBDM process, and barriers and facilitators to EBDM implementation. Data were collected from June to November 2010 and analyzed in 2011. Overall, participants supported EBDM and expressed a desire to increase their department's use of it. Although most people understood the concept, a relatively small number had substantial expertise and experience with its practice. Many indicated that they applied EBDM unevenly. Factors associated with use of EBDM included strong leadership; workforce capacity (number and skills); resources; funding and program mandates; political support; and access to data and program models suitable to community conditions. EBDM is used inconsistently in LHDs in New York. Despite knowledge and interest among LHD leadership, the LHD capacity, resources, appropriate programming, and other issues serve as impediments to EBDM and optimal implementation of evidence-based strategies. Published by Elsevier Inc.

Heterogeneous computing architecture for fast detection of SNP-SNP interactions

PubMed Central

2014-01-01

Background The extent of data in a typical genome-wide association study (GWAS) poses considerable computational challenges to software tools for gene-gene interaction discovery. Exhaustive evaluation of all interactions among hundreds of thousands to millions of single nucleotide polymorphisms (SNPs) may require weeks or even months of computation. Massively parallel hardware within a modern Graphic Processing Unit (GPU) and Many Integrated Core (MIC) coprocessors can shorten the run time considerably. While the utility of GPU-based implementations in bioinformatics has been well studied, MIC architecture has been introduced only recently and may provide a number of comparative advantages that have yet to be explored and tested. Results We have developed a heterogeneous, GPU and Intel MIC-accelerated software module for SNP-SNP interaction discovery to replace the previously single-threaded computational core in the interactive web-based data exploration program SNPsyn. We report on differences between these two modern massively parallel architectures and their software environments. Their utility resulted in an order of magnitude shorter execution times when compared to the single-threaded CPU implementation. GPU implementation on a single Nvidia Tesla K20 runs twice as fast as that for the MIC architecture-based Xeon Phi P5110 coprocessor, but also requires considerably more programming effort. Conclusions General purpose GPUs are a mature platform with large amounts of computing power capable of tackling inherently parallel problems, but can prove demanding for the programmer. On the other hand the new MIC architecture, albeit lacking in performance reduces the programming effort and makes it up with a more general architecture suitable for a wider range of problems. PMID:24964802

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion.

PubMed

Palinkas, Lawrence A; Campbell, Mark; Saldana, Lisa

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion

PubMed Central

Palinkas, Lawrence A.; Campbell, Mark; Saldana, Lisa

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation. PMID:29896471

Developing Community-Based Rehabilitation Programs for Musculoskeletal Diseases in Low-Income Areas of Mexico: The Community-Based Rehabilitation for Low-Income Communities Living With Rheumatic Diseases (CONCORD) Protocol

PubMed Central

2014-01-01

Background The negative impact of musculoskeletal diseases on the physical function and quality of life of people living in developing countries is considerable. This disabling effect is even more marked in low-socioeconomic communities within developing countries. In Mexico, there is a need to create community-based rehabilitation programs for people living with musculoskeletal diseases in low-socioeconomic areas. These programs should be directed to prevent and decrease disability, accommodating the specific local culture of communities. Objective The objective of this paper is to describe a research protocol designed to develop, implement, and evaluate culturally sensitive community-based rehabilitation programs aiming to decrease disability of people living with musculoskeletal diseases in two low-income Mexican communities. Methods A community-based participatory research approach is proposed, including multi and transdisciplinary efforts among the community, medical anthropology, and the health sciences. The project is structured in 4 main stages: (1) situation analysis, (2) program development, (3) program implementation, and (4) program evaluation. Each stage includes the use of quantitative and qualitative methods (mixed method program). Results So far, we obtained resources from a Mexican federal agency and completed stage one of the project at Chankom, Yucatán. We are currently receiving funding from an international agency to complete stage two at this same location. We expect that the project at Chankom will be concluded by December of 2017. On the other hand, we just started the execution of stage one at Nuevo León with funding from a Mexican federal agency. We expect to conclude the project at this site by September of 2018. Conclusions Using a community-based participatory research approach and a mixed method program could result in the creation of culturally sensitive community-based rehabilitation programs that promote community development and decrease the disabling effects of musculoskeletal diseases within two low-income Mexican communities. PMID:25474820

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

ERIC Educational Resources Information Center

Gerstner, Jerusha J.; Finney, Sara J.

2013-01-01

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

Design and Hospital-Wide Implementation of a Standardized Discharge Summary in an Electronic Health Record

PubMed Central

Dean, Shannon M; Gilmore-Bykovskyi, Andrea; Buchanan, Joel; Ehlenfeldt, Brad; Kind, Amy JH

2016-01-01

Background The hospital discharge summary is the primary method used to communicate a patient's plan of care to the next provider(s). Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to post-hospital care, incomplete discharge summaries remain a common problem that may contribute to poor post-hospital outcomes. Electronic health records (EHRs) are regularly used as a platform upon which standardization of content and format can be implemented. Objective We describe here the design and hospital-wide implementation of a standardized discharge summary using an EHR. Methods We employed the evidence-based Replicating Effective Programs implementation strategy to guide the development and implementation during this large-scale project. Results Within 18 months, 90% of all hospital discharge summaries were written using the standardized format. Hospital providers found the template helpful and easy to use, and recipient providers perceived an improvement in the quality of discharge summaries compared to those sent from our hospital previously. Conclusions Discharge summaries can be standardized and implemented hospital-wide with both author and recipient provider satisfaction, especially if evidence-based implementation strategies are employed. The use of EHR tools to guide clinicians in writing comprehensive discharge summaries holds promise in improving the existing deficits in communication at transitions of care. PMID:28334559

Sustainability of teacher implementation of school-based mental health programs.

PubMed

Han, Susan S; Weiss, Bahr

2005-12-01

Evidence-based prevention and intervention programs are increasingly being implemented in schools and it therefore is becoming increasingly important to understand the complexities of program implementation under real-world conditions. Much research has focused on the contextual factors that influence program implementation but less work has attempted to provide an integrated understanding of mechanisms (e.g., teacher-training processes) that affect teachers' program implementation. In this paper, we review literature on factors related to teachers' implementation of school-based prevention and intervention programs, then from this review abstract what we believe are four basic ingredients that characterize potentially sustainable teacher-implemented classroom programs. Finally, we present a sequential model, based on these ingredients, of the naturalistic processes underlying sustainability of teachers' program implementation and describe how this sustainability can be enhanced through provision of teacher training and performance feedback from a classroom consultant.

A case study of polypharmacy management in nine European countries: Implications for change management and implementation

PubMed Central

MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F.; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

2018-01-01

Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives. PMID:29668763

Implementation of a study to examine the persistence of Ebola virus in the body fluids of Ebola virus disease survivors in Sierra Leone: Methodology and lessons learned

PubMed Central

Marrinan, Jaclyn E.; Sesay, Foday R.; Ervin, Elizabeth; Thorson, Anna E.; Xu, Wenbo; Ströher, Ute; Ongpin, Patricia; Abad, Neetu; Ariyarajah, Archchun; Malik, Tasneem; Liu, Hongtu; Ross, Christine; Durski, Kara N.; Gaillard, Philippe; Morgan, Oliver; Formenty, Pierre; Knust, Barbara; Broutet, Nathalie; Sahr, Foday

2017-01-01

Background The 2013–2016 West African Ebola virus disease epidemic was unprecedented in terms of the number of cases and survivors. Prior to this epidemic there was limited data available on the persistence of Ebola virus in survivors’ body fluids and the potential risk of transmission, including sexual transmission. Methodology/Principal findings Given the urgent need to determine the persistence of Ebola virus in survivors’ body fluids, an observational cohort study was designed and implemented during the epidemic response operation in Sierra Leone. This publication describes study implementation methodology and the key lessons learned. Challenges encountered during implementation included unforeseen duration of follow-up, complexity of interpreting and communicating laboratory results to survivors, and the urgency of translating research findings into public health practice. Strong community engagement helped rapidly implement the study during the epidemic. The study was conducted in two phases. The first phase was initiated within five months of initial protocol discussions and assessed persistence of Ebola virus in semen of 100 adult men. The second phase assessed the persistence of virus in multiple body fluids (semen or vaginal fluid, menstrual blood, breast milk, and urine, rectal fluid, sweat, saliva, tears), of 120 men and 120 women. Conclusion/Significance Data from this study informed national and global guidelines in real time and demonstrated the need to implement semen testing programs among Ebola virus disease survivors. The lessons learned and study tools developed accelerated the implementation of such programs in Ebola virus disease affected countries, and also informed studies examining persistence of Zika virus. Research is a vital component of the public health response to an epidemic of a poorly characterized disease. Adequate resources should be rapidly made available to answer critical research questions, in order to better inform response efforts. PMID:28892501

Informed decision-making with and for people with dementia: Developing and pilot testing an education program for legal representatives (PRODECIDE).

PubMed

Lühnen, Julia; Mühlhauser, Ingrid; Richter, Tanja

2017-01-01

Background People living with dementia are often appointed a legal representative, to support and protect their ethical and legal rights to informed healthcare decisions. However, legal representatives usually have no qualifications in healthcare. Objective The aim of this study was to explore decision-making processes with participation of legal representatives and, resulting from this, to develop and pilot test an education program for legal representatives in Germany. Methods We conducted interviews with legal representatives and senior citizens about decision-making processes in healthcare, with special focus on percutaneous endoscopic gastrostomy, physical restraints, and prescription of antipsychotics for people with dementia. We generated a curriculum based on systematic literature searches and the results of these interviews. We tested the education program for comprehensibility, feasibility, usability, and acceptance. Results Personal interviews with voluntary ( n = 12) and professional ( n = 12) representatives, and senior citizens ( n = 14) were conducted. Preferences, attitudes, and wishes regarding percutaneous endoscopic gastrostomy, physical restraints, and antipsychotics, and the process of decision-making, were heterogeneous. A structural approach is lacking. The education program proxy-decison-making (PRODECIDE) comprises four modules: (A) decision-making processes and methods; (B-D) evidence-based knowledge about percutaneous endoscopic gastrostomy, physical restraints, and antipsychotics. We conducted eight trainings with 47 legal representatives. PRODECIDE was well accepted. Comprehensibility of contents and materials was rated high. The program seems feasible for implementation. Conclusion PRODECIDE seems suitable to improve the decision-making processes of legal representatives in Germany. Implementation will be appropriate if efficacy is proven; a randomized controlled trial is currently underway.

Structural Optimization Methodology for Rotating Disks of Aircraft Engines

NASA Technical Reports Server (NTRS)

Armand, Sasan C.

1995-01-01

In support of the preliminary evaluation of various engine technologies, a methodology has been developed for structurally designing the rotating disks of an aircraft engine. The structural design methodology, along with a previously derived methodology for predicting low-cycle fatigue life, was implemented in a computer program. An interface computer program was also developed that gathers the required data from a flowpath analysis program (WATE) being used at NASA Lewis. The computer program developed for this study requires minimum interaction with the user, thus allowing engineers with varying backgrounds in aeropropulsion to successfully execute it. The stress analysis portion of the methodology and the computer program were verified by employing the finite element analysis method. The 10th- stage, high-pressure-compressor disk of the Energy Efficient Engine Program (E3) engine was used to verify the stress analysis; the differences between the stresses and displacements obtained from the computer program developed for this study and from the finite element analysis were all below 3 percent for the problem solved. The computer program developed for this study was employed to structurally optimize the rotating disks of the E3 high-pressure compressor. The rotating disks designed by the computer program in this study were approximately 26 percent lighter than calculated from the E3 drawings. The methodology is presented herein.

The relative efficacy of pamphlets, CD-ROM, and the Internet for disseminating adolescent drug abuse prevention programs: an exploratory study⋆

PubMed Central

Di Noia, Jennifer; Schwinn, Traci M.; Dastur, Zubin A.; Schinke, Steven P.

2010-01-01

Background Despite the availability of an increasing array of empirically validated adolescent drug abuse prevention programs, program materials and evaluation findings are poorly disseminated. CD-ROM and the Internet hold promise for disseminating this information to schools and agencies that directly serve youth, and to policy-making bodies that exercise control over funds to support adolescent drug abuse prevention programming. However, data on the relative efficacy of these newer technologies over conventional print means of dissemination are lacking. Methods Recruited through schools, community agencies, and policy-making bodies, 188 professionals were randomized to receive prevention program materials via pamphlets (55 participants), CD-ROM (64 participants), and the Internet (69 participants). Participants completed pretest, posttest, and 6-month follow-up measures that assessed their access to prevention program materials; self-efficacy for identifying, obtaining, and recommending these programs; and their likelihood of requesting, implementing, and recommending prevention programs to their constituents. Results Participants exposed to dissemination via CD-ROM and the Internet evidenced the greatest short- and long-term gains on accessibility, self-efficacy, and behavioral intention variables. Conclusions CD-ROM and the Internet are viable means for disseminating adolescent drug abuse prevention programs to schools, community agencies, and policy-making bodies, and should be increasingly used for dissemination purposes. PMID:14636798

Dissemination of the CDC's Hand Hygiene Guideline and impact on infection rates

PubMed Central

Larson, Elaine L.; Quiros, Dave; Lin, Susan X.

2007-01-01

Background The diffusion of national evidence-based practice guidelines and their impact on patient outcomes often go unmeasured. Methods Our objectives were to (1) evaluate implementation and compliance with clinical practices recommended in the new Centers for Disease Control and Prevention (CDC) Hand Hygiene Guideline, (2) compare rates of health care-associated infections (HAI) before and after implementation of the Guideline recommendations, and (3) examine the patterns and correlates of changes in rates of HAI. We used pre- and post-Guideline implementation site visits and surveys in the setting of 40 US hospitals—members of the National Nosocomial Infections Surveillance System—and measured HAI rates 1 year before and after publication of the CDC Guideline and used direct observation of hand hygiene compliance and Guideline implementation scores. Results All study hospitals had changed their policies and procedures and provided products in compliance with Guideline recommendations; 89.8% of 1359 staff members surveyed anonymously reported that they were familiar with the Guideline. However, in 44.2% of the hospitals (19/40), there was no evidence of a multidisciplinary program to improve compliance. Hand hygiene rates remained low (mean, 56.6%). Rates of central line-associated bloodstream infections were significantly lower in hospitals with higher rates of hand hygiene (P < .001). No impact of Guideline implementation or hand hygiene compliance on other HAI rates was identified. Other factors occurring over time could affect rates of HAI. Observed hand hygiene compliance rates were likely to overestimate rates in actual practice. The study may have been of too short duration to detect the impact of a practice guideline. Conclusion Wide dissemination of this Guideline was not sufficient to change practice. Only some hospitals had initiated multidisciplinary programs; practice change is unlikely without such multidisciplinary efforts and explicit administrative support. PMID:18063132

Implementation of a Regional Virtual Tumor Board: A Prospective Study Evaluating Feasibility and Provider Acceptance

PubMed Central

Marshall, Christy L.; Petersen, Nancy J.; Naik, Aanand D.; Velde, Nancy Vander; Artinyan, Avo; Albo, Daniel; Berger, David H.

2014-01-01

Abstract Background: Tumor board (TB) conferences facilitate multidisciplinary cancer care and are associated with overall improved outcomes. Because of shortages of the oncology workforce and limited access to TB conferences, multidisciplinary care is not available at every institution. This pilot study assessed the feasibility and acceptance of using telemedicine to implement a virtual TB (VTB) program within a regional healthcare network. Materials and Methods: The VTB program was implemented through videoconference technology and electronic medical records between the Houston (TX) Veterans Affairs Medical Center (VAMC) (referral center) and the New Orleans (LA) VAMC (referring center). Feasibility was assessed as the proportion of completed VTB encounters, rate of technological failures/mishaps, and presentation duration. Validated surveys for confidence and satisfaction were administered to 36 TB participants to assess acceptance (1–5 point Likert scale). Secondary outcomes included preliminary data on VTB utilization and its effectiveness in providing access to quality cancer care within the region. Results: Ninety TB case presentations occurred during the study period, of which 14 (15%) were VTB cases. Although one VTB encounter had a technical mishap during presentation, all scheduled encounters were completed (100% completion rate). Case presentations took longer for VTB than for regular TB cases (p=0.0004). However, VTB was highly accepted with mean scores for satisfaction and confidence of 4.6. Utilization rate of VTB was 75%, and its effectiveness was equivalent to that observed for non-VTB cases. Conclusions: Implementation of VTB is feasible and highly accepted by its participants. Future studies should focus on widespread implementation and validating the effectiveness of this model. PMID:24845366

Implementing Quality Improvement in Small, Autonomous Primary Care Practices: Implications for the Patient Centered Medical Home

PubMed Central

Arar, Nedal H.; Noel, Polly H.; Leykum, Luci; Zeber, John E.; Romero, Raquel; Parchman, Michael L.

2012-01-01

Background Implementing improvement programs to enhance quality of care within primary care clinics is complex, with limited practical guidance available to help practices during the process. Understanding how improvement strategies can be implemented in primary care is timely given the recent national movement towards transforming primary care into patient-centered medical homes (PCMH). This study examined practice members’ perceptions of the opportunities and challenges associated with implementing changes in their practice. Methods Semi-structured interviews were conducted with a purposive sample of 56 individuals working in 16 small, community-based primary care practices. The interview consisted of open-ended questions focused on participants’ perceptions of: (1) practice vision, (2) perceived need for practice improvement, and (3) barriers that hinder practice improvement. The interviews were conducted at the participating clinics and were tape-recorded, transcribed, and content analyzed. Results Content analysis identified two main domains for practice improvement related to: (1) the process of care, and (2) patients’ involvement in their disease management. Examples of desired process of care changes included improvement in patient tracking/follow-up system, standardization of processes of care, and overall clinic documentations. Changes related to the patients’ involvement in their care included improving (a) health education, and (b) self care management. Among the internal barriers were: staff readiness for change, poor communication, and relationship difficulties among team members. External barriers were: insurance regulations, finances and patient health literacy. Practice Implications Transforming their practices to more patient-centered models of care will be a priority for primary care providers. Identifying opportunities and challenges associated with implementing change is critical for successful improvement programs. Successful strategy for enhancing the adoption and uptake of PCMH elements should leverage areas of concordance between practice members’ perceived needs and planned improvement efforts. PMID:22186171

The fully integrated biomedical engineering programme at Eindhoven University of Technology.

PubMed

Slaaf, D W; van Genderen, M H P

2009-05-01

The development of a fully integrated biomedical engineering programme (life sciences included from the start) is described. Details are provided about background, implementation, and didactic concept: design centred learning combined with courses. The curriculum has developed into a bachelor-master's programme with two different master's degrees: Master's Degree in Biomedical Engineering and Master's Degree in Medical Engineering. Recently, the programme has adopted semester programming, has included a major and minor in the bachelor's degree phase, and a true bachelor's degree final project. Details about the programme and data about where graduates find jobs are provided in this paper.

Peer mentoring for undergraduates in a research-focused diversity initiative

PubMed Central

Keller, Thomas E.; Logan, Kay; Lindwall, Jennifer; Beals, Caitlyn

2017-01-01

To provide multi-dimensional support for undergraduates from traditionally underrepresented backgrounds who aspire to careers in research, the BUILD EXITO project, part of a major NIH-funded diversity initiative, matches each scholar with three mentors: peer mentor (advanced student), career mentor (faculty adviser), and research mentor (research project supervisor). After describing the aims of the diversity initiative, the institutional context of the BUILD EXITO project, and the training program model, this article devotes special attention to the rationale for and implementation of the peer mentoring component within the context of the multi-faceted mentoring model. PMID:29398880

Quest for quality: department of laboratory medicine and pathology, Mayo Clinic.

PubMed

Arney, Kris R; Hopper, Mary H; Tran, Sheryl A; Ward, Melissa M; Hanson, Curtis A

2004-01-01

This article describes our journey for quality in the Department of Laboratory Medicine and Pathology (DLMP) at Mayo Clinic. It provides the background of the department and the process for the development and implementation of the quality program. In addition, a quality conference and the development of a quality school are outlined. Throughout the course of this process, valuable lessons were learned and are discussed. We are pleased with the success of the quality journey. However, we realize that the quest has just begun. We look forward to the future and the challenges that lie ahead.

Peer mentoring for undergraduates in a research-focused diversity initiative.

PubMed

Keller, Thomas E; Logan, Kay; Lindwall, Jennifer; Beals, Caitlyn

2017-01-01

To provide multi-dimensional support for undergraduates from traditionally underrepresented backgrounds who aspire to careers in research, the BUILD EXITO project, part of a major NIH-funded diversity initiative, matches each scholar with three mentors: peer mentor (advanced student), career mentor (faculty adviser), and research mentor (research project supervisor). After describing the aims of the diversity initiative, the institutional context of the BUILD EXITO project, and the training program model, this article devotes special attention to the rationale for and implementation of the peer mentoring component within the context of the multi-faceted mentoring model.

Determinants of health insurance ownership among women in Kenya: evidence from the 2008–09 Kenya demographic and health survey

PubMed Central

2014-01-01

Background The Government of Kenya is making plans to implement a social health insurance program by transforming the National Hospital Insurance Fund (NHIF) into a universal health coverage program. The objective of this study was to examine the determinants associated with health insurance ownership among women in Kenya. Methods Data came from the 2008–09 Kenya Demographic and Health Survey, a nationally representative survey. The sample comprised 8,435 women aged 15–49 years. Descriptive statistics and multivariable logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with health insurance ownership. Results Being employed in the formal sector, being married, exposure to the mass media, having secondary education or higher, residing in households in the middle or rich wealth index categories and residing in a female-headed household were associated with having health insurance. However, region of residence was associated with a lower likelihood of having insurance coverage. Women residing in Central (OR = 0.4; p < 0.01) and North Eastern (OR = 0.1; p < 0.5) provinces were less likely to be insured compared to their counterparts in Nairobi province. Conclusions As the Kenyan government transforms the NHIF into a universal health program, it is important to implement a program that will increase equity and access to health care services among the poor and vulnerable groups. PMID:24678655

Community concepts of poverty: an application to premium exemptions in Ghana’s National Health Insurance Scheme

PubMed Central

2013-01-01

Background Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana’s National Health Insurance Scheme. Methods We employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty. Results Community defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community. Conclusion The in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care. PMID:23497484

The effect of mothers’ empowerment program on premature infants’ weight gain and duration of hospitalization

PubMed Central

Mohammaddoost, Fatemeh; Mosayebi, Ziba; Peyrovi, Hamid; Chehrzad, Minoo-Mitra; Mehran, Abbas

2016-01-01

Background: The readiness of mothers to take care for infants at discharge is a critical issue. Poor readiness of mothers in taking care of premature infants at the time of discharge is associated with potential adverse consequences. This study examined the effect of implementing mothers’ empowerment program on the weight gain and duration of hospitalization in premature infants. Materials and Methods: This study was a quasi-experimental before-after study with a control group, in which 80 mothers with premature infants who were hospitalized in NICU Level II of two hospitals were recruited in the study. Mothers’ empowerment program was implemented as a three-stage training program for the intervention group. Mothers’ readiness questionnaire was completed by the mothers before the intervention and at the discharge time. The changes in mean of mothers’ readiness scores were compared in both the groups. Results: The mean of daily weight gain in infants of the intervention group (3.95 g) was significantly higher than that of the infants in the control group (−0.9 g) (P = 0.003). The average duration of hospitalization for infants in the intervention and control groups was 15.45 days and 20.95 days, respectively, showing a statistically significant difference (P = 0.003). Conclusions: Providing training to the mothers regarding how to care for premature infants can be a useful and effective method in the process of weight gain of premature and low-birth newborns, and may shorten the duration of infants’ hospitalization. PMID:27563317

Empowering Promotores de Salud to engage in Community-Based Participatory Research

PubMed Central

Cupertino, A. Paula; Suarez, Natalia; Cox, Lisa Sanderson; Fernández, Cielo; Jaramillo, Mary Lou; Morgan, Aura; Garrett, Susan; Mendoza, Irazema; Ellerbeck, Edward F.

2015-01-01

Background Latino immigrants are less likely to be involved in addressing health-related issues affecting their own community. Community health workers have played a significant role in addressing the health of underserved communities in several countries. Objective The objective of this article is to describe the development, implementation and evaluation of a community-based training program that empowers promotores to identify the health needs of recent Latino immigrants. Promotores were able to develop interventions based on the needs of recent Latino immigrants. Methods Latino community members participated in a 30-hour training program. Training was provided in 15 two-hour sessions over 3 months. Training included field work accompanied by skills development in leadership, organization, interpersonal communication, and survey implementation. Upon completion of the training, promotores conducted household surveys designed to identify community health needs. The evaluation employed quantitative measures to track promotores’ canvassing activities and assessment of health behaviors. Results Out of the 22 promotores enrolled in the training program, 15 (68.18%) completed the training program. Within 3 months, promotores administered 105 household surveys and identified poor access to health care, lack of insurance (78.6%), low daily consumption of fruits (73%) and vegetables (37.5%) and frequent exposure to tobacco smoke (31.7%). Conclusion Our study demonstrated the feasibility of recruiting and engaging promotores to identify health priorities within the Latino community. This initial step will inform the development of future community-based interventions. PMID:25705141

Development of an Internet-Based Obesity Prevention Program for Children

PubMed Central

Gabriele, Jeanne M.; Stewart, Tiffany M.; Sample, Alicia; Davis, Allison B.; Allen, Ray; Martin, Corby K.; Newton, Robert L.; Williamson, Donald A.

2010-01-01

Background Childhood obesity is a growing problem, particularly in rural, Louisiana school children. Traditionally, school-based obesity prevention programs have used a primary prevention approach. Finding methods to deliver secondary prevention programs to large numbers of students without singling out overweight students has been a challenge. An innovative approach to achieving this goal is through use of an Internet intervention targeted toward a student's weight status. This article describes the Louisiana (LA) Health Internet intervention, including the student Web site, the Internet counselor Web site, and the Internet counseling process. Method The LA Health Internet intervention had separate interfaces for students and Internet counselors. The main features of the student site were behavioral weight loss lessons, lesson activities, chat with an Internet counselor, and email. The Internet counselor site contained these same features, plus a student directory and various means of obtaining student information to guide counseling. Based on their baseline weight status, students received lessons and counseling that promoted either weight loss or weight maintenance. Intervention was delivered during class time, and teachers scheduled Internet counseling sessions with intervention personnel. Results The LA Health Internet intervention was initially implemented within 14 schools; 773 students were granted access to the site. From Fall 2007 to Spring 2009, 1174 hours of Internet counselor coverage was needed to implement the Internet counseling component of this intervention Conclusion The LA Health Internet intervention is an innovative and feasible method of delivering a secondary prevention program within a school setting to large numbers of students. PMID:20513340

Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective

PubMed Central

2010-01-01

Background Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. Discussion This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Summary Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children. PMID:20478054

Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador

PubMed Central

Mitchell-Foster, Kendra; Ayala, Efraín Beltrán; Breilh, Jaime; Spiegel, Jerry; Wilches, Ana Arichabala; Leon, Tania Ordóñez; Delgado, Jefferson Adrian

2015-01-01

Background This project investigates the effectiveness and feasibility of scaling-up an eco-bio-social approach for implementing an integrated community-based approach for dengue prevention in comparison with existing insecticide-based and emerging biolarvicide-based programs in an endemic setting in Machala, Ecuador. Methods An integrated intervention strategy (IIS) for dengue prevention (an elementary school-based dengue education program, and clean patio and safe container program) was implemented in 10 intervention clusters from November 2012 to November 2013 using a randomized controlled cluster trial design (20 clusters: 10 intervention, 10 control; 100 households per cluster with 1986 total households). Current existing dengue prevention programs served as the control treatment in comparison clusters. Pupa per person index (PPI) is used as the main outcome measure. Particular attention was paid to social mobilization and empowerment with IIS. Results Overall, IIS was successful in reducing PPI levels in intervention communities versus control clusters, with intervention clusters in the six paired clusters that followed the study design experiencing a greater reduction of PPI compared to controls (2.2 OR, 95% CI: 1.2 to 4.7). Analysis of individual cases demonstrates that consideration for contexualizing programs and strategies to local neighborhoods can be very effective in reducing PPI for dengue transmission risk reduction. Conclusions In the rapidly evolving political climate for dengue control in Ecuador, integration of successful social mobilization and empowerment strategies with existing and emerging biolarvicide-based government dengue prevention and control programs is promising in reducing PPI and dengue transmission risk in southern coastal communities like Machala. However, more profound analysis of social determination of health is called for to assess sustainability prospects. PMID:25604763

Effect of a supportive-educative program in the math class for stress, anxiety, and depression in female students in the third level of junior high school: An action research

PubMed Central

Emamjomeh, Seyedeh Mahtab; Bahrami, Masoud

2015-01-01

Background and Aim: Students in junior high school, particularly in the third level, are prone to a variety of stressors. This in turn might lead to stress, anxiety, depression, and other health-related problems. There are a very limited number of action research studies to identify the effect of stress management techniques among students. Therefore, a study was conducted to assess the effect of a program used in the math class to decrease the student's level of stress, anxiety, and depression. Material and Methods: This was an action research study, which was conducted in region three of the Education and Training Office of Isfahan, in the year 2012. Fifty-one students in a junior high school were selected and underwent a comprehensive stress management program. This program was prepared in collaboration with the students, their parents, teachers, and managers of the school, and was implemented approximately during a four-month period. The student's stress, anxiety, and depression were measured before and after the program using the DASS-21 questionnaire. Findings: The t-test identified that the mean scores of stress, anxiety, and depression after the intervention were significantly lower than the corresponding scores before the program. One-way analysis of variance (ANOVA) also showed that the students from the veterans (Janbaz) families had higher levels of stress compared to their classmates, who belonged to the non-veteran families (P< 0.05). Results: Education and implementation of stress management techniques including cognitive and behavioral interventions along with active and collaborative methods of learning in the math class might be useful both inside and outside the class, for better management of stress and other health-related problems of students. PMID:25767821

Childcare Service Centers’ Preferences and Intentions to Use a Web-Based Program to Implement Healthy Eating and Physical Activity Policies and Practices: A Cross-Sectional Study

PubMed Central

Williams, Christopher Michael; Finch, Meghan; Wyse, Rebecca; Jones, Jannah; Freund, Megan; Wiggers, John Henry; Nathan, Nicole; Dodds, Pennie; Wolfenden, Luke

2015-01-01

Background Overweight and obesity is a significant public health problem that impacts a large number of children globally. Supporting childcare centers to deliver healthy eating and physical activity-promoting policies and practices is a recommended strategy for obesity prevention, given that such services provide access to a substantial proportion of children during a key developmental period. Electronic Web-based interventions represent a novel way to support childcare service providers to implement such policies and practices. Objective This study aimed to assess: (1) childcare centers’ current use of technology, (2) factors associated with intention to use electronic Web-based interventions, and (3) Web-based features that managers rated as useful to support staff with implementing healthy eating and physical activity-promoting policies and practices. Methods A computer-assisted telephone interview (CATI) was conducted with service managers from long day care centers and preschools. The CATI assessed the following: (1) childcare center characteristics, (2) childcare centers’ use of electronic devices, (3) intention to use a hypothetical electronic Web-based program—assessed using the Technology Acceptance Model (TAM) with ratings between 1 (strongly disagree) and 7 (strongly agree), and (4) features rated as useful to include in a Web-based program. Results Overall, 214 service centers out of 277 (77.3%) consented to participate. All service centers except 2 reported using computers (212/214, 99.1%), whereas 40.2% (86/214) used portable tablets. A total of 71.9% (151/210) of childcare service managers reported a score of 6 or more for intention to use a hypothetical electronic Web-based program. In a multivariable logistic regression analysis, intention to use the program was significantly associated with perceived ease of use (P=.002, odds ratio [OR] 3.9, 95% CI 1.6-9.2) and perceived usefulness (P<.001, OR 28,95% CI 8.0-95.2). Features reported by service managers as useful or very useful for a Web-based program included decision-support tools to support staff with menu planning (117/129, 90.7%), links to relevant resources (212/212, 100%), updated information on guidelines (208/212, 98.1%), and feedback regarding childcare center performance in relation to other childcare centers (212/212, 100%). Conclusions Childcare service managers reported high intention to use a Web-based program and identified several useful features to support staff to implement healthy eating and physical activity policies and practices. Further descriptive and intervention research examining the development and use of such a program to support childcare centers with the implementation of healthy eating and physical activity-promoting policies and practices is warranted. PMID:25931430

Performance of HIV Prevention of Mother-To-Child Transmission Programs in Sub-Saharan Africa: Longitudinal Assessment of 64 Nevirapine-Based Programs Implemented in 25 Countries, 2000-2011

PubMed Central

Ladner, Joël; Besson, Marie-Hélène; Rodrigues, Mariana; Saba, Joseph; Audureau, Etienne

2015-01-01

Background To evaluate the performance and to identify predictive factors of performance in prevention of mother-to-child HIV transmission programs (PMTCT) in sub-Saharan African countries. Methods From 2000 to 2011, PMTCT programs included in the Viramune Donation Programme (VDP) were prospectively followed. Each institution included in the VDP provided data on program implementation, type of management institution, number of PMTCT sites, key programs outputs (HIV counseling and testing, NVP regimens received by mothers and newborns). Nevirapine Coverage Ratio (NCR), defined as the number of women who should have received nevirapine (observed HIV prevalence x number of women in antenatal care), was used to measure performance. Included programs were followed every six months through progress reports. Results A total of 64 programs in 25 sub-Saharan African countries were included. The mean program follow-up was 48.0 months (SD = 24.5); 20,084,490 women attended in antenatal clinics were included. The overall mean NCR was 0.52 (SD = 0.25), with an increase from 0.37 to 0.57 between the first and last progress reports (p<.0001); NCR increased by 3.26% per year-program. Between the first and the last report, the number of women counseled and tested increased from 64.3% to 86.0% (p<.0001), the number of women post-counseled from 87.5% to 91.3% (p = 0.08). After mixed linear regression analysis, type of responsible institution, number of women attended in ANC, and program initiation in 2005-2006 were significant predictive factors associated with the NCR. The effect of the time period increased from earlier to later periods. Conclusion A longitudinal assessment of large PMTCT programs shows that scaling-up of programs was increased in sub-Saharan African countries. The PMTCT coverage increased throughout the study period, especially after 2006. Performance may be better for programs with a small or medium number of women attended in ANC. Identification of factors that predict PMTCT program performance may help in the development and expansion of additional large PMTCT services in sub-Saharan Africa. PMID:26098311

Program Implementers' Evaluation of the Project P.A.T.H.S.: Findings Based on Different Datasets over Time

PubMed Central

Shek, Daniel T. L.; Ma, Cecilia M. S.

2012-01-01

This paper integrates the evaluation findings based on program implementers in nine datasets collected from 2005 to 2009 (244 schools and 7,926 implementers). Using consolidated data with schools as the unit of analysis, results showed that program implementers generally had positive perceptions of the program, themselves, and benefits of the program, with more than four-fifths of the implementers regarding the program as beneficial to the program participants. The subjective outcome evaluation instrument was found to be internally consistent. Multiple regression analyses revealed that perceived qualities of the program and program implementers predicted perceived effectiveness of the program. In conjunction with evaluation findings based on other sources, the present study provides support for the effectiveness of the Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in Hong Kong. PMID:22629224

Customizing for clients: developing a library liaison program from need to plan.

PubMed

Tennant, M R; Butson, L C; Rezeau, M E; Tucker, P J; Boyle, M E; Clayton, G

2001-01-01

Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations.

Customizing for clients: developing a library liaison program from need to plan*

PubMed Central

Tennant, Michele R.; Butson, Linda C.; Rezeau, Michelle E.; Tucker, Prudence J.; Boyle, Marian E.; Clayton, Greg

2001-01-01

Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven |primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations. PMID:11209807

How Do Implementation Efforts Relate to Program Adherence? Examining the Role of Organizational, Implementer, and Program Factors

ERIC Educational Resources Information Center

Dariotis, Jacinda K.; Bumbarger, Brian K.; Duncan, Larissa G.; Greenberg, Mark T.

2008-01-01

Widespread replications of evidence-based prevention programs (EBPPs) prompt prevention scientists to examine program implementation adherence in real world settings. Based on Chen's model (1990), we identified five key factors of the implementation system and assessed which characteristics related to program adherence. The sample included 32…

Practical Application of Model-based Programming and State-based Architecture to Space Missions

NASA Technical Reports Server (NTRS)

Horvath, Gregory; Ingham, Michel; Chung, Seung; Martin, Oliver; Williams, Brian

2006-01-01

A viewgraph presentation to develop models from systems engineers that accomplish mission objectives and manage the health of the system is shown. The topics include: 1) Overview; 2) Motivation; 3) Objective/Vision; 4) Approach; 5) Background: The Mission Data System; 6) Background: State-based Control Architecture System; 7) Background: State Analysis; 8) Overview of State Analysis; 9) Background: MDS Software Frameworks; 10) Background: Model-based Programming; 10) Background: Titan Model-based Executive; 11) Model-based Execution Architecture; 12) Compatibility Analysis of MDS and Titan Architectures; 13) Integrating Model-based Programming and Execution into the Architecture; 14) State Analysis and Modeling; 15) IMU Subsystem State Effects Diagram; 16) Titan Subsystem Model: IMU Health; 17) Integrating Model-based Programming and Execution into the Software IMU; 18) Testing Program; 19) Computationally Tractable State Estimation & Fault Diagnosis; 20) Diagnostic Algorithm Performance; 21) Integration and Test Issues; 22) Demonstrated Benefits; and 23) Next Steps

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

PubMed Central

2014-01-01

Background In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS). Methods Participants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n = 229; k = 46 teams) or for a confirmatory factor analysis (n = 230; k = 47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample. Results The exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity. Conclusions The ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation. The ILS also holds promise as a tool for leader and organizational development to improve EBP implementation. PMID:24731295

Implementation Plan. Environmental Restoration and Waste Management Programmatic Environmental Impact Statement

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

Not Available

1994-01-01

In accordance with the Department of Energy`s National Environmental Policy Act implementing procedures in Volume 10 of the Code of Federal Regulations, Section 1021,312, the Environmental Restoration and Waste Management Programmatic Environmental Impact Statement Implementation Plan has two primary purposes: to provide guidance for the preparation of the Programmatic Environmental Impact Statement and to record the issues resulting from the scoping and the extended public participation process. The Implementation Plan identifies and discusses the following: background of Environmental Restoration and Waste Management activities, the purpose of the Programmatic Environmental Impact Statement, and the relationship of the Programmatic Environmental Impact Statementmore » to other Departmental initiatives (Chapter 1); need and purposes for action (Chapter 2); scoping process and results of the public participation program in defining the scope of the Programmatic Environmental Impact Statement, including a summary of the comments received and their disposition (Chapter 3); planned scope and content of the Programmatic Environmental Impact Statement (Chapter 4); consultations with other agencies and the role of cooperating agencies (Chapter 5); planned schedule of major Programmatic Environmental Impact Statement milestones (Chapter 6); and responsibilities for preparation of the Programmatic Environmental Impact Statement (Chapter 7).« less

Institutional capacity for health systems research in East and Central Africa schools of public health: enhancing capacity to design and implement teaching programs

PubMed Central

2014-01-01

Background The role of health systems research (HSR) in informing and guiding national programs and policies has been increasingly recognized. Yet, many universities in sub-Saharan African countries have relatively limited capacity to teach HSR. Seven schools of public health (SPHs) in East and Central Africa undertook an HSR institutional capacity assessment, which included a review of current HSR teaching programs. This study determines the extent to which SPHs are engaged in teaching HSR-relevant courses and assessing their capacities to effectively design and implement HSR curricula whose graduates are equipped to address HSR needs while helping to strengthen public health policy. Methods This study used a cross-sectional study design employing both quantitative and qualitative approaches. An organizational profile tool was administered to senior staff across the seven SPHs to assess existing teaching programs. A self-assessment tool included nine questions relevant to teaching capacity for HSR curricula. The analysis triangulates the data, with reflections on the responses from within and across the seven SPHs. Proportions and average of values from the Likert scale are compared to determine strengths and weaknesses, while themes relevant to the objectives are identified and clustered to elicit in-depth interpretation. Results None of the SPHs offer an HSR-specific degree program; however, all seven offer courses in the Master of Public Health (MPH) degree that are relevant to HSR. The general MPH curricula partially embrace principles of competency-based education. Different strengths in curricula design and staff interest in HSR at each SPH were exhibited but a number of common constraints were identified, including out-of-date curricula, face-to-face delivery approaches, inadequate staff competencies, and limited access to materials. Opportunities to align health system priorities to teaching programs include existing networks. Conclusions Each SPH has key strengths that can be leveraged to design and implement HSR teaching curricula. We propose networking for standardizing HSR curricula competencies, institutionalizing sharing of teaching resources, creating an HSR eLearning platform to expand access, regularly reviewing HSR teaching content to infuse competency-based approaches, and strengthening staff capacity to deliver such curricula. PMID:24888353

Case-oriented computer-based-training in radiology: concept, implementation and evaluation

PubMed Central

Dugas, Martin; Trumm, Christoph; Stäbler, Axel; Pander, Ernst; Hundt, Walter; Scheidler, Jurgen; Brüning, Roland; Helmberger, Thomas; Waggershauser, Tobias; Matzko, Matthias; Reiser, Maximillian

2001-01-01

Background Providing high-quality clinical cases is important for teaching radiology. We developed, implemented and evaluated a program for a university hospital to support this task. Methods The system was built with Intranet technology and connected to the Picture Archiving and Communications System (PACS). It contains cases for every user group from students to attendants and is structured according to the ACR-code (American College of Radiology) [2]. Each department member was given an individual account, could gather his teaching cases and put the completed cases into the common database. Results During 18 months 583 cases containing 4136 images involving all radiological techniques were compiled and 350 cases put into the common case repository. Workflow integration as well as individual interest influenced the personal efforts to participate but an increasing number of cases and minor modifications of the program improved user acceptance continuously. 101 students went through an evaluation which showed a high level of acceptance and a special interest in elaborate documentation. Conclusion Electronic access to reference cases for all department members anytime anywhere is feasible. Critical success factors are workflow integration, reliability, efficient retrieval strategies and incentives for case authoring. PMID:11686856

Investing in a Surgical Outcomes Auditing System

PubMed Central

Bermudez, Luis; Trost, Kristen; Ayala, Ruben

2013-01-01

Background. Humanitarian surgical organizations consider both quantity of patients receiving care and quality of the care provided as a measure of success. However, organizational efficacy is often judged by the percent of resources spent towards direct intervention/surgery, which may discourage investment in an outcomes monitoring system. Operation Smile's established Global Standards of Care mandate minimum patient followup and quality of care. Purpose. To determine whether investment of resources in an outcomes monitoring system is necessary and effectively measures success. Methods. This paper analyzes the quantity and completeness of data collected over the past four years and compares it against changes in personnel and resources assigned to the program. Operation Smile began investing in multiple resources to obtain the missing data necessary to potentially implement a global Surgical Outcomes Auditing System. Existing personnel resources were restructured to focus on postoperative program implementation, data acquisition and compilation, and training materials used to educate local foundation and international employees. Results. An increase in the number of postoperative forms and amount of data being submitted to headquarters occurred. Conclusions. Humanitarian surgical organizations would benefit from investment in a surgical outcomes monitoring system in order to demonstrate success and to ameliorate quality of care. PMID:23401763

The Smartphone Peer Physical Activity Counseling (SPPAC) Program for Manual Wheelchair Users: Protocol of a Pilot Randomized Controlled Trial

PubMed Central

Best, Krista L; Sweet, Shane N; Arbour-Nicitopoulos, Kelly P; Borisoff, Jaimie F; Noreau, Luc; Martin Ginis, Kathleen A

2017-01-01

Background Physical activity (PA) must be performed regularly to accrue health benefits. However, the majority of manual wheelchair users do not meet PA recommendations. Existing community-based PA programs for manual wheelchair users appear to work, but effect sizes are small and retention is low. Existing PA programs may not fully implement some psychosocial factors that are strongly linked with PA (eg, autonomy). The use of peers and mobile phone technology in the Smartphone Peer PA Counseling (SPPAC) program represents a novel approach to cultivating a PA-supportive environment for manual wheelchair users. Objective The primary objective is to compare change in objective PA between the experimental (SPPAC) and control groups from baseline to postintervention (10 weeks) and follow-up (3 months). Changes in and relationships between subjective PA, wheelchair skills, motivation, self-efficacy (for overcoming barriers to PA for manual wheelchair use), satisfaction of psychological needs for PA, and satisfaction with PA participation will be explored (secondary outcome). Program implementation will be explored (tertiary objective). Methods A total of 38 community-living manual wheelchair users (≥18 years) will be recruited in a randomized controlled trial (RCT). Participants in both the control and experimental groups will receive existing PA guidelines. Participants in the experimental group will also receive the SPPAC program: 14 sessions (~30 min) over a 10-week period delivered by a peer trainer using a mobile phone. PA activities will be based on individuals’ preferences and goals. Implementation of important theoretical variables will be enforced through a peer-trainer checklist. Outcomes for objective PA (primary) and subjective PA, wheelchair skills, motivation, self-efficacy, satisfaction of psychological needs, and satisfaction with participation will be collected at three time points (baseline, postintervention, follow-up). Multiple imputations will be used to treat missing data. A mixed-model ANCOVA will be conducted, controlling for covariates (primary and secondary objectives). The strength and direction of the relationships between the primary and secondary outcomes will be explored (secondary objective). Descriptive and content analysis will be used to appraise program implementation (tertiary objective). Results Funding has been obtained from the Craig Neilsen Foundation and the Canadian Disability Participation Project, with additional funds being sought from the Canadian Institute for Health Research and Fonds de Recherche du Québec-Santé. Pilot evaluation of intervention implementation is currently underway, with enrollment anticipated to begin early 2018. Conclusions There may be substantial benefits for the SPPAC program including limited burden on health care professionals, decreased barriers (eg. accessibility, transportation), development of peer social supports, and potential cost savings related to physical inactivity. Before conducting a large and expensive multisite RCT within a small heterogeneous population of manual wheelchair users, a pilot study affords a prudent step to establishing an adequate study protocol and implementation strategies. Trial Registration ClinicalTrials.gov NCT02826707; https://clinicaltrials.gov/ct2/show/NCT02826707 (Archived by WebCite at http://www.webcitation.org/6pqIc14dU) PMID:28446419

Implementing Immediate Postpartum Long-Acting Reversible Contraception Programs.

PubMed

Hofler, Lisa G; Cordes, Sarah; Cwiak, Carrie A; Goedken, Peggy; Jamieson, Denise J; Kottke, Melissa

2017-01-01

To understand the most important steps required to implement immediate postpartum long-acting reversible contraception (LARC) programs in different Georgia hospitals and the barriers to implementing such a program. This was a qualitative study. We interviewed 32 key personnel from 10 Georgia hospitals working to establish immediate postpartum LARC programs. Data were analyzed using directed qualitative content analysis principles. We used the Stages of Implementation to organize participant-identified key steps for immediate postpartum LARC into an implementation guide. We compared this guide to hospitals' implementation experiences. At the completion of the study, LARC was available for immediate postpartum placement at 7 of 10 study hospitals. Participants identified common themes for the implementation experience: team member identification and ongoing communication, payer preparedness challenges, interdependent department-specific tasks, and piloting with continuing improvements. Participants expressed a need for anticipatory guidance throughout the process. Key first steps to immediate postpartum LARC program implementation were identifying project champions, creating an implementation team that included all relevant departments, obtaining financial reassurance, and ensuring hospital administration awareness of the project. Potential barriers included lack of knowledge about immediate postpartum LARC, financial concerns, and competing clinical and administrative priorities. Hospitals that were successful at implementing immediate postpartum LARC programs did so by prioritizing clear communication and multidisciplinary teamwork. Although the implementation guide reflects a comprehensive assessment of the steps to implementing immediate postpartum LARC programs, not all hospitals required every step to succeed. Hospital teams report that implementing immediate postpartum LARC programs involves multiple departments and a number of important steps to consider. A stage-based approach to implementation, and a standardized guide detailing these steps, may provide the necessary structure for the complex process of implementing immediate postpartum LARC programs in the hospital setting.

A New Educational Scaffolding Approach to Support Authentic Solar Research in the Classroom

NASA Astrophysics Data System (ADS)

Demuth, N.; Walker, C. E.; Isbell, D. M.; Pompea, S. M.

2006-12-01

Teacher Leaders in Research Based Science Education (TLRBSE) is a multi-year teacher professional development program sponsored by NSF and administered through the National Optical Astronomy Observatory (NOAO). The program reaches the formal education community through a national audience of well-trained and supported middle- and high-school teachers. Every year, a new cohort of teachers prepare for research through an on-line course in the spring. In the summer they conduct astronomy research at NOAO, working with astronomer-mentors to gather and analyze their data. They then return to their classrooms and engage their students in inquiry-based astronomy research using this authentic data. TLRBSE has much to offer teachers both inside and outside the program who wish to initiate research in the classroom. However, the activation energy to conduct authentic research is high. To address the needs of a wider audience of teachers and students, steps have been taken to supply web-based foundational resources for the solar research program. Teachers can use this "solar scaffolding" to support the implementation of authentic solar research in the classroom. The scaffolding files on the webpage will serve as a template for other TLRBSE research strands, as well as enable non-TLRBSE middle and high school teachers to download and use TLRBSE data in their own classrooms. The resultant webpage has links to high quality, vetted resources (webpages, interactives, movies, etc.) that provide content background and lesson plans relevant to solar research. Tools on presenting research, print resources, sample articles on research, videos, DVDs, and posters are included. Powerpoint presentations have been provided with lecture notes on themes ranging from "Why Study the Sun" to "The Nature of Light." Sample teaching materials give examples for a calendar to implement the research project, a daily point sheet, a rubric for a student poster evaluation, a student research project description and a student self evaluation. Various background activities help to pave the way to more challenging solar research projects. As a culminating feature, the website includes several downloadable support files from the TLRBSE solar research project, as well as the solar data files and software programs. These scaffolding resources and future directions will be described in detail. NOAO is operated by the Association of Universities for Research in Astronomy (AURA), Inc. under cooperative agreement with the National Science Foundation. For further information on the TLRBSE.

Design principles of a cooperative robot controller

NASA Technical Reports Server (NTRS)

Hayward, Vincent; Hayati, Samad

1987-01-01

The paper describes the design of a controller for cooperative robots being designed at McGill University in a collaborative effort with the Jet Propulsion Laboratory. The first part of the paper discusses the background and motivation for multiple arm control. Then, a set of programming primitives, which are based on the RCCL system and which permit a programmer to specify cooperative tasks are described. The first group of primitives are motion primitives which specify asynchronous motions, master/slave motions, and cooperative motions. In the context of cooperative robots, trajectory generation issues will be discussed and the implementation described. A second set of primitives provides for the specification of spatial relationships. The relations between programming and control in the case of multiple robot are examined. Finally, the paper describes the allocation of various tasks among a set of microprocessors sharing a common bus.

In-Home Respite Care Program Development. Background. Coordinator's Manual. Training Manual.

ERIC Educational Resources Information Center

Parham, J. D.; And Others

This volume consists of a background discussion, coordinator's manual, and training manual dealing with developing programs for the in-home respite care (IHRC) of the developmentally disabled. Addressed in the background information unit are the nature of developmental disabilities; program variables, planning, and funding; and practical…

Food Safety Programs Based on HACCP Principles in School Nutrition Programs: Implementation Status and Factors Related to Implementation

ERIC Educational Resources Information Center

Stinson, Wendy Bounds; Carr, Deborah; Nettles, Mary Frances; Johnson, James T.

2011-01-01

Purpose/Objectives: The objectives of this study were to assess the extent to which school nutrition (SN) programs have implemented food safety programs based on Hazard Analysis and Critical Control Point (HACCP) principles, as well as factors, barriers, and practices related to implementation of these programs. Methods: An online survey was…