Sitting Time, Physical Activity and Sleep by Work Type and Pattern—The Australian Longitudinal Study on Women’s Health

PubMed Central

Clark, Bronwyn K.; Kolbe-Alexander, Tracy L.; Duncan, Mitch J.; Brown, Wendy

2017-01-01

Data from the Australian Longitudinal Study on Women’s Health were used to examine how work was associated with time spent sleeping, sitting and in physical activity (PA), in working women. Young (31–36 years; 2009) and mid-aged (59–64 years; 2010) women reported sleep (categorised as shorter ≤6 h/day and longer ≥8 h/day) and sitting time (work, transport, television, non-work computer, and other; summed for total sitting time) on the most recent work and non-work day; and moderate and vigorous PA (categorised as meeting/not meeting guidelines) in the previous week. Participants reported occupation (manager/professional; clerical/sales; trades/transport/labourer), work hours (part-time; full-time) and work pattern (shift/night; not shift/night). The odds of shorter sleep on work days was higher in both cohorts for women who worked shift or night hours. Longer sitting time on work days, made up primarily of sitting for work, was found for managers/professionals, clerical/sales and full-time workers. In the young cohort, clerical/sales workers and in the mid-aged cohort, full-time workers were less likely to meet PA guidelines. These results suggest multiple behaviour interventions tailored to work patterns and occupational category may be useful to improve the sleep, sitting and activity of working women. PMID:28287446

Sitting Time, Physical Activity and Sleep by Work Type and Pattern-The Australian Longitudinal Study on Women's Health.

PubMed

Clark, Bronwyn K; Kolbe-Alexander, Tracy L; Duncan, Mitch J; Brown, Wendy

2017-03-10

Data from the Australian Longitudinal Study on Women's Health were used to examine how work was associated with time spent sleeping, sitting and in physical activity (PA), in working women. Young (31-36 years; 2009) and mid-aged (59-64 years; 2010) women reported sleep (categorised as shorter ≤6 h/day and longer ≥8 h/day) and sitting time (work, transport, television, non-work computer, and other; summed for total sitting time) on the most recent work and non-work day; and moderate and vigorous PA (categorised as meeting/not meeting guidelines) in the previous week. Participants reported occupation (manager/professional; clerical/sales; trades/transport/labourer), work hours (part-time; full-time) and work pattern (shift/night; not shift/night). The odds of shorter sleep on work days was higher in both cohorts for women who worked shift or night hours. Longer sitting time on work days, made up primarily of sitting for work, was found for managers/professionals, clerical/sales and full-time workers. In the young cohort, clerical/sales workers and in the mid-aged cohort, full-time workers were less likely to meet PA guidelines. These results suggest multiple behaviour interventions tailored to work patterns and occupational category may be useful to improve the sleep, sitting and activity of working women.

The Effects of Disease Management on Glycemic Control and Adherence to American Diabetes Association Guidelines in an Air Force Population

DTIC Science & Technology

2001-05-01

Joynes , & Hollander, 1991). This can be measured in the short term by self-monitored blood glucose (SMBG) testing and lab tests for blood... ian n Vi sit An nu al Vi sit W t C he ck E a Vi sit BP C he ck E a Vi sit SM BG E ac h Vi sit Se lf M gm t A ss es s A nn An n Re...tin a Ex am Se m ian n Hg bA 1C An nu al Hg bA 1C In div N ut r R ec Fl u Sh ot * Pn eu m oc c *

Development of the Design Laboratory.

ERIC Educational Resources Information Center

Silla, Harry

1986-01-01

Describes the design laboratory at the Stevens Institute of Technology (SIT). Considers course objectives, design projects, project structure, mechanical design, project management, and laboratory operation. This laboratory complements SIT's course in process design, giving students a complete design experience. (JN)

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes.

PubMed

Mendes, Romeu; Sousa, Nelson; Themudo-Barata, José; Reis, Victor

2016-01-01

Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic+resistance+agility/balance+flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. This was a non-experimental pre-post evaluation study. Participants (N=43; 62.92±5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70min per session) of 9 months' duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. Significant improvements in the performance of the 6-Minute Walk Test (Δ=8.20%, p<0.001), 30-Second Chair Stand Test (Δ=28.84%, p<0.001), Timed Up and Go Test (Δ=14.31%, p<0.001), and Chair Sit and Reach Test (Δ=102.90%, p<0.001) were identified between baseline and end-exercise intervention time points. A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Improving health-related fitness in adolescents: the CrossFit Teens™ randomised controlled trial.

PubMed

Eather, Narelle; Morgan, Philip James; Lubans, David Revalds

2016-01-01

The aim of this study was to evaluate the preliminary efficacy and feasibility of the CrossFit Teens™ resistance training programme for improving health-related fitness and resistance training skill competency in adolescents. This assessor-blinded randomised controlled trial was conducted in one secondary school in the Hunter Region, Australia, from July to September 2013. Ninety-six (96) students (age = 15.4 (.5) years, 51.5% female) were randomised into intervention (n = 51) or control (n = 45) conditions for 8-weeks (60 min twice per week). Waist circumference, body mass index (BMI), BMI-Z score (primary outcomes), cardiorespiratory fitness (shuttle run test), muscular fitness (standing jump, push-up, handgrip, curl-up test), flexibility (sit and reach) and resistance training skill competency were measured at baseline and immediate post-intervention. Feasibility measures of recruitment, retention, adherence and satisfaction were assessed. Significant group-by-time intervention effects were found for waist circumference [-3.1 cm, P < 0.001], BMI [-1.38 kg · m(‒)(2), P < 0.001], BMI-Z [-0.5 z-scores, P < 0.001], sit and reach [+3.0 cm, P < 0.001], standing jump [+0.1 m, P = 0.021] and shuttle run [+10.3 laps, P = 0.019]. Retention rate was 82.3%. All programme sessions were delivered and participants' mean satisfaction scores ranged from 4.2 to 4.6 out of 5. The findings demonstrate that CrossFit Teens™ is a feasible and efficacious programme for improving health-related fitness in adolescents.

Neutral lumbar spine sitting posture in pain-free subjects.

PubMed

O'Sullivan, Kieran; O'Dea, Patrick; Dankaerts, Wim; O'Sullivan, Peter; Clifford, Amanda; O'Sullivan, Leonard

2010-12-01

Sitting is a common aggravating factor in low back pain (LBP), and re-education of sitting posture is a common aspect of LBP management. However, there is debate regarding what is an optimal sitting posture. This pilot study had 2 aims; to investigate whether pain-free subjects can be reliably positioned in a neutral sitting posture (slight lumbar lordosis and relaxed thorax); and to compare perceptions of neutral sitting posture to habitual sitting posture (HSP). The lower lumbar spine HSP of seventeen pain-free subjects was initially recorded. Subjects then assumed their own subjectively perceived ideal posture (SPIP). Finally, 2 testers independently positioned the subjects into a tester perceived neutral posture (TPNP). The inter-tester reliability of positioning in TPNP was very good (intraclass correlation coefficient (ICC) = 0.91, mean difference = 3% of range of motion). A repeated measures ANOVA revealed that HSP was significantly more flexed than both SPIP and TPNP (p <0.05). There was no significant difference between SPIP and TPNP (p > 0.05). HSP was more kyphotic than all other postures. This study suggests that pain-free subjects can be reliably positioned in a neutral lumbar sitting posture. Further investigation into the role of neutral sitting posture in LBP subjects is warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Can we reduce the effort of maintaining a neutral sitting posture? A pilot study.

PubMed

O'Sullivan, Kieran; McCarthy, Raymond; White, Alison; O'Sullivan, Leonard; Dankaerts, Wim

2012-12-01

Neutral sitting postures encouraging lumbar lordosis have been recommended in the management of sitting-related low back pain (LBP). However, prolonged lordotic sitting postures can be associated with increased fatigue and discomfort. This pilot study investigated whether changing the type of chair used in sitting can reduce the effort of maintaining a neutral sitting posture. The muscle activation of six trunk muscles was recorded using surface electromyography in 12 painfree participants. Participants were facilitated into a neutral sitting posture for 1 min on both a standard backless office chair and a dynamic, forward-inclined chair (Back App). Lumbar multifidus activity was significantly lower on the Back App chair (p=0.013). None of the other five trunk muscles measured demonstrated a significant difference in activity between the chairs. There was no significant difference (p=0.108) in the perceived effort of maintaining the neutral sitting posture on the two chairs. This study suggests that the lumbar multifidus activation required to maintain a neutral sitting posture can be reduced by considering the type of chair used. The mechanism through which the Back App chair reduces lumbar multifidus activation is unclear, but the greatest difference between chairs is the degree of hip flexion. The ability to maintain a neutral lumbar posture with less lumbar multifidus activation is potentially advantageous during prolonged sitting. Further investigations of the effects of chair design on longer duration sitting, and among LBP subjects, are warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Italian Society of Hygiene (SItI) recommendations for a healthy, safe and sustainable housing].

PubMed

Signorelli, Carlo; Capolongo, Stefano; Buffoli, Maddalena; Capasso, Lorenzo; Faggioli, Antonio; Moscato, Umberto; Oberti, Ilaria; Petronio, Maria Grazia; D'Alessandro, Daniela

2016-01-01

As part of the strategies to promote health in urban areas, the Italian Society of Hygiene (SItI) has updated its recommendations for healthy, safe and sustainable housing. They were issued by an ad hoc SitI working group on the basis of the best available evidence retrieved from a review of the scientific and legal literature on the topic and in line with World Health Organisation, European Union, and other international bodies statements. SItI document includes recommendations for environmental comfort, mental and social wellbeing, environmental protection as well as the safety of people who dwell houses. In addition to typical issues (such as relative humidity parameters, ventilation, and safety rules), SItI recommendations address innovative aspects such as building compatibility between different functions, building safety management and green area design. In this context, SItI recommendations emphasise the need of a strengthened interaction between architects and public health experts to ensure the complete wellbeing in houses where people spend more than 50% of their lives.

A mobile technology intervention to reduce sedentary behaviour in 2- to 4-year-old children (Mini Movers): study protocol for a randomised controlled trial.

PubMed

Downing, Katherine L; Salmon, Jo; Hinkley, Trina; Hnatiuk, Jill A; Hesketh, Kylie D

2017-03-03

Sedentary behaviour (e.g. television viewing, sitting time) tracks over time and is associated with adverse health and developmental outcomes across the lifespan. Young children (5 years or younger) spend up to 12 h/day sedentary, of which around 2 h is spent in screen time (e.g. watching television). Interventions to reduce sedentary behaviour in early childhood report mixed results and many have limited potential for scalability. Mobile phones offer a wide-reaching, low-cost avenue for the delivery of health behaviour programmes to parents but their potential to reduce young children's sedentary behaviour has not been widely tested. This study aims to test the feasibility and efficacy of a parent-focused, predominantly mobile telephone-delivered intervention to support parents to minimise the amount of time their child spends using screens and in overall sitting time. Mini Movers is a pilot randomised controlled trial recruiting 100 parents and children. Inclusion criteria include having a child aged between 2 and 4 years, being able to speak, read and write English, and smartphone ownership. Participants will be randomised to the intervention or a wait-list control group at a 1:1 ratio. Intervention group parents will receive printed materials including a content booklet and goal-checking magnet and will participate in a one-on-one discussion with the interventionist to plan two goals to reduce their child's sedentary behaviour. Subsequently, the intervention will be delivered over 6 weeks via personalised and interactive text messages promoting positive health behaviours (strategies for decreasing screen time and overall sitting time), goal setting and self-monitoring. Outcomes to be assessed include intervention feasibility and children's screen time and objectively-assessed sitting time. Few studies have used mobile phone technology to deliver health behaviour programmes to parents of young children. Findings will inform the development of larger-scale interventions to reduce sedentary behaviour during early childhood. Australian New Zealand Clinical Trials registry, identifier: ACTRN12616000628448 . Prospectively registered on 16 May 2016.

Specific flexion-related low back pain and sitting: comparison of seated discomfort on two different chairs.

PubMed

O'Keeffe, Mary; Dankaerts, Wim; O'Sullivan, Peter; O'Sullivan, Leonard; O'Sullivan, Kieran

2013-01-01

No study has examined the effectiveness of prescribing seating modifications according to the individual clinical presentation of people with low back pain (LBP). A dynamic, forward-inclined chair ('Back App') can reduce seated paraspinal muscle activation among pain-free participants. This study examined 21 participants whose LBP was specifically aggravated by prolonged sitting and was eased by standing. Low back discomfort (LBD) and overall body discomfort (OBD) were assessed every 15 min while participants sat for 1 h on both the dynamic, forward-inclined chair and a standard office chair. LBD increased significantly more (p = 0.005) on the standard office chair, with no significant difference (p = 0.178) in OBD between the chairs. The results demonstrate that, in a specific flexion-related subgroup of people with LBP, increased LBD during sitting can be minimised through modifying chair design. Mechanisms that minimise seated discomfort may be of relevance in LBP management, as part of a biopsychosocial management plan. This study examined low back discomfort (LBD) during a typing task among people with low back pain (LBP). Sitting on a dynamic, forward-inclined chair resulted in less seated LBD than sitting on a standard office chair. Further research is required to examine the long-term effectiveness of ergonomics interventions in LBP.

Back on Track: Exploring How a Further Education College Re-Motivates Learners to Re-Sit Previously Failed Qualifications at GCSE

ERIC Educational Resources Information Center

Anderson, Nadia; Peart, Sheine

2016-01-01

Underachievement at GCSE level has significant effects on an individual's life chances. Each year, around half of 16-year-olds leave school without having achieved a full level-2 qualification (five GCSEs at A*-C including English and maths). Many of these students enrol on a programme of study at local further education (FE) colleges. Recent…

Sampling and Survey Operations for the PISA for Development Out-of-School Assessment Field Trial. PISA for Development Brief 15

ERIC Educational Resources Information Center

OECD Publishing, 2017

2017-01-01

Across many of the middle- and low-income countries that have participated in the Programme for International Student Assessment (PISA) or are potential new participants, significant proportions of 15-year-olds are not enrolled in school or are in school but in grades below PISA's target sample (Grade 7 and above) and thus not eligible to sit for…

Conceptual framework and rationale

PubMed Central

Robinson, Alan S; Knols, Bart GJ; Voigt, Gabriella; Hendrichs, Jorge

2009-01-01

The sterile insect technique (SIT) has been shown to be an effective and sustainable genetic approach to control populations of selected major pest insects, when part of area-wide integrated pest management (AW-IPM) programmes. The technique introduces genetic sterility in females of the target population in the field following their mating with released sterile males. This process results in population reduction or elimination via embryo lethality caused by dominant lethal mutations induced in sperm of the released males. In the past, several field trials have been carried out for mosquitoes with varying degrees of success. New technology and experience gained with other species of insect pests has encouraged a reassessment of the use of the sterility principle as part of integrated control of malaria vectors. Significant technical and logistic hurdles will need to be overcome to develop the technology and make it effective to suppress selected vector populations, and its application will probably be limited to specific ecological situations. Using sterile males to control mosquito vector populations can only be effective as part of an AW-IPM programme. The area-wide concept entails the targeting of the total mosquito population within a defined area. It requires, therefore, a thorough understanding of the target pest population biology especially as regards mating behaviour, population dynamics, dispersal and level of reproductive isolation. The key challenges for success are: 1) devising methods to monitor vector populations and measuring competitiveness of sterile males in the field, 2) designing mass rearing, sterilization and release strategies that maintain competitiveness of the sterile male mosquitoes, 3) developing methods to separate sexes in order to release only male mosquitoes and 4) adapting suppression measures and release rates to take into account the high reproductive rate of mosquitoes. Finally, success in area-wide implementation in the field can only be achieved if close attention is paid to political, socio-economic and environmental sensitivities and an efficient management organization is established taking into account the interests of all potential stakeholders of an AW-IPM programme. PMID:19917070

Genetics and biology of Anastrepha fraterculus: research supporting the use of the sterile insect technique (SIT) to control this pest in Argentina.

PubMed

Cladera, Jorge L; Vilardi, Juan C; Juri, Marianela; Paulin, Laura E; Giardini, M Cecilia; Gómez Cendra, Paula V; Segura, Diego F; Lanzavecchia, Silvia B

2014-01-01

Two species of true fruit flies (taxonomic family Tephritidae) are considered pests of fruit and vegetable production in Argentina: the cosmopolitan Mediterranean fruit fly (Ceratitis capitata Wiedemann) and the new world South American fruit fly (Anastrepha fraterculus Wiedemann). The distribution of these two species in Argentina overlaps north of the capital, Buenos Aires. Regarding the control of these two pests, the varied geographical fruit producing regions in Argentina are in different fly control situations. One part is under a programme using the sterile insect technique (SIT) for the eradication of C. capitata, because A. fraterculus is not present in this area. The application of the SIT to control C. capitata north of the present line with the possibility of A. fraterculus occupying the niche left vacant by C. capitata becomes a cause of much concern. Only initial steps have been taken to investigate the genetics and biology of A. fraterculus. Consequently, only fragmentary information has been recorded in the literature regarding the use of SIT to control this species. For these reasons, the research to develop a SIT protocol to control A. fraterculus is greatly needed. In recent years, research groups have been building a network in Argentina in order to address particular aspects of the development of the SIT for Anastrepha fraterculus. The problems being addressed by these groups include improvement of artificial diets, facilitation of insect mass rearing, radiation doses and conditions for insect sterilisation, basic knowledge supporting the development of males-only strains, reduction of male maturation time to facilitate releases, identification and isolation of chemical communication signals, and a good deal of population genetic studies. This paper is the product of a concerted effort to gather all this knowledge scattered in numerous and often hard-to-access reports and papers and summarize their basic conclusions in a single publication.

Genetics and biology of Anastrepha fraterculus: research supporting the use of the sterile insect technique (SIT) to control this pest in Argentina

PubMed Central

2014-01-01

Two species of true fruit flies (taxonomic family Tephritidae) are considered pests of fruit and vegetable production in Argentina: the cosmopolitan Mediterranean fruit fly (Ceratitis capitata Wiedemann) and the new world South American fruit fly (Anastrepha fraterculus Wiedemann). The distribution of these two species in Argentina overlaps north of the capital, Buenos Aires. Regarding the control of these two pests, the varied geographical fruit producing regions in Argentina are in different fly control situations. One part is under a programme using the sterile insect technique (SIT) for the eradication of C. capitata, because A. fraterculus is not present in this area. The application of the SIT to control C. capitata north of the present line with the possibility of A. fraterculus occupying the niche left vacant by C. capitata becomes a cause of much concern. Only initial steps have been taken to investigate the genetics and biology of A. fraterculus. Consequently, only fragmentary information has been recorded in the literature regarding the use of SIT to control this species. For these reasons, the research to develop a SIT protocol to control A. fraterculus is greatly needed. In recent years, research groups have been building a network in Argentina in order to address particular aspects of the development of the SIT for Anastrepha fraterculus. The problems being addressed by these groups include improvement of artificial diets, facilitation of insect mass rearing, radiation doses and conditions for insect sterilisation, basic knowledge supporting the development of males-only strains, reduction of male maturation time to facilitate releases, identification and isolation of chemical communication signals, and a good deal of population genetic studies. This paper is the product of a concerted effort to gather all this knowledge scattered in numerous and often hard-to-access reports and papers and summarize their basic conclusions in a single publication. PMID:25471175

Challenges in healthcare delivery in an economic downturn, in the Republic of Ireland.

PubMed

Carney, Marie

2010-07-01

The purpose of the present study was to discuss some of effects of the downturn in the Irish economy and to demonstrate that in the face of economic difficulties innovation in health care is still occurring. Staff that are managing and delivering healthcare need to know the challenges facing them and have an awareness of the importance of maintaining interest in innovative practice in turbulent times. Information obtained from several sources including government papers, the nursing regulatory board and quality authority documents and current best practice articles. Information was evaluated based on the study's aim. Issues emerging were that current challenges facing Irish health care delivery relate mainly to economic, clinical management, education and information technology factors and further reductions in the cost base of health care delivery remains focused on value for money. In the face of the economic downturn Ireland is achieving health targets and is now sitting in 13th place on the European health index, down from number 28 in 2008. This improvement in position has resulted from several new innovative work practices. As a result of cost reduction measures in place nurse managers will face greater challenges than ever before in meeting the objectives of the healthcare transformation programme.

Comparison of laboratory and field bioassays of lab-reared Cydia pomonella (Lepidoptera: Tortricidae) quality and field performance.

USDA-ARS?s Scientific Manuscript database

Maximum production and fitness of insect species that are mass-reared for biological control programs such as the sterile insect technique (SIT) have benefitted from the employment of quality control and quality management. With a growing interest in the use of SIT as a tactic for the suppression/e...

Developing Sterile Insect Technique (SIT) as a tool Mosquito Control Districts can use for integrated Aedes aegypti control

USDA-ARS?s Scientific Manuscript database

New tools are clearly needed for integrated mosquito management of Ae. aegypti. We describe the sterile insect technique (SIT) that we are developing as a method to control Ae. aegypti by partnering with two prominent Florida mosquito control districts (MCD) and the FAO/IAEA Insect Pest Control Sub...

Training unsupported sitting in people with chronic spinal cord injuries: a randomized controlled trial.

PubMed

Boswell-Ruys, C L; Harvey, L A; Barker, J J; Ben, M; Middleton, J W; Lord, S R

2010-02-01

Randomized, assessor-blinded trial. To evaluate the effectiveness of a 6-week task-specific training programme on the abilities of people with chronic spinal cord injuries to sit unsupported. NSW, Australia. Thirty adults with spinal cord injuries of at least 1-year duration were recruited. Participants in the training group (n=15) performed up to 1 h of task-specific training three times a week for 6 weeks. Participants in the control group (n=15) did not receive any training or additional therapy. Primary outcome measures were the Canadian Occupational Performance Measure (COPM), and tests of Upper Body Sway, Maximal Balance Range and donning and doffing a T-shirt (the T-shirt test). The between-group mean difference (95% confidence interval) for the maximal balance range was 64 mm (95% confidence interval 20 to 108 mm; P=0.006). There were no significant between-group mean differences for the COPM and the Upper Body Sway and T-shirt tests. This trial shows initial support for intensive task-specific training for improving the abilities of people with chronic spinal cord injuries to sit unsupported, although the real-world implications of the observed treatment effects are yet to be determined.

Sit less and move more: perspectives of adults with multiple sclerosis.

PubMed

Aminian, Saeideh; Ezeugwu, Victor E; Motl, Robert W; Manns, Patricia J

2017-12-20

Multiple sclerosis is a chronic neurological disease with the highest prevalence in Canada. Replacing sedentary behavior with light activities may be a feasible approach to manage multiple sclerosis symptoms. This study explored the perspectives of adults with multiple sclerosis about sedentary behavior, physical activity and ways to change behavior. Fifteen adults with multiple sclerosis (age 43 ± 13 years; mean ± standard deviation), recruited through the multiple sclerosis Clinic at the University of Alberta, Edmonton, Canada, participated in semi-structured interviews. Interview audios were transcribed verbatim and coded. NVivo software was used to facilitate the inductive process of thematic analysis. Balancing competing priorities between sitting and moving was the primary theme. Participants were aware of the benefits of physical activity to their overall health, and in the management of fatigue and muscle stiffness. Due to fatigue, they often chose sitting to get their energy back. Further, some barriers included perceived fear of losing balance or embarrassment while walking. Activity monitoring, accountability, educational and individualized programs were suggested strategies to motivate more movement. Adults with multiple sclerosis were open to the idea of replacing sitting with light activities. Motivational and educational programs are required to help them to change sedentary behavior to moving more. IMPLICATIONS FOR REHABILITATION One of the most challenging and common difficulties of multiple sclerosis is walking impairment that worsens because of multiple sclerosis progression, and is a common goal in the rehabilitation of people with multiple sclerosis. The deterioration in walking abilities is related to lower levels of physical activity and more sedentary behavior, such that adults with multiple sclerosis spend 8 to 10.5 h per day sitting. Replacing prolonged sedentary behavior with light physical activities, and incorporating education, encouragement, and self-monitoring strategies are feasible approaches to manage the symptoms of multiple sclerosis.

Iterative development of Stand Up Australia: a multi-component intervention to reduce workplace sitting

PubMed Central

2014-01-01

Background Sitting, particularly in prolonged, unbroken bouts, is widespread within the office workplace, yet few interventions have addressed this newly-identified health risk behaviour. This paper describes the iterative development process and resulting intervention procedures for the Stand Up Australia research program focusing on a multi-component workplace intervention to reduce sitting time. Methods The development of Stand Up Australia followed three phases. 1) Conceptualisation: Stand Up Australia was based on social cognitive theory and social ecological model components. These were operationalised via a taxonomy of intervention strategies and designed to target multiple levels of influence including: organisational structures (e.g. via management consultation), the physical work environment (via provision of height-adjustable workstations), and individual employees (e.g. via face-to-face coaching). 2) Formative research: Intervention components were separately tested for their feasibility and acceptability. 3) Pilot studies: Stand Up Comcare tested the integrated intervention elements in a controlled pilot study examining efficacy, feasibility and acceptability. Stand Up UQ examined the additional value of the organisational- and individual-level components over height-adjustable workstations only in a three-arm controlled trial. In both pilot studies, office workers’ sitting time was measured objectively using activPAL3 devices and the intervention was refined based on qualitative feedback from managers and employees. Results Results and feedback from participants and managers involved in the intervention development phases suggest high efficacy, acceptance, and feasibility of all intervention components. The final version of the Stand Up Australia intervention includes strategies at the organisational (senior management consultation, representatives consultation workshop, team champions, staff information and brainstorming session with information booklet, and supportive emails from managers to staff), environmental (height-adjustable workstations), and individual level (face-to-face coaching session and telephone support). Stand Up Australia is currently being evaluated in the context of a cluster-randomised controlled trial at the Department of Human Services (DHS) in Melbourne, Australia. Conclusions Stand Up Australia is an evidence-guided and systematically developed workplace intervention targeting reductions in office workers’ sitting time. PMID:24559162

Assessment of fruit fly (Diptera: Tephritidae) management practices in deciduous fruit growing areas in South Africa.

PubMed

Manrakhan, Aruna; Addison, Pia

2014-04-01

Ceratitis capitata (Wiedemann) and Ceratitis rosa Karsch are important fruit fly pests of deciduous fruit in the Western Cape Province, South Africa. The main techniques used for fruit fly control in the Western Cape are the sterile insect technique (SIT) targeting C. capitata and the bait application technique (BAT). We determined the relative success of SIT by comparing adult fly-trap catches and fruit infestation in commercial orchards between three regions under SIT and two regions under BAT in the Western Cape, from 2006 to 2008. Ceratitis capitata was predominant in all regions. In commercial orchards, C. capitata catches peaked towards the end of the fruiting season (March to May) and were low between July and January. During the late season, C. capitata catches were significantly higher in two of the regions under SIT. The sterile to wild male ratio in those regions was found to be mostly <1. SIT is not being properly applied in some regions. SIT should be implemented when the pest population is low. The sterile to wild fly ratios should be increased. Alternatively, BAT should be used to lower the pest population before SIT application. Control methods should be more integrated and applied area-wide. © 2013 Society of Chemical Industry.

Acceptability and feasibility of a low-cost, theory-based and co-produced intervention to reduce workplace sitting time in desk-based university employees.

PubMed

Mackenzie, Kelly; Goyder, Elizabeth; Eves, Francis

2015-12-24

Prolonged sedentary time is linked with poor health, independent of physical activity levels. Workplace sitting significantly contributes to sedentary time, but there is limited research evaluating low-cost interventions targeting reductions in workplace sitting. Current evidence supports the use of multi-modal interventions developed using participative approaches. This study aimed to explore the acceptability and feasibility of a low-cost, co-produced, multi-modal intervention to reduce workplace sitting. The intervention was developed with eleven volunteers from a large university department in the UK using participative approaches and "brainstorming" techniques. Main components of the intervention included: emails suggesting ways to "sit less" e.g. walking and standing meetings; free reminder software to install onto computers; social media to increase awareness; workplace champions; management support; and point-of-decision prompts e.g. by lifts encouraging stair use. All staff (n = 317) were invited to take part. Seventeen participated in all aspects of the evaluation, completing pre- and post-intervention sitting logs and questionnaires. The intervention was delivered over four weeks from 7th July to 3rd August 2014. Pre- and post-intervention difference in daily workplace sitting time was presented as a mean ± standard deviation. Questionnaires were used to establish awareness of the intervention and its various elements, and to collect qualitative data regarding intervention acceptability and feasibility. Mean baseline sitting time of 440 min/workday was reported with a mean reduction of 26 ± 54 min/workday post-intervention (n = 17, 95 % CI = -2 to 53). All participants were aware of the intervention as a whole, although there was a range of awareness for individual elements of the intervention. The intervention was generally felt to be both acceptable and feasible. Management support was perceived to be a strength, whilst specific strategies that were encouraged, including walking and standing meetings, received mixed feedback. This small-scale pilot provides encouragement for the acceptability and feasibility of low-cost, multi-modal interventions to reduce workplace sitting in UK settings. Evaluation of this intervention provides useful information to support participatory approaches during intervention development and the potential for more sustainable low-cost interventions. Findings may be limited in terms of generalisability as this pilot was carried out within a health-related academic setting.

Effectiveness of a balance training home exercise programme for adults with haemophilia: a pilot study.

PubMed

Hill, K; Fearn, M; Williams, S; Mudge, L; Walsh, C; McCarthy, P; Walsh, M; Street, A

2010-01-01

Adults with haemophilia and other bleeding disorders often develop lower limb musculoskeletal problems associated with bleeds into joints and muscles, which may affect balance performance and increase likelihood of falling. The aim of this study was to evaluate the effectiveness of an individualized balance and strength home exercise programme on improving balance and related outcomes for adults with haemophilia and other bleeding disorders. Twenty male adults with haemophilia and other bleeding disorders (mean age 39.4 years, 95% CI = 33.7-45.1) were recruited to participate. They underwent a comprehensive clinical and force platform assessment of balance and related measures. Based on assessment findings, the assessing physiotherapist provided an individualized home exercise programme of balance, strengthening and walking exercises. Re-assessment occurred after the 4-month exercise programme. Twelve participants (60%) completed the programme and were re-assessed. There were no safety problems or dropouts associated with the exercise programme aggravating joint status. Although there were no statistically significant changes in any of the measures (adjusted for multiple comparisons), there were improvements of between 5% and 22% on 10 of the 16 measures, with the Neurocom modified Clinical Test of Sensory Interaction on Balance (P = 0.036) and Timed Sit to Stand (P = 0.064) approaching significance. A tailored home exercise programme targeting balance, strengthening and walking is feasible for adults with haemophilia and other bleeding disorders. These results suggest that positive physical outcomes including improved balance and mobility may be achieved with this type of programme.

Irradiated Male Tsetse from a 40-Year-Old Colony Are Still Competitive in a Riparian Forest in Burkina Faso

PubMed Central

Sow, Adama; Sidibé, Issa; Bengaly, Zakaria; Bancé, Augustin Z.; Sawadogo, Germain J.; Solano, Philippe; Vreysen, Marc J. B.; Lancelot, Renaud; Bouyer, Jeremy

2012-01-01

Background Tsetse flies are the cyclical vectors of African trypanosomosis that constitute a major constraint to development in Africa. Their control is an important component of the integrated management of these diseases, and among the techniques available, the sterile insect technique (SIT) is the sole that is efficient at low densities. The government of Burkina Faso has embarked on a tsetse eradication programme in the framework of the PATTEC, where SIT is an important component. The project plans to use flies from a Glossina palpalis gambiensis colony that has been maintained for about 40 years at the Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES). It was thus necessary to test the competitiveness of the sterile males originating from this colony. Methodology/Principal Findings During the period January–February 2010, 16,000 sterile male G. p. gambiensis were released along a tributary of the Mouhoun river. The study revealed that with a mean sterile to wild male ratio of 1.16 (s.d. 0.38), the abortion rate of the wild female flies was significantly higher than before (p = 0.026) and after (p = 0.019) the release period. The estimated competitiveness of the sterile males (Fried index) was 0.07 (s.d. 0.02), indicating that a sterile to wild male ratio of 14.4 would be necessary to obtain nearly complete induced sterility in the female population. The aggregation patterns of sterile and wild male flies were similar. The survival rate of the released sterile male flies was similar to that observed in 1983–1985 for the same colony. Conclusions/Significance We conclude that gamma sterilised male G. p. gambiensis derived from the CIRDES colony have a competitiveness that is comparable to their competitiveness obtained 35 years ago and can still be used for an area-wide integrated pest management campaign with a sterile insect component in Burkina Faso. PMID:22590652

Standing up in multiple sclerosis (SUMS): protocol for a multi-centre randomised controlled trial evaluating the clinical and cost effectiveness of a home-based self-management standing frame programme in people with progressive multiple sclerosis.

PubMed

Freeman, J A; Hendrie, W; Creanor, S; Jarrett, L; Barton, A; Green, C; Marsden, J; Rogers, E; Zajicek, J

2016-05-05

Multiple sclerosis (MS) is an incurable, unpredictable but typically progressive neurological condition. It is the most common cause of neurological disability in young adults. Within 15 years of diagnosis, approximately 50 % of affected people are unable to walk unaided, and over time an estimated 25 % depend on a wheelchair. Typically, people with such limited mobility are excluded from clinical trials. Severely impaired people with MS spend much of their day sitting, often with limited ability to change position. In response, secondary complications can occur including: muscle wasting, pain, reduced skin integrity, spasms, limb stiffness, constipation, and associated psychosocial problems such as depression and lowered self-esteem. Effective self-management strategies, which can be implemented relatively easily and cheaply within people's homes, are needed to improve or maintain mobility and reduce sedentary behaviour. However this is challenging, particularly in the latter stages of disease. Regular supported standing using standing frames is one potential option. SUMS is a pragmatic multi-centre randomised controlled trial evaluating use of Oswestry standing frames with blinded outcome assessment and full economic evaluation. Participants will be randomly allocated (1:1) to either a home-based, self-management standing programme (with advice and support) along with their usual care or to usual care alone. Those in the intervention group will be asked to stand for a minimum of 30 min three times weekly over 20 weeks. Each participant will be followed-up at 20 and 36 weeks post baseline. The primary clinical outcome is motor function, assessed using the Amended Motor Club Assessment. The primary economic endpoint is quality-adjusted life years. The secondary outcomes include measures of explanatory physical impairments, key clinical outcomes, and health-related quality of life. An embedded qualitative component will explore participant's and carer's experiences of the standing programme. This is the first large scale multi-centre trial to assess the clinical and cost effectiveness of a home based standing frame programme for people who are severely impaired by MS. If demonstrated to be effective and cost-effective, we will use this evidence to develop recommendations for a health service delivery model which could be implemented across the United Kingdom. ISRCTN69614598 DATE OF REGISTRATION: 3.2.16 (retrospectively registered).

Study design and protocol for a mixed methods evaluation of an intervention to reduce and break up sitting time in primary school classrooms in the UK: The CLASS PAL (Physically Active Learning) Programme

PubMed Central

Routen, Ash C; Biddle, Stuart J H; Bodicoat, Danielle H; Cale, Lorraine; Clemes, Stacy; Edwardson, Charlotte L; Glazebrook, Cris; Harrington, Deirdre M; Khunti, Kamlesh; Pearson, Natalie; Salmon, Jo; Sherar, Lauren B

2017-01-01

Introduction Children engage in a high volume of sitting in school, particularly in the classroom. A number of strategies, such as physically active lessons (termed movement integration (MI)), have been developed to integrate physical activity into this learning environment; however, no single approach is likely to meet the needs of all pupils and teachers. This protocol outlines an implementation study of a primary school-based MI intervention: CLASS PAL (Physically Active Learning) programme. This study aims to (A) determine the degree of implementation of CLASS PAL, (B) identify processes by which teachers and schools implement CLASS PAL and (C) investigate individual (pupil and teacher) level and school-level characteristics associated with implementation of CLASS PAL. Methods and analysis The intervention will provide teachers with a professional development workshop and a bespoke teaching resources website. The study will use a single group before-and-after design, strengthened by multiple interim measurements. Six state-funded primary schools will be recruited within Leicestershire, UK. Evaluation data will be collected prior to implementation and at four discrete time points during implementation: At measurement 0 (October 2016), school, teacher and pupil characteristics will be collected. At measurements 0 and 3 (June–July 2017), accelerometry, cognitive functioning, self-reported sitting and classroom engagement data will be collected. At measurements 1(December 2016–March 2017) and 3, teacher interviews (also at measurement 4; September–October 2017) and pupil focus groups will be conducted, and at measurements 1 and 2 (April–May 2017), classroom observations. Implementation will be captured through website analytics and ongoing teacher completed logs. Ethics and dissemination Ethical approval was obtained through the Loughborough University Human Participants Ethics Sub-Committee (Reference number: R16-P115). Findings will be disseminated via practitioner and/or research journals and to relevant regional and national stakeholders through print and online media and dissemination event(s). PMID:29122808

Competitiveness and survival of two strains of Glossina palpalis gambiensis in an urban area of Senegal

PubMed Central

Bassène, Mireille Djimangali; Seck, Momar Talla; Pagabeleguem, Soumaïla; Fall, Assane Gueye; Sall, Baba; Vreysen, Marc J. B.; Gimonneau, Geoffrey

2017-01-01

Background In the Niayes area, located in the west of Senegal, only one tsetse species, Glossina palpalis gambiensis Vanderplank (Diptera: Glossinidae) was present. The Government of Senegal initiated and implemented an elimination programme in this area that included a sterile insect technique (SIT) component. The G. p. gambiensis strain (BKF) mass-reared at the Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES) in Burkina Faso was used for the SIT component. Methodology/principal findings Studies conducted in 2011 in four localities in the Niayes area (Pout, Sébikotane, Diacksao Peul and the Parc de Hann) showed that the BKF strain demonstrated inferior survival in the ecosystem of the Parc de Hann, a forested area in the city centre of the capital Dakar. Therefore, G. p. gambiensis flies from the Niayes area (SEN strain) were colonized. Here we compared the competitiveness and survival of the two strains (BKF and SEN) in the Parc de Hann. Released sterile males of the SEN colony showed a daily mortality rate of 0.08 (SD 0.08) as compared with 0.14 (SD 0.08) for the BKF flies but the difference was not significant (p-value = 0.14). However, the competitiveness of the SEN males was lower (0.14 (SD 0.10)) as compared with that of the BKF males (0.76 (SD 0.11)) (p-value < 10−3). Conclusions/significance Based on the results of this study, it can be concluded that the BKF strain will remain the main strain to be used in the elimination programme. Despite the slightly longer survival of the SEN males in the Parc de Hann, the superior competitiveness of the BKF males is deemed more important for the SIT component, as their shorter survival rates can be easily compensated for by more frequent fly releases. PMID:29281634

Competitiveness and survival of two strains of Glossina palpalis gambiensis in an urban area of Senegal.

PubMed

Bassène, Mireille Djimangali; Seck, Momar Talla; Pagabeleguem, Soumaïla; Fall, Assane Gueye; Sall, Baba; Vreysen, Marc J B; Gimonneau, Geoffrey; Bouyer, Jérémy

2017-12-01

In the Niayes area, located in the west of Senegal, only one tsetse species, Glossina palpalis gambiensis Vanderplank (Diptera: Glossinidae) was present. The Government of Senegal initiated and implemented an elimination programme in this area that included a sterile insect technique (SIT) component. The G. p. gambiensis strain (BKF) mass-reared at the Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES) in Burkina Faso was used for the SIT component. Studies conducted in 2011 in four localities in the Niayes area (Pout, Sébikotane, Diacksao Peul and the Parc de Hann) showed that the BKF strain demonstrated inferior survival in the ecosystem of the Parc de Hann, a forested area in the city centre of the capital Dakar. Therefore, G. p. gambiensis flies from the Niayes area (SEN strain) were colonized. Here we compared the competitiveness and survival of the two strains (BKF and SEN) in the Parc de Hann. Released sterile males of the SEN colony showed a daily mortality rate of 0.08 (SD 0.08) as compared with 0.14 (SD 0.08) for the BKF flies but the difference was not significant (p-value = 0.14). However, the competitiveness of the SEN males was lower (0.14 (SD 0.10)) as compared with that of the BKF males (0.76 (SD 0.11)) (p-value < 10-3). Based on the results of this study, it can be concluded that the BKF strain will remain the main strain to be used in the elimination programme. Despite the slightly longer survival of the SEN males in the Parc de Hann, the superior competitiveness of the BKF males is deemed more important for the SIT component, as their shorter survival rates can be easily compensated for by more frequent fly releases.

E-learning and educational diversity.

PubMed

Forman, Dawn; Nyatanga, Lovemore; Rich, Terry

2002-01-01

This article discusses the nature of electronic learning (E-learning) and argues for its centrality to educational diversity and the shift from teaching to learning. It is argued that E-learning is the new wave strategy that sits comfortably with other strategies developed for the 21st century. As such it challenges the traditional 'banking concept' of education, where the teacher is seen as the font of knowledge as long as students acknowledge this and are eager to absorb the teacher's vital knowledge. The article argues that E-learning should replace what Freire (1994) calls the backing concept of education, which is at odds with other 21st century approaches such as lifelong learning, open and flexible learning and the accreditation of prior learning (APL) to name only a few. In suggesting the shift from the traditional approach to E-learning, the article acknowledges issues of quality assurance and the need to maintain not only standards of achievements but also the comparability of those standards. Strategies for developing E-learning material and maintaining standards are discussed. McKey (2000) and Salmon's (2001) model of E-learning development and management are used to show how E-learning works in practise. The article then focuses on the role of E-learning as a catalyst for educational diversity, freedom to learn and equality of opportunity. While E-learning encourages diversity it paradoxically creates programmes that are more specifically tailored to the market needs than traditionally validated programmes. This is seen as very good in terms of addressing specific needs, for instance, specific knowledge and skills for a particular market. The learners or students in that particular market will feel that their specific needs are recognized and addressed, and will thus see the E-learning programme as having relevance for them. The article concludes by asserting that adequate resources, particularly learner support, will distinguish quality or good programmes from bad ones. Copyright 2002 Harcourt Publishers Ltd.

Home-based balance training programme using Wii Fit with balance board for Parkinsons's disease: a pilot study.

PubMed

Esculier, Jean-Francois; Vaudrin, Joanie; Bériault, Patrick; Gagnon, Karine; Tremblay, Louis E

2012-02-01

To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.

Perspectives on a ‘Sit Less, Move More’ Intervention in Australian Emergency Call Centres

PubMed Central

Chau, Josephine Y; Engelen, Lina; Burks-Young, Sarah; Daley, Michelle; Maxwell, Jen-Kui; Milton, Karen; Bauman, Adrian

2016-01-01

Background Prolonged sitting is associated with increased risk of chronic diseases. Workplace programs that aim to reduce sitting time (sit less) and increase physical activity (move more) have targeted desk-based workers in corporate and university settings with promising results. However, little is known about ‘move more, sit less’ programs for workers in other types of jobs and industries, such as shift workers. This formative research examines the perceptions of a ‘sit less, move more’ program in an Australian Emergency Call Centre that operates 24 hours per day, 7 days per week. Methods Participants were employees (N = 39, 72% female, 50% aged 36–55 years) recruited from Emergency Services control centres located in New South Wales, Australia. The ‘sit less, move more’ intervention, consisting of emails, posters and timer lights, was co-designed with the management team and tailored to the control centre environment and work practices, which already included electronic height-adjustable sit-stand workstations for all call centre staff. Participants reported their perceptions and experiences of the intervention in a self-report online questionnaire, and directly to the research team during regular site visits. Questionnaire topics included barriers and facilitators to standing while working, mental wellbeing, effects on work performance, and workplace satisfaction. Field notes and open-ended response data were analysed in an iterative process during and after data collection to identify the main themes. Results Whilst participants already had sit-stand workstations, use of the desks in the standing position varied and sometimes were contrary to expectations (e.g, less tired standing than sitting; standing when experiencing high call stress). Participants emphasised the “challenging” and “unrelenting” nature of their work. They reported sleep issues (“always tired”), work stress (“non-stop demands”), and feeling mentally and physically drained due to shift work and length of shifts. Overall, participants liked the initiative but acknowledged that their predominantly sitting habits were entrenched and work demands took precedence. Conclusions This study demonstrates the low acceptability of a ‘sit less, move more’ program in shift workers in high stress environments like emergency call centres. Work demands take priority and other health concerns, like poor sleep and high stress, may be more salient than the need to sit less and move more during work shifts. PMID:29546163

Perspectives on a 'Sit Less, Move More' Intervention in Australian Emergency Call Centres.

PubMed

Chau, Josephine Y; Engelen, Lina; Burks-Young, Sarah; Daley, Michelle; Maxwell, Jen-Kui; Milton, Karen; Bauman, Adrian

2016-01-01

Prolonged sitting is associated with increased risk of chronic diseases. Workplace programs that aim to reduce sitting time (sit less) and increase physical activity (move more) have targeted desk-based workers in corporate and university settings with promising results. However, little is known about 'move more, sit less' programs for workers in other types of jobs and industries, such as shift workers. This formative research examines the perceptions of a 'sit less, move more' program in an Australian Emergency Call Centre that operates 24 hours per day, 7 days per week. Participants were employees (N = 39, 72% female, 50% aged 36-55 years) recruited from Emergency Services control centres located in New South Wales, Australia. The 'sit less, move more' intervention, consisting of emails, posters and timer lights, was co-designed with the management team and tailored to the control centre environment and work practices, which already included electronic height-adjustable sit-stand workstations for all call centre staff. Participants reported their perceptions and experiences of the intervention in a self-report online questionnaire, and directly to the research team during regular site visits. Questionnaire topics included barriers and facilitators to standing while working, mental wellbeing, effects on work performance, and workplace satisfaction. Field notes and open-ended response data were analysed in an iterative process during and after data collection to identify the main themes. Whilst participants already had sit-stand workstations, use of the desks in the standing position varied and sometimes were contrary to expectations (e.g, less tired standing than sitting; standing when experiencing high call stress). Participants emphasised the "challenging" and "unrelenting" nature of their work. They reported sleep issues ("always tired"), work stress ("non-stop demands"), and feeling mentally and physically drained due to shift work and length of shifts. Overall, participants liked the initiative but acknowledged that their predominantly sitting habits were entrenched and work demands took precedence. This study demonstrates the low acceptability of a 'sit less, move more' program in shift workers in high stress environments like emergency call centres. Work demands take priority and other health concerns, like poor sleep and high stress, may be more salient than the need to sit less and move more during work shifts.

Complete low-intensity endurance training programme in haemodialysis patients: improving the care of renal patients.

PubMed

Esteve Simó, Vicent; Junqué, Anna; Fulquet, Miquel; Duarte, Verónica; Saurina, Anna; Pou, Mónica; Moreno, Fátima; Carneiro, Jose; Ramírez de Arellano, Manel

2014-01-01

Patients on haemodialysis (HD) have a decreased physical and functional capacity. Several studies have reported the beneficial effects of exercise on the physical, functional and psychological functioning of HD patients. Despite these results, exercise programmes on HD are not commonplace. To analyse the effect of an intradialysis endurance training programme on muscular strength and functional capacity in our HD patients. A 6-month single-centre prospective study. HD patients were non-randomly assigned to an exercise group (group E) or a control group (group C). Exercise training included complete endurance training using balls, weights and elastic bands in the first 2 h of an HD session; group C received standard HD care. Analysed data: (1) biochemical parameters; (2) biceps and quadriceps muscle tone, maximum quadriceps length strength (MQLS) and dominant hand grip (HG); (3) functional capacity tests: sit-to-stand-to-sit (STS10) and 6-min walking test (6MWT). Forty patients were included, 55% were men; their mean age was 68.4 years; the patients were 61.6 months on HD; 16 patients were in group E and 24 in group C. In group E, muscular strength showed a significant improvement in MQLS (15.6 ± 10.7 vs. 17.7 ± 12.5 kg, p < 0.05) and HG (22.1 ± 13.2 vs. 24.1 ± 15.8 kg, p < 0.05) at the end of the programme, while a global decrease was reported in group C (MQLS 20.9 ± 9.3 vs. 16.2 ± 8.4 kg, p < 0.05; HG 25.1 ± 10.3 vs. 24.1 ± 11.1 kg). 6MWT significantly improved in group E (20%, 293.1 vs. 368 m, p < 0.001) and decreased in group C (10%, 350 vs. 315 m, p < 0.004). At the end of the programme, STS10 time was reduced in group E (2.1 ± 18.5 vs. 28.7 ± 20.6 s), while it rose in group C (31.5 ± 17.9 vs. 36.4 ± 19.8 s), though significant differences were not found. (1) The intradialysis training programme improved muscular strength and functional capacity in our HD patients. (2) These results support the benefits of exercise training for HD patients. (3) Nephrologists should consider exercise training as a standard practice for the care of HD patients. © 2014 S. Karger AG, Basel.

Dancing in time: feasibility and acceptability of a contemporary dance programme to modify risk factors for falling in community dwelling older adults.

PubMed

Britten, Laura; Addington, Christine; Astill, Sarah

2017-04-11

Falls are a common cause of injury in older adults, with the prevention of falls being a priority for public health departments around the world. This study investigated the feasibility, and impact of an 8 week contemporary dance programme on modifiable physical (physical activity status, mobility, sedentary behaviour patterns) and psychosocial (depressive state, fear of falling) risk factors for falls. An uncontrolled 'pre-post' intervention design was used. Three groups of older (60 yrs.+) adults were recruited from local community groups to participate in a 3 separate, 8 week dance programmes. Each programme comprised two, 90 min dance classes per week. Quantitative measures of physical activity, sedentary behaviour, depression, mobility and fear of falling were measured at baseline (T1) and after 8 weeks of dance (T2). Weekly attendance was noted, and post-study qualitative work was conducted with participants in 3 separate focus groups. A combined thematic analysis of these data was conducted. Of the 38 (Mean Age = 77.3 ± 8.4 yrs., 37 females) who attended the dance sessions, 22 (21 females; 1 male; mean age = 74.8, ±8.44) consented to be part of the study. Mean attendance was 14.6 (±2.6) sessions, and mean adherence was 84.3% (±17). Significant increases in moderate and vigorous physical activity were noted, with a significant decrease in sitting time over the weekdays (p < 0.05). Statistically significant decreases in the mean Geriatric Depression Scale (p < 0.05) and fear of falling (p < 0.005) score were noted, and the time taken to complete the TUG test decreased significantly from 10.1 s to 7.7 s over the 8 weeks (p < 0.005). Themes from the focus groups included the dance programme as a means of being active, health Benefits, and dance-related barriers and facilitators. The recruitment of older adults, good adherence and favourability across all three sites indicate that a dance programme is feasible as an intervention, but this may be limited to females only. Contemporary dance has the potential to positively affect the physical activity, sitting behaviour, falls related efficacy, mobility and incidence of depression in older females which could reduce their incidence of falls. An adequately powered study with control groups are required to test this intervention further.

Occupational sitting: practitioner perceptions of health risks, intervention strategies and influences.

PubMed

Gilson, Nicholas; Straker, Leon; Parry, Sharon

2012-12-01

Workplace practitioners are well placed to provide practical insights on sedentary behaviour issues in the workplace. This study consulted occupational health and safety (OHS) practitioners, examining their perceptions of sedentary health risks and views on strategies and influences to reduce and break prolonged occupational sitting. Three focus groups were conducted with convenience samples of OHS practitioners (n=34; 6 men; 46.4 ± 9.6 years) attending an Australian national conference in November 2010. Open-ended questions concerning health risks, sitting reduction strategies and influences were posed by lead researchers and practitioners invited to express opinions, viewpoints and experiences. Audio-recordings and summary notes of focus group discussions were reviewed by researchers to identify key response themes. OHS practitioners were well informed about the chronic disease and musculoskeletal risks associated with prolonged occupational sitting, but noted the importance of not replacing one workplace health issue (too much sitting) with another (too much standing). Ideas for strategies were diverse and explored the dichotomy between providing choices for employees to stand and move more (e.g. sit-stand desks), as opposed to obligating change through adapting job and office design (e.g. centralising printers and scanners). Productivity concerns were cited as a major influence for change. OHS practitioners also highlighted the value of using cross-disciplinary expertise to bridge the gap between research and practice. This study identified that OHS practitioners in Australia have a good understanding of the risks of prolonged occupational sitting and potential strategies to manage these risks.

Evaluating the effectiveness of organisational-level strategies with or without an activity tracker to reduce office workers' sitting time: a cluster-randomised trial.

PubMed

Brakenridge, C L; Fjeldsoe, B S; Young, D C; Winkler, E A H; Dunstan, D W; Straker, L M; Healy, G N

2016-11-04

Office workers engage in high levels of sitting time. Effective, context-specific, and scalable strategies are needed to support widespread sitting reduction. This study aimed to evaluate organisational-support strategies alone or in combination with an activity tracker to reduce sitting in office workers. From one organisation, 153 desk-based office workers were cluster-randomised (by team) to organisational support only (e.g., manager support, emails; 'Group ORG', 9 teams, 87 participants), or organisational support plus LUMOback activity tracker ('Group ORG + Tracker', 9 teams, 66 participants). The waist-worn tracker provided real-time feedback and prompts on sitting and posture. ActivPAL3 monitors were used to ascertain primary outcomes (sitting time during work- and overall hours) and other activity outcomes: prolonged sitting time (≥30 min bouts), time between sitting bouts, standing time, stepping time, and number of steps. Health and work outcomes were assessed by questionnaire. Changes within each group (three- and 12 months) and differences between groups were analysed by linear mixed models. Missing data were multiply imputed. At baseline, participants (46 % women, 23-58 years) spent (mean ± SD) 74.3 ± 9.7 % of their workday sitting, 17.5 ± 8.3 % standing and 8.1 ± 2.7 % stepping. Significant (p < 0.05) reductions in sitting time (both work and overall) were observed within both groups, but only at 12 months. For secondary activity outcomes, Group ORG significantly improved in work prolonged sitting, time between sitting bouts and standing time, and overall prolonged sitting time (12 months), and in overall standing time (three- and 12 months); while Group ORG + Tracker, significantly improved in work prolonged sitting, standing, stepping and overall standing time (12 months). Adjusted for confounders, the only significant between-group differences were a greater stepping time and step count for Group ORG + Tracker relative to Group ORG (+20.6 min/16 h day, 95 % CI: 3.1, 38.1, p = 0.021; +846.5steps/16 h day, 95 % CI: 67.8, 1625.2, p = 0.033) at 12 months. Observed changes in health and work outcomes were small and not statistically significant. Organisational-support strategies with or without an activity tracker resulted in improvements in sitting, prolonged sitting and standing; adding a tracker enhanced stepping changes. Improvements were most evident at 12 months, suggesting the organisational-support strategies may have taken time to embed within the organisation. Australian New Zealand Clinical Trial Registry: ACTRN12614000252617 . Registered 10 March 2014.

EPODE approach for childhood obesity prevention: methods, progress and international development

PubMed Central

Borys, J-M; Le Bodo, Y; Jebb, S A; Seidell, J C; Summerbell, C; Richard, D; De Henauw, S; Moreno, L A; Romon, M; Visscher, T L S; Raffin, S; Swinburn, B

2012-01-01

Summary Childhood obesity is a complex issue and needs multistakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. ‘Ensemble Prévenons l'ObésitéDes Enfants’ (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity. At a central level, a coordination team, using social marketing and organizational techniques, trains and coaches a local project manager nominated in each EPODE community by the local authorities. The local project manager is also provided with tools to mobilize local stakeholders through a local steering committee and local networks. The added value of the methodology is to mobilize stakeholders at all levels across the public and the private sectors. Its critical components include political commitment, sustainable resources, support services and a strong scientific input – drawing on the evidence-base – together with evaluation of the programme. Since 2004, EPODE methodology has been implemented in more than 500 communities in six countries. Community-based interventions are integral to childhood obesity prevention. EPODE provides a valuable model to address this challenge. PMID:22106871

A qualitative exploration of student perceptions of the impact of progress tests on learning and emotional wellbeing.

PubMed

Yielder, Jill; Wearn, Andy; Chen, Yan; Henning, Marcus A; Weller, Jennifer; Lillis, Steven; Mogol, Vernon; Bagg, Warwick

2017-08-29

Progress testing was introduced to the MBChB programme at the University of Auckland in 2013. As there has been a focus in published literature on aspects relating to the format or function of progress tests, the purpose of this study was to explore a qualitative student perspective on the introduction of progress testing and its impact on approaches to learning and perceived stress. This article presents the qualitative aspects of a longitudinal evaluation study. The qualitative data were derived from eight focus groups of Year 2-5 medical students in the University of Auckland medical programme. Two themes, 'Impact on Learning' and 'Emotional Wellbeing' and their subthemes offered insight into student perceptions and behaviour. Students described a variety of learning responses to progress testing that clustered around the employment of a range of learning strategies based on their experience of sitting progress tests and their individualised feedback. A range of emotional responses were also expressed, with some finding progress tests stressful, while others enjoyed not needing to intensively cram before the tests. Progress tests appear to influence the approach of students to their learning. They employ a mix of learning strategies, shaped by their performance, individualised feedback and the learning environment. While students expressed some stress and anxiety with respect to sitting progress tests, this form of testing was viewed by these students as no worse, and sometimes better than traditional assessments.

Subcutaneous ICD screening with the Boston Scientific ZOOM programmer versus a 12-lead ECG machine.

PubMed

Chang, Shu C; Patton, Kristen K; Robinson, Melissa R; Poole, Jeanne E; Prutkin, Jordan M

2018-02-24

The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires preimplant screening to ensure appropriate sensing and reduce risk of inappropriate shocks. Screening can be performed using either an ICD programmer or a 12-lead electrocardiogram (ECG) machine. It is unclear whether differences in signal filtering and digital sampling change the screening success rate. Subjects were recruited if they had a transvenous single-lead ICD without pacing requirements or were candidates for a new ICD. Screening was performed using both a Boston Scientific ZOOM programmer (Marlborough, MA, USA) and General Electric MAC 5000 ECG machine (Fairfield, CT, USA). A pass was defined as having at least one lead that fit within the screening template in both supine and sitting positions. A total of 69 subjects were included and 27 sets of ECG leads had differing screening results between the two machines (7%). Of these sets, 22 (81%) passed using the ECG machine but failed using the programmer and five (19%) passed using the ECG machine but failed using the programmer (P < 0.001). Four subjects (6%) passed screening using the ECG machine but failed using the programmer. No subject passed screening with the programmer but failed with the ECG machine. There can be occasional disagreement in S-ICD patient screening between an ICD programmer and ECG machine, all of whom passed with the ECG machine but failed using the programmer. On a per lead basis, the ECG machine passes more subjects. It is unknown what the inappropriate shock rate would be if an S-ICD was implanted. Clinical judgment should be used in borderline cases. © 2018 Wiley Periodicals, Inc.

Acceptability and non-compliance in a family-led weight-management programme for obese Pacific children.

PubMed

Teevale, Tasileta; Taufa, Seini; Percival, Teuila

2015-10-01

To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children. Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme. New Zealand. Forty-two parents/primary caregivers of obese children who were randomised in the intervention weight-management programme. Programmatic factors that enhanced retention included: simultaneous delivery to both children and parents as participants; delivery of the programme in small group settings at local community venues; enabling trustworthy and accountable relationships; providing resources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals; and day and time scheduling. Suggested programme improvements included having ethnic-specific Island-language delivery and practical sessions like cooking classes and shopping expeditions at local food stores. The research found that unpredictable external life crises like extended family deaths, a change in job shift, family illnesses (both acute and those requiring chronic management) and long-term family visitations affected participation and momentum. A loss of momentum through managing life crises was often difficult to overcome for participants, leading them to drop out of the weight-management programme. Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time. In order for weight-management programmes to be effective, participants must be able to complete them. Identifying factors that predict participation and attrition may serve as a basis for programme improvement.

[Relevance of medical rehabilitation in disease management programmes].

PubMed

Lüngen, M; Lauterbach, K W

2003-10-01

Disease management programmes will increasingly be introduced in Germany due to the new risk adjustment scheme. The first disease management programmes started in 2003 for breast cancer and diabetes mellitus type II. German rehabilitation will have to face several challenges. Disease management programmes are strongly based on the notion of Evidence so that proof of the efficacy of a care giving task should be present. Verification of the evidence of the specifically German rehabilitation treatments must therefore be given. However, integration of rehabilitation in disease management programmes could lead to changes in the alignment of German rehabilitation. The essence of German rehabilitation, notably its holistic approach, could get lost with integration in disease management programmes.

Guidelines to site selection for population surveillance and mosquito control trials: a case study from Mauritius.

PubMed

Iyaloo, Diana P; Elahee, Khouaildi B; Bheecarry, Ambicadutt; Lees, Rosemary Susan

2014-04-01

Many novel approaches to controlling mosquito vectors through the release of sterile and mass reared males are being developed in the face of increasing insecticide resistance and other limitations of current methods. Before full scale release programmes can be undertaken there is a need for surveillance of the target population, and investigation of parameters such as dispersal and longevity of released, as compared to wild males through mark-release-recapture (MRR) and other experiments, before small scale pilot trials can be conducted. The nature of the sites used for this field work is crucial to ensure that a trial can feasibly collect sufficient and relevant information, given the available resources and practical limitations, and having secured the correct regulatory, community and ethical approvals and support. Mauritius is considering the inclusion of the sterile insect technique (SIT), for population reduction of Aedes albopictus, as a component of the Ministry of Health and Quality of Life's 'Operational Plan for Prevention and Control of Chikungunya and Dengue'. As part of an investigation into the feasibility of integrating the SIT into the Integrated Vector Management (IVM) scheme in Mauritius a pilot trial is planned. Two potential sites have been selected for this purpose, Pointe des Lascars and Panchvati, villages in the North East of the country, and population surveillance has commenced. This case study will here be used to explore the considerations which go into determining the most appropriate sites for mosquito field research. Although each situation is unique, and an ideal site may not be available, this discussion aims to help researchers to consider and balance the important factors and select field sites that will meet their needs. Copyright © 2013 International Atomic Energy Agency 2013. Published by Elsevier B.V. All rights reserved.

Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.

PubMed

Singh, Devinder Kaur Ajit; Mohd Nordin, Nor Azlin; Abd Aziz, Noor Azah; Lim, Beng Kooi; Soh, Li Ching

2013-12-13

Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. In this controlled trial, the experimental group received 30 minutes of virtual reality balance games in addition to 90 minutes of standard physiotherapy. The control group continued with their two hours of routine standard physiotherapy. Both groups received 12 therapy sessions: two-hour sessions twice per week for six continuous weeks. Changes in physical function, activities of daily living and balance ability were assessed using the Timed Up and Go test, 30-second Sit to Stand test, Timed Ten-Metre Walk test, Six-Minute Walk test and the Barthel Index, and static balance was assessed using a probalance board. Twenty-eight participants completed post-intervention assessments. The results showed a significant within-subject effect on the Timed Up and Go test: F (1, 26) = 5.83, p = 0.02; and the 30-second Sit to Stand test; F (1, 26) = 13.50, p = 0.001. The between-subject effect was not significant (p > 0.05) for any of the outcome measurements. Substituting a portion of the standard physiotherapy time with virtual reality games was equally effective in maintaining physical function outcomes and activities of daily living among community-dwelling stroke survivors. Australia and New Zealand Clinical Trials Register, ACTRN12613000478718.

Auditing emergency management programmes: Measuring leading indicators of programme performance.

PubMed

Tomsic, Heather

Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.

Posture Allocation Revisited: Breaking the Sedentary Threshold of Energy Expenditure for Obesity Management

PubMed Central

Miles-Chan, Jennifer L.; Dulloo, Abdul G.

2017-01-01

There is increasing recognition that low-intensity physical activities of daily life play an important role in achieving energy balance and that their societal erosion through substitution with sedentary (mostly sitting) behaviors, whether occupational or for leisure, impact importantly on the obesity epidemic. This has generated considerable interest for better monitoring, characterizing, and promoting countermeasures to sedentariness through a plethora of low-level physical activities (e.g., active workstations, standing desks, sitting breaks), amid the contention that altering posture allocation (lying, sitting, standing) can modify energy expenditure to impact upon body weight regulation and health. In addressing this contention, this paper first revisits the past and more recent literature on postural energetics, with particular emphasis on potential determinants of the large inter-individual variability in the energy cost of standing and the impact of posture on fat oxidation. It subsequently analyses the available data pertaining to various strategies by which posture allocations, coupled with light physical activity, may increase energy expenditure beyond the sedentary threshold, and their relevance as potential targets for obesity management. PMID:28690547

The utility of microsatellite DNA markers for the evaluation of area-wide integrated pest management using SIT for the fruit fly, Bactrocera dorsalis (Hendel), control programs in Thailand.

PubMed

Aketarawong, Nidchaya; Chinvinijkul, Suksom; Orankanok, Watchreeporn; Guglielmino, Carmela Rosalba; Franz, Gerald; Malacrida, Anna Rodolfa; Thanaphum, Sujinda

2011-01-01

The oriental fruit fly, Bactrocera dorsalis (Hendel), is a key pest that causes reduction of the crop yield within the international fruit market. Fruit flies have been suppressed by two Area-Wide Integrated Pest Management programs in Thailand using Sterile Insect Technique (AW-IPM-SIT) since the late 1980s and the early 2000s. The projects' planning and evaluation usually rely on information from pest status, distribution, and fruit infestation. However, the collected data sometimes does not provide enough detail to answer management queries and public concerns, such as the long term sterilization efficacy of the released fruit fly, skepticism about insect migration or gene flow across the buffer zone, and the re-colonisation possibility of the fruit fly population within the core area. Established microsatellite DNA markers were used to generate population genetic data for the analysis of the fruit fly sampling from several control areas, and non-target areas, as well as the mass-rearing facility. The results suggested limited gene flow (m < 0.100) across the buffer zones between the flies in the control areas and flies captured outside. In addition, no genetic admixture was revealed from the mass-reared colony flies from the flies within the control area, which supports the effectiveness of SIT. The control pests were suppressed to low density and showed weak bottleneck footprints although they still acquired a high degree of genetic variation. Potential pest resurgence from fragmented micro-habitats in mixed fruit orchards rather than pest incursion across the buffer zone has been proposed. Therefore, a suitable pest control effort, such as the SIT program, should concentrate on the hidden refuges within the target area.

Program Manager: Journal of the Defense Systems Management College. Volume 17, Number 5, September-October 1988

DTIC Science & Technology

1988-09-01

difficulties), 1580. Engineers, Boston, Mass., December Polaroid, and Xerox. 25. William Shakespeare (1564-1616), 1987. 19. Ibid. Hamlet , Act I, Scene...ethics institute, former philosophy philospher said "Know thyself." 26 next step is to sit down with manage- teacher and magazine editor. Shakespeare

NTL Data Management Planning "Greenout" Bingo Self Assessment Tool

DOT National Transportation Integrated Search

2016-08-11

This tool is designed to help assess your current data management practices. Pick a dataset or research project, sit down with your data collection team, and discuss each prompt below. This tool can guide DMP improvement by revealing best practices t...

Developing Researching Managers and Relevant Research--The "Executive Research Programme"

ERIC Educational Resources Information Center

Werr, Andreas; Strannegård, Lars

2014-01-01

The current paper argues for bridging the "relevance gap" in management research and education by creating educational programmes that bring together experienced managers and management researchers. In the "Executive Research Programme" discussed in this paper, managers were paired up with researchers to conduct a collaborative…

Effect of an experiential learning-based programme to foster competence among nurse managers.

PubMed

Kuraoka, Yumiko

2018-03-30

The present study aimed to examine the effect of providing an experiential learning-based programme to foster competence among nurse managers in the early years of their supervisory roles. Nurse managers take supervisory positions without being sufficiently prepared for the task and therefore often experience difficultly in the early years of managerial roles. They need support from their supervisor and require opportunities for development. We developed an experiential learning-based programme for nurse managers in the first 3 years of a supervisory role. Sixty-three nurse managers and their supervisors were enrolled. The programme was evaluated using a one-group pretest-posttest design. The outcome measures were experiential learning, knowledge, social support, competency as a nurse manager, and sense of coherence. Outcomes were compared using paired t tests. Nurse managers showed significantly improved experiential learning (p = .001), knowledge (p < .001) and competence as a nurse manager (p = .002) after participating in this programme. This programme increased knowledge, promoted experiential learning, and improved competence among nurse managers. This experiential learning-based programme for nurse managers in the early years of a supervisory role fostered competence among nurse managers. © 2018 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

Study design and protocol for a mixed methods evaluation of an intervention to reduce and break up sitting time in primary school classrooms in the UK: The CLASS PAL (Physically Active Learning) Programme.

PubMed

Routen, Ash C; Biddle, Stuart J H; Bodicoat, Danielle H; Cale, Lorraine; Clemes, Stacy; Edwardson, Charlotte L; Glazebrook, Cris; Harrington, Deirdre M; Khunti, Kamlesh; Pearson, Natalie; Salmon, Jo; Sherar, Lauren B

2017-11-08

Children engage in a high volume of sitting in school, particularly in the classroom. A number of strategies, such as physically active lessons (termed movement integration (MI)), have been developed to integrate physical activity into this learning environment; however, no single approach is likely to meet the needs of all pupils and teachers. This protocol outlines an implementation study of a primary school-based MI intervention: CLASS PAL (Physically Active Learning) programme. This study aims to (A) determine the degree of implementation of CLASS PAL, (B) identify processes by which teachers and schools implement CLASS PAL and (C) investigate individual (pupil and teacher) level and school-level characteristics associated with implementation of CLASS PAL. The intervention will provide teachers with a professional development workshop and a bespoke teaching resources website. The study will use a single group before-and-after design, strengthened by multiple interim measurements. Six state-funded primary schools will be recruited within Leicestershire, UK.Evaluation data will be collected prior to implementation and at four discrete time points during implementation: At measurement 0 (October 2016), school, teacher and pupil characteristics will be collected. At measurements 0 and 3 (June-July 2017), accelerometry, cognitive functioning, self-reported sitting and classroom engagement data will be collected. At measurements 1(December 2016-March 2017) and 3 , teacher interviews (also at measurement 4; September-October 2017) and pupil focus groups will be conducted, and at measurements 1 and 2 (April-May 2017), classroom observations. Implementation will be captured through website analytics and ongoing teacher completed logs. Ethical approval was obtained through the Loughborough University Human Participants Ethics Sub-Committee (Reference number: R16-P115). Findings will be disseminated via practitioner and/or research journals and to relevant regional and national stakeholders through print and online media and dissemination event(s). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The management of cardiovascular disease in the Netherlands: analysis of different programmes

PubMed Central

Cramm, Jane M.; Tsiachristas, Apostolos; Walters, Bethany H.; Adams, Samantha A.; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P.M.H.; Nieboer, Anna P.

2013-01-01

Background Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery. But, disease management programme development and implementation is a complex undertaking that requires effective decision-making. Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. Methods To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Results Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Conclusions Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in routine care. As care pathways become more complex, they also become more expensive. Better preparedness and training can prevent unnecessary delays during the implementation period and are crucial to reducing costs. PMID:24167456

The management of cardiovascular disease in the Netherlands: analysis of different programmes.

PubMed

Cramm, Jane M; Tsiachristas, Apostolos; Walters, Bethany H; Adams, Samantha A; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P M H; Nieboer, Anna P

2013-01-01

Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery. But, disease management programme development and implementation is a complex undertaking that requires effective decision-making. Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in routine care. As care pathways become more complex, they also become more expensive. Better preparedness and training can prevent unnecessary delays during the implementation period and are crucial to reducing costs.

Identity-driven differences in stakeholder concerns about hunting wolves.

PubMed

Lute, Michelle L; Bump, Adam; Gore, Meredith L

2014-01-01

Whereas past wolf management in the United States was restricted to recovery, managers must now contend with publicly contentious post-recovery issues including regulated hunting seasons. Understanding stakeholder concerns associated with hunting can inform stakeholder engagement, communication, and policy development and evaluation. Social identity theory (SIT) has been used to understand how groups interact, why they conflict, and how collaboration may be achieved. Applying SIT to stakeholder conflicts about wolf hunting may help delineate groups according to their concern about, support for or opposition to the policy choice of hunting wolves. Our objective was to assess concerns about hunting as a tool to resolve conflict in Michigan, using SIT as a framework. We used a mixed-modal sampling approach (e.g., paper, Internet) with wolf hunting-related public meeting participants in March 2013. Survey questions focused on 12 concerns previously identified as associated with hunting as a management tool to resolve conflict. Respondents (n  =  666) cared greatly about wolves but were divided over hunting wolves. Wolf conflicts, use of science in policy decisions, and maintaining a wolf population were the highest ranked concerns. Principle components analysis reduced concerns into three factors that explained 50.7% of total variance; concerns crystallized over justifications for hunting. General linear models revealed a lack of geographic influence on care, fear and support for hunting related to wolves. These findings challenge assumptions about regional differences and suggest a strong role for social identity in driving dichotomized public perceptions in wildlife management.

Organizational-Level Strategies With or Without an Activity Tracker to Reduce Office Workers’ Sitting Time: Rationale and Study Design of a Pilot Cluster-Randomized Trial

PubMed Central

Fjeldsoe, Brianna S; Young, Duncan C; Winkler, Elisabeth A H; Dunstan, David W; Straker, Leon M; Brakenridge, Christian J; Healy, Genevieve N

2016-01-01

Background The office workplace is a key setting in which to address excessive sitting time and inadequate physical activity. One major influence on workplace sitting is the organizational environment. However, the impact of organizational-level strategies on individual level activity change is unknown. Further, the emergence of sophisticated, consumer-targeted wearable activity trackers that facilitate real-time self-monitoring of activity, may be a useful adjunct to support organizational-level strategies, but to date have received little evaluation in this workplace setting. Objective The aim of this study is to evaluate the feasibility, acceptability, and effectiveness of organizational-level strategies with or without an activity tracker on sitting, standing, and stepping in office workers in the short (3 months, primary aim) and long-term (12 months, secondary aim). Methods This study is a pilot, cluster-randomized trial (with work teams as the unit of clustering) of two interventions in office workers: organizational-level support strategies (eg, visible management support, emails) or organizational-level strategies plus the use of a waist-worn activity tracker (the LUMOback) that enables self-monitoring of sitting, standing, and stepping time and enables users to set sitting and posture alerts. The key intervention message is to ‘Stand Up, Sit Less, and Move More.’ Intervention elements will be implemented from within the organization by the Head of Workplace Wellbeing. Participants will be recruited via email and enrolled face-to-face. Assessments will occur at baseline, 3, and 12 months. Time spent sitting, sitting in prolonged (≥30 minute) bouts, standing, and stepping during work hours and across the day will be measured with activPAL3 activity monitors (7 days, 24 hours/day protocol), with total sitting time and sitting time during work hours the primary outcomes. Web-based questionnaires, LUMOback recorded data, telephone interviews, and focus groups will measure the feasibility and acceptability of both interventions and potential predictors of behavior change. Results Baseline and follow-up data collection has finished. Results are expected in 2016. Conclusions This pilot, cluster-randomized trial will evaluate the feasibility, acceptability, and effectiveness of two interventions targeting reductions in sitting and increases in standing and stepping in office workers. Few studies have evaluated these intervention strategies and this study has the potential to contribute both short and long-term findings. PMID:27226457

Quality of care in patients with psoriasis: an initial clinical study of an international disease management programme.

PubMed

de Korte, J; Van Onselen, J; Kownacki, S; Sprangers, M A G; Bos, J D

2005-01-01

Patients with psoriasis have to cope with their disease for many years or even throughout their entire life. To provide optimal care, a disease management programme was developed. This programme consisted of disease education, disease management training, and psychological support, together with topical treatment. To test a disease management programme in dermatological practice, to assess patients' satisfaction with this programme, and adherence to topical treatment. Additionally, disease severity and quality of life were assessed. An initial clinical investigation was conducted in 10 European treatment centres. A total of 330 patients were included. Patient satisfaction, adherence, disease severity and quality of life were measured with study-specific and standardized self-report questionnaires. Patients reported a high degree of satisfaction with the programme, and a high degree of adherence to topical treatment. Disease severity and quality of life significantly improved. The programme was well received by the participating professionals. The disease management programme was found to be a useful tool in the management of psoriasis, providing patients with relief from the burden of psoriasis in everyday life. A full-scale evaluation is recommended.

Effects of a Worksite Health Programme on the Improvement of Physical Health among Overweight and Obese Civil Servants: A Pilot Study.

PubMed

Ramli, Ayiesah; Henry, Leonard Joseph; Liang, York Fuan; Beh, Jyh Yun

2013-10-01

Physical inactivity and reduced energy expenditure has led to increased obesity among office workers. This study was conducted to investigate the effectiveness of a worksite health programme aimed at improving physical health among obese civil servants. A total of 28 employees participated in a six-month-long obesity health programme, which consisted of two weekly unsupervised exercise sessions and monthly dietary/health education sessions. The physical fitness and body fat percentages of participants were assessed at the baseline and after six months, using SPSS version 20.0. The participants were 31.6 years (SD 8.2) of age, and had a BMI of 27.6 kg/m(2) (SD 3.2). The Wilcoxon test showed significant differences in body fat percentage (P = 0.010), gross maximum oxygen uptake (VO2max, P = 0.014), partial curl up repetition (P = 0.001) and sit and reach distance (P = 0.005). However, no significant effects were observed on body mass (P = 0.193), self-perceived level of physical activity (P = 0.145) or behaviour toward exercise (P = 0.393). The worksite health programme successfully improved the physical fitness and body fat percentages of subjects, despite not improving the subjects' self-perceptions with regard to physical activity.

Assessing the efficacy of immunotherapy with a glutaraldehyde-modified house dust mite extract in children by monitoring changes in clinical parameters and inflammatory markers in exhaled breath.

PubMed

Lozano, Jaime; Cruz, María-Jesús; Piquer, Mónica; Giner, Maria-Teresa; Plaza, Ana María

2014-01-01

The aim of this study was to evaluate the effectiveness of specific immunotherapy (SIT) management with allergoids in children with allergic asthma by monitoring changes in clinical parameters and inflammatory markers in exhaled breath. The study population included 43 patients (24 males) of 6-14 years of age, who had allergic asthma and were sensitized to mites. Twenty-three individuals were treated with subcutaneous SIT (PURETHAL® Mites, HAL Allergy) for 8 months, i.e. the SIT group, and 20 were given medication to treat symptoms only, i.e. the control group. Before treatment and after 4 and 8 months, several clinical parameters, the levels of exhaled nitric oxide and the pH of exhaled breath condensate (EBC) were determined. The SIT group presented with an improvement in asthma classification, a reduction in maintenance drug therapy and improved scores on the quality-of-life questionnaire. These changes were not observed in the control group. Both groups presented significant decreases in EBC pH values at 4 and 8 months after treatment compared to at baseline. However, analysis of the variable 'ratio' showed an increase in the EBC pH values after 8 months of treatment in the SIT group compared with the values at 4 months. SIT with standardized mite extract reduces asthma symptoms in children. A decrease in EBC pH values was observed in both groups, although the SIT group presented a tendency of recovered values after 8 months. Future studies of EBC pH monitoring in the longer term are needed to determine the effectiveness of this marker. © 2014 S. Karger AG, Basel.

Classroom Management for Kids Who Won't Sit Still and Other "Bad Apples"

ERIC Educational Resources Information Center

Cahill, Susan M.

2006-01-01

This article presents a case description of collaboration between an occupational therapist and a general education teacher to develop an effective classroom management system. The classroom management system described here was based on the Alert Program for Self-regulation: How Does Your Engine Run? In addition, the case description provides a…

Heart failure management programmes in Europe.

PubMed

Jaarsma, T; Strömberg, A; De Geest, S; Fridlund, B; Heikkila, J; Mårtensson, J; Moons, P; Scholte op Reimer, W; Smith, K; Stewart, S; Thompson, D R

2006-09-01

The ESC guidelines recommend that an organised system of specialist heart failure (HF) care should be established to improve outcomes of HF patients. The aim of this study was therefore to identify the number and the content of HF management programmes in Europe. A two-phase descriptive study was conducted: an initial screening to identify the existence of HF management programmes; and a survey to describe the content in countries where at least 30% of the hospitals had a programme. Of the 43 European countries approached, 26 (60%) estimated the percentage of HF management programmes. Seven countries reported that they had such programmes in more than 30% of their hospitals. Of the 673 hospitals responding to the questionnaire, 426 (63%) had a HF management programme. Half of the programmes (n = 205) were located in an outpatient clinic. In the UK a combination of hospital and home-based programmes was common (75%). The most programmes included physical examination, telephone consultation, patient education, drug titration and diagnostic testing. Most (89%) programmes involved nurses and physicians. Multi-disciplinary teams were active in 56% of the HF programmes. The most prominent differences between the 7 countries were the degree of collaboration with home care and GP's, the role in palliative care and the funding. Only a few European countries have a large number of organised programmes for HF care and follow up. To improve outcomes of HF patients throughout Europe more effort should be taken to increase the number of these programmes in all countries.

A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes).

PubMed

Biddle, Stuart J H; Edwardson, Charlotte L; Wilmot, Emma G; Yates, Thomas; Gorely, Trish; Bodicoat, Danielle H; Ashra, Nuzhat; Khunti, Kamlesh; Nimmo, Myra A; Davies, Melanie J

2015-01-01

Type 2 diabetes mellitus (T2DM), a serious and prevalent chronic disease, is traditionally associated with older age. However, due to the rising rates of obesity and sedentary lifestyles, it is increasingly being diagnosed in the younger population. Sedentary (sitting) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes, including T2DM. Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM. We aimed to investigate, through a randomised controlled trial (RCT) design, whether a group-based structured education workshop focused on sitting reduction, with self-monitoring, reduced sitting time. Adults aged 18-40 years who were either overweight (with an additional risk factor for T2DM) or obese were recruited for the Sedentary Time ANd Diabetes (STAND) RCT. The intervention programme comprised of a 3-hour group-based structured education workshop, use of a self-monitoring tool, and follow-up motivational phone call. Data were collected at three time points: baseline, 3 and 12 months after baseline. The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months. Secondary outcomes included other objective (activPAL) and self-reported measures of sedentary behaviour and physical activity, and biochemical, anthropometric, and psycho-social variables. 187 individuals (69% female; mean age 33 years; mean BMI 35 kg/m2) were randomised to intervention and control groups. 12 month data, when analysed using intention-to-treat analysis (ITT) and per-protocol analyses, showed no significant difference in the primary outcome variable, nor in the majority of the secondary outcome measures. A structured education intervention designed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months. Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change. Moreover, some participants reported a focus on physical activity rather than reductions in sitting per se. The habitual nature of sedentary behaviour means that behaviour change is challenging. Controlled-Trials.com ISRCTN08434554.

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users' and health professionals' perceptions.

PubMed

Solberg, Hilde Strøm; Steinsbekk, Aslak; Solbjør, Marit; Granbo, Randi; Garåsen, Helge

2014-11-08

Development of more self-management support programmes in primary health care has been one option used to enhance positive outcomes in chronic disease management. At present, research results provide no consensus on what would be the best way to develop support programmes into new settings. The aim of the present study was therefore to explore users' and health professionals' perceptions of what would be the vital elements in a self - management support programme applicable in primary health care, how to account for them, and why. Four qualitative, semi-structured focus group interviews were conducted in Central Norway. The informants possessed experience in development, provision, or participation in a self-management support programme. Data was analysed by the Systematic Text Condensation method. The results showed an overall positive expectation to the potential benefits of development of a self-management support programme in primary health care. Despite somewhat different arguments and perspectives, the users and the health professionals had a joint agreement on core characteristics; a self-management support programme in primary health care should therefore be generic, not disease specific, and delivered in a group- based format. A special focus should be on the everyday- life of the participants. The most challenging aspect was a present lack of competence and experience among health professionals to moderate self-management support programmes. The development and design of a relevant and applicable self-management support programme in primary health care should balance the interests of the users with the possibilities and constraints within each municipality. It would be vital to benefit from the closeness of the patients' every-day life situations. The user informants' perception of a self-management support programme as a supplement to regular medical treatment represented an expanded understanding of the self-management support concept. An exploring approach should be applied in the development of the health professionals' competence in practice. The effect of a self-management support programme based on the core characteristics found in this study needs to be evaluated.

Management of organisational changes in a case of de-institutionalisation.

PubMed

Parlalis, Stavros K

2011-01-01

This paper seeks to explore the development of a discharge programme in one learning disability hospital in Scotland. The study aims to concentrate on organisational developmental changes in that institution. The model of the management during the discharge programme was investigated. The aim of the study is to explore how the discharge programme developed, as seen under the lens of organisational change, in order to find out what kind of model of management is more suitable in similar programmes. A case study was employed. Data were collected by means of interviews. The interviews followed a structured format. The sample of the study had to be a purposive sample and the method of snowball sampling was used; finally, 28 interviews were conducted. A grounded approach was adopted for the data analysis. The software program QSR "NUD*IST" (version "N6") was used as a technical tool, in order to facilitate the data analysis. The findings of this study show that various management models were adopted in the four phases of the discharge programme. These different models represent a "quest" by the institution's management regarding the most appropriate model for managing the discharge programme. This study shows that this goes on continuously in organisations under transition until they settle down to a more permanent state. It was concluded that management models, which are composed of characteristics from the organic theory of organisational management, could apply in discharge programmes. The data gathered enabled the researcher to arrive at a model of management which is suitable for managing organisational changes in discharge programmes, the named "stakeholder management model".

The integration of studio cycling into a worksite stress management programme.

PubMed

Clark, Matthew M; Soyring, Jason E; Jenkins, Sarah M; Daniels, Denise C; Berkland, Bridget E; Werneburg, Brooke L; Hagen, Philip T; Lopez-Jimenez, Francisco; Warren, Beth A; Olsen, Kerry D

2014-04-01

High stress is a prevalent problem in the worksite. To reduce stress, improve productivity, reduce absenteeism, and lower healthcare costs, many companies offer exercise classes or stress management programmes. Although physical activity is an important component of stress management, few worksites have integrated physical activity into their comprehensive stress reduction programmes. The purpose of this single-arm pilot project was to examine the potential effectiveness of an integrated exercise (studio cycling) and cognitive-behavioural stress management programme. Eighty-four adults, 75% female, mostly aged 40+ years, participated in an integrated 12-week cycling studio and cognitive-behavioural stress management programme. Participants experienced a significant and clinically meaningful reduction on the Perceived Stress Scale (p < 0.01), rating of current stress level and confidence to manage stress at the programme's end and at a 1-month follow-up. Participants also reported having significantly improved overall health, improved nutritional habits, higher physical activity level, greater confidence in their ability to follow a healthy diet, higher spiritual well-being, improved sleep, receiving more support for maintaining healthy living and improved quality of life at the completion of the 12-week programme and 1-month follow-up. These findings provide further support for an integrated exercise and stress management programme. © 2013 John Wiley & Sons, Ltd.

29 CFR 1926.1401 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-management or management personnel. Articulating crane means a crane whose boom consists of a series of... means a signal made by a distinct sound or series of sounds. Examples include, but are not limited to... sling (which may be incorporated into a full body harness) designed to support one employee in a sitting...

29 CFR 1926.1401 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-management or management personnel. Articulating crane means a crane whose boom consists of a series of... means a signal made by a distinct sound or series of sounds. Examples include, but are not limited to... sling (which may be incorporated into a full body harness) designed to support one employee in a sitting...

29 CFR 1926.1401 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-management or management personnel. Articulating crane means a crane whose boom consists of a series of... means a signal made by a distinct sound or series of sounds. Examples include, but are not limited to... sling (which may be incorporated into a full body harness) designed to support one employee in a sitting...

Land-use history

Treesearch

David L. White

2001-01-01

The management of natural resources at the Savannah River Site (SRS) has been variously executed over the years to meet conservation and restoration objectives, to provide research and educational opportunities, and to generate revenue from the sale of forest products. However, these management activities have been implemented under the constraints imposed by the Sit...

29 CFR 1926.1401 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-management or management personnel. Articulating crane means a crane whose boom consists of a series of... means a signal made by a distinct sound or series of sounds. Examples include, but are not limited to... sling (which may be incorporated into a full body harness) designed to support one employee in a sitting...

Lumbar lateral shift in a patient with interspinous device implantation: a case report.

PubMed

Peterson, Seth; Hodges, Cheri

2016-09-01

Lumbar lateral shift (LLS) is a common clinical observation but has rarely been described in a patient with a history of lumbar surgery. The purpose of the current case report was to describe the use of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) in the multi-modal treatment of a patient with an LLS and a history of multiple surgical procedures in the lumbar spine, including interspinous process device (IPD) implantation. A 72-year-old female with chronic low back pain (LBP) and a surgical history in the lumbar spine was referred to physical therapy for radiating leg pain and presented with a right LLS. Her chief complaints included sitting for long periods, vacuuming and ascending stairs into her home. The patient was treated during eight visits over 30 days. Treatment interventions included manual shift correction, self-correction and management, joint mobilisation below the level of IPD implantation ,neurophysiology education, and development of a home exercise programme. At discharge, her leg pain was resolved and all goals had been met. The patient reported maintenance of gains at 6-month follow-up. Utilisation of the MDT approach, including LLS correction, produced positive outcomes in a complex patient with previous IPD implantation. Future research should investigate treatment and outcomes after invasive spinal procedures in similar patient populations to better inform clinical management. 4.

Self-management programmes for people living with chronic obstructive pulmonary disease: a call for a reconceptualisation.

PubMed

Jonsdottir, Helga

2013-03-01

To synthesise findings from previously published studies on the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease. Self-management is a widely valued concept to address contemporary issues of chronic health problems. Yet, findings of self-management programmes for people with chronic obstructive pulmonary disease are indecisive. Literature review of (1) previously published systematic reviews and (2) an integrative literature review. Synthesis of findings from previously published systematic reviews (n = 4) of the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease and an integrated review that was performed on papers published between January 2007-June 2012 (n = 9). Findings demonstrate that there are few studies on the effectiveness of self-management programmes on people with chronic obstructive pulmonary disease despite more than a decade of research activities. Outcomes of the studies reveal some increase in health-related quality of life and reduction in use of healthcare resources. The methodological approaches vary, and the sample size is primarily small. Families are not acknowledged. Features of patient-centredness exist in self-management programmes, particularly in the more recent articles. The effectiveness of self-management programmes for people with chronic obstructive pulmonary disease remains indecisive. A reconceptualisation of self-management programmes is called for with attention to a family-centred, holistic and relational care focusing on living with and minimising the handicapping consequences of the health problems in their entirety. © 2013 Blackwell Publishing Ltd.

How Do Management and Non-Management Employees Perceive Workplace Wellness Programmes? A Qualitative Examination

ERIC Educational Resources Information Center

Caperchione, Cristina M.; Reid, R. Colin; Sharp, Paul G.; Stehmeier, Joshua

2016-01-01

Objectives: The value of workplace wellness programmes (WWPs) has been established in the literature. Such programmes, however, have an increased likelihood for success when both management and non-management employees' perspectives and needs are incorporated into development and implementation. This study aimed to identify the perspectives of…

The Japanese Space Program (Le Programme Spatial Japonais),

DTIC Science & Technology

1982-04-22

three-axis stabilization, study of vertical * structure of the earth); --series of probes for exploration of the moon and the planets. Future Missions...in foreground and 7 rr IArk j I, I *151 Fig. 9. Structural detail of the MU 3S (rear skirt) Fi. 1. St u tu a de ai of MU 3S..’’ ’ -, t r-’ ,’ s:,ru...ture) The total l t of te M I is 2-8. 2 m, - . The Fig. i. Structural detail of tU S (ri er sit)ctre 1.65 mthiamr. ach bfotitaniu wll have a

Standing Classrooms: Research and Lessons Learned from Around the World.

PubMed

Hinckson, Erica; Salmon, Jo; Benden, Mark; Clemes, Stacey A; Sudholz, Bronwyn; Barber, Sally E; Aminian, Saeideh; Ridgers, Nicola D

2016-07-01

Children spend between 50 and 70 % of their time sitting while at school. Independent of physical activity levels, prolonged sitting is associated with poor health outcomes in adulthood. While there is mixed evidence of health associations among children and adolescents, public health guidelines in the USA, UK, Australia and Canada now recommend young people should break up long periods of sitting as frequently as possible. A potentially effective approach for reducing and breaking up sitting throughout the day is changing the classroom environment. This paper presents an overview of a relatively new area of research designed to reduce youth sitting time while at school by changing the classroom environment (n = 13 studies). Environmental changes included placement of height-adjustable or stand-biased standing desks/workstations with stools, chairs, exercise balls, bean bags or mats in the classroom. These 13 published studies suggest that irrespective of the approach, youth sitting time was reduced by between ~44 and 60 min/day and standing time was increased by between 18 and 55 min/day during classroom time at school. Other benefits include increased energy expenditure and the potential for improved management of students' behaviour in the classroom. However, few large trials have been conducted, and there remains little evidence regarding the impact on children's learning and academic achievement. Nevertheless, with an increasing demand placed on schools and teachers regarding students' learning outcomes, strategies that integrate moving throughout the school day and that potentially enhance the learning experience and future health outcomes for young people warrant further exploration.

Preventing and Treating Peri-Implantitis: A Cost-Effectiveness Analysis.

PubMed

Schwendicke, Falk; Tu, Yu-Kang; Stolpe, Michael

2015-09-01

A large number of treatments for peri-implantitis are available, but their cost-effectiveness remains uncertain. This study evaluates the cost-effectiveness of preventing and treating peri-implantitis. A Markov model was constructed that followed each implant over 20 years. Supportive implant therapy (SIT) for managing peri-implant mucositis and preventing development of peri-implantitis was either provided or not. Risk of peri-implantitis was assumed to be affected by SIT and the patient's risk profile. If peri-implantitis occurred, 11 treatment strategies (non-surgical or surgical debridement alone or combined with adjunct therapies) were compared. Treatments and risk profiles determined disease progression. Modeling was performed based on systematically collected data. Primary outcomes were costs and proportion of lost implants, as assessed via Monte Carlo microsimulations. Not providing SIT and performing only non-surgical debridement was both least costly and least effective. The next best (more costly and effective) option was to provide SIT and perform surgical debridement (additional 0.89 euros per 1% fewer implants lost). The most effective option included bone grafts, membranes, and laser treatment (56 euros per 1%). For patients at high risk, the cost-effectiveness of SIT increased, whereas in low-risk groups, a cost-optimized strategy was cost-effective. Although clinical decision-making will be guided mainly by clinical condition, cost-effectiveness analyses might add another perspective. Based on these findings, an unambiguous comparative effectiveness ranking was not established. However, cost-effectiveness was predominantly determined by provision of SIT and initial treatment costs. Transferability of these findings to other healthcare systems needs further confirmation.

Factors Affecting Herd Status for Bovine Tuberculosis in Dairy Cattle in Northern Thailand

PubMed Central

Singhla, Tawatchai; Punyapornwithaya, Veerasak; VanderWaal, Kimberly L.; Alvarez, Julio; Sreevatsan, Srinand; Phornwisetsirikun, Somphorn; Sankwan, Jamnong; Srijun, Mongkol; Wells, Scott J.

2017-01-01

The objective of this case-control study was to identify farm-level risk factors associated with bovine tuberculosis (bTB) in dairy cows in northern Thailand. Spatial analysis was performed to identify geographical clustering of case-farms located in Chiang Mai and Chiang Rai provinces in northern Thailand. To identify management factors affecting bTB status, a matched case-control study was conducted with 20 case-farms and 38 control-farms. Case-farms were dairy farms with at least single intradermal tuberculin test- (SIT-) reactor(s) in the farms during 2011 to 2015. Control-farms were dairy farms with no SIT-reactors in the same period and located within 5 km from case-farms. Questionnaires were administered for data collection with questions based on epidemiological plausibility and characteristics of the local livestock industry. Data were analyzed using multiple logistic regressions. A significant geographic cluster was identified only in Chiang Mai province (p < 0.05). The risk factor associated with presence of SIT-reactors in dairy herds located in this region was purchasing dairy cows from dealers (OR = 5.85, 95% CI = 1.66–20.58, and p = 0.006). From this study, it was concluded that geographic clustering was identified for dairy farms with SIT-reactors in these provinces, and the cattle movements through cattle dealers increased the risks for SIT-reactor farm status. PMID:28553557

Quality management systems for fruit fly (Diptera: Tephritidae) sterile insect technique

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

Caceres, C.; Robinson, A.; McInnis, D.

The papers presented in this issue are focused on developing and validating procedures to improve the overall quality of sterile fruit flies for use in area-wide integrated pest management (AW-IPM) programs with a sterile insect technique (SIT) component. The group was coordinated and partially funded by the Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, International Atomic Energy Agency, Vienna, Austria, under a five-year Coordinated Research Project (CRP) on 'Quality Assurance in Mass-Reared and Released Fruit Flies for Use in SIT Programmes'. Participants in the CRP from 16 countries came from both basic and applied fields of expertisemore » to ensure that appropriate and relevant procedures were developed. A variety of studies was undertaken to develop protocols to assess strain compatibility and to improve colonization procedures and strain management. Specific studies addressed issues related to insect nutrition, irradiation protocols, field dispersal and survival, field cage behavior assessments, and enhancement of mating competitiveness. The main objective was to increase the efficiency of operational fruit fly programs using sterile insects and to reduce their cost. Many of the protocols developed or improved during the CRP will be incorporated into the international quality control manual for sterile tephritid fruit flies, standardizing key components of the production, sterilization, shipment, handling, and release of sterile insects. (author) [Spanish] Los articulos presentados en este numero se enfocan en el desarrollo y la validacion de procedimientos para mejorar la calidad total de moscas de las frutas esteriles para su uso en programas de manejo integrado de plagas en donde la tecnica del insecto esteril (TIE) es uno de los componentes clave. El grupo fue coordinado y parcialmente financiado por la Division Conjunta de Tecnicas Nucleares para la Alimentacion y la Agricultura de la FAO/OIEA, Viena, Austria, por un periodo de cinco anos bajo el proyecto de Investigacion Coordinada (PIC) sobre 'el Aseguramiento de la Calidad de Moscas de las Frutas Criadas y Liberadas para su Uso en Programas de TIE'. Los participantes en el PIC representan 16 paises con experiencia en campos de investigacion basica y aplicada. Para asegurar que los procedimientos desarrollados fueran apropiados y pertinentes, se realizaron una variedad de estudios para el desarrollo de protocolos para evaluar la compatibilidad y para mejorar los procedimientos de colonizacion y manejo de cepas salvajes. Estudios especificos trataron asuntos relacionados con la nutricion de insectos, los protocolos de irradiacion, la dispersion y supervivencia en el campo, evaluacion del comportamiento en jaulas de campo, y el mejoramiento de la competitividad sexual. Los objetivos fundamentales fueron el aumentar la eficiencia y reducir los costos de los programas operacionales de control de moscas de las frutas donde TIE es utilizada. Muchos de los protocolos desarrollados o mejorados durante el PIC seran incorporados en el Manual Internacional de Control de Calidad para Moscas Estriles de la familia Tephritidae, para estandarizar componentes claves como la produccion, esterilizacion, envio, manejo y liberacion de insectos esteriles. (author)« less

Efficacy of a telerehabilitation intervention programme using biofeedback among computer operators.

PubMed

Golebowicz, Merav; Levanon, Yafa; Palti, Ram; Ratzon, Navah Z

2015-01-01

Computer operators spend long periods of time sitting in a static posture at computer workstations and therefore have an increased exposure to work-related musculoskeletal disorders (WRMSD). The present study is aimed at investigating the feasibility and effectiveness of a tele-biofeedback ergonomic intervention programme among computer operators suffering from WRMSD. Twelve subjects with WRMSD were assigned an ergonomic intervention accompanied by remote tele-biofeedback training, which was practised at their workstations. Evaluations of pain symptoms and locations, body posture and psychosocial characteristics were carried out before and after the intervention in the workplace. The hypothesis was partially verified as it showed improved body position at the workstation and decreased pain in some body parts. Tele-biofeedback, as part of an intervention, appears to be feasible and efficient for computer operators who suffer from WRMSD. This study encourages further research on tele-health within the scope of occupational therapy practice. Practitioner summary: Research concerning tele-health using biofeedback is scarce. The present study analyses the feasibility and partial effectiveness of a tele-biofeedback ergonomic intervention programme for computer operators suffering from WRMSD. The uniqueness and singularity of this study is the usage of remote communication between participants and practitioners through the Internet.

IMPACT OF CLINICAL OFFICER ANAESTHETIST TRAINING PROGRAMME AT THE KENYA MEDICAL TRAINING COLLEGE, NAKURU, ON TRAINEE SATISFACTION, QUALITY OF PRACTICE, AND CADRE SHORTFALL ALLEVIATION.

PubMed

Nyamai, K; Ng'ang'a, P; Mutisya, R

2013-07-01

To determine the impact of Clinical Officer (C.O) Anaesthetist Training programme at Kenya Medical Training College (KMTC) Nakuru, on Trainee satisfaction, quality of practice and cadre shortfall alleviation. Cross-sectional descriptive study. Kenya Medical Training College, Nakuru. All thirty one Clinical Officer Anaesthetist graduates from KMTC Nakuru, since the training programme started 8 years ago. Twenty nine of the 31 C.O Anaesthetist graduates responded. Twenty six of the 29 respondents (89.7%) passed in the final qualifying examination in the first sitting. Twenty one (72.4%) are working in Public health facilities. All graduates are distributed in 16 out of the 47 counties in Kenya. Twenty six (89.7%) are satisfied with the training. Their average working week is 54 hours, with a median of 45 working hours a week. They recommend an improvement in peripheral nerve blocks and epidural training in the 2005 curriculum. C.O Anaesthetist training in KMTC Nakuru over the last eight years has produced self reported satisfied, adequately trained graduates and has had an impact in alleviating shortage of this cadre in Kenya. Improvement in peripheral nerve blocks and epidural training is needed.

Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study

PubMed Central

Maity, Ipsita; Meena, N.; Kumari, R. Anitha

2014-01-01

Aims: The aim of this study was to assess the outcome of single sitting root canal treatment (RCT) of asymptomatic teeth with periapical cysts. Materials and Methods: Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD) for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Results: Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. Conclusions: It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases. PMID:24963246

Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study.

PubMed

Maity, Ipsita; Meena, N; Kumari, R Anitha

2014-04-01

The aim of this study was to assess the outcome of single sitting root canal treatment (RCT) of asymptomatic teeth with periapical cysts. Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD) for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases.

Human Resources as a Strategic Partner: Sitting at the Table with Six Sigma

ERIC Educational Resources Information Center

Fazzari, Alan J.; Levitt, Kenneth

2008-01-01

For nearly three decades, the quality management philosophy known as Six Sigma has brought competitive advantage to organizations implementing it. The typical approach, however, has been to have leaders from operations, engineering, quality, and marketing manage this strategic initiative. Human resource's role has been to default to the…

Active self-correction of back posture in children instructed with 'straighten your back' command.

PubMed

Czaprowski, Dariusz; Pawłowska, Paulina; Stoliński, Lukasz; Kotwicki, Tomasz

2014-10-01

The ability to adopt the properly corrected body posture is one of the factors determining the effectiveness of therapeutic programmes. This study determined the active self-correction expressed by the change of sagittal spinal curvatures (in standing and sitting positions) in 249 children (136 females, 113 males, aged 10-14 years) instructed with 'straighten your back' command (SYB). Spinal curvatures (sacral slope-SS, lumbar lordosis-LL, global, lower and upper thoracic kyphosis-TK, LK, UK, respectively) were assessed using Saunders inclinometer. The assessment was done in spontaneous standing and sitting positions and in the positions adopted after the SYB. In a standing position SYB led to the significant (P < 0.001) increase in SS, and the significant (P < 0.01) decrease in LL, TK, LK, UK. In a sitting position SYB led to significant changes (P < 0.001) from kyphotic to lordotic position of SS and LL and to the significant (P < 0.001) reduction of TK (36.5° ± 10.8 vs. 23.5° ± 11) and the flattening of LK (15.2° ± 8.7 vs. 1.0° ± 8.4). There were gender-based discrepancy regarding active self-correction only for LL in a standing and UK in a sitting position. Females demonstrated a significant decrease in LL (P < 0.001). UK significantly increased only in males (P < 0.001). The 'straighten your back' command leads to moving the spine away from mid-range towards end range of motion. Therefore, the command should not be used to elicit the most optimal back posture. Further studies are needed to determine if the active self-correction is different in females and males. Copyright © 2013 Elsevier Ltd. All rights reserved.

Stakeholder Perspectives: CLIL Programme Management in Estonia

ERIC Educational Resources Information Center

Mehisto, Peeter; Asser, Hiie

2007-01-01

In 2000, Estonia launched a voluntary Estonian language CLIL programme for seven year-olds in four Russian-medium schools. The programme has expanded rapidly to a total of 48 kindergartens and schools. This paper reports on research into stakeholder perspectives on programme management. In addition to surveying parents, teachers, vice-principals…

School Security Assessment Programme in Australia

ERIC Educational Resources Information Center

Marrapodi, John

2007-01-01

This article describes a successful security risk management programme in Australia. The state-wide programme follows a structured risk management approach focusing on the safety and security of people, information, provision, and assets in the school environment. To assist school principals, a Security Risk Assessment Programme was developed on a…

Physical activity and frailty as indicators of cardiorespiratory reserve and predictors of surgical prognosis: General and digestive surgery population characterization.

PubMed

Dana, F; Capitán, D; Ubré, M; Hervás, A; Risco, R; Martínez-Pallí, G

2018-01-01

Frailty and low physical activity and cardiorespiratory reserve are related to higher perioperative morbimortality. The crucial step in improving the prognosis is to implement specific measures to optimize these aspects. It is critical to know the magnitude of the problem in order to implement preoperative optimization programmes. To characterize surgical population in a university hospital. All patients undergoing preoperative evaluation for abdominal surgery with admission were prospectively included during a 3-month period. Level of physical activity, functional capacity, frailty and emotional state were assessed using score tests. Additionally, physical condition was evaluated using 5 Times Sit-to-Stand Test. Demographic, clinical and surgical data were collected. One hundred and forty patients were included (60±15yr-old, 56% male, 25% ASA III or IV). Forty-nine percent of patients were proposed for oncologic surgery and 13% of which had received neoadjuvant treatment. Seventy percent of patients presented a low functional capacity and were sedentary. Eighteen percent of patients were considered frail and more than 50% completed the 5 Times Sit-to-Stand Test at a higher time than the reference values adjusted to age and sex. Advanced age, ASA III/IV, sedentarism, frailty and a high level of anxiety and depression were related to a lower functional capacity. The surgical population of our area has a low functional reserve and a high index of sedentary lifestyle and frailty, predictors of postoperative morbidity. It is mandatory to implement preoperative measures to identify population at risk and prehabilitation programmes, considered highly promising preventive interventions towards improving surgical outcome. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Stand More AT Work (SMArT Work): using the behaviour change wheel to develop an intervention to reduce sitting time in the workplace.

PubMed

Munir, Fehmidah; Biddle, Stuart J H; Davies, Melanie J; Dunstan, David; Esliger, David; Gray, Laura J; Jackson, Ben R; O'Connell, Sophie E; Yates, Tom; Edwardson, Charlotte L

2018-03-06

Sitting (sedentary behaviour) is widespread among desk-based office workers and a high level of sedentary behaviour is a risk factor for poor health. Reducing workplace sitting time is therefore an important prevention strategy. Interventions are more likely to be effective if they are theory and evidence-based. The Behaviour Change Wheel (BCW) provides a framework for intervention development. This article describes the development of the Stand More AT Work (SMArT Work) intervention, which aims to reduce sitting time among National Health Service (NHS) office-based workers in Leicester, UK. We followed the BCW guide and used the Capability, Opportunity and Motivation Behaviour (COM-B) model to conduct focus group discussions with 39 NHS office workers. With these data we used the taxonomy of Behaviour Change Techniques (BCTv1) to identify the most appropriate strategies for facilitating behaviour change in our intervention. To identify the best method for participants to self-monitor their sitting time, a sub-group of participants (n = 31) tested a number of electronic self-monitoring devices. From our BCW steps and the BCT-Taxonomy we identified 10 behaviour change strategies addressing environmental (e.g. provision of height adjustable desks,), organisational (e.g. senior management support, seminar), and individual level (e.g. face-to-face coaching session) barriers. The Darma cushion scored the highest for practicality and acceptability for self-monitoring sitting. The BCW guide, COM-B model and BCT-Taxonomy can be applied successfully in the context of designing a workplace intervention for reducing sitting time through standing and moving more. The intervention was developed in collaboration with office workers (a participatory approach) to ensure relevance for them and their work situation. The effectiveness of this intervention is currently being evaluated in a randomised controlled trial. ISRCTN10967042 . Registered on 2 February 2015.

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

PubMed

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

2016-01-01

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

Analysis of how the health systems context shapes responses to the control of human immunodeficiency virus: case-studies from the Russian Federation.

PubMed Central

Atun, Rifat A.; McKee, Martin; Drobniewski, Francis; Coker, Richard

2005-01-01

OBJECTIVE: To develop a methodology and an instrument that allow the simultaneous rapid and systematic examination of the broad public health context, the health care systems, and the features of disease-specific programmes. METHODS: Drawing on methodologies used for rapid situational assessments of vertical programmes for tackling communicable disease, we analysed programmes for the control human of immunodeficiency virus (HIV) and their health systems context in three regions in the Russian Federation. The analysis was conducted in three phases: first, analysis of published literature, documents and routine data from the regions; second, interviews with key informants, and third, further data collection and analysis. Synthesis of findings through exploration of emergent themes, with iteration, resulted in the identification of the key systems issues that influenced programme delivery. FINDINGS: We observed a complex political economy within which efforts to control HIV sit, an intricate legal environment, and a high degree of decentralization of financing and operational responsibility. Although each region displays some commonalities arising from the Soviet traditions of public health control, there are considerable variations in the epidemiological trajectories, cultural responses, the political environment, financing, organization and service delivery, and the extent of multisectoral work in response to HIV epidemics. CONCLUSION: Within a centralized, post-Soviet health system, centrally directed measures to enhance HIV control may have varying degrees of impact at the regional level. Although the central tenets of effective vertical HIV programmes may be present, local imperatives substantially influence their interpretation, operationalization and effectiveness. Systematic analysis of the context within which vertical programmes are embedded is necessary to enhance understanding of how the relevant policies are prioritized and translated to action. PMID:16283049

Can physiotherapy after stroke based on the Bobath concept result in improved quality of movement compared to the motor relearning programme.

PubMed

Langhammer, Birgitta; Stanghelle, Johan K

2011-06-01

The primary aim of the present study was to investigate, based on data from our study in 2000, whether the Bobath approach enhanced quality of movement better than the Motor Relearning Programme (MRP) during rehabilitation of stroke patients. A randomized controlled stratified trial of acute stroke patients. The patients were treated according to Motor Relearning Programme and Bobath approach and assessed with Motor Assessment Scale, Sødring Motor Evaluation Scale, Nottingham Health Profile and the Barthel Index. A triangulation of the test scores was made in reference to the Movement Quality Model and biomechanical, physiological, psycho-socio-cultural, and existential themes. The items arm (p = 0.02-0.04) sitting (p = 0.04) and hand (p = 0.01-0.03) were significantly better in the Motor Relearning Programme group than in the Bobath group, in both Sødring Motor Evaluation Scale and Motor Assessment Scale. Leg function, balance, transfer, walking and stair climbing did not differ between the groups. The Movement Quality Model and the movement qualities biomechanical, physiological and psycho-socio-cultural showed higher scoring in the Motor Relearning Programme group, indicating better quality of movement in all items. Regression models established the relationship with significant models of motor performance and self reported physical mobility (adjusted R(2) 0.30-0.68, p < 0.0001), energy (adjusted R(2) 0.13-0.14, p = 0.03-0.04, emotion (adjusted R(2) 0.30-0.38, p < 0.0001) and social interaction (arm function, adjusted R(2) 0.25, p = 0.0001). These analyses confirm that task oriented exercises of the Motor Relearning Programme type are preferable regarding quality of movement in the acute rehabilitation of patients with stroke. Copyright © 2010 John Wiley & Sons, Ltd.

Improving Educational Objectives of the Industrial and Management Systems Engineering Programme at Kuwait University

ERIC Educational Resources Information Center

Aldowaisan, Tariq; Allahverdi, Ali

2016-01-01

This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and…

A Masters Programme in Telecommunications Management--Demand-Based Curriculum Design

ERIC Educational Resources Information Center

Gharaibeh, Khaled M.; Kaylani, Hazem; Murphy, Noel; Brennan, Conor; Itradat, Awni; Al-Bataineh, Mohammed; Aloqlah, Mohammed; Salhieh, Loay; Altarazi, Safwan; Rawashdeh, Nathir; del Carmen Bas Cerdá, María; Conchado Peiró, Andrea; Al-Zoubi, Asem; Harb, Bassam; Bany Salameh, Haythem

2015-01-01

This paper presents a curriculum design approach for a Masters Programme in Telecommunications Management based on demand data obtained from surveying the needs of potential students of the proposed programme. Through online surveys disseminated at telecom companies in Jordan, it was possible to measure the demand for such a programme and to…

Effects of a group-based reproductive management extension programme on key management outcomes affecting reproductive performance.

PubMed

Brownlie, Tom S; Morton, John M; Heuer, Cord; McDougall, Scott

2015-02-01

A group-based reproductive management extension programme has been designed to help managers of dairy herds improve herd reproductive performance. The aims of this study were, firstly, to assess effects of participation by key decision makers (KDMs) in a farmer action group programme in 2009 and 2010 on six key management outcomes (KMOs) that affect reproductive performance over 2 years (2009-2010 and 2010-2011), and secondly, to describe KDM intentions to change management behaviour(s) affecting each management outcome after participation in the programme. Seasonal calving dairy herds from four regions of New Zealand were enrolled in the study. Intentions to modify management behaviour were recorded using the formal written action plans developed during the extension programme. KMOs assessed were calving pattern of the herd, pre-calving heifer liveweight, pre-calving and premating body condition score (BCS), oestrus detection, anoestrus cow management and bull management. Participation was associated with improvements in heifer liveweight, more heifers calving in the first 6 weeks of the seasonal calving period, premating BCS and oestrus detection. No significant effects were observed on anoestrus cow management or bull management. KDMs with greater numbers of proposed actions had lower 6 week in-calf rates in the second study year than KDMs who proposed fewer actions. A more effective strategy to ensure more appropriate objectives is proposed. Strategies to help KDMs to implement proposed actions more successfully should be investigated to improve the programme further. Copyright © 2014 Elsevier Ltd. All rights reserved.

Towards Developing an Initial Programme Theory: Programme Designers and Managers Assumptions on the Antiretroviral Treatment Adherence Club Programme in Primary Health Care Facilities in the Metropolitan Area of Western Cape Province, South Africa.

PubMed

Mukumbang, Ferdinand C; van Belle, Sara; Marchal, Bruno; van Wyk, Brian

2016-01-01

The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theory-the assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. The perspectives of the programme designers and managers provided an important step towards developing an initial programme theory, which will guide our realist evaluation of the adherence club programme in South Africa.

Employees' perceptions of the Aid-for-AIDS disease-management programme, South Africa.

PubMed

Rothberg, Alan; Van Huyssteen, Karen

2008-11-01

It is estimated that 18-20% of South Africa's more than 5 million HIV-positive individuals are formally employed. Disease management programmes for these employees vary in scope and sophistication, with services provided by the employer, or third-party specialist disease managers, or through medical aid schemes. This study surveyed 215 HIV-positive employees in two organisations contracted to the Aid for AIDS (AfA) disease management programme through their in-house medical aid schemes. The two organisations differed in their overall approach to HIV and AIDS: one mainly relies on on-site access to voluntary counselling and testing (VCT) and AfA's management of registered HIV-positive employees, while the other has invested in and actively developed a comprehensive programme that also extends to families and the community as well as links employees to the AfA programme. Responses received from 28 of the 215 employees surveyed indicate that fear of disclosure of one's HIV status and of stigmatisation are reasons for late registration with the AfA programme or non-utilisation of other available support programmes. Respondents mentioned that confidence in the employer's ability to maintain confidentiality was also an issue. Respondents' important suggestions for change included: a) on-site educational and awareness programmes for management personnel and staff in order to reduce HIV discrimination and stigmatisation; b) information directed at HIV-positive employees publicising the benefits and effectiveness of medical treatment; c) support groups for HIV-positive employees; and d) management personnel to engage with HIV-infected employees who are willing to take an active role in staff education and the development of workplace policies and programmes.

The role of intrinsic motivation in a group of low vision patients participating in a self-management programme to enhance self-efficacy and quality of life.

PubMed

Tay, Kay Chai Peter; Drury, Vicki Blair; Mackey, Sandra

2014-02-01

Self-management programmes have previously been found to decrease health problems, enhance quality of life and increase independence. However, there is no literature that examines the influence of the participants' intrinsic motivation on the outcomes of such programmes. This study examined the role of intrinsic motivation in a pilot low vision self-management programme to enhance self-efficacy and quality of life of the programme participants. A positive association was observed between the female participants' perceived choice and perceived competence, two underlying dimensions of the Intrinsic Motivation Inventory. In addition, a positive correlation was observed between the younger participants' perceived competence and the change in their quality of life. The findings provide some support for consideration of participants' intrinsic motivation in the development of effective self-management programmes. © 2013 Wiley Publishing Asia Pty Ltd.

Practical applications of insects' sexual development for pest control.

PubMed

Koukidou, M; Alphey, L

2014-01-01

Elucidation of the sex differentiation pathway in insects offers an opportunity to understand key aspects of evolutionary developmental biology. In addition, it provides the understanding necessary to manipulate insects in order to develop new synthetic genetics-based tools for the control of pest insects. Considerable progress has been made in this, especially in improvements to the sterile insect technique (SIT). Large scale sex separation is considered highly desirable or essential for most SIT targets. This separation can be provided by genetic methods based on sex-specific gene expression. Investigation of sex determination by many groups has provided molecular components and methods for this. Though the primary sex determination signal varies considerably, key regulatory genes and mechanisms remain surprisingly similar. In most cases studied so far, a primary signal is transmitted to a basal gene at the bottom of the hierarchy (dsx) through an alternative splicing cascade; dsx is itself differentially spliced in males and females. A sex-specific alternative splicing system therefore offers an attractive route to achieve female-specific expression. Experience has shown that alternative splicing modules can be developed with cross-species function; modularity and standardisation and re-use of parts are key principles of synthetic biology. Both female-killing and sex reversal (XX females to phenotypic males) can in principle also be used as efficient alternatives to sterilisation in SIT-like methods. Sexual maturity is yet another area where understanding of sexual development may be applied to insect control programmes. Further detailed understanding of this crucial aspect of insect biology will undoubtedly continue to underpin innovative practical applications. © 2014 S. Karger AG, Basel.

The efficacy of self-management programmes for increasing physical activity in community-dwelling adults with acquired brain injury (ABI): a systematic review

PubMed Central

2014-01-01

Background Acquired brain injury (ABI), often arising from stroke or trauma, is a common cause of long-term disability, physical inactivity and poor health outcomes globally. Individuals with ABI face many barriers to increasing physical activity, such as impaired mobility, access to services and knowledge regarding management of physical activity. Self-management programmes aim to build skills to enable an individual to manage their condition, including their physical activity levels, over a long period of time. Programme delivery modes can include traditional face-to-face methods, or remote delivery, such as via the Internet. However, it is unknown how effective these programmes are at specifically improving physical activity in community-dwelling adults with ABI, or how effective and acceptable remote delivery of self-management programmes is for this population. Methods/Design We will conduct a comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro and Science Citation Index Expanded (SCI-EXPANDED) databases that assess the efficacy of a self-management intervention, which aims to enhance levels of physical activity in adults living in the community with ABI. Two independent reviewers will screen studies for eligibility, assess risk of bias, and extract relevant data. Where possible, a meta-analysis will be performed to calculate the overall effect size of self-management interventions on physical activity levels and on outcomes associated with physical activity. A comparison will also be made between face-to-face and remote delivery modes of self-management programmes, in order to examine efficacy and acceptability. A content analysis of self-management programmes will also be conducted to compare aspects of the intervention that are associated with more favourable outcomes. Discussion This systematic review aims to review the efficacy of self-management programmes aimed at increasing physical activity levels in adults living in the community with ABI, and the efficacy and acceptability of remote delivery of these programmes. If effective, remote delivery of self-management programmes may offer an alternative way to overcome barriers and empower individuals with ABI to increase their levels of physical activity, improving health and general wellbeing. Trial registration Our protocol has been registered on PROSPERO 2013: CRD42013006748. PMID:24745356

The efficacy of self-management programmes for increasing physical activity in community-dwelling adults with acquired brain injury (ABI): a systematic review.

PubMed

Jones, Taryn M; Hush, Julia M; Dear, Blake F; Titov, Nickolai; Dean, Catherine M

2014-04-21

Acquired brain injury (ABI), often arising from stroke or trauma, is a common cause of long-term disability, physical inactivity and poor health outcomes globally. Individuals with ABI face many barriers to increasing physical activity, such as impaired mobility, access to services and knowledge regarding management of physical activity. Self-management programmes aim to build skills to enable an individual to manage their condition, including their physical activity levels, over a long period of time. Programme delivery modes can include traditional face-to-face methods, or remote delivery, such as via the Internet. However, it is unknown how effective these programmes are at specifically improving physical activity in community-dwelling adults with ABI, or how effective and acceptable remote delivery of self-management programmes is for this population. We will conduct a comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro and Science Citation Index Expanded (SCI-EXPANDED) databases that assess the efficacy of a self-management intervention, which aims to enhance levels of physical activity in adults living in the community with ABI. Two independent reviewers will screen studies for eligibility, assess risk of bias, and extract relevant data. Where possible, a meta-analysis will be performed to calculate the overall effect size of self-management interventions on physical activity levels and on outcomes associated with physical activity. A comparison will also be made between face-to-face and remote delivery modes of self-management programmes, in order to examine efficacy and acceptability. A content analysis of self-management programmes will also be conducted to compare aspects of the intervention that are associated with more favourable outcomes. This systematic review aims to review the efficacy of self-management programmes aimed at increasing physical activity levels in adults living in the community with ABI, and the efficacy and acceptability of remote delivery of these programmes. If effective, remote delivery of self-management programmes may offer an alternative way to overcome barriers and empower individuals with ABI to increase their levels of physical activity, improving health and general wellbeing. Our protocol has been registered on PROSPERO 2013: CRD42013006748.

The Prevalence and Characteristics of Higher Education Peer Helping Programmes: Managerial Perspectives

ERIC Educational Resources Information Center

de Jager, M.; Ntlokwana, N.

2011-01-01

A survey was sent to 33 managers at units and centres involved in Higher Education student-to-student support services in the form of peer help programmes. The survey focused on managers' perspectives on peer help programme demographics, management, planning and resourcing, on intra-institutional and other linkages, as well as on institutional…

Cost Analysis of Chronic Disease Self-Management Programmes Being Delivered in South Florida

ERIC Educational Resources Information Center

Page, Timothy F.; Palmer, Richard C.

2014-01-01

Background: Chronic disease accounts for the majority of healthcare costs. The Chronic Disease Self-Management Programme (CDSMP) has been shown to be effective in reducing the burden of chronic disease. Objectives: The objective of this study was to measure the cost of delivering the Chronic Disease Self-Management Programme (CDSMP) in order to…

Tourism and Management Study Programme through Blended Learning: Development and Results

ERIC Educational Resources Information Center

Simonova, Ivana

2018-01-01

This paper introduces and discusses a tourism and management study programme at the Faculty of Informatics and Management (FIM), University of Hradec Králové. It begins with description of the programme, along with a summary of its history and is considered in the light of changes in accreditation requirements. Students' interest in the programme…

Additional Equipment for Soil Biodegradation

NASA Astrophysics Data System (ADS)

Vondráčková, Terezie; Kraus, Michal; Šál, Jiří

2017-12-01

Intensification of industrial production, increasing citizens’ living standards, expanding the consumer assortment mean in the production - consumption cycle a constantly increasing occurrence of waste material, which by its very nature must be considered as a source of useful raw materials in all branches of human activity. In addition to strict legislative requirements, a number of circumstances characterize waste management. It is mainly extensive transport associated with the handling and storage of large volumes of substances with a large assortment of materials (substances of all possible physical and chemical properties) and high demands on reliability and time coordination of follow-up processes. Considerable differences in transport distances, a large number of sources, processors and customers, and not least seasonal fluctuations in waste and strong price pressures cannot be overlooked. This highlights the importance of logistics in waste management. Soils that are contaminated with oil and petroleum products are hazardous industrial waste. Methods of industrial waste disposal are landfilling, biological processes, thermal processes and physical and chemical methods. The paper focuses on the possibilities of degradation of oil pollution, in particular biodegradation by bacteria, which is relatively low-cost among technologies. It is necessary to win the fight with time so that no ground water is contaminated. We have developed two additional devices to help reduce oil accident of smaller ranges. In the case of such an oil accident, it is necessary to carry out the permeability test of contaminated soil in time and, on this basis, to choose the technology appropriate to the accident - either in-sit biodegradation - at the site of the accident, or on-sit - to remove the soil and biodegrade it on the designated deposits. A special injection drill was developed for in-sit biodegradation, tossing and aeration equipment of the extracted soil was developed for on-sit biodegradation.

Transfer of Learning from Management Development Programmes: Testing the Holton Model

ERIC Educational Resources Information Center

Kirwan, Cyril; Birchall, David

2006-01-01

Transfer of learning from management development programmes has been described as the effective and continuing application back at work of the knowledge and skills gained on those programmes. It is a very important issue for organizations today, given the large amounts of investment in these programmes and the small amounts of that investment that…

Postflight reconditioning for European Astronauts - A case report of recovery after six months in space.

PubMed

Petersen, Nora; Lambrecht, Gunda; Scott, Jonathan; Hirsch, Natalie; Stokes, Maria; Mester, Joachim

2017-01-01

Postflight reconditioning of astronauts is understudied. Despite a rigorous, daily inflight exercise countermeasures programme during six months in microgravity (μG) on-board the International Space Station (ISS), physiological impairments occur and postflight reconditioning is still required on return to Earth. Such postflight programmes are implemented by space agency reconditioning specialists. Case Description and Assessments: A 38 year old male European Space Agency (ESA) crewmember's pre- and postflight (at six and 21 days after landing) physical performance from a six-month mission to ISS are described. muscle strength (squat and bench press 1 Repetition Maximum) and power (vertical jump), core muscle endurance and hip flexibility (Sit and Reach, Thomas Test). In-flight, the astronaut undertook a rigorous daily (2-h) exercise programme. The 21 day postflight reconditioning exercise concept focused on motor control and functional training, and was delivered in close co-ordination by the ESA physiotherapist and exercise specialist to provide the crewmember with comprehensive reconditioning support. Despite an intensive inflight exercise programme for this highly motivated crewmember, postflight performance showed impairments at R+6 for most parameters, all of which recovered by R+21 except muscular power (jump tests). Regardless of intense inflight exercise countermeasures and excellent compliance to postflight reconditioning, postflight performance showed impairments at R+6 for most parameters. Complex powerful performance tasks took longer to return to preflight values. Research is needed to develop optimal inflight and postflight exercise programmes to overcome the negative effects of microgravity and return the astronaut to preflight status as rapidly as possible. Copyright © 2016 Elsevier Ltd. All rights reserved.

Temporal patterns of physical activity in Olympic dinghy racing.

PubMed

Legg, S; Mackie, H; Smith, P

1999-12-01

The objective of the present study was to determine the temporal patterns of physical activity in four classes of Olympic racing dinghy. Descriptive. A field (on-water) study. Nineteen elite New Zealand sailors (fifteen male and four female). Not applicable. The temporal pattern (duration and frequency) and nature of the physical activities of each sailor during each leg of simulated races were recorded on video tape and subsequently systematically quantified and categorised using notational analysis. The accumulated percentage of total leg time spent sitting (upright or leaning backwards), hiking (upright or fully extended) whilst trimming and whilst pumping the mainsheet and for the time spent on rig adjustments, tacking and gybing were calculated for both up-wind and off-wind sailing. When sailing up-wind, the most time was spent hiking upright (average 29-66% of total leg time) while trimming the mainsheet. During off-wind sailing, sailors spent the most time sitting upright while trimming the mainsheet (average 29-55% total leg time). Hiking upright while trimming the mainsheet was executed the greatest number of times (average 15.8-23.9) when sailing up-wind and sitting upright while trimming was executed the most times (average 3.5-7.4) when sailing off-wind. The most lengthy continuous activity was hiking upright while trimming the mainsheet when sailing up-wind (9-18 seconds) and sitting upright while trimming the mainsheet when sailing off-wind (17-34 seconds). The most physically demanding aspect of Olympic yacht racing is hiking. It occurs for the majority of up-wind legs when the wind starts to exceed approximately 8 knots. The only respite that the sailor gets from hiking is during tacking, rig adjustments or sitting in-board for brief periods when the wind is low. Sustained hiking tends to last for no more than approximately 20 seconds before the sailor changes to either a more extended or more upright hiking posture. The physical demands during off-wind sailing are generally less, except for a greater requirement for power in the arms and shoulders to pump the mainsheet in order to assist the dinghy in accelerating down waves. The findings of the present study are directly applicable to the design of sailing specific physical conditioning programmes for Olympic class sailors.

A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes)

PubMed Central

Biddle, Stuart J. H.; Edwardson, Charlotte L.; Wilmot, Emma G.; Yates, Thomas; Gorely, Trish; Bodicoat, Danielle H.; Ashra, Nuzhat; Khunti, Kamlesh; Nimmo, Myra A.; Davies, Melanie J.

2015-01-01

Aims Type 2 diabetes mellitus (T2DM), a serious and prevalent chronic disease, is traditionally associated with older age. However, due to the rising rates of obesity and sedentary lifestyles, it is increasingly being diagnosed in the younger population. Sedentary (sitting) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes, including T2DM. Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM. We aimed to investigate, through a randomised controlled trial (RCT) design, whether a group-based structured education workshop focused on sitting reduction, with self-monitoring, reduced sitting time. Methods Adults aged 18–40 years who were either overweight (with an additional risk factor for T2DM) or obese were recruited for the Sedentary Time ANd Diabetes (STAND) RCT. The intervention programme comprised of a 3-hour group-based structured education workshop, use of a self-monitoring tool, and follow-up motivational phone call. Data were collected at three time points: baseline, 3 and 12 months after baseline. The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months. Secondary outcomes included other objective (activPAL) and self-reported measures of sedentary behaviour and physical activity, and biochemical, anthropometric, and psycho-social variables. Results 187 individuals (69% female; mean age 33 years; mean BMI 35 kg/m2) were randomised to intervention and control groups. 12 month data, when analysed using intention-to-treat analysis (ITT) and per-protocol analyses, showed no significant difference in the primary outcome variable, nor in the majority of the secondary outcome measures. Conclusions A structured education intervention designed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months. Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change. Moreover, some participants reported a focus on physical activity rather than reductions in sitting per se. The habitual nature of sedentary behaviour means that behaviour change is challenging. Trial Registration Controlled-Trials.com ISRCTN08434554 PMID:26623654

Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors

PubMed Central

2013-01-01

Background Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. Methods In this controlled trial, the experimental group received 30 minutes of virtual reality balance games in addition to 90 minutes of standard physiotherapy. The control group continued with their two hours of routine standard physiotherapy. Both groups received 12 therapy sessions: two-hour sessions twice per week for six continuous weeks. Changes in physical function, activities of daily living and balance ability were assessed using the Timed Up and Go test, 30-second Sit to Stand test, Timed Ten-Metre Walk test, Six-Minute Walk test and the Barthel Index, and static balance was assessed using a probalance board. Results Twenty-eight participants completed post-intervention assessments. The results showed a significant within-subject effect on the Timed Up and Go test: F (1, 26) = 5.83, p = 0.02; and the 30-second Sit to Stand test; F (1, 26) = 13.50, p = 0.001. The between-subject effect was not significant (p > 0.05) for any of the outcome measurements. Conclusion Substituting a portion of the standard physiotherapy time with virtual reality games was equally effective in maintaining physical function outcomes and activities of daily living among community-dwelling stroke survivors. Trial Registration Australia and New Zealand Clinical Trials Register, ACTRN12613000478718 PMID:24330250

Evaluating stakeholder participation in water management: intermediary outcomes as potential indicators for future resource management outcomes

NASA Astrophysics Data System (ADS)

Carr, Gemma; Bloeschl, Guenter; Loucks, Daniel Pete

2013-04-01

Evaluation of participation programmes, projects and activities is essential to identify whether stakeholder involvement has been successful in achieving its aims. Aims may include an improvement in water resource management such as enhanced ecological functioning, an improvement in human wellbeing and economic conditions, or overcoming a conflict between interest groups. Evaluating against "interest-based" resource management criteria requires that a desirable outcome can be identified, agreed upon and be measured at the time of evaluation. In many water management situations where collaborative approaches are applied, multiple interests and objectives are present, or stakeholders have not yet identified their own positions and priorities. Even if a resource management objective has been identified and strategy agreed upon, resource management changes tend to emerge over longer timescales and evaluation frequently takes place before they can be recognised. Evaluating against resource management criteria may lead evaluators to conclude that a programme has failed because it has not achieved a resource management objective at the time of evaluation. This presents a critical challenge to researchers assessing the effectiveness of stakeholder participation programmes. One strategy to overcome this is to conduct "goal-free" evaluation to identify what the programme is actually achieving. An evaluation framework that includes intermediary outcomes that are both tangible achievements such as innovation, creation of new organisations, and shared information and knowledge, as well as intangible achievements such as trust and network development can be applied to more broadly assess a programme's success. Analysis of case-studies in the published literature for which a resource management outcome has been achieved shows that intermediary outcomes frequently precede resource management outcomes. They seem to emerge over shorter timescales than resource management outcomes. Furthermore, failure to achieve intermediary outcomes correlates to failure to achieve resource management outcomes. Evaluating intermediary outcomes leads to both a broader assessment of a programme's achievements at the time of evaluation, and can indicate whether a programme will go on to achieve resource management objectives in the future.

Developments in veterinary herd health programmes on dairy farms: a review.

PubMed

Noordhuizen, J P; Wentink, G H

2001-11-01

This review article addresses some major developments in herd health programmes for dairy farms over the last decades. It focuses particularly on herd health and production management programmes that use protocols and monitoring activities. The article further emphasizes the need for merging herd health programmes with quantitative epidemiological principles and methods. Subsequently, this article points to the latest developments regarding quality assurance in the dairy sector and some quality management methods. Quality should be regarded in its broadest sense. The importance of integrating veterinary herd health programmes and quality (risk) management support at a dairy farm level is stressed. Examples are provided.

Bottom-up implementation of disease-management programmes: results of a multisite comparison.

PubMed

Lemmens, K M M; Nieboer, A P; Rutten-Van Mölken, M P M H; van Schayck, C P; Spreeuwenberg, C; Asin, J D; Huijsman, R

2011-01-01

To evaluate the implementation of three regional disease-management programmes on chronic obstructive pulmonary disease (COPD) based on bottlenecks experienced in professional practice. The authors performed a multisite comparison of three Dutch regional disease-management programmes combining patient-related, professional-directed and organisational interventions. Process (Assessing Chronic Illness Care survey) and outcome (disease specific quality of life (clinical COPD questionnaire (CCQ); chronic respiratory questionnaire (CRQ)), Medical Research Council dyspnoea and patients' experiences) data were collected for 370 COPD patients and their care providers. Bottlenecks in region A were mostly related to patient involvement, in region B to organisational issues and in region C to both. Selected interventions related to identified bottlenecks were implemented in all programmes, except for patient-related interventions in programme A. Within programmes, significant improvements were found on dyspnoea and patients' experiences with practice nurses. Outcomes on quality of life differed between programmes: programme A did not show any significant improvements; programme B did show any significant improvements on CCQ total (p<0.001), functional (p=0.011) and symptom (p<0.001), CRQ fatigue (p<0.001) and emotional scales (p<0.001); in programme C, CCQ symptom (p<0.001) improved significantly, whereas CCQ mental score (p<0.001) deteriorated significantly. Regression analyses showed that programmes with better implementation of selected interventions resulted in relatively larger improvements in quality of life (CCQ). Bottom-up implementation of COPD disease-management programmes is a feasible approach, which in multiple settings leads to significant improvements in outcomes of care. Programmes with a better fit between implemented interventions and bottlenecks showed more positive changes in outcomes.

Development of a group-based self-management programme for individuals with chronic fatigue syndrome: a pilot study.

PubMed

Pinxsterhuis, Irma; Hellum, Live Lange; Aannestad, Hilde Hassum; Sveen, Unni

2015-03-01

The aim of the study was to develop a group-based self-management programme for individuals with chronic fatigue syndrome (CFS) by using the participants' experiences with the initial version of the programme, which intends to promote coping with the illness in a primary healthcare setting. An initial programme was developed, based on self-efficacy theory and the concepts of client-centred practice and empowerment. Subsequently, the programme was tested and further developed by drawing on the participants' experiences with the programme. Focus-group interviews were applied. The interviews were analysed using thematic analysis. The initial programme was found to be feasible, although several modifications regarding the content and practical organization of the programme were proposed. In line with the participants' experiences, the final self-management programme was developed, which includes short presentations of eight topics, exchange of experiences among participants, goal-setting, construction of action plans, and relaxation exercises, in addition to a meeting for relatives. The programme will be provided in eight biweekly sessions and be led by juxtaposed peer counsellors and occupational therapists. The effects of the final programme will be evaluated in a randomized controlled trial.

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

PubMed Central

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

2016-01-01

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

A model to evaluate quality and effectiveness of disease management.

PubMed

Lemmens, K M M; Nieboer, A P; van Schayck, C P; Asin, J D; Huijsman, R

2008-12-01

Disease management has emerged as a new strategy to enhance quality of care for patients suffering from chronic conditions, and to control healthcare costs. So far, however, the effects of this strategy remain unclear. Although current models define the concept of disease management, they do not provide a systematic development or an explanatory theory of how disease management affects the outcomes of care. The objective of this paper is to present a framework for valid evaluation of disease-management initiatives. The evaluation model is built on two pillars of disease management: patient-related and professional-directed interventions. The effectiveness of these interventions is thought to be affected by the organisational design of the healthcare system. Disease management requires a multifaceted approach; hence disease-management programme evaluations should focus on the effects of multiple interventions, namely patient-related, professional-directed and organisational interventions. The framework has been built upon the conceptualisation of these disease-management interventions. Analysis of the underlying mechanisms of these interventions revealed that learning and behavioural theories support the core assumptions of disease management. The evaluation model can be used to identify the components of disease-management programmes and the mechanisms behind them, making valid comparison feasible. In addition, this model links the programme interventions to indicators that can be used to evaluate the disease-management programme. Consistent use of this framework will enable comparisons among disease-management programmes and outcomes in evaluation research.

The sterile insect technique for the management of the spotted wing drosophila, Drosophila suzukii: Establishing the optimum irradiation dose

PubMed Central

Brodeur, Jacques; Fournier, François; Martel, Véronique; Vreysen, Marc; Cáceres, Carlos; Firlej, Annabelle

2017-01-01

The spotted wing drosophila Drosophila suzukii Matsumura (Diptera: Drosophilidae), a pest of berries stone fruits, invaded North America and Europe in 2008. Current control methods rely mainly on insecticides. The sterile insect technique (SIT) has potential as an additional control tactic for the integrated management of D. suzukii. As a step towards the development of the SIT, this study aimed at finding the optimum irradiation dose to sterilize D. suzukii under controlled laboratory conditions. Four-day-old D. suzukii pupae were irradiated 12 to 24 hours prior to adult emergence in a 60Co Gamma Cell 220 and in a 137Cs Gamma Cell 3000 with doses of 30, 50, 70, 80, 90, 100 or 120 Gy. Emergence rate (88.1%), percent of deformed flies (4.0%) and survival curves were not affected by the tested irradiation doses. However, some reproductive parameters of the flies were affected by irradiation. Females irradiated with a dose of 50 Gy or more had almost no fecundity. When non-irradiated females were mated with irradiated males, egg hatch decreased exponentially with irradiation dose from 82.6% for the untreated control males to 4.0% for males irradiated with 120 Gy. Mortality of F1 individuals from the irradiated treatment also occurred during larval and pupal stages, with an egg to adult survival of 0.2%. However, descendants produced by the irradiated generation were fertile. These results are an encouraging first experimental step towards the development of the SIT for the management of D. suzukii populations. PMID:28957331

Introducing innovation in a management development programme for a UK primary care organisation.

PubMed

Smith, Paul; Hampson, Libby; Scott, Jonathan; Bower, Karen

2011-01-01

The aim of this paper is to examine the introduction of innovation as part of a management development programme at a primary care organisation, a legal form known as a Primary Care Trust (PCT), in the UK. The paper draws on experience of managing a successful management development programme for a PCT. The report of the case study analyses the key events that took place between 2008 and 2010, from direct observation, surveys, discussion and documentary evidence. The Northern PCT has partnerships with a number of educational providers to deliver their leadership and management development programmes. A close working relationship had developed and the programme is bespoke - hence it is current and of practical use to the UK's National Health Service (NHS). In addition, there are regular meetings, with module leaders gaining a firsthand understanding of the organisation's needs and aspirations. This has resulted in a very focused and personalised offering and a genuine involvement in the programme and individuals concerned. The research was conducted among a relatively small sample, and there is a lack of previous literature evidence to make significant comparisons. The paper identifies key implications for practitioners and educators in this area. This paper is one of few to investigate innovation and improvement in the NHS, and is unique in that it uses the lenses of a management development programme to explore this important, and under-researched, topic.

The Effectiveness of SDMs in the Development of E-Learning Systems in South Africa

ERIC Educational Resources Information Center

van Aswegen, Kobus; Huisman, Magda; Taylor, Estelle

2014-01-01

E-learning systems, or learning management systems, as it is known in the field, sit at the heart of educational systems and are used to systematically deliver on-line content and facilitate the learning experience around that content. It becomes essential to ensure that Learning Management Systems of a high standard are being developed. In the…

Guidelines for the use of mathematics in operational area-wide integrated pest management programs using the sterile insect technique with a special focus on Tephritid Fruit Flies

USDA-ARS?s Scientific Manuscript database

Pest control managers can benefit from using mathematical approaches, particularly models, when implementing area-wide pest control programs that include sterile insect technique (SIT), especially when these are used to calculate required rates of sterile releases to result in suppression or eradica...

Application of a theoretical framework to foster a cardiac-diabetes self-management programme.

PubMed

Wu, C-J Jo; Chang, A M

2014-09-01

This paper analyses and illustrates the application of Bandura's self-efficacy construct to an innovative self-management programme for patients with both type 2 diabetes and coronary heart disease. Using theory as a framework for any health intervention provides a solid and valid foundation for aspects of planning and delivering such an intervention; however, it is reported that many health behaviour intervention programmes are not based upon theory and are consequently limited in their applicability to different populations. The cardiac-diabetes self-management programme has been specifically developed for patients with dual conditions with the strategies for delivering the programme based upon Bandura's self-efficacy theory. This patient group is at greater risk of negative health outcomes than that with a single chronic condition and therefore requires appropriate intervention programmes with solid theoretical foundations that can address the complexity of care required. The cardiac-diabetes self-management programme has been developed incorporating theory, evidence and practical strategies. This paper provides explicit knowledge of the theoretical basis and components of a cardiac-diabetes self-management programme. Such detail enhances the ability to replicate or adopt the intervention in similar or differing populations and/or cultural contexts as it provides in-depth understanding of each element within the intervention. Knowledge of the concepts alone is not sufficient to deliver a successful health programme. Supporting patients to master skills of self-care is essential in order for patients to successfully manage two complex, chronic illnesses. Valuable information has been provided to close the theory-practice gap for more consistent health outcomes, engaging with patients for promoting holistic care within organizational and cultural contexts. © 2014 International Council of Nurses.

Enhancing frontline clinical leadership in an acute hospital trust.

PubMed

Phillips, Natasha; Byrne, Geraldine

2013-09-01

To report on a leadership programme for ward managers in one National Health Service Trust that aimed to enhance their contribution to the delivery of the organisation's key objectives to support excellent patient experience. Effective ward leadership has been recognised as vital to the quality of care, resource management and interprofessional working. However, there is evidence that, at present, front-line nurse leaders are ill equipped to lead effectively and lack confidence in their ability to do so. The project aimed to provide a tailored programme for ward managers to develop their portfolio of skills to perform this pivotal role. The course contained two key elements: an integrated teaching programme to enhance leadership knowledge and skills and action learning to facilitate application to individual's own leadership practice. Both were underpinned by a change project where each individual identified, undertook and evaluated an innovation in practice. Twenty-two ward managers completed the leadership programme. Participants completed semi-structured questionnaires after each taught module. Action learning was evaluated through a combined structured and semi-structured questionnaire. All participants evaluated the programme as increasing their repertoire of leadership skills. Following completion of the programme, ward managers continue to work together as an evolving community of practice. Ward managers' development is enhanced by a programme integrating theory, action learning and completion of a ward-based project. Ward managers cannot be effectively developed in isolation. Leadership development is best supported where the organisation is also committed to developing. A leadership development programme that incorporates knowledge from within the organisation with external expertise can be an effective method to enhance front-line clinical leadership. © 2013 Blackwell Publishing Ltd.

The Effects and Costs of a Group-Based Education Programme for Self-Management of Patients with Type 2 Diabetes. A Community-Based Study

ERIC Educational Resources Information Center

Molsted, Stig; Tribler, Jane; Poulsen, Peter B.; Snorgaard, Ole

2012-01-01

The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type 2 diabetes. Seven hundred and two patients…

[Surgical treatment of choledocholithiasis in a patient with situs inversus totalis: a case report and literature review].

PubMed

Morales-Rodríguez, Jerson Francisco; Corina Cotillo, Estefania; Moreno-Loaiza, Oscar

2017-07-26

Situs inversus totalis (SIT) is a rare condition, in which there is transposition of the thoraco-abdominal organs. This situation leads to diagnostic and therapeutic difficulties in patients with acute surgical abdomen. The objective of this report is to present the case of a patient who presented with colonic pain in the epigastrium and left hypochondrium, in which the diagnosis of SIT, cholelithiasis and choledocholithiasis was reached after the respective imaging studies. Once the diagnosis was made, treatment was performed through retrograde endoscopic cholangiopancreatography (ERCP) and subsequent surgical exploration of bile ducts. Both procedures were failed due to technical difficulties generated by the patient's condition. In conclusion, in spite of the report of successful cases in the literature of ERCP and surgical treatment of the biliary tract in SIT, there may be situations that do not allow a successful approach, so meticulous surgical planning and the use of support methods are necessary In the management of these patients.

Towards Developing an Initial Programme Theory: Programme Designers and Managers Assumptions on the Antiretroviral Treatment Adherence Club Programme in Primary Health Care Facilities in the Metropolitan Area of Western Cape Province, South Africa

PubMed Central

Mukumbang, Ferdinand C.; van Belle, Sara; Marchal, Bruno; van Wyk, Brian

2016-01-01

Background The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theory—the assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). Methods We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. Results We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. Conclusion The perspectives of the programme designers and managers provided an important step towards developing an initial programme theory, which will guide our realist evaluation of the adherence club programme in South Africa. PMID:27560352

Payday, ponchos, and promotions: a qualitative analysis of perspectives from non-governmental organization programme managers on community health worker motivation and incentives.

PubMed

B-Lajoie, Marie-Renée; Hulme, Jennifer; Johnson, Kirsten

2014-12-05

Community health workers (CHWs) have been central to broadening the access and coverage of preventative and curative health services worldwide. Much has been debated about how to best remunerate and incentivize this workforce, varying from volunteers to full time workers. Policy bodies, including the WHO and USAID, now advocate for regular stipends. This qualitative study examines the perspective of health programme managers from 16 international non-governmental organizations (NGOs) who directly oversee programmes in resource-limited settings. It aimed to explore institutional guidelines and approaches to designing CHW incentives, and inquire about how NGO managers are adapting their approaches to working with CHWs in this shifting political and funding climate. Second, it meant to understand the position of stakeholders who design and manage non-governmental organization-run CHW programmes on what they consider priorities to boost CHW motivation. Individuals were recruited using typical case sampling through chain referral at the semi-annual CORE Group meeting in the spring of 2012. Semi-structured interviews were guided by a peer reviewed tool. Two reviewers analyzed the transcripts for thematic saturation. Six key factors influenced programme manager decision-making: National-level government policy, donor practice, implicit organizational approaches, programmatic, cultural, and community contexts, experiences and values of managers, and the nature of the work asked of CHWs. Programme managers strongly relied on national government to provide clear guidance on CHW incentives schemes. Perspectives on remuneration varied greatly, from fears that it is unsustainable, to the view that it is a basic human right, and a mechanism to achieve greater gender equity. Programme managers were interested in exploring career paths and innovative financing schemes for CHWs, such as endowment funds or material sales, to heighten local ownership and sustainability of programmes. Participants also supported the creation of both national-level and global interfaces for sharing practical experience and best practices with other CHW programmes. Prescriptive recommendations for monetary remuneration, aside from those coming from national governments, will likely continue to meet resistance by NGOs, as contexts are nuanced. There is growing consensus that incentives should reflect the nature of the work asked of CHWs, and the potential for motivation through sustainable financial schemes other than regular salaries. Programme managers advocate for greater transparency and information sharing among organizations.

Interrupting prolonged sitting with brief bouts of light walking or simple resistance activities reduces resting blood pressure and plasma noradrenaline in type 2 diabetes.

PubMed

Dempsey, Paddy C; Sacre, Julian W; Larsen, Robyn N; Straznicky, Nora E; Sethi, Parneet; Cohen, Neale D; Cerin, Ester; Lambert, Gavin W; Owen, Neville; Kingwell, Bronwyn A; Dunstan, David W

2016-12-01

Prolonged sitting is increasingly recognized as a ubiquitous cardiometabolic risk factor, possibly distinct from lack of physical exercise. We examined whether interrupting prolonged sitting with brief bouts of light-intensity activity reduced blood pressure (BP) and plasma noradrenaline in type 2 diabetes (T2D). In a randomized crossover trial, 24 inactive overweight/obese adults with T2D (14 men; mean ± SD; 62 ± 6 years) consumed standardized meals during 3 × 8 h conditions: uninterrupted sitting (SIT); sitting + half-hourly bouts of walking (3.2 km/h for 3-min) (light-intensity walking); and sitting + half-hourly bouts of simple resistance activities for 3 min (SRAs), each separated by 6-14 days washout. Resting seated BP was measured hourly (mean of three recordings, ≥20-min postactivity). Plasma noradrenaline was measured at 30-min intervals for the first hour after meals and hourly thereafter. Compared with SIT, mean resting SBP and DBP were significantly reduced (P < 0.001) for both light-intensity walking (mean ± SEM; -14 ± 1/-8 ± 1 mmHg) and SRA (-16 ± 1/-10 ± 1 mmHg), with a more pronounced effect for SRA (P < 0.05 versus light-intensity walking). Similarly, mean plasma noradrenaline was significantly reduced for both light-intensity walking (-0.3 ± 0.1 nmol/l) and SRA (-0.6 ± 0.1 nmol/l) versus SIT, with SRA lower than light-intensity walking (P < 0.05). Mean resting heart rate was lowered by light-intensity walking (-3 ± 1 bpm; P < 0.05), but not SRA (-1 ± 1 bpm). Interrupting prolonged sitting with brief bouts of light-intensity walking or SRA reduces resting BP and plasma noradrenaline in adults with T2D, with SRA being more effective. Given the ubiquity of sedentary behaviors and poor adherence to structured exercise, this approach may have important implications for BP management in patients with T2D.

Effectiveness of a primary care-based intervention to reduce sitting time in overweight and obese patients (SEDESTACTIV): a randomized controlled trial; rationale and study design

PubMed Central

2014-01-01

Background There is growing evidence suggesting that prolonged sitting has negative effects on people’s weight, chronic diseases and mortality. Interventions to reduce sedentary time can be an effective strategy to increase daily energy expenditure. The purpose of this study is to evaluate the effectiveness of a six-month primary care intervention to reduce daily of sitting time in overweight and mild obese sedentary patients. Method/Design The study is a randomized controlled trial (RCT). Professionals from thirteen primary health care centers (PHC) will randomly invite to participate mild obese or overweight patients of both gender, aged between 25 and 65 years old, who spend 6 hours at least daily sitting. A total of 232 subjects will be randomly allocated to an intervention (IG) and control group (CG) (116 individuals each group). In addition, 50 subjects with fibromyalgia will be included. Primary outcome is: (1) sitting time using the activPAL device and the Marshall questionnaire. The following parameters will be also assessed: (2) sitting time in work place (Occupational Sitting and Physical Activity Questionnaire), (3) health-related quality of life (EQ-5D), (4) evolution of stage of change (Prochaska and DiClemente's Stages of Change Model), (5) physical inactivity (catalan version of Brief Physical Activity Assessment Tool), (6) number of steps walked (pedometer and activPAL), (7) control based on analysis (triglycerides, total cholesterol, HDL, LDL, glycemia and, glycated haemoglobin in diabetic patients) and (8) blood pressure and anthropometric variables. All parameters will be assessed pre and post intervention and there will be a follow up three, six and twelve months after the intervention. A descriptive analysis of all variables and a multivariate analysis to assess differences among groups will be undertaken. Multivariate analysis will be carried out to assess time changes of dependent variables. All the analysis will be done under the intention to treat principle. Discussion If the SEDESTACTIV intervention shows its effectiveness in reducing sitting time, health professionals would have a low-cost intervention tool for sedentary overweight and obese patients management. Trial registration A service of the U.S. National Institutes of Health. Developed by the National Library of Medicine. ClinicalTrials.gov NCT01729936 PMID:24597534

Effectiveness of a primary care-based intervention to reduce sitting time in overweight and obese patients (SEDESTACTIV): a randomized controlled trial; rationale and study design.

PubMed

Martín-Borràs, Carme; Giné-Garriga, Maria; Martínez, Elena; Martín-Cantera, Carlos; Puigdoménech, Elisa; Solà, Mercè; Castillo, Eva; Beltrán, Angela Ma; Puig-Ribera, Anna; Trujillo, José Manuel; Pueyo, Olga; Pueyo, Javier; Rodríguez, Beatriz; Serra-Paya, Noemí

2014-03-05

There is growing evidence suggesting that prolonged sitting has negative effects on people's weight, chronic diseases and mortality. Interventions to reduce sedentary time can be an effective strategy to increase daily energy expenditure. The purpose of this study is to evaluate the effectiveness of a six-month primary care intervention to reduce daily of sitting time in overweight and mild obese sedentary patients. The study is a randomized controlled trial (RCT). Professionals from thirteen primary health care centers (PHC) will randomly invite to participate mild obese or overweight patients of both gender, aged between 25 and 65 years old, who spend 6 hours at least daily sitting. A total of 232 subjects will be randomly allocated to an intervention (IG) and control group (CG) (116 individuals each group). In addition, 50 subjects with fibromyalgia will be included.Primary outcome is: (1) sitting time using the activPAL device and the Marshall questionnaire. The following parameters will be also assessed: (2) sitting time in work place (Occupational Sitting and Physical Activity Questionnaire), (3) health-related quality of life (EQ-5D), (4) evolution of stage of change (Prochaska and DiClemente's Stages of Change Model), (5) physical inactivity (catalan version of Brief Physical Activity Assessment Tool), (6) number of steps walked (pedometer and activPAL), (7) control based on analysis (triglycerides, total cholesterol, HDL, LDL, glycemia and, glycated haemoglobin in diabetic patients) and (8) blood pressure and anthropometric variables. All parameters will be assessed pre and post intervention and there will be a follow up three, six and twelve months after the intervention. A descriptive analysis of all variables and a multivariate analysis to assess differences among groups will be undertaken. Multivariate analysis will be carried out to assess time changes of dependent variables. All the analysis will be done under the intention to treat principle. If the SEDESTACTIV intervention shows its effectiveness in reducing sitting time, health professionals would have a low-cost intervention tool for sedentary overweight and obese patients management. A service of the U.S. National Institutes of Health. Developed by the National Library of Medicine. ClinicalTrials.gov NCT01729936.

The Community Connection Model: implementation of best evidence into practice for self-management of chronic diseases.

PubMed

Liddy, C; Johnston, S; Irving, H; Nash, K

2013-06-01

With chronic diseases becoming an increasing burden for healthcare systems worldwide, self-management support has gained traction in many health regions and organizations. However, the real-world application of the findings from clinical trials into actual community programming is not self-evident. The aim of this study was to present a model of programme implementation, namely the Community Connection Model. The process of implementing a chronic disease self-management programme has been documented in detail from its initial inception through to a sustainable programme. This account includes a description of the strategic activities undertaken (e.g. alignment with local policy and the formation of community partnerships) and the specific steps taken on the path to programme implementation (e.g. a scoping literature review, an environmental scan and a pilot programme with an evaluation component). Reflection on this case example suggests that a cognizance of the interactions between policy, partnership, planning and programme could act as a useful tool to guide programme implementation, evaluation and sustainability. Multiple types of self-management support have been implemented (as part of the Living Health Champlain programme), and are being evaluated and adapted in response to new evidence, shifting priorities and direction from more partners. The widespread access means that self-management support programmes are becoming part of the culture of care in the study region. Establishing a connection around an important health problem, ensuring active partnerships, adequate planning and early implementation of a programme grounded on the principles of applying best-available evidence can lead to successful solutions. The Community Connection Model is proposed as a way of conceptualizing these processes. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Translating childhood tuberculosis case management research into operational policies.

PubMed

Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O

2011-08-01

The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.

Feasibility of a multidimensional home-based exercise programme for the elderly with structured support given by the general practitioner's surgery: Study protocol of a single arm trial preparing an RCT [ISRCTN58562962

PubMed Central

2009-01-01

Background Physical activity programmes can help to prevent functional decline in the elderly. Until now, such programmes use to target either on healthy community-dwelling seniors or on elderly living in special residences or care institutions. Sedentary or frail people, however, are difficult to reach when they live in their own homes. The general practitioner's (GP) practice offers a unique opportunity to acquire these people for participation in activity programmes. We conceptualised a multidimensional home-based exercise programme that shall be delivered to the target group through cooperation between GPs and exercise therapists. In order to prepare a randomised controlled trial (RCT), a feasibility study is being conducted. Methods The study is designed as a single arm interventional trial. We plan to recruit 90 patients aged 70 years and above through their GPs. The intervention lasts 12 weeks and consists of physical activity counselling, a home-exercise programme, and exercise consultations provided by an exercise therapist in the GP's practice and via telephone. The exercise programme consists of two main components: 1. a combination of home-exercises to improve strength, flexibility and balance, 2. walking for exercise to improve aerobic capacity. Primary outcome measures are: appraisal by GP, undesirable events, drop-outs, adherence. Secondary outcome measures are: effects (a. motor tests: timed-up-and-go, chair rising, grip strength, tandem stand, tandem walk, sit-and-reach; b. telephone interview: PRISCUS-Physical Activity Questionnaire, Short Form-8 Health Survey, three month recall of frequency of falls, Falls Efficacy Scale), appraisal by participant, exercise performance, focus group discussion. Data analyses will focus on: 1. decision-making concerning the conduction of a RCT, 2. estimation of the effects of the programme, detection of shortcomings and identification of subgroups with contrary results, 3. feedback to participants and to GPs. Conclusion A new cooperation between GPs and exercise therapists to approach community-dwelling seniors and to deliver a home-exercise programme is object of research with regard to feasibility and acceptance. In case of success, an RCT should examine the effects of the programme. A future implementation within primary medical care may take advantage from the flexibility of the programme. Trial registration Current Controlled Trials ISRCTN58562962. PMID:19686587

A qualitative study of patients' experiences of participating in SPACE for COPD: a Self-management Programme of Activity, Coping and Education.

PubMed

Apps, Lindsay D; Harrison, Samantha L; Mitchell, Katy E; Williams, Johanna E A; Hudson, Nicky; Singh, Sally J

2017-10-01

The aim of this study was to understand experiences of participation in a supported self-management programme for chronic obstructive pulmonary disease (COPD). There is a wealth of clinical trials examining the outcomes of self-management interventions for individuals with COPD, but current understanding regarding patients' perspectives of such complex interventions is limited. Further insight may help to tailor self-management interventions and maximise patient engagement. Semi-structured interviews were conducted with individuals participating in a self-management programme, SPACE for COPD. Interviews took place at 6 weeks and 6 months following the programme. Data were analysed at each time point using inductive thematic analysis, and subsequently re-examined together. 40 interviews were undertaken and four themes emerged from the analysis: perceptions of the programme; lifestyle changes; social support; and disrupting factors and barriers to maintaining routines. SPACE for COPD was acceptable to participants in this study. The importance of education and social support was emphasised at both time points studied, but there were challenges such as comorbidities, ill health of family members and limited maintenance of exercise behaviours over the longer term. Further consideration of the role of carers and partners may help to improve adherence to self-management programmes once healthcare professional support has stopped.

Patient participation during and after a self-management programme in primary healthcare - The experience of patients with chronic obstructive pulmonary disease or chronic heart failure.

PubMed

Luhr, Kristina; Holmefur, Marie; Theander, Kersti; Eldh, Ann Catrine

2018-06-01

Patient participation is facilitated by patients' ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF); the aim was to describe if and how a self-management programme in primary healthcare influenced patient participation. Patients who had participated in a self-management programme were interviewed in nine focus groups (36 patients). Data was analysed using qualitative content analysis. Patients described equality in personal interactions, opportunities to share and discuss, and a willingness to share and learn to facilitate patient participation in a self-management programme. Consequently, patient participation was promoted by a match between the individuals' personal traits and the context. Features facilitating patient participation by means of sharing and assimilating knowledge and insights should be included in self-management programmes and in the care for patients with COPD and CHF. A self-management programme can complement regular primary care regarding enhanced understanding of one's disease and support patient participation and the patient's own resources in self-management. Copyright © 2018 Elsevier B.V. All rights reserved.

Medical care of type 2 diabetes in German disease management programmes: a population-based evaluation.

PubMed

Stark, Reneé G; Schunk, Michaela V; Meisinger, Christine; Rathmann, Wolfgang; Leidl, Reiner; Holle, Rolf

2011-05-01

Type 2 diabetes disease management programmes (DDMPs) are offered by German social health insurance to promote healthcare consistent with evidence-based medical guidelines. The aim of this study was to compare healthcare quality and medical endpoints between diabetes management programme participants and patients receiving usual care designated as controls. All patients with type 2 diabetes (age range: 36-81) in a cross-sectional survey of a cohort study, performed by the Cooperative Health Research in the Region of Augsburg, received a self-administered questionnaire regarding their diabetes care. Physical examination and laboratory tests were also performed. The analysis only included patients with social health insurance and whose participation status in a diabetes disease management program was validated by the primary physician (n = 166). Regression analyses, adjusting for age, sex, education, diabetes duration, baseline waist circumference and clustering regarding primary physician were conducted. Evaluation of healthcare processes showed that those in diabetes disease management programmes (n = 89) reported medical examination of eyes and feet and medical advice regarding diet [odds ratio (OR): 2.39] and physical activity (OR: 2.87) more frequently, received anti-diabetic medications (OR: 3.77) and diabetes education more often (OR: 2.66) than controls. Both groups had satisfactory HbA(1c) control but poor low-density lipoprotein cholesterol control. Blood pressure goals (<140/90 mmHg) were achieved more frequently by patients in diabetes disease management programmes (OR: 2.21). German diabetes disease management programmes are associated with improved healthcare processes and blood pressure control. Low-density lipoprotein cholesterol control must be improved for all patients with diabetes. Further research will be required to assess the long-term effects of this diabetes disease management programme. Copyright © 2011 John Wiley & Sons, Ltd.

Continuous Improvement in the Industrial and Management Systems Engineering Programme at Kuwait University

ERIC Educational Resources Information Center

Aldowaisan, Tariq; Allahverdi, Ali

2016-01-01

This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been…

Experiences of Action Leaning in Two SME Business Support Programmes

ERIC Educational Resources Information Center

Smith, Laurie

2009-01-01

Action learning sets are used by Lancaster University Management School's Institute for Entrepreneurship and Enterprise Development to provide business support to owner managers of small to medium sized enterprises (SMEs). This paper compares the experiences of participants and facilitator of two programmes: one part of a wider programme of…

Discrete physiological effects of beetroot juice and potassium nitrate supplementation following 4-wk sprint interval training.

PubMed

Thompson, Christopher; Vanhatalo, Anni; Kadach, Stefan; Wylie, Lee J; Fulford, Jonathan; Ferguson, Scott K; Blackwell, Jamie R; Bailey, Stephen J; Jones, Andrew M

2018-06-01

The physiological and exercise performance adaptations to sprint interval training (SIT) may be modified by dietary nitrate ([Formula: see text]) supplementation. However, it is possible that different types of [Formula: see text] supplementation evoke divergent physiological and performance adaptations to SIT. The purpose of this study was to compare the effects of 4-wk SIT with and without concurrent dietary [Formula: see text] supplementation administered as either [Formula: see text]-rich beetroot juice (BR) or potassium [Formula: see text] (KNO 3 ). Thirty recreationally active subjects completed a battery of exercise tests before and after a 4-wk intervention in which they were allocated to one of three groups: 1) SIT undertaken without dietary [Formula: see text] supplementation (SIT); 2) SIT accompanied by concurrent BR supplementation (SIT + BR); or 3) SIT accompanied by concurrent KNO 3 supplementation (SIT + KNO 3 ). During severe-intensity exercise, V̇o 2peak and time to task failure were improved to a greater extent with SIT + BR than SIT and SIT + KNO 3 ( P < 0.05). There was also a greater reduction in the accumulation of muscle lactate at 3 min of severe-intensity exercise in SIT + BR compared with SIT + KNO 3 ( P < 0.05). Plasma [Formula: see text] concentration fell to a greater extent during severe-intensity exercise in SIT + BR compared with SIT and SIT + KNO 3 ( P < 0.05). There were no differences between groups in the reduction in the muscle phosphocreatine recovery time constant from pre- to postintervention ( P > 0.05). These findings indicate that 4-wk SIT with concurrent BR supplementation results in greater exercise capacity adaptations compared with SIT alone and SIT with concurrent KNO 3 supplementation. This may be the result of greater NO-mediated signaling in SIT + BR compared with SIT + KNO 3 . NEW & NOTEWORTHY We compared the influence of different forms of dietary nitrate supplementation on the physiological and performance adaptations to sprint interval training (SIT). Compared with SIT alone, supplementation with nitrate-rich beetroot juice, but not potassium [Formula: see text], enhanced some physiological adaptations to training.

Nurse manager succession planning: A cost-benefit analysis.

PubMed

Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

2018-03-01

This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

Emerging models for mobilizing family support for chronic disease management: a structured review.

PubMed

Rosland, Ann-Marie; Piette, John D

2010-03-01

We identify recent models for programmes aiming to increase effective family support for chronic illness management and self-care among adult patients without significant physical or cognitive disabilities. We then summarize evidence regarding the efficacy for each model identified. Structured review of studies published in medical and psychology databases from 1990 to the present, reference review, general Web searches and conversations with family intervention experts. Review was limited to studies on conditions that require ongoing self-management, such as diabetes, chronic heart disease and rheumatologic disease. Programmes with three separate foci were identified: (1) Programmes that guide family members in setting goals for supporting patient self-care behaviours have led to improved implementation of family support roles, but have mixed success improving patient outcomes. (2) Programmes that train family in supportive communication techniques, such as prompting patient coping techniques or use of autonomy supportive statements, have successfully improved patient symptom management and health behaviours. (3) Programmes that give families tools and infrastructure to assist in monitoring clinical symptoms and medications are being conducted, with no evidence to date on their impact on patient outcomes. The next generation of programmes to improve family support for chronic disease management incorporate a variety of strategies. Future research can define optimal clinical situations for family support programmes, the most effective combinations of support strategies, and how best to integrate family support programmes into comprehensive models of chronic disease care.

Implementing the NHS information technology programme: qualitative study of progress in acute trusts.

PubMed

Hendy, Jane; Fulop, Naomi; Reeves, Barnaby C; Hutchings, Andrew; Collin, Simon

2007-06-30

To describe progress and perceived challenges in implementing the NHS information and technology (IT) programme in England. Case studies and in-depth interviews, with themes identified using a framework developed from grounded theory. We interviewed personnel who had been interviewed 18 months earlier, or new personnel in the same posts. Four NHS acute hospital trusts in England. Senior trust managers and clinicians, including chief executives, directors of IT, medical directors, and directors of nursing. Interviewees unreservedly supported the goals of the programme but had several serious concerns. As before, implementation is hampered by local financial deficits, delays in implementing patient administration systems that are compliant with the programme, and poor communication between Connecting for Health (the agency responsible for the programme) and local managers. New issues were raised. Local managers cannot prioritise implementing the programme because of competing financial priorities and uncertainties about the programme. They perceive a growing risk to patients' safety associated with delays and a loss of integration of components of the programme, and are discontented with Choose and Book (electronic booking for referrals from primary care). We recommend that the programme sets realistic timetables for individual trusts and advises managers about interim IT systems they have to purchase because of delays outside their control. Advice needs to be mindful of the need for trusts to ensure longer term compatibility with the programme and value for money. Trusts need assistance in prioritising modernisation of IT by, for example, including implementation of the programme in the performance management framework. Even with Connecting for Health adopting a different approach of setting central standards with local implementation, these issues will still need to be addressed. Lessons learnt in the NHS have wider relevance as healthcare systems, such as in France and Australia, look to realise the potential of large scale IT modernisation.

The return to work discussion: a qualitative study of the line manager conversation about return to work and the development of an educational programme.

PubMed

Cohen, Debbie; Allen, Joanna; Rhydderch, Melody; Aylward, Mansel

2012-07-01

To investigate the conversation between line manager and employee about return to work to inform the development of an online interactive educational programme for line managers to improve the effectiveness of their discussions. An inductive qualitative approach, using the principles of action research and motivational interviewing were adopted. The results informed the development of the educational programme for line managers. Middle grade line managers in a large public services employer in the UK. Four discussion groups were conducted over a period of 8 months. Line managers explored the challenges of the return to work interview, analysed their interactions with employees and constructed the content of an educational programme. Multiple methods were used to build engagement with participants, including video and role-play. Nine line managers were recruited across 3 business areas. Managers recognised that their conversations focused on the organisations' policies and procedures and the outcome, rather than the interaction. They recognised the strength of shifting style to shared decision-making and guidance rather than process and instruction. These communication strategies were depicted in the educational programme. The content and flow of the return to work discussion is of high importance and influences employee behaviour and return to work outcomes.

Sitting Time in Adults 65 Years and Over: Behavior, Knowledge, and Intentions to Change.

PubMed

Alley, Stephanie; van Uffelen, Jannique G Z; Duncan, Mitch J; De Cocker, Katrien; Schoeppe, Stephanie; Rebar, Amanda L; Vandelanotte, Corneel

2018-04-01

This study examined sitting time, knowledge, and intentions to change sitting time in older adults. An online survey was completed by 494 Australians aged 65+. Average daily sitting was high (9.0 hr). Daily sitting time was the highest during TV (3.3 hr), computer (2.1 hr), and leisure (1.7 hr). A regression analysis demonstrated that women were more knowledgeable about the health risks of sitting compared to men. The percentage of older adults intending to sit less were the highest for TV (24%), leisure (24%), and computer (19%) sitting time. Regression analyses demonstrated that intentions varied by gender (for TV sitting), education (leisure and work sitting), body mass index (computer, leisure, and transport sitting), and physical activity (TV, computer, and leisure sitting). Interventions should target older adults' TV, computer, and leisure time sitting, with a focus on intentions in older males and older adults with low education, those who are active, and those with a normal weight.

Energy utilization associated with regular activity breaks and continuous physical activity: A randomized crossover trial.

PubMed

Fenemor, S P; Homer, A R; Perry, T L; Skeaff, C M; Peddie, M C; Rehrer, N J

2018-06-01

To quantify and compare energy utilization associated with prolonged sitting alone, or interrupted with regular activity breaks and/or an additional bout of continuous physical activity. Thirty six adults (11 males, BMI 24.1 ± 4.6) completed four interventions: (1) prolonged sitting (SIT), (2) sitting with 2-min of walking every 30 min (RAB), (3) prolonged sitting with 30-min of continuous walking at the end of the day (SIT + PA), (4) a combination of the activities in (2) and (3) above (RAB + PA). All walking was at a speed and incline corresponding to 60% V̇O 2max . Energy utilization over 7 h for each intervention was estimated using indirect calorimetry. Compared to SIT, SIT + PA increased total energy utilization by 709 kJ (95% CI 485-933 kJ), RAB by 863 kJ (95% CI 638-1088 kJ), and RAB + PA by 1752 kJ (95% CI 1527-1927 kJ) (all p < 0.001). There was no difference in total energy utilization between SIT + PA and RAB, however, post-physical activity energy utilization in RAB was 632 kJ greater than SIT + PA (95% CI 561-704 kJ; p < 0.001). Short frequent activity, results in greater accumulation of elevated post-physical activity energy utilization compared to a single bout of continuous activity; however the total energy utilization is similar. Combining activity breaks with a longer continuous bout of activity will further enhance energy utilization, and in the longer term, may positively affect weight management of a greater magnitude than either activity pattern performed alone. ANZCTR12614000624684. Copyright © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Talent Management Programmes at British, American and Canadian Universities: Comparative Study

ERIC Educational Resources Information Center

Boichenko, Maryna

2015-01-01

The article deals with the peculiarities of talent management programmes implementation at the top British, American and Canadian universities. The essence of the main concepts of research--talent and talent management--has been revealed. Talent management is referred to as the systematic attraction, identification, development, engagement,…

Protocol for the residents in action pilot cluster randomised controlled trial (RiAT): evaluating a behaviour change intervention to promote walking, reduce sitting and improve mental health in physically inactive older adults in retirement villages.

PubMed

Thøgersen-Ntoumani, Cecilie; Wright, Ashlene; Quested, Eleanor; Burton, Elissa; Hill, Keith D; Cerin, Ester; Biddle, Stuart J H; Ntoumanis, Nikos

2017-06-23

Ageing is accompanied by increased risks of chronic disease, declined functioning and increased dependency. Physical activity is critical to retaining health and independence, but the majority of older people are insufficiently physically active to achieve these benefits and have high levels of sedentary (sitting) time. Activity programmes are often offered in retirement villages; however, their uptake is limited. Furthermore, although the physical environment in and around these villages can play an important role in decisions to be physically active, its role is often overlooked by research in these settings. We aim to develop, implement and evaluate a proof-of-concept motivationally embellished intervention designed to increase walking, reduce sitting and improve mental health in residents in retirement villages. This will be a 16-week pilot intervention using a cluster randomised design with retirement villages as the unit of randomisation and residents as the unit of assessment. Fourteen retirement villages around Perth, Western Australia, will be recruited for the intervention. Objective audits of neighbourhood environments around each village will be completed using the Pathway Environmental Audit Tool. Seven villages will be randomised to the experimental arm and seven to the control arm. Only participants in the experimental arm will receive motivational training. All outcomes will be assessed at baseline, end of intervention and 6-month follow-up. Changes in physical activity levels, sitting time and mental health will be examined. Multilevel modelling will be used to analyse the data. A mixed methods process evaluation will also be conducted. Ethics approval was granted by Curtin University's Human Research Ethics Committee (HREC2016-0187). The results of the study will be disseminated via peer-reviewed publications, conference presentations and reports to, and seminars with, stakeholders. The trial is registered with the Australian New Zealand Clinical Trials Registry: ACTRN12616001177448. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exploring the use of social network analysis to measure communication between disease programme and district managers at sub-national level in South Africa.

PubMed

Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

2015-06-01

With increasing interest in maximising synergies between disease control programmes (DCP) and general health services (GHS), methods are needed to measure interactions between DCP and GHS actors. In South Africa, administrative integration reforms make GHS managers at decentralised level (district managers) responsible for the oversight of DCP operations within districts, with DCP managers (programme managers) providing specialist support. The reforms necessitate interdependence, but these actors work together ineffectively. Communication is crucial for joint working, but no research to assess communication between these actors has been done. This study explores the use of social network analysis (SNA) to measure the extent to which programme and district managers in South Africa communicate, using HIV monitoring and evaluation (M&E) as an exemplar. Data were collected from fifty one managers in two provinces during 2010-2011, to measure: a) one-on-one task-related communication - talking about the collation (verification, reporting) and use of HIV data for monitoring HIV interventions; and b) group communication through co-participating in management committees where HIV data are used for monitoring HIV interventions in districts. SNA measures were computed to describe actor centrality, network density (cohesion), and communication within and between respective manager groups. Block modelling was applied to identify management committees that connect respective manager groups. Results show HIV programme managers located at higher level communicated largely amongst themselves as a group (homophily), seldom talked to the district managers to whom they are supposed to provide specialist HIV M&E support, and rarely participated with them in management committees. This research demonstrates the utility of SNA as a tool for measuring the extent of communication between DCP and GHS actors at sub-national level. Actions are needed to bridge observed communication gaps in order to promote collaborative monitoring of HIV programme interventions within districts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Risk management and lessons learned solutions for satellite product assurance

NASA Astrophysics Data System (ADS)

Larrère, Jean-Luc

2004-08-01

The historic trend of the space industry towards lower cost programmes and more generally a better economic efficiency raises a difficult question to the quality assurance community: how to achieve the same—or better—mission success rate while drastically reducing the cost of programmes, hence the cost and level of quality assurance activities. EADS Astrium Earth Observation and Science (France) Business Unit have experimented Risk Management and Lessons Learned on their satellite programmes to achieve this goal. Risk analysis and management are deployed from the programme proposal phase through the development and operations phases. Results of the analysis and the corresponding risk mitigation actions are used to tailor the product assurance programme and activities. Lessons learned have been deployed as a systematic process to collect positive and negative experience from past and on-going programmes and feed them into new programmes. Monitoring and justification of their implementation in programmes is done under supervision from the BU quality assurance function. Control of the system is ensured by the company internal review system. Deployment of these methods has shown that the quality assurance function becomes more integrated in the programme team and development process and that its tasks gain focus and efficiency while minimising the risks associated with new space programmes.

Device For Controlling Crystallization Of Protein

NASA Technical Reports Server (NTRS)

Noever, David A.

1993-01-01

Variable sandwich spacer enables optimization of evaporative driving force that governs crystallization of protein from solution. Mechanically more rigid than hanging-drop and sitting-drop devices. Large oscillations and dislodgment of drop of solution in response to vibrations suppressed by glass plates. Other advantages include: suitable for automated delivery, stable handling, and programmable evaporation of protein solution; controlled configuration enables simple and accurate determination of volume of solution without disrupting crystallization; pH and concentration of precipitant controlled dynamically because pH and concentration coupled to rate of evaporation, controllable via adjustment of gap between plates; and enables variation of ratio between surface area and volume of protein solution. Alternative version, plates oriented vertically instead of horizontally.

The Application of a Total Quality Management Approach to Support Student Recruitment in Schools of Music

ERIC Educational Resources Information Center

Weinstein, Larry

2009-01-01

One of the greatest challenges music programme administrators face is that of recruiting students for their programmes. This article suggests that administrators should investigate the benefits of implementing a comprehensive total quality management programme in their institutions. The core values, techniques and tools embodied in the Total…

Navigating the Turbulent Waters of Academia: The Leadership Role of Programme Managers

ERIC Educational Resources Information Center

Vilkinas, Tricia; Cartan, Greg

2015-01-01

The focus of our paper is the leadership role of programme managers in the higher education sector. In particular, we highlight the complex and paradoxical nature of the programme leader's role, and provide an insight into leadership in this challenging and dynamic environment. We identify cognitive and behavioural complexity as necessary…

An Analysis of Whitewater Rafting Safety Data: Risk Management for Programme Organizers

ERIC Educational Resources Information Center

Hunter, I. Roy

2007-01-01

Many outdoor organizations integrate whitewater rafting into their programmes. Often this is accomplished by contracting with a whitewater outfitter. This paper analyses rafting accident data collected by the American Canoe Association in an effort to suggest ways in which programmes can better manage risk while contracting with outfitters for…

A comparison of trunk biomechanics, musculoskeletal discomfort and productivity during simulated sit-stand office work.

PubMed

Karakolis, Thomas; Barrett, Jeff; Callaghan, Jack P

2016-10-01

Sedentary office work has been shown to cause low back discomfort and potentially cause injury. Prolonged standing work has been shown to cause discomfort. The implementation of a sit-stand paradigm is hypothesised to mitigate discomfort and prevent injury induced by prolonged exposure to each posture in isolation. This study explored the potential of sit-stand to reduce discomfort and prevent injury, without adversely affecting productivity. Twenty-four participants performed simulated office work in three different conditions: sitting, standing and sit-stand. Variables measured included: perceived discomfort, L4-L5 joint loading and typing/mousing productivity. Working in a sit-stand paradigm was found to have the potential to reduce discomfort when compared to working in a sitting or standing only configuration. Sit-stand was found to be associated with reduced lumbar flexion during sitting compared to sitting only. Increasing lumbar flexion during prolonged sitting is a known injury mechanism. Therefore, sit-stand exhibited a potentially beneficial response of reduced lumbar flexion that could have the potential to prevent injury. Sit-stand had no significant effect on productivity. Practitioner Summary: This study has contributed foundational elements to guide usage recommendations for sit-stand workstations. The sit-stand paradigm can reduce discomfort; however, working in a sit-stand ratio of 15:5 min may not be the most effective ratio. More frequent posture switches may be necessary to realise the full benefit of sit-stand.

Are we chained to our desks? Describing desk-based sitting using a novel measure of occupational sitting.

PubMed

Ryde, Gemma Cathrine; Brown, Helen Elizabeth; Gilson, Nicholas David; Brown, Wendy J

2014-09-01

Prolonged occupational sitting is related to poor health outcomes. Detailed data on sitting time at desks are required to understand and effectively influence occupational sitting habits. Full-time office employees were recruited (n = 105; mean age 40.9 ± 11.5 years; BMI 26.1 ± 3.9, 65% women). Sitting at the desk and in other work contexts was measured using a sitting pad and ActivPAL for an entire working week. Employees used a diary to record work hours. Time spent at work, sitting at work and at the desk; number of sit to stand transitions at the desk; and number of bouts of continuous sitting at the desk < 20 and > 60 minutes, were calculated. Average time spent at work was 8.7 ± 0.8 hours/day with 67% spent sitting at the desk (5.8 ± 1.2 hours/day), and 4% in other workplace settings. On average, employees got up from their desks 3 times/hour (29 ± 13/day). Sitting for more than 60 consecutive minutes occurred infrequently (0.69 ± 0.62 times/day), with most sit to stands (80%; 23 ± 14) occurring before 20 minutes of continual sitting. The findings provide highly detailed insights into desk-based sitting habits, highlighting large proportions of time spent sitting at desks, but with frequent interruptions.

Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya

PubMed Central

2010-01-01

Abstract Background The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. Methods The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. Results The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a “resource team”, supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. Conclusions For effective scaling up of PMR programmes, the provision of technical support and adequate resources are vital, but not sufficient on their own. An active strategy to manage relationships between implementing actors through effective communication mechanisms is essential. Successful outcomes may be realised if a strong and transparent management system, including management of financial resources, is put in place. This study provides evidence of the value of assessing implementation processes as part of impact evaluation for public health programmes. PMID:20594373

Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya.

PubMed

Abuya, Timothy; Amin, Abdinasir; Molyneux, Sassy; Akhwale, Willis; Marsh, Vicki; Gilson, Lucy

2010-07-02

The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a "resource team", supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. For effective scaling up of PMR programmes, the provision of technical support and adequate resources are vital, but not sufficient on their own. An active strategy to manage relationships between implementing actors through effective communication mechanisms is essential. Successful outcomes may be realised if a strong and transparent management system, including management of financial resources, is put in place. This study provides evidence of the value of assessing implementation processes as part of impact evaluation for public health programmes.

How Does Definition of Minimum Break Length Affect Objective Measures of Sitting Outcomes Among Office Workers?

PubMed

Kloster, Stine; Danquah, Ida Høgstedt; Holtermann, Andreas; Aadahl, Mette; Tolstrup, Janne Schurmann

2017-01-01

Harmful health effects associated with sedentary behavior may be attenuated by breaking up long periods of sitting by standing or walking. However, studies assess interruptions in sitting time differently, making comparisons between studies difficult. It has not previously been described how the definition of minimum break duration affects sitting outcomes. Therefore, the aim was to address how definitions of break length affect total sitting time, number of sit-to-stand transitions, prolonged sitting periods and time accumulated in prolonged sitting periods among office workers. Data were collected from 317 office workers. Thigh position was assessed with an ActiGraph GT3X+ fixed on the right thigh. Data were exported with varying bout length of breaks. Afterward, sitting outcomes were calculated for the respective break lengths. Absolute numbers of sit-to-stand transitions decreased, and number of prolonged sitting periods and total time accumulated in prolonged sitting periods increased, with increasing minimum break length. Total sitting time was not influenced by varying break length. The definition of minimum break length influenced the sitting outcomes with the exception of total sitting time. A standard definition of break length is needed for comparison and interpretation of studies in the evolving research field of sedentary behavior.

Perceived office environments and occupational physical activity in office-based workers.

PubMed

Sawyer, A; Smith, L; Ucci, M; Jones, R; Marmot, A; Fisher, A

2017-06-01

Individuals in office-based occupations have low levels of physical activity but there is little research into the socio-ecological correlates of workplace activity. To identify factors contributing to office-based workers' perceptions of the office environment and explore cross-sectional relationships between these factors and occupational physical activity. Participants in the Active Buildings study reported perceptions of their office environment using the Movement at Work Survey. A principal component analysis (PCA) was conducted on survey items. A sub-sample wore the ActivPAL3TM accelerometer for ≥3 workdays to measure occupational step count, standing, sitting and sit-to-stand transitions. Linear regression analyses assessed relationships between environmental perceptions and activity. There were 433 participants, with accelerometer data available for 115 participants across 11 organ izations. The PCA revealed four factors: (i) perceived distance to office destinations, (ii) perceived office aesthetics and comfort, (iii) perceived office social environment and (iv) perceived management discouragement of unscheduled breaks. Younger participants perceived office destinations as being closer to their desk. Younger and female participants perceived more positive office social environments; there were no other socio-demographic differences. Within the sub-sample with accelerometer data, perceived discouragement of breaks by management was related to occupational step count/hour (B = -64.5; 95% CI -109.7 to -19.2). No other environmental perceptions were related to activity or sitting. Perceived managerial discouragement of breaks could be related to meaningful decreases in occupational step count. Future research should aim to elucidate the role of the workplace socio-cultural environment in occupational walking, with a focus on the role of management. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Programmes for tobacco and alcohol users in Australian work-places.

PubMed

Richmond, R; Heather, N; Holt, P

1996-12-01

This article presents findings from a survey of programmes available for tobacco and alcohol users working in 455 of Australia's top 600 companies. Companies were twice as likely to have programmes for smokers (43%) as for problem drinkers (24%) and these programmes were more apparent in large companies. The majority of programmes for smoking were delivered within a health promotion context which included other life-style issues, such as nutrition, exercise, weight management and stress management. Although Employee Assistance Programs (EAPs) were the most commonly available type of work-place programme for excessive drinkers and other drug users, followed by Alcoholics Anonymous and local hospital clinics, only 6% had an EAP for alcohol. Only 21% of programmes for smokers and 12% for excessive alcohol users were evaluated. Around one-quarter of companies knew the costs of smoking programmes, and 9% reported costs of conducting programmes for excessive alcohol consumers.

The SLMTA programme: Transforming the laboratory landscape in developing countries

PubMed Central

Maruta, Talkmore; Luman, Elizabeth T.; Nkengasong, John N.

2014-01-01

Background Efficient and reliable laboratory services are essential to effective and well-functioning health systems. Laboratory managers play a critical role in ensuring the quality and timeliness of these services. However, few laboratory management programmes focus on the competencies required for the daily operations of a laboratory in resource-limited settings. This report provides a detailed description of an innovative laboratory management training tool called Strengthening Laboratory Management Toward Accreditation (SLMTA) and highlights some challenges, achievements and lessons learned during the first five years of implementation (2009–2013) in developing countries. Programme SLMTA is a competency-based programme that uses a series of short courses and work-based learning projects to effect immediate and measurable laboratory improvement, while empowering laboratory managers to implement practical quality management systems to ensure better patient care. A SLMTA training programme spans from 12 to 18 months; after each workshop, participants implement improvement projects supported by regular supervisory visits or on-site mentoring. In order to assess strengths, weaknesses and progress made by the laboratory, audits are conducted using the World Health Organization’s Regional Office for Africa (WHO AFRO) Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist, which is based on International Organization for Standardization (ISO) 15189 requirements. These internal audits are conducted at the beginning and end of the SLMTA training programme. Conclusion Within five years, SLMTA had been implemented in 617 laboratories in 47 countries, transforming the laboratory landscape in developing countries. To our knowledge, SLMTA is the first programme that makes an explicit connection between the performance of specific management behaviours and routines and ISO 15189 requirements. Because of this close relationship, SLMTA is uniquely positioned to help laboratories seek accreditation to ISO 15189. PMID:26752335

Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

PubMed Central

Van Grootven, Bastiaan; McNicoll, Lynn; Mendelson, Daniel A; Friedman, Susan M; Fagard, Katleen; Milisen, Koen; Flamaing, Johan; Deschodt, Mieke

2018-01-01

Objective To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. Design An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). Setting Western Europe and the USA. Participants Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate). Measures Participants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method. Results In the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications. Conclusion The indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes. PMID:29549210

Structured patient education: the X-PERT Programme.

PubMed

Deakin, Trudi; Whitham, Claire

2009-09-01

The X-PERT Programme seeks to develop the knowledge, skills and confidence in diabetes treatment for health-care professionals and diabetes self-management. The programme trains health-care professionals to deliver the six-week structured patient education programme to people with diabetes. Over 850 health-care professionals have attended the X-PERT 'Train the Trainer' course and audit results document improved job satisfaction and competence in diabetes treatment and management. National audit statistics for X-PERT implementation to people with diabetes illustrate excellent attendance rates, improved diabetes control, reduced weight, blood pressure, cholesterol and waist circumference and more confidence in self-managing diabetes that has impacted positively on quality of life.

What Do Older People Do When Sitting and Why? Implications for Decreasing Sedentary Behavior.

PubMed

Palmer, Victoria J; Gray, Cindy M; Fitzsimons, Claire F; Mutrie, Nanette; Wyke, Sally; Deary, Ian J; Der, Geoff; Chastin, Sebastien F M; Skelton, Dawn A

2018-05-15

Sitting less can reduce older adults' risk of ill health and disability. Effective sedentary behavior interventions require greater understanding of what older adults do when sitting (and not sitting), and why. This study compares the types, context, and role of sitting activities in the daily lives of older men and women who sit more or less than average. Semistructured interviews with 44 older men and women of different ages, socioeconomic status, and objectively measured sedentary behavior were analyzed using social practice theory to explore the multifactorial, inter-relational influences on their sedentary behavior. Thematic frameworks facilitated between-group comparisons. Older adults described many different leisure time, household, transport, and occupational sitting and non-sitting activities. Leisure-time sitting in the home (e.g., watching TV) was most common, but many non-sitting activities, including "pottering" doing household chores, also took place at home. Other people and access to leisure facilities were associated with lower sedentary behavior. The distinction between being busy/not busy was more important to most participants than sitting/not sitting, and informed their judgments about high-value "purposeful" (social, cognitively active, restorative) sitting and low-value "passive" sitting. Declining physical function contributed to temporal sitting patterns that did not vary much from day-to-day. Sitting is associated with cognitive, social, and/or restorative benefits, embedded within older adults' daily routines, and therefore difficult to change. Useful strategies include supporting older adults to engage with other people and local facilities outside the home, and break up periods of passive sitting at home.

A Masters Programme in telecommunications management - demand-based curriculum design

NASA Astrophysics Data System (ADS)

Gharaibeh, Khaled M.; Kaylani, Hazem; Murphy, Noel; Brennan, Conor; Itradat, Awni; Al-Bataineh, Mohammed; Aloqlah, Mohammed; Salhieh, Loay; Altarazi, Safwan; Rawashdeh, Nathir; Bas Cerdá, María del Carmen; Conchado Peiró, Andrea; Al-Zoubi, Asem; Harb, Bassam; Bany Salameh, Haythem

2015-05-01

This paper presents a curriculum design approach for a Masters Programme in Telecommunications Management based on demand data obtained from surveying the needs of potential students of the proposed programme. Through online surveys disseminated at telecom companies in Jordan, it was possible to measure the demand for such a programme and to determine the required programme contents and specifications. The curriculum design is based on definition of programme outcomes and on using a house of quality approach (HOQ) to determine the list of courses required in the programme. Surveyed competencies are mapped to a long list of proposed courses in a HOQ in order to determine the importance of each of these courses. A final list of core and elective courses is then developed considering the contribution to programme outcomes and the academic standards.

Hospital management training and improvement in managerial skills: Serbian experience.

PubMed

Supic, Zorica Terzic; Bjegovic, Vesna; Marinkovic, Jelena; Milicevic, Milena Santric; Vasic, Vladimir

2010-06-01

The purpose of this study was to analyze the improvement of managerial skills of hospitals' top managers after a specific management training programme, and to explore possible predictors and relations. The study was conducted during the years 2006 and 2007 with cohort of 107 managers from 20 Serbian general hospitals. The managers self-assessed the improvement in their managerial skills before and after the training programme. After the training programme, all managers' skills had improved. The biggest improvement was in the following skills: organizing daily activities, motivating and guiding others, supervising the work of others, group discussion, and situation analysis. The least improved were: applying creative techniques, working well with peers, professional self-development, written communication, and operational planning. Identified predictors of improvement were: shorter years of managerial experience, type of manager, type of profession, and recognizing the importance of the managerial skills in oral communication, evidence-based decision making, and supervising the work of others. Specific training programme related to strategic management can increase managerial competencies, which are an important source of competitive advantage for organizations. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Information Systems Plan.

DTIC Science & Technology

1985-04-01

increase in load factors. CURENUT YEARLY COST OF INFOR TION MANAGEK1KUT 0.04 FTE’s $876 DATA SET: Natural Resource (Management) VINAGE .QUIRRmuT OF...OF DATA SITS NEEDED TO SUPPORT IDENTIFIED DISTRICT PROCESSES PXOCESSz 53 - Provide Audio-Visual Services DATA SET: Equipment (Slide File) VINAG

[Disease management programs from a health insurer's point of view].

PubMed

Szymkowiak, Christof; Walkenhorst, Karen; Straub, Christoph

2003-06-01

Disease Management Programmes represent a great challenge to the German statutory health insurance system. According to politicians, disease management programmes are an appropriate tool for increasing the level of care for chronically ill patients significantly, while at the same time they can slow down the cost explosion in health care. The statutory health insurers' point of view yields a more refined picture of the chances and risks involved. The chances are that a medical guideline-based, evidence-based, co-operative care of the chronically ill could be established. But also, there are the risks of misuse of disease management programmes and of misallocation of funds due to the ill-advised linkage with the so-called risk compensation scheme (RSA) balancing the sickness funds' structural deficits through redistribution. The nation-wide introduction of disease management programmes appears to be a gigantic experiment whose aim is to change the care of chronically ill patients and whose outcome is unpredictable.

The central role of national programme management for the achievement of malaria elimination: a cross case-study analysis of nine malaria programmes.

PubMed

Smith Gueye, Cara; Newby, Gretchen; Tulloch, Jim; Slutsker, Laurence; Tanner, Marcel; Gosling, Roland D

2016-09-22

A malaria eradication goal has been proposed, at the same time as a new global strategy and implementation framework. Countries are considering the strategies and tools that will enable progress towards malaria goals. The eliminating malaria case-study series reports were reviewed to identify successful programme management components using a cross-case study analytic approach. Nine out of ten case-study reports were included in the analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for malaria elimination programme management was developed and data were extracted and synthesized. Findings were reviewed at a consultative workshop, which led to a revision of the framework and further data extraction and synthesis. Success factors of implementation, programme choices and changes, and enabling factors were distilled. Decentralized programmes enhanced engagement in malaria elimination by sub-national units and communities. Integration of the malaria programme into other health services was also common. Decentralization and integration were often challenging due to the skill and experience levels of newly tasked staff. Accountability for programme impact was not clarified for most programmes. Motivation of work force was a key factor in maintaining programme quality but there were few clear, detailed strategies provided. Different incentive schemes targeted various stakeholders. Training and supervision, although not well described, were prioritized by most programmes. Multi-sectoral collaboration helped some programmes share information, build strategies and interventions and achieve a higher quality of implementation. In most cases programme action was spurred by malaria outbreaks or a new elimination goal with strong leadership. Some programmes showed high capacity for flexibility through introduction of new strategies and tools. Several case-studies described methods for monitoring implementation quality and coverage; however analysis and feedback to those implementing malaria elimination in the periphery was not well described. Political commitment and sustained financing contributed to malaria programme success. Consistency of malaria programmes depends on political commitment, human and financial resources, and leadership. Operational capacity of the programme and the overall health system structure and strength are also important aspects. Malaria eradication will require adaptive, well-managed malaria programmes that are able to tailor implementation of evidence-based strategies, founded upon strong sub-national surveillance and response, with adequate funding and human resources.

Use of herd management programmes to improve the reproductive performance of dairy cattle.

PubMed

McDougall, S; Heuer, C; Morton, J; Brownlie, T

2014-05-01

There has been a long history of herd health and production management programmes in many dairy industries around the world, but evidence for the efficacy of such programmes is limited. In response to a perceived decline in fertility of dairy cows, a herd reproductive management programme (InCalf) was introduced in New Zealand in 2007. This programme uses a management cycle approach that includes an assessment of the current herd status, identification of areas for improvement, development of a plan, implementation of this plan and finally a review process. The programme uses facilitators who work with farmers either in a one-to-one manner or in a formalised group setting that involves a series of meetings over a 12-month period (the farmer action group). The hypothesis that involvement in a reproductive management programme would improve herd reproductive performance was tested using a herd-level controlled randomised study (the National Herd Fertility Study) involving herds in four geographic regions of New Zealand over 2 years. Within each region, herds were ranked on the basis of the 6-week in-calf rate (i.e. the proportion of the herd pregnant in the first 6 weeks of the seasonal breeding programme) in the year preceding commencement of the study and then randomly assigned to be involved in a farmer action group or left as untreated controls. The key outcome variable of the study was the 6-week in-calf rate. Pregnancy diagnosis was undertaken at 12 weeks after the start of the seasonal breeding programme, which allowed determination of conception dates and hence calculation of the 6-week in-calf rate. Additional measurements including heifer live weight and body condition score (pre-calving and pre-mating) were undertaken to test whether treatment resulted in measurable changes in some of the key determinants of herd reproductive performance. Involvement in the farmer action group of InCalf resulted in a 2 percentage point increase in the 6-week in-calf rate (P=0.05). The following additional observations were made in herds involved in the farmer action group relative to control herds: heifers had live weight closer to target; the pre-mating body condition score of cows was higher; and oestrous detection rates were higher. It was concluded that involvement in this herd reproductive management programme improved reproductive outcomes in this New Zealand study. However, to achieve substantial improvements in herd reproductive performance at the regional or national level a greater response to the programme and a high uptake of such programmes is required, as well as use of other industry-level tools such as genetic management programmes.

Community Capacity Development in Universities: Empowering Communities through Education Management Programmes in Strathmore University (A Pilot Study)

ERIC Educational Resources Information Center

Kitawi, Alfred Kirigha

2014-01-01

This research examined the issue of community capacity development in a university. The main way communities were empowered was through the education management programmes offered at Strathmore University in Nairobi, Kenya. The research is among the first to examine the issue of community capacity development through university programmes. The…

An Empirical Comparative Investigation of Operations Management Programmes: Demand, Content and Entrance Criteria within the Context of Internationalization

ERIC Educational Resources Information Center

Wang, Chengbo; Chen, Xuezhong; Edgar, David; Zhao, Yang

2013-01-01

In higher education institutes (HEIs), Operations Management programmes (OMPs) are among those programmes attracting a substantial amount of international student enrollment. With the current situation that the government is reducing its funding input, the UK HEIs' financial balance relies more than before on the international students who pay…

Socio-demographic, behavioural and cognitive correlates of work-related sitting time in German men and women.

PubMed

Wallmann-Sperlich, Birgit; Bucksch, Jens; Schneider, Sven; Froboese, Ingo

2014-12-11

Sitting time is ubiquitous for most adults in developed countries and is most prevalent in three domains: in the workplace, during transport and during leisure time. The correlates of prolonged sitting time in workplace settings are not well understood. Therefore, the aim of this study was to examine the gender-specific associations between the socio-demographic, behavioural and cognitive correlates of work-related sitting time. A cross-sectional sample of working German adults (n = 1515; 747 men; 43.5 ± 11.0 years) completed questionnaires regarding domain-specific sitting times and physical activity (PA) and answered statements concerning beliefs about sitting. To identify gender-specific correlates of work-related sitting time, we used a series of linear regressions. The overall median was 2 hours of work-related sitting time/day. Regression analyses showed for men (β = -.43) and for women (β = -.32) that work-related PA was negatively associated with work-related sitting time, but leisure-related PA was not a significant correlate. For women only, transport-related PA (β = -.07) was a negative correlate of work-related sitting time, suggesting increased sitting times during work with decreased PA in transport. Education and income levels were positively associated, and in women only, age (β = -.14) had a negative correlation with work-related sitting time. For both genders, TV-related sitting time was negatively associated with work-related sitting time. The only association with cognitive correlates was found in men for the belief 'Sitting for long periods does not matter to me' (β = .10) expressing a more positive attitude towards sitting with increasing sitting durations. The present findings show that in particular, higher educated men and women as well as young women are high-risk groups to target for reducing prolonged work-related sitting time. In addition, our findings propose considering increasing transport-related PA, especially in women, as well as promoting recreation-related PA in conjunction with efforts to reduce long work-related sitting times.

Patient level cost of diabetes self-management education programmes: an international evaluation

PubMed Central

Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan

2017-01-01

Objectives The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Setting Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Participants Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary and secondary measures Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. Results We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. Conclusions This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. PMID:28583913

Patient level cost of diabetes self-management education programmes: an international evaluation.

PubMed

Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan

2017-06-04

The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Healthcare reforms: implications for the education and training of acute and critical care nurses.

PubMed

Glen, S

2004-12-01

This paper offers a wide ranging analysis of the drivers that resulted in scrutiny of medical, nursing, and healthcare professional roles. It suggests that what is needed is a coherent vision of the future shape of the health workforce. This requires moving beyond the presumption that reforming working practices primarily involves "delegating doctors" responsibilities to nurses. The paper argues that it is self evident that the implications of changes in healthcare roles and the ability of existing professionals to function effectively in the future will require education, training, and human resource investment supportive of the changes. It suggests a clear definition of competence and a national standard to practice is essential for nurses working in acute and acute critical settings. There should therefore be a correlation between levels of practice, levels of education, and remuneration. Furthermore, education programmes for senior nurses should sit coherently alongside the education programmes required by Modernising Medical Careers. Finally, the realisation of the government's service and modernisation agenda will require a culture change within higher education institutions, postgraduate deaneries, professional organisations, workforce development confederations, and NHS trusts.

Perceived body discomfort and trunk muscle activity in three prolonged sitting postures

PubMed Central

Waongenngarm, Pooriput; Rajaratnam, Bala S.; Janwantanakul, Prawit

2015-01-01

[Purpose] This study aimed to investigate the perceived discomfort and trunk muscle activity in three different 1-hour sitting postures. [Subjects] A repeated-measures design study was conducted on 10 healthy subjects. [Methods] Each subject sat for an hour in three sitting postures (i.e., upright, slumped, and forward leaning sitting postures). Subjects rated perceived body discomfort using Borg’s CR-10 scale at the beginning and after 1 hour sitting. The electromyographic activity of the trunk muscle activity was recorded during the 1-hour period of sitting. [Results] The forward leaning sitting posture led to higher Borg scores in the low back than those in the upright (p = 0.002) and slumped sitting postures (p < 0.001). The forward leaning posture was significantly associated with increased iliocostalis lumborum pars thoracis (ICL) and superficial lumbar multifidus (MF) muscle activity compared with the upright and slumped sitting postures. The upright sitting posture was significantly associated with increased internal oblique (IO)/transversus abdominis (TrA) and ICL muscle activity compared with the slumped sitting posture. [Conclusion] The sitting posture with the highest low back discomfort after prolonged sitting was the forward leaning posture. Sitting in an upright posture is recommended because it increases IO/TrA muscle activation and induces only relatively moderate ICL and MF muscle activation. PMID:26311951

System and method for acquisition management of subject position information

DOEpatents

Carrender, Curt

2005-12-13

A system and method for acquisition management of subject position information that utilizes radio frequency identification (RF ID) to store position information in position tags. Tag programmers receive position information from external positioning systems, such as the Global Positioning System (GPS), from manual inputs, such as keypads, or other tag programmers. The tag programmers program each position tag with the received position information. Both the tag programmers and the position tags can be portable or fixed. Implementations include portable tag programmers and fixed position tags for subject position guidance, and portable tag programmers for collection sample labeling. Other implementations include fixed tag programmers and portable position tags for subject route recordation. Position tags can contain other associated information such as destination address of an affixed subject for subject routing.

System and method for acquisition management of subject position information

DOEpatents

Carrender, Curt [Morgan Hill, CA

2007-01-23

A system and method for acquisition management of subject position information that utilizes radio frequency identification (RF ID) to store position information in position tags. Tag programmers receive position information from external positioning systems, such as the Global Positioning System (GPS), from manual inputs, such as keypads, or other tag programmers. The tag programmers program each position tag with the received position information. Both the tag programmers and the position tags can be portable or fixed. Implementations include portable tag programmers and fixed position tags for subject position guidance, and portable tag programmers for collection sample labeling. Other implementations include fixed tag programmers and portable position tags for subject route recordation. Position tags can contain other associated information such as destination address of an affixed subject for subject routing.

Development of a self-managed loaded exercise programme for rotator cuff tendinopathy.

PubMed

Littlewood, Chris; Malliaras, Peter; Mawson, Sue; May, Stephen; Walters, Stephen

2013-12-01

This paper describes a self-managed loaded exercise programme which has been designed to address the pain and disability associated with rotator cuff tendinopathy. The intervention has been developed with reference to current self-management theory and with reference to the emerging benefit of loaded exercise for tendinopathy. This self-managed loaded exercise programme is being evaluated within the mixed methods SELF study (ISRCTN 84709751) which includes a pragmatic randomised controlled trial conducted within the UK National Health Service. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Analysis of sitting forces on stationary chairs for daily activities.

PubMed

Hu, Lingling; Tackett, Bob; Tor, Onder; Zhang, Jilei

2016-04-01

No literature related to the study of sitting forces on chairs sat on by people who weighed over 136 kg was found. The Business Institutional Furniture Manufactures Association needs force data for development of performance test standards to test chairs for users who weigh up to 181 kg. 20 participants who weighed from 136 to 186 kg completed 6 tasks on an instrumented chair in the sequence of sitting down, remaining seated and rising. Effects of sitting motion, armrest use and seat cushion thickness on vertical sitting forces and centre-of-force were investigated. Results indicated hard sitting down yielded the highest sitting force of 213% in terms of participants' body weights. Armrest use affected sitting forces of normal sitting down, but not of rising and hard sitting down. Cushion thickness affected sitting forces of normal and hard sitting down and shifting, but not of rising, static seating or stretching backward situations. Practitioner Summary: Results of the sitting force and centre-of-force data obtained for this research can help furniture manufacturers develop new product performance test standards for creating reliable engineering design and manufacturing quality and durable products to meet a niche market need.

Infant positioning in daily life may mediate associations between physiotherapy and child development-video-analysis of an early intervention RCT.

PubMed

Dirks, Tineke; Hielkema, Tjitske; Hamer, Elisa G; Reinders-Messelink, Heleen A; Hadders-Algra, Mijna

2016-01-01

Paediatric physiotherapy (PPT) in high-risk infants comprises family involvement, but it is unclear whether parents mediate the intervention effect. We demonstrated in a randomized controlled trial in high-risk infants comparing the family centred programme Coping and Caring for infants with special needs (COPCA) and Traditional Infant Physiotherapy (TIP) that process evaluation revealed associations between COPCA-characteristics and outcome. To assess whether PPT affects how parents position their infant during bathing and whether this is associated with child outcome. 21 infants received COPCA and 25 TIP between 3 and 6 months corrected age. Bathing sessions were videotaped at 3, 6 and 18 months. Time spent with specific infant positions was correlated with quantified PPT-actions and functional mobility at 18 months measured with the Paediatric Evaluation of Disability Inventory (PEDI). At 3 and 18 months bathing position was similar in both groups, but differed at 6 months (time spent on sitting: COPCA 77.7%, TIP 39.2%; median difference 32.0% (95% CI: 10.6-50.5%). Sitting-time at 6 months was associated with higher PEDI functional mobility scores. Early PPT may affect parental behaviour, such as infant positioning during bathing, which, in turn, may affect child development. Copyright © 2016 Elsevier Ltd. All rights reserved.

Planning for sedentary behaviour interventions: office workers' survey and focus group responses.

PubMed

McGuckin, Teneale; Sealey, Rebecca; Barnett, Fiona

2017-11-01

As sedentary behaviour is becoming more prominent in office-based work environments, this study aimed to explore office workers' perceptions of sedentary behaviour, explore potential behavioural strategies to reduce sedentary behaviour in the workplace and identify barriers which may hamper behaviour change. A total of 140 office workers were recruited and surveyed from the same workplace. The survey included questions regarding perceptions of the relationship between sitting time and health. Following the survey, 12 employees also participated in focus groups to identify potential sedentary behaviour intervention strategies and barriers. The responses from the survey and focus groups were thematically analysed. In total, 88% of all participants surveyed agreed that there was a relationship between sitting time and their health. The most prominent theme identified was musculoskeletal complaints followed by general health and weight gain or obesity. The focus groups identified that interventions targeting reducing sitting time should include education, supportive and knowledgeable managers, and a variety of behaviour change strategies to address individual preferences and barriers. Multiple behavioural strategies were identified, which appear to be appropriate for sedentary behaviour change.

Comparison of Sedentary Behaviors in Office Workers Using Sit-Stand Tables With and Without Semiautomated Position Changes.

PubMed

Barbieri, Dechristian França; Srinivasan, Divya; Mathiassen, Svend Erik; Oliveira, Ana Beatriz

2017-08-01

We compared usage patterns of two different electronically controlled sit-stand tables during a 2-month intervention period among office workers. Office workers spend most of their working time sitting, which is likely detrimental to health. Although the introduction of sit-stand tables has been suggested as an effective intervention to decrease sitting time, limited evidence is available on usage patterns of sit-stand tables and whether patterns are influenced by table configuration. Twelve workers were provided with standard sit-stand tables (nonautomated table group) and 12 with semiautomated sit-stand tables programmed to change table position according to a preset pattern, if the user agreed to the system-generated prompt (semiautomated table group). Table position was monitored continuously for 2 months after introducing the tables, as a proxy for sit-stand behavior. On average, the table was in a "sit" position for 85% of the workday in both groups; this percentage did not change significantly during the 2-month period. Switches in table position from sit to stand were, however, more frequent in the semiautomated table group than in the nonautomated table group (0.65 vs. 0.29 hr -1 ; p = .001). Introducing a semiautomated sit-stand table appeared to be an attractive alternative to a standard sit-stand table, because it led to more posture variation. A semiautomated sit-stand table may effectively contribute to making postures more variable among office workers and thus aid in alleviating negative health effects of extensive sitting.

Assessment of a Targeted Trap-Neuter-Return Pilot Study in Auckland, New Zealand

PubMed Central

Zito, Sarah; Vigeant, Shalsee; Dale, Arnja

2018-01-01

Simple Summary It is generally accepted that stray cats need to be managed to minimise the associated negative impacts and there is a need for effective and humane management tools. One such potential tool is trap-neuter-return (TNR), which anecdotally has been used in New Zealand to manage stray cats, but no concerted and targeted implementation of this technique has been reported, nor any formal assessments conducted. A targeted TNR (TTNR) programme for urban stray cats was implemented and assessed in one Auckland suburb. Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray feline, underage euthanasia, and unsocialised stray cat euthanasia numbers all reduced for the targeted suburb when these outcome measures were compared for the years before and after the programme. These outcome measures had a greater reduction in the targeted suburb compared to the other Auckland suburbs not targeted by the TTNR programme, although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable humane cat management tool in urban New Zealand, and further assessment is warranted. Abstract There is a need for effective and humane management tools to manage urban stray cats and minimise negative impacts associated with stray cats. One such tool is targeted trap-neuter-return (TTNR), but no concerted implementation of this technique or formal assessments have been reported. To address this deficit, a TTNR programme was implemented and assessed in one Auckland suburb from May 2015 to June 2016; the programme sterilised and returned 348 cats (4.2 cats/1000 residents). Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray felines, underage euthanasias, and unsocialised stray cat euthanasias were all reduced for the targeted suburb when compared for the years before and after the programme (the percentage reduction in these parameters was −39, −17, −34, −7, and −47, respectively). These outcome measures had a greater reduction in the targeted suburb compared to the Auckland suburbs not targeted by the TTNR programme (p < 0.01), although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable, humane cat management tool in urban New Zealand, and further assessment is warranted. PMID:29757255

An Integrated Approach to Environmental Education: A Case Study

ERIC Educational Resources Information Center

du Preez, Nicolaas P.; Mohr-Swart, Maryna

2004-01-01

In 1994, the Executive Management Committee (EMC) of Technikon Pretoria took a strategic decision to develop educational programmes in environmental management and sustainable development. The EMC also decided to integrate these programmes with the development and implementation of an environmental management policy for Technikon Pretoria. This…

Planning, Designing and Managing Higher Education Institutions

ERIC Educational Resources Information Center

Daigneau, William A.; Valenti, Mark S.; Ricciarini, Sylvana; Bender, Stephen O.; Alleyne, Nicole; Di Grappa, Michael; Duart, Josep M.; Lupianez, Francisco; Sanchez, Miguel Angel Ehrenzweig

2005-01-01

The OECD Programme on Educational Building, together with the Association of Higher Education Facilities Officers (APPA) and the OECD Programme on Institutional Management in Higher Education, organised an international conference on the planning, design and management of facilities for higher education institutions on April 24-27, 2005. The…

Skylab

NASA Image and Video Library

1971-06-01

The Apollo Telescope Mount (ATM) was one of four major components of Skylab that were designed and constructed under the management of the Marshall Space Flight Center (MSFC). In this photograph, an ATM is seen sitting inside the MSFC's Structural Load Test Arnex where the main structural elements were simulated under launch conditions.

Spousal Conflicts of Interest

ERIC Educational Resources Information Center

Lewis, Shana R.

2005-01-01

Romantic relationships bud and sometimes bloom in the school district workplace. When those relationships involve a sitting member of a school board or an administrator with responsibility for managing other employees, questions about a conflict of interest will be raised. Most states have laws prohibiting a public official from taking official…

Applicability of Non-Modular Assessment in Construction Management and Allied Undergraduate Programmes: Perspective of the Academics Involved

ERIC Educational Resources Information Center

Wedawatta, Gayan

2018-01-01

Undergraduate programmes on construction management and other closely related built environment disciplines are currently taught and assessed on a modular basis. This is the case in the UK and in many other countries globally. However, it can be argued that professionally oriented programmes like these are better assessed on a non-modular basis,…

A disease management programme for patients with diabetes mellitus is associated with improved quality of care within existing budgets.

PubMed

Steuten, L M G; Vrijhoef, H J M; Landewé-Cleuren, S; Schaper, N; Van Merode, G G; Spreeuwenberg, C

2007-10-01

To assess the impact of a disease management programme for patients with diabetes mellitus (Type 1 and Type 2) on cost-effectiveness, quality of life and patient self-management. By organizing care in accordance with the principles of disease management, it is aimed to increase quality of care within existing budgets. Single-group, pre-post design with 2-year follow-up in 473 patients. Substantial significant improvements in glycaemic control, health-related quality of life (HRQL) and patient self-management were found. No significant changes were detected in total costs of care. The probability that the disease management programme is cost-effective compared with usual care amounts to 74%, expressed in an average saving of 117 per additional life year at 5% improved HRQL. Introduction of a disease management programme for patients with diabetes is associated with improved intermediate outcomes within existing budgets. Further research should focus on long-term cost-effectiveness, including diabetic complications and mortality, in a controlled setting or by using decision-analytic modelling techniques.

The effectiveness of a multidisciplinary pain management programme managing chronic pain.

PubMed

Dysvik, Elin; Vinsnes, Anne Guttormsen; Eikeland, Ole-Johan

2004-10-01

The aim of this study was to develop and evaluate the effects of a multidisciplinary pain management programme on coping, health-related quality of life and pain intensity. Seventy-six outpatients suffering from chronic pain completed this eight-week programme with the primary aims to increase coping, as measured by the Ways of Coping Checklist, and health-related quality of life, as measured by the Short Form-36 Health Survey. Therapeutic dialogues and education, combined with physical activity, were given in order to increase understanding of and attention to non-medical factors that might affect pain perception. The programme was active, time-limited and structured on the basis of multidisciplinary pain management programmes based on a cognitive-behavioural approach. The findings suggest that this programme has the potential to improve coping skills and health-related quality of life. Additionally, pain intensity, as measured by the Visual Analogue Scale, was reduced. Age and disability were revealed as the prominent predictors of change after treatment. The differences in this sample indicated that the drop-outs tended to be older and reported more health problems, although these findings were non-significant. Clinical and research implications are discussed.

Effecting change in primary care management of respiratory conditions: a global scoping exercise and literature review of educational interventions to inform the IPCRG's E-Quality initiative.

PubMed

McDonnell, Juliet; Williams, Siân; Chavannes, Niels H; Correia de Sousa, Jaime; Fardy, H John; Fletcher, Monica; Stout, James; Tomlins, Ron; Yusuf, Osman M; Pinnock, Hilary

2012-12-01

This discussion paper describes a scoping exercise and literature review commissioned by the International Primary Care Respiratory Group (IPCRG) to inform their E-Quality programme which seeks to support small-scale educational projects to improve respiratory management in primary care. Our narrative review synthesises information from three sources: publications concerning the global context and health systems development; a literature search of Medline, CINAHL and Cochrane databases; and a series of eight interviews conducted with members of the IPCRG faculty. Educational interventions sit within complex healthcare, economic, and policy contexts. It is essential that any development project considers the local circumstances in terms of economic resources, political circumstances, organisation and administrative capacities, as well as the specific quality issue to be addressed. There is limited evidence (in terms of changed clinician behaviour and/or improved health outcomes) regarding the merits of different educational and quality improvement approaches. Features of educational interventions that were most likely to show some evidence of effectiveness included being carefully designed, multifaceted, engaged health professionals in their learning, provided ongoing support, were sensitive to local circumstances, and delivered in combination with other quality improvement strategies. To be effective, educational interventions must consider the complex healthcare systems within which they operate. The criteria for the IPCRG E-Quality awards thus require applicants not only to describe their proposed educational initiative but also to consider the practical and local barriers to successful implementation, and to propose a robust evaluation in terms of changed clinician behaviour or improved health outcomes.

The efficacy of a self-management programme for people with diabetes, after a special training programme for healthcare workers in Taiwan: a quasi-experimental design.

PubMed

Wu, Shu-Fang Vivienne; Liang, Shu-Yuan; Lee, Mei-Chen; Yu, Neng-Chun; Kao, Mu-Jung

2014-09-01

To analyse the efficacy of improving disease management after implementing a self-management programme for people with type 2 diabetes administered by healthcare workers who have received special training. The needs for diabetic care include increased training for healthcare providers to enhance their confidence and skills in managing patients, both physically and mentally. Quasi-experimental design. This study recruited participants from outpatient clinics in 10 hospitals in Taiwan. In 2010, purposive sampling was used to recruit 228 participants from two medical centres, five regional hospitals and three district hospitals. Participants were enrolled in a 'diabetes self-management programme' (watching patient videos, reading a diabetes self-care handbook, participating in four consultation courses of diabetes self-efficacy improvement, telephone follow-up and positive reinforcement). Efficacy analysis of post-test diabetes outcome variables of the experimental group was carried out. Sex, age and pretest score were used as the control variables for ancova test. Patients in the experimental group had significant improvement in body mass index (p < 0·01), waistline circumference (p < 0·001), haemoglobin A1C levels (p < 0·001), degrees of anxiety and depression (p < 0·001), self-efficacy (p < 0·001) and levels of self-care (p < 0·001). Self-efficacy of people with diabetes can be effectively improved by planned implementation of a 'diabetes self-management programme' by trained healthcare workers. The diabetes care professionals are provided the self-management programme to strengthen the awareness and importance of self-management in diabetes care. © 2013 John Wiley & Sons Ltd.

'20 days protected learning' - students' experiences of an overseas nurses programme - 4 years on: a retrospective survey

PubMed Central

2011-01-01

Background From September 2005 the Nursing and Midwifery Council (NMC) introduced new arrangements for the registration of non-EU overseas nurses which requires all applicants to undertake '20 days of protected learning' time in the UK and for some, a period of supervised practice. A survey was undertaken at Bournemouth University, which offers a '20 days protected learning only' programme, to elicit overseas nurses' demographic details, experiences in completing the programme and their 'final destinations' once registered. Methods An online survey was devised which contained a mixture of tick box and open ended questions which covered demographic details, views on the programme and final destinations This was uploaded to http://www.surveymonkey.com/ and sent out to nurses who had completed the Overseas Nurses Programme (ONP) with Bournemouth University (n = 1050). Quantitative data were analysed using descriptive statistics and the qualitative data were coded and analysed using content analysis. Results There were 251 respondents (27.7% response rate). The typical 'profile' of a nurse who responded to the survey was female, aged 25-40 years and had been qualified for more than 5 years with a bachelors degree. The majority came from Australia on a 2 year working holiday visa and the key final destination in the UK, on registration with the NMC, was working for an agency. There were five key findings regarding experience of the programme. Of those surveyed 61.2% did not feel it necessary to undergo an ONP; 71.6% felt that they should be able to complete the programme on-line in their own country; 64.2% that the ONP should only contain information about delivery of healthcare in UK and Legal and professional (NMC) issues; 57% that European nurses should also undergo the same programme and sit an IELTS test; and 68.2% that the programme was too theory orientated; and should have links to practice (21%). Conclusions The NMC set the admissions criteria for entry to the register and Standards for an ONP. The findings of this survey raise issues regarding the perceived value and use of this approach for overseas nurses, and it may be helpful to take this into account when considering future policy. PMID:21504556

'20 days protected learning' - students' experiences of an overseas nurses programme - 4 years on: a retrospective survey.

PubMed

Jordan, Gill; Brown, Petra

2011-04-19

From September 2005 the Nursing and Midwifery Council (NMC) introduced new arrangements for the registration of non-EU overseas nurses which requires all applicants to undertake '20 days of protected learning' time in the UK and for some, a period of supervised practice. A survey was undertaken at Bournemouth University, which offers a '20 days protected learning only' programme, to elicit overseas nurses' demographic details, experiences in completing the programme and their 'final destinations' once registered. An online survey was devised which contained a mixture of tick box and open ended questions which covered demographic details, views on the programme and final destinations This was uploaded to http://www.surveymonkey.com/ and sent out to nurses who had completed the Overseas Nurses Programme (ONP) with Bournemouth University (n = 1050). Quantitative data were analysed using descriptive statistics and the qualitative data were coded and analysed using content analysis. There were 251 respondents (27.7% response rate). The typical 'profile' of a nurse who responded to the survey was female, aged 25-40 years and had been qualified for more than 5 years with a bachelors degree. The majority came from Australia on a 2 year working holiday visa and the key final destination in the UK, on registration with the NMC, was working for an agency.There were five key findings regarding experience of the programme. Of those surveyed 61.2% did not feel it necessary to undergo an ONP; 71.6% felt that they should be able to complete the programme on-line in their own country; 64.2% that the ONP should only contain information about delivery of healthcare in UK and Legal and professional (NMC) issues; 57% that European nurses should also undergo the same programme and sit an IELTS test; and 68.2% that the programme was too theory orientated; and should have links to practice (21%). The NMC set the admissions criteria for entry to the register and Standards for an ONP. The findings of this survey raise issues regarding the perceived value and use of this approach for overseas nurses, and it may be helpful to take this into account when considering future policy.

Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania.

PubMed

Chaki, Prosper P; Kannady, Khadija; Mtasiwa, Deo; Tanner, Marcel; Mshinda, Hassan; Kelly, Ann H; Killeen, Gerry F

2014-06-25

Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam's City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes.

The cost-effectiveness of weight management programmes in a postnatal population.

PubMed

Rawdin, A C; Duenas, A; Chilcott, J B

2014-09-01

The aim of the study was to estimate the cost-effectiveness of a weight management programme including elements of physical exercise and dietary restriction which are designed to help women lose excess weight gained during pregnancy in the vulnerable postnatal period and inhibit the development of behaviours which could lead to future excess weight gain and obesity. A mathematical model based on a regression equation predicting change in weight over a fifteen year postnatal period was developed. The model included programme effectiveness and resource data based on a randomized controlled trial of a weight management programme implemented in a postnatal population in the United States. Utility and mortality data based on body mass index categories were also included. The model adopted a National Health Service (NHS) and personal social services (PSS) perspective, a lifetime time horizon and estimated the cost effectiveness of a weight management programme against a no change comparator in terms of an incremental cost-effectiveness ratio (ICER). The baseline results show that the difference in weight between women who received the weight management programme and women who received the control intervention was 3.02 kg at six months and 3.53 kg at fifteen years following childbirth. This results in an ICER of £7355 per quality adjusted life year (QALY) for women who were married at childbirth. The estimated ICER would suggest that such a weight management programme is cost-effective at a NICE threshold of £20,000 per QALY. However significant structural and evidence based uncertainty is present in the analysis. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania

PubMed Central

2014-01-01

Background Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. Case description The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. Discussion and evaluation The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. Conclusions The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes. PMID:24964790

Living in the country and studying in the city. The art of passing exams and remaining sane.

PubMed

Grant, Cameron C; Pinnock, Ralph; Asher, M Innes; Sullivan, Michael James

2008-10-01

Doctors working in smaller centres have fewer resources available to help them pass the specialist examination components of their training. To describe the delivery of a teaching programme that helps paediatricians in training in both peripheral and regional centres in New Zealand (NZ) to successfully prepare for their specialist written examinations. The teaching programme was initially developed for paediatricians in training in Auckland and then developed into a national teaching resource. Real-time visual and auditory communication among the various teaching sites was established by the NZ Telepaediatric Service. The sessions were also available for subsequent review, initially as a DVD recording or via a Telepaediatric service videoconferencing unit and, since 2007, as a webcast. In association with the development of this teaching programme, the percentage pass rate for the paediatric specialist examinations has increased significantly for those exam candidates that access the teaching sessions remotely from other NZ centres (60% vs. 82%, chi(1)(2) = 4.28, P = 0.04). Between 80 and 90% of NZ candidates now pass the examination. In comparison, the pass rate for Australian candidates sitting the identical examination remains between 60 and 70%. Telepaediatrics has enabled interactive sessions to be conducted with students in peripheral and the other regional centres as well as those attending in person in Auckland. Its development has enabled examination pass rates in smaller centres to increase.

Morphological and health-related changes associated with a 12-week self-guided exercise programme in overweight adults: a pilot study.

PubMed

Stewart, Arthur D; Rolland, Catherine; Gryka, Ania; Findlay, Sally; Smith, Sara; Jones, Jacklyn; Davidson, Isobel M

2014-01-01

Over 12 weeks, supervised physical activity (PA) interventions have demonstrated improvements in morphological and health parameters, whereas community walking programmes have not. The present study piloted a self-guided programme for promoting PA and reducing sedentary behaviour in overweight individuals and measured its effect on a range of health outcomes. Six male and 16 female sedentary adults aged 48.5 ± 5.5 years with body mass index (BMI) 33.4 ± 6.3 kg m(-2) were assessed for anthropometric variables, blood pressure, functional capacity, well-being and fatigue. After an exercise consultation, participants pursued their own activity and monitored PA points weekly. At baseline, mid-point and 12 weeks, eight participants wore activity monitors, and all participants undertook a 5-day food diary to monitor dietary intake. In 17 completers, mass, BMI, sit-to-stand, physical and general fatigue had improved by 6 weeks. By 12 weeks, waist, sagittal abdominal diameter (SAD), diastolic blood pressure, well-being and most fatigue dimensions had also improved. Throughout the intervention, PA was stable, energy intake and lying time decreased and standing time increased; thus, changes in both energy intake and expenditure explain the health-related outcomes. Observed changes in function, fatigue and quality of life are consistent with visceral fat loss and can occur at levels of weight loss which may not be considered clinically significant.

Postgraduate Programmes on Environmental Water Resources Engineering and Management in Greek Universities

ERIC Educational Resources Information Center

Latinopoulos, Pericles; Angelidis, Panagiotis

2014-01-01

The management of complex water problems is nowadays being practised through new ways and approaches. Therefore, water engineers, planners and managers should be appropriately educated through modern undergraduate curricula and by well-designed postgraduate specialisation programmes. Within this framework, a study of the specific characteristics…

The experience of facilitators and participants of long term condition self-management group programmes: A qualitative synthesis.

PubMed

Hughes, Stephen; Lewis, Sophie; Willis, Karen; Rogers, Anne; Wyke, Sally; Smith, Lorraine

2017-12-01

Our aim was to systematically review the qualitative literature about the experiences of both facilitators and participants in a range of group-based programmes to support the self-management of long-term conditions. We searched 7 databases using the terms 'self-management', 'group' and 'qualitative'. Full text articles meeting the inclusion criteria were retrieved for review. A thematic synthesis approach was used to analyse the studies. 2126 articles were identified and 24 were included for review. Group participants valued being with similar others and perceived peer support benefits. Facilitators (HCP and lay) had limited group specific training, were uncertain of purpose and prioritised education and medical conformity over supportive group processes and the promotion of self-management agency and engagement. Overall, studies prioritised positive descriptions. Group programmes' medical self-management focus may reduce their ability to contribute to patient-valued outcomes. Further research is needed to explore this disconnect. This review supports broadening the scope of group-based programmes to foreground shared learning, social support and development of agency. It is of relevance to developers and facilitators of group self-management programmes and their ability to address the burden of long-term conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

Impact of increasing social media use on sitting time and body mass index.

PubMed

Alley, Stephanie; Wellens, Pauline; Schoeppe, Stephanie; de Vries, Hein; Rebar, Amanda L; Short, Camille E; Duncan, Mitch J; Vandelanotte, Corneel

2017-08-01

Issue addressed Sedentary behaviours, in particular sitting, increases the risk of cardiovascular disease, type 2 diabetes, obesity and poorer mental health status. In Australia, 70% of adults sit for more than 8h per day. The use of social media applications (e.g. Facebook, Twitter, and Instagram) is on the rise; however, no studies have explored the association of social media use with sitting time and body mass index (BMI). Methods Cross-sectional self-report data on demographics, BMI and sitting time were collected from 1140 participants in the 2013 Queensland Social Survey. Generalised linear models were used to estimate associations of a social media score calculated from social media use, perceived importance of social media, and number of social media contacts with sitting time and BMI. Results Participants with a high social media score had significantly greater sitting times while using a computer in leisure time and significantly greater total sitting time on non-workdays. However, no associations were found between social media score and sitting to view TV, use motorised transport, work or participate in other leisure activities; or total workday, total sitting time or BMI. Conclusions These results indicate that social media use is associated with increased sitting time while using a computer, and total sitting time on non-workdays. So what? The rise in social media use may have a negative impact on health by contributing to computer sitting and total sitting time on non-workdays. Future longitudinal research with a representative sample and objective sitting measures is needed to confirm findings.

Content, participants and outcomes of three diabetes care programmes in three low and middle income countries.

PubMed

Van Olmen, Josefien; Marie, Ku Grace; Christian, Darras; Clovis, Kalobu Jean; Emery, Bewa; Maurits, Van Pelt; Heang, Hen; Kristien, Van Acker; Natalie, Eggermont; François, Schellevis; Guy, Kegels

2015-06-01

To improve access and quality of diabetes care for people in low-income countries, it is important to understand which elements of diabetes care are effective. This paper analyses three diabetes care programmes in the DR Congo, Cambodia and the Philippines. Three programmes offering diabetes care and self-management were selected. Programme information was collected through document review and interviews. Data about participants' characteristics, health outcomes, care utilisation, expenditures, care perception and self-management were extracted from a study database. Comparative univariate analyses were performed. Kin-réseau (DR Congo) is an urban primary care network with 8000 patients. MoPoTsyo (Cambodia) is a community-based peer educator network, covering 7000 patients. FiLDCare (Philippines) is a programme in which 1000 patients receive care in a health facility and self-management support from a community health worker. Content of care of the programmes is comparable, the focus on self-management largest in MoPoTsyo. On average, Kin-réseau patients have a higher age, longer diabetes history and more overweight. MoPoTsyo includes most female, most illiterate and most lean patients. Health outcomes (HbA1C level, systolic blood pressure, diabetes foot lesions) were most favourable for MoPoTsyo patients. Diabetes-related health care expenditure was highest for FiLDCare patients. This study shows it possible to maintain a diabetes programme with minimal external resources, offering care and self-management support. It also illustrates that health outcomes of persons with diabetes are determined by their bio-psycho-social characteristics and behaviour, which are each subject to the content of care and the approach to chronic illness and self-management of the programme, in turn influenced by the larger context. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

U.S. Army Medical Department Journal, July-September 2005

DTIC Science & Technology

2005-09-01

problems exposed by the press in Oct 03, Fort Lewis formalized Remote Care the Remote Care Program with protocols agreed by senior level commanders...workload of MAMC, like most of the formal work of the case management practice to identify key AMEDD, has not decreased with combat deployments and, in...and return to SRCMP within 72 hours, receive a formal case couches with sitting and standing Soldiers drinking coffee and number, Case Manager, and

Correlates of occupational, leisure and total sitting time in working adults: results from the Singapore multi-ethnic cohort.

PubMed

Uijtdewilligen, Léonie; Yin, Jason Dean-Chen; van der Ploeg, Hidde P; Müller-Riemenschneider, Falk

2017-12-13

Evidence on the health risks of sitting is accumulating. However, research identifying factors influencing sitting time in adults is limited, especially in Asian populations. This study aimed to identify socio-demographic and lifestyle correlates of occupational, leisure and total sitting time in a sample of Singapore working adults. Data were collected between 2004 and 2010 from participants of the Singapore Multi Ethnic Cohort (MEC). Medical exclusion criteria for cohort participation were cancer, heart disease, stroke, renal failure and serious mental illness. Participants who were not working over the past 12 months and without data on sitting time were excluded from the analyses. Multivariable regression analyses were used to examine cross-sectional associations of self-reported age, gender, ethnicity, marital status, education, smoking, caloric intake and moderate-to-vigorous leisure time physical activity (LTPA) with self-reported occupational, leisure and total sitting time. Correlates were also studied separately for Chinese, Malays and Indians. The final sample comprised 9384 participants (54.8% male): 50.5% were Chinese, 24.0% Malay, and 25.5% Indian. For the total sample, mean occupational sitting time was 2.71 h/day, mean leisure sitting time was 2.77 h/day and mean total sitting time was 5.48 h/day. Sitting time in all domains was highest among Chinese. Age, gender, education, and caloric intake were associated with higher occupational sitting time, while ethnicity, marital status and smoking were associated with lower occupational sitting time. Marital status, smoking, caloric intake and LTPA were associated with higher leisure sitting time, while age, gender and ethnicity were associated with lower leisure sitting time. Gender, marital status, education, caloric intake and LTPA were associated with higher total sitting time, while ethnicity was associated with lower total sitting time. Stratified analyses revealed different associations within sitting domains for Indians compared to Chinese and Malays. Our findings highlight the need to focus on separate domains of sitting (occupational, leisure or total) when identifying which factors determine this behavior, and that the content of intervention programs should be tailored to domain-specific sitting rather than to sitting in general. Finally, our study showed ethnic differences and therefore we recommend to culturally target interventions.

Exploring the experience of facilitating self-management with minority ethnic stroke survivors: a qualitative study of therapists' perceptions

PubMed Central

Jones, Fiona; Kilbride, Cherry; Victor, Christina

2014-01-01

Purpose: The utility of self-management with people from minority ethnic backgrounds has been questioned, resulting in the development of culturally specific tools. Yet, the use of stroke specific self-management programmes is underexplored in these high risk groups. This article presents the experience of stroke therapists in using a stroke specific self-management programme with stroke survivors from minority ethnic backgrounds. Methods: 26 stroke therapists with experience of using the self-management programme with stroke survivors from minority ethnic backgrounds participated in semi-structured interviews. These were audio recorded, transcribed verbatim and analysed thematically. Results: Three themes were identified. One questioned perceived differences in stroke survivors interaction with self-management based on ethnicity. The other themes contrasted with this view demonstrating two areas in which ethnic and cultural attributes were deemed to influence the self-management process both positively and negatively. Aspects of knowledge of health, illness and recovery, religion, family and the professionals themselves are highlighted. Conclusions: This study indicates that ethnicity should not be considered a limitation to the use of an individualized stroke specific self-management programme. However, it highlights potential facilitators and barriers, many of which relate to the capacity of the professional to effectively navigate cultural and ethnic differences. Implications for Rehabilitation Stroke therapists suggest that ethnicity should not be considered a barrier to successful engagement with a stroke specific self-management programme. Health, illness and recovery beliefs along with religion and the specific role of the family do however need to be considered to maximize the effectiveness of the programme. A number of the facilitators and barriers identified are not unique to stroke survivors from ethnic minority communities, nor shared by all. The therapists skills at negotiating identified barriers to self-management are highlighted as an area for further development. PMID:24670190

77 FR 33243 - Applications and Amendments to Facility Operating Licenses and Combined Licenses Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

... Operations Management Tricon Programmable Logic Controller (PLC), Version 10, and the CS Innovations, LLC... process protection system that is based on the Invensys Operations Management Tricon Programmable Logic...

Promoting evidence-based childhood fever management through a peer education programme based on the theory of planned behaviour.

PubMed

Edwards, Helen; Walsh, Anne; Courtney, Mary; Monaghan, Sarah; Wilson, Jenny; Young, Jeanine

2007-10-01

This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management. Paediatric nurses' inconsistent, ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests. Determinants of antipyretic administration, identified by the theory of planned behaviour, were belief-based attitudes and subjective norms. A quasi-experiment explored group effects of a peer education programme, based on the theory of planned behaviour, on factors influencing paediatric nurses' antipyretic administration. Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months postpeer education programme. All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited. The peer education programme consisted of four one-hour sessions targeting evidence-based knowledge, myths and misconceptions, normative, attitudinal and control influences over and rehearsal of evidence-based fever management. All nurses in experimental hospital targeted wards were eligible to attend. Peer education and support facilitated session information reaching those unable to attend sessions. Two-way univariate anovas explored between subject, experimental and control group and within subject factors, pre, post and latency data. Significant interactions in normative influence (p = 0.01) and intentions (p = 0.01), a significant main group effect in control influence (p = 0.01) and a significant main effect between audit data across time points (p = 0.03) highlight peer education programme effectiveness in behaviour change. Normative, control and intention changes postpeer education programme were maintained in latency data; mean temperature was not. The peer education programme, based on a behaviour change theory, initiated and maintained evidence-based intentions for antipyretics use in fever management. The promotion of evidence-based change in organizational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes.

Security Protocol Verification and Optimization by Epistemic Model Checking

DTIC Science & Technology

2010-11-05

Three cryptographers are sitting down to dinner at their favourite restau- rant. Their waiter informs them that arrangements have been made with the...Unfortunately, the protocol cannot be expected to satisfy this: suppose that all agents manage to broadcast their mes- sage and all messages have the

Influence of holding temperature and irradiation on field performance of mass-reared Thaumatotibia leucotreta (Lepidoptera: Tortricidae)

USDA-ARS?s Scientific Manuscript database

The Sterile Insect Technique (SIT) as an integral component to the area-wide integrated management of the false codling moth, Thaumatotibia leucotreta (Meyrick) (Lepidoptera: Tortricidae), was successfully implemented in the Western Cape region of South Africa and subsequently expanded to citrus are...

Statistically Derived System Relationship Models for the SASSY Management Unit, 1st Force Service Support Group, Camp Pendelton, California.

DTIC Science & Technology

1981-06-01

TI - 59 programmable calculator to aid...training. The Texas Instruments TI - 59 Programmable Calculator has only ten lettered registers that would be simple for clerical personnel to use (A...SASSY Management Units. Appendix C is a set of user instructions written for the Texas Instrument TI - 59 Programmable Calculator . The TI-59 was

Information systems for administration, clinical documentation and quality assurance in an Austrian disease management programme.

PubMed

Beck, Peter; Truskaller, Thomas; Rakovac, Ivo; Bruner, Fritz; Zanettin, Dominik; Pieber, Thomas R

2009-01-01

5.9% of the Austrian population is affected by diabetes mellitus. Disease Management is a structured treatment approach that is suitable for application to the diabetes mellitus area and often is supported by information technology. This article describes the information systems developed and implemented in the Austrian disease management programme for type 2 diabetes. Several workflows for administration as well as for clinical documentation have been implemented utilizing the Austrian e-Health infrastructure. De-identified clinical data is available for creating feedback reports for providers and programme evaluation.

Peer-led diabetes self-management programme for community-dwelling older people in China: study protocol for a quasi-experimental design.

PubMed

Shen, Huixia; Edwards, Helen; Courtney, Mary; McDowell, Jan; Wu, Ming

2012-12-01

A protocol for a new peer-led self-management programme for community-dwelling older people with diabetes in Shanghai, China. The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self-management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising. Quasi-experimental. This study is a non-equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self-efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self-efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self-efficacy, social support, self-management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks. This theory-based programme tailored to Chinese patients has potential for improving diabetes self-management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks, is especially promising considering healthcare resource shortage in China. © 2012 Blackwell Publishing Ltd.

Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study.

PubMed

Van Grootven, Bastiaan; McNicoll, Lynn; Mendelson, Daniel A; Friedman, Susan M; Fagard, Katleen; Milisen, Koen; Flamaing, Johan; Deschodt, Mieke

2018-03-16

To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). Western Europe and the USA. Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate). Participants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method. In the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications. The indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effectiveness of a partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease: a pragmatic randomized controlled trial.

PubMed

Jonsdottir, Helga; Amundadottir, Olof R; Gudmundsson, Gunnar; Halldorsdottir, Bryndis S; Hrafnkelsson, Birgir; Ingadottir, Thorbjorg Soley; Jonsdottir, Rosa; Jonsson, Jon Steinar; Sigurjonsdottir, Ellen D; Stefansdottir, Ingibjorg K

2015-11-01

To evaluate the effectiveness of a 6-month, partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease. Self-management is a widely valued concept used to address contemporary issues of chronic health problems. Findings of self-management programmes for people with chronic obstructive pulmonary disease are inconclusive. Pragmatic randomized control trial. Patients, 45-65 years old, with mild and moderate chronic obstructive pulmonary disease were invited with a family member. Experimental group (n = 48) participated in a 6-month, partnership-based self-management programme consisting of: (a) three to four conversations between nurse and patient-family member; (b) 6 months of smoking cessation; and (c) interdisciplinary team-patient-family member group meeting. Control group (n = 52) received usual care. Data were collected at months zero, six and 12. The trial lasted from June 2009-March 2013. Patients with mild and moderate chronic obstructive pulmonary disease who participated in the partnership-based self-management programme perceived less intrusiveness of the disease and its treatment than patients in the control group. Patients in the experimental group did not have better health-related quality of life, less anxiety or depression, increased physical activity, fewer exacerbations or better smoking status than patients in the control group. Patients in both groups found participation in the research useful and important. The partnership-based self-management programme had benefits concerning perception of the intrusiveness of chronic obstructive pulmonary disease and its treatment on lifestyles, activities and interests for young patients with the disease in its early stages. High satisfaction in control group, low family attendance and the relatively short treatment period may explain the less than expected benefits of the programme. © 2015 John Wiley & Sons Ltd.

Is questionnaire-based sitting time inaccurate and can it be improved? A cross-sectional investigation using accelerometer-based sitting time

PubMed Central

Gupta, Nidhi; Christiansen, Caroline Stordal; Hanisch, Christiana; Bay, Hans; Burr, Hermann; Holtermann, Andreas

2017-01-01

Objectives To investigate the differences between a questionnaire-based and accelerometer-based sitting time, and develop a model for improving the accuracy of questionnaire-based sitting time for predicting accelerometer-based sitting time. Methods 183 workers in a cross-sectional study reported sitting time per day using a single question during the measurement period, and wore 2 Actigraph GT3X+ accelerometers on the thigh and trunk for 1–4 working days to determine their actual sitting time per day using the validated Acti4 software. Least squares regression models were fitted with questionnaire-based siting time and other self-reported predictors to predict accelerometer-based sitting time. Results Questionnaire-based and accelerometer-based average sitting times were ≈272 and ≈476 min/day, respectively. A low Pearson correlation (r=0.32), high mean bias (204.1 min) and wide limits of agreement (549.8 to −139.7 min) between questionnaire-based and accelerometer-based sitting time were found. The prediction model based on questionnaire-based sitting explained 10% of the variance in accelerometer-based sitting time. Inclusion of 9 self-reported predictors in the model increased the explained variance to 41%, with 10% optimism using a resampling bootstrap validation. Based on a split validation analysis, the developed prediction model on ≈75% of the workers (n=132) reduced the mean and the SD of the difference between questionnaire-based and accelerometer-based sitting time by 64% and 42%, respectively, in the remaining 25% of the workers. Conclusions This study indicates that questionnaire-based sitting time has low validity and that a prediction model can be one solution to materially improve the precision of questionnaire-based sitting time. PMID:28093433

CuOF: an electrical to optical interface for the upgrade of the CMS muon Drift Tubes system

NASA Astrophysics Data System (ADS)

Dattola, D.; De Remigis, P.; Maselli, S.; Mazza, G.; Rotondo, F.; Wheadon, R.

2013-02-01

The upgrade of the Drift Tube system of the CMS experiment foresee the relocation of the electronics actually sitting on the racks beside the magnet from the cavern to the counting room. It is thus required to convert the signals from electrical to optical, for a total number of 3500 channels that run at up to 480 Mb/s. A Copper to Optical Fiber board is currently under design. The board is divided into a mother board, which hosts the slow control system based on Field Programmable Gate Array, and four mezzanine cards, each with 8 conversion channels. A prototype of the mezzanine board has been designed and tested under irradiation.

A Productivity Enhancement Study of the FMSO (Fleet Material Support Office) Software Effort.

DTIC Science & Technology

1983-11-01

Project management 20.~~~~~4 AUSTRAC’ *I**ne- eeee~ Iffteeee.sit aiftneilt by ble ninbee) This report presents the results of a productivity enhance...they a _-o.a: tc ouz=..e.s. it is -he opinion of the authors that FISO is weli managed and that employee morale is genarally goDd, bum tnat the or...Syszem that will suppcrt comput-r progriaming work, documen- tation and software management . h :his should be a / unified system (all parts of it cin

IMHE-Info. OECD Programme on Institutional Management in Higher Education, December 2006

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2006

2006-01-01

IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: Governance on the Agenda. IMHE News, publications of interest and upcoming events are included.

Evaluation of a regional disease management programme for patients with asthma or chronic obstructive pulmonary disease.

PubMed

Steuten, Lotte; Vrijhoef, Bert; Van Merode, Frits; Wesseling, Geert-Jan; Spreeuwenberg, Cor

2006-12-01

To assess the impact of a population-based disease management programme for adult patients with asthma or chronic obstructive pulmonary disease (COPD) on process measures, intermediate outcomes, and endpoints of care. Quasi-experimental design with 12-month follow-up. Region of Maastricht (the Netherlands) including university hospital and 16 general practices. Nine hundred and seventy-five patients of whom 658 have asthma and 317 COPD. Disease management programme. Endpoints of care are respiratory health, health utility, patient satisfaction, and total health care costs related to asthma or COPD. Quality aspects of care, disease control, self-care behaviour, smoking status, disease-specific knowledge, and patients' satisfaction improved after implementation of the programme. Lung function was not affected by implementation of the programme. For COPD patients, a significant improvement in health utility was found. For patients with asthma, significant cost savings were measured. Organizing health care according to principles of disease management for adults with asthma or COPD is associated with significant improvements in several processes and outcomes of care, while costs of care do not exceed the existing budget.

University Lawyers: A Study of Legal Risk, Risk Management and Role in Work Integrated Learning Programmes

ERIC Educational Resources Information Center

Cameron, Craig; Klopper, Christopher

2015-01-01

Work integrated learning (WIL) is in growing demand by multiple stakeholders within the higher education sector in Australia. There are significant and distinct legal risks to universities associated with WIL programmes. University lawyers, along with WIL administrators and university management, are responsible for managing legal risk. This…

Reducing Office Workers' Sitting Time at Work Using Sit-Stand Protocols: Results From a Pilot Randomized Controlled Trial.

PubMed

Li, Ingrid; Mackey, Martin G; Foley, Bridget; Pappas, Evangelos; Edwards, Kate; Chau, Josephine Y; Engelen, Lina; Voukelatos, Alexander; Whelan, Anna; Bauman, Adrian; Winkler, Elisabeth; Stamatakis, Emmanuel

2017-06-01

To examine the effects of different sit-stand protocols on work-time sitting and physical activity (PA) of office workers. Participants (n = 26, 77% women, mean age 42) were randomly allocated to usual sitting (control) or one of three sit-stand protocols (intervention) facilitated by height-adjustable workstations for a 4-week period between June and August 2015. Sitting, standing, and stepping time were assessed by inclinometry (activPAL); leisure-time physical activity (LTPA) by self-report. One-way analysis of covariance (ANCOVA) and post-hoc (Bonferroni) tests explored between-group differences. Compared with baseline, intervention groups reduced work sitting time by 113 minutes/8-hour workday (95% confidence interval [CI] [-147,-79]) and increased work standing time by 96 minutes/8-hour workday (95% CI [67,125]) without significantly impacting LTPA/sleep time. Sit-stand protocols facilitated by height-adjustable workstations appear to reduce office workers' sitting time without significant adverse effects on LTPA.

Challenges in designing an All-Wales professional development programme to empower ward sisters and charge nurses.

PubMed

Jasper, Melanie A; Grundy, Lynne; Curry, Esther; Jones, Lynne

2010-09-01

To discuss the challenges of designing a professional development programme for ward managers working in in-patient facilities in Wales. In 2008, the Minister of Health launched the Free to Lead, Free to Care initiative to empower ward managers. One work-stream involved the creation of a universal professional development programme to ensure they had the skills and knowledge to function effectively in their roles in the newly restructured NHS in Wales. A collaborative, staged approach, involving multiple stakeholders, resulted in the design of a programme founded in principles of action and work-based learning tailored to the needs of the individual in attaining accredited competencies. Achieving buy-in and ownership from stakeholders are essential to ensure standardization and consistency of implementation of a universal programme. Shared responsibility and acceptance of key principles underpinning an individualized, work-based programme are fundamental to ensuring equity of outcome achievement. IMPLICATIONS FOR MANAGEMENT: Managerially facilitated cultural change is needed to embed individual work-based professional development programmes in the clinical environment, with practitioners supported through a variety of learning strategies appropriate to their learning needs. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Immediate effects of dynamic sitting exercise on the lower back mobility of sedentary young adults

PubMed Central

Chatchawan, Uraiwan; Jupamatangb, Unthika; Chanchitc, Sunisa; Puntumetakul, Rungthip; Donpunha, Wanida; Yamauchi, Junichiro

2015-01-01

[Purpose] The aim of this study was to investigate the effects of dynamic sitting exercises during prolonged sitting on the lower back mobility of sedentary young adults. [Subjects and Methods] Seventy-one subjects aged between 18–25 years participated in this study. Following a randomized crossover study design, subjects were randomly assigned to two groups: sitting only and dynamic sitting exercise. The dynamic sitting exercise was a combination of lower back hyperextension and abdominal drawing-in movements which were repeated 6 times in a 1-minute period and performed every 20 minutes during a 2-hour sitting session. Lumbar range of movement was measured with the modified-modified Schober test, and the pain intensity was evaluated using the visual analog scale. [Results] After the experiment, the lumbar range of movement was significantly impaired in the sitting only group; however, it was significantly improved in the dynamic sitting exercise group. There were significant differences in lumbar range of movement of both flexion and extension between the groups. No significant difference in pain intensity between the groups was found. [Conclusion] These results suggest that dynamic sitting exercises during prolonged sitting can prevent decreases in lumbar range of movement in both back flexion and extension following a 2-hour sitting period. PMID:26696698

Separate and joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors in working adults: a cross-sectional study.

PubMed

Saidj, Madina; Jørgensen, Torben; Jacobsen, Rikke K; Linneberg, Allan; Aadahl, Mette

2013-01-01

The workplace is a main setting for prolonged sitting for some occupational groups. Convincing evidence has recently accumulated on the detrimental cardio-metabolic health effects of leisure-time sitting. Yet, much less is known about occupational sitting, and the potential health risk attached compared to leisure-time sitting. To explore the separate and joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors in working adults. All working adults (N = 2544) from the Health2006, a Danish population-based study, were included in this cross-sectional study. Participants reported hours of sitting during work, during leisure-time along with socio-demographic and behavioral characteristics, including physical activity. Cardio-metabolic risk factors (waist circumference, body mass index, body fat percentage, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, insulin, hemoglobin A1c and plasma glucose) were measured. Associations were explored by linear regression for leisure-time, occupational, and overall sitting time. Statistically significant (p<.05) detrimental associations of leisure-time sitting were observed with all cardio-metabolic risk factors, except hemoglobin A1c and plasma glucose. Similarly, occupational sitting time was significantly detrimentally associated with HDL cholesterol, triglycerides, and insulin. For categories of sitting time, a joint adverse association of sitting much during both work-time and leisure-time was observed. The associations of occupational sitting time with cardio-metabolic risk factors were fewer and weaker compared to leisure-time sitting. Yet, the joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors were higher than the separate. Our findings amplify the need for further focus in this area prior to making assumptions about equivalent health risks across sedentary behaviors. To our knowledge, this is the first study to contrast the deleterious associations of prolonged occupational and leisure-time sitting, both separately and jointly.

Prior exercise and standing as strategies to circumvent sitting-induced leg endothelial dysfunction.

PubMed

Morishima, Takuma; Restaino, Robert M; Walsh, Lauren K; Kanaley, Jill A; Padilla, Jaume

2017-06-01

We have previously shown that local heating or leg fidgeting can prevent prolonged sitting-induced leg endothelial dysfunction. However, whether physical activity prevents subsequent sitting-induced leg endothelial dysfunction remains unknown. Herein, we tested the hypothesis that sitting-induced leg endothelial dysfunction would be prevented by prior exercise. We also examined if, in the absence of exercise, standing is an effective alternative strategy to sitting for conserving leg endothelial function. Fifteen young healthy subjects completed three randomized experimental trials: (1) sitting without prior exercise; (2) sitting with prior exercise; and (3) standing without prior exercise. Following baseline popliteal artery flow-mediated dilation (FMD) measurements, subjects maintained a supine position for 45 min in the sitting and standing trials, without prior exercise, or performed 45 min of leg cycling before sitting (i.e. sitting with prior exercise trial). Thereafter, subjects were positioned into a seated or standing position, according to the trial, for 3 h. Popliteal artery FMD measures were then repeated. Three hours of sitting without prior exercise caused a significant impairment in popliteal artery FMD (baseline: 3.8±0.5%, post-sitting: 1.5±0.5%, P <0.05), which was prevented when sitting was preceded by a bout of cycling exercise (baseline: 3.8±0.5%, post-sitting: 3.6±0.7%, P >0.05). Three hours of standing did not significantly alter popliteal artery FMD (baseline: 4.1±0.4%, post-standing: 4.3±0.4%, P >0.05). In conclusion, prolonged sitting-induced leg endothelial dysfunction can be prevented by prior aerobic exercise. In addition, in the absence of exercise, standing represents an effective substitute to sitting for preserving leg conduit artery endothelial function. © 2017 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society.

Association of biopsychosocial factors with degree of slump in sitting posture and self-report of back pain in adolescents: a cross-sectional study.

PubMed

O'Sullivan, Peter B; Smith, Anne J; Beales, Darren J; Straker, Leon M

2011-04-01

Conflicting evidence exists regarding relationships among sitting posture, factors that influence sitting posture, and back pain. This conflicting evidence may partially be due to the presence of multiple and overlapping factors associated with both sitting posture and back pain. The purpose of this study was to determine whether the degree of slump in sitting was associated with sex and other physical, lifestyle, or psychosocial factors. Additionally, the relationship between the report of back pain made worse by sitting and the degree of slump in sitting and other physical, lifestyle, or psychosocial factors was investigated. This was a cross-sectional study. Adolescents (n=1,596) completed questionnaires to determine lifestyle and psychosocial profiles and the experience of back pain. Sagittal sitting posture, body mass index (BMI), and back muscle endurance (BME) were recorded. Standing posture subgroup categorization was determined. Multivariate analysis revealed that the most significant factor associated with the degree of slump in sitting was male sex, followed by non-neutral standing postures, lower perceived self-efficacy, lower BME, greater television use, and higher BMI. Multivariable analysis indicated poorer Child Behaviour Checklist scores were the strongest correlate of report of back pain made worse by sitting, whereas degree of slump in sitting, female sex, and BME were more weakly related. Causality cannot be determined from this cross-sectional study, and 60% of sitting posture variation was not explained by the measured variables. Slump in sitting was associated with physical correlates, as well as sex, lifestyle, and psychosocial factors, highlighting the complex, multidimensional nature of usual sitting posture in adolescents. Additionally, this study demonstrated that a greater degree of slump in sitting was only weakly associated with adolescent back pain made worse by sitting after adjustment for other physical and psychosocial factors.

Integrating business continuity, emergency preparedness and emergency response: How these seemingly different disciplines can come together to make a comprehensive integrated programme.

PubMed

Halsne, Julia

2015-01-01

The East Bay Municipal Utility District provides potable water to approximately 1.3 million customers and treats wastewater for approximately 680,000 customers on the eastern side of San Francisco Bay in Northern California. Corporate policy requires the District to create and maintain an active emergency preparedness programme to manage its critical functions during an emergency and protect people, property and the environment. The policy also requires the District to create and maintain a business continuity programme to minimise disruptions of critical business functions and enhance its capability to recover operations. For these programmes to work effectively they must be coordinated. As the programmes at the District have evolved, the natural interrelationship, overlaps and integration have become inherent in their success. To ensure integration and coordination of these programmes, the District has developed management systems to effectively drive towards a seamless overarching programme.

Programmable multi-node quantum network design and simulation

NASA Astrophysics Data System (ADS)

Dasari, Venkat R.; Sadlier, Ronald J.; Prout, Ryan; Williams, Brian P.; Humble, Travis S.

2016-05-01

Software-defined networking offers a device-agnostic programmable framework to encode new network functions. Externally centralized control plane intelligence allows programmers to write network applications and to build functional network designs. OpenFlow is a key protocol widely adopted to build programmable networks because of its programmability, flexibility and ability to interconnect heterogeneous network devices. We simulate the functional topology of a multi-node quantum network that uses programmable network principles to manage quantum metadata for protocols such as teleportation, superdense coding, and quantum key distribution. We first show how the OpenFlow protocol can manage the quantum metadata needed to control the quantum channel. We then use numerical simulation to demonstrate robust programmability of a quantum switch via the OpenFlow network controller while executing an application of superdense coding. We describe the software framework implemented to carry out these simulations and we discuss near-term efforts to realize these applications.

Clinical case management for patients with schizophrenia with high care needs.

PubMed

Mas-Expósito, Laia; Amador-Campos, Juan Antonio; Gómez-Benito, Juana; Mauri-Mas, Lluís; Lalucat-Jo, Lluís

2015-02-01

The aim of this study is to establish the effectiveness of a clinical case management (CM) programme compared to a standard treatment programme (STP) in patients with schizophrenia. Patients for the CM programme were consecutively selected among patients in the STP with schizophrenia who had poor functioning. Seventy-five patients were admitted to the CM programme and were matched to 75 patients in the STP. Patients were evaluated at baseline and at 1 year follow-up. At baseline, patients in the CM programme showed lower levels of clinical and psychosocial functioning and more care needs than patients in the STP. Both treatment programmes were effective in maintaining contact with services but the CM programme did not show advantages over the STP on outcomes. Differences between groups at baseline may be masking the effects of CM at one year follow-up. A longer follow-up may be required to evaluate the real CM practices effects.

Adapting a generic coping skills programme for adolescents with type 1 diabetes: a qualitative study.

PubMed

Serlachius, A; Northam, E; Frydenberg, E; Cameron, F

2012-04-01

Few qualitative studies have examined the views of adolescents with type 1 diabetes mellitus (T1DM) regarding psychosocial programme development and content. We conducted focus groups with 13 adolescents with T1DM to explore stressors and gain feedback on adapting a generic coping skills programme. The following prevalent stressors were identified: parental/adolescent conflict, balancing self-management and daily life, and health concerns. Prevalent views on programme adaptation included enhancing social support and adding diabetes-specific information and skills. Based on these data, the programme was adapted to address stressors and support self-management, thus better meeting the needs of, and appeal to, adolescents with T1DM.

Praying Sitting Position for Pineal Region Surgery: An Efficient Variant of a Classic Position in Neurosurgery.

PubMed

Choque-Velasquez, Joham; Colasanti, Roberto; Resendiz-Nieves, Julio C; Gonzáles-Echevarría, Kléber E; Raj, Rahul; Jahromi, Behnam Rezai; Goehre, Felix; Lindroos, Ann-Christine; Hernesniemi, Juha

2018-05-01

The sitting position has lost favor among neurosurgeons partly owing to assumptions of increased complications, such as venous air embolisms and hemodynamic disturbances. Moreover, the surgeon must assume a tiring posture. We describe our protocol for the "praying position" for pineal region surgery; this variant may reduce some of the risks of the sitting position, while providing a more ergonomic surgical position. A retrospective review of 56 pineal lesions operated on using the praying position between January 2008 and October 2015 was performed. The praying position is a steeper sitting position with the upper torso and the head bent forward and downward. The patient's head is tilted about 30° making the tentorium almost horizontal, thus providing a good viewing angle. G-suit trousers or elastic bandages around the lower extremities are always used. Complete lesion removal was achieved in 52 cases; subtotal removal was achieved in 4. Venous air embolism associated with persistent hemodynamic changes was nonexistent in this series. When venous air embolism was suspected, an immediate reaction based on good teamwork was imperative. No cervical spine cord injury or peripheral nerve damage was reported. The microsurgical time was <45 minutes in most of the cases. Postoperative pneumocephalus was detected in all patients, but no case required surgical treatment. A protocolized praying position that includes proper teamwork management may provide a simple, fast, and safe approach for proper placement of the patient for pineal region surgery. Copyright © 2018 Elsevier Inc. All rights reserved.

How an integrated change programme has accelerated the reduction in high hazard nuclear facilities at Sellafield

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

Mackintosh, Angela

For over five decades the Sellafield Site has been central to the UK's nuclear programme. Now operated by Sellafield Ltd, under the management of Parent Body Organisation Nuclear Management Partners (NMP), a consortium of URS Washington Division, AMEC and AREVA is focussed on the decommissioning of historical facilities. When Decommissioning commenced in the late 1980's the site focus at that time was on commercial reprocessing and waste management. Now through the implementation of a company change programme, emphasis has shifted towards accelerated risk and hazard reduction of degraded legacy plants with nuclear inventory whilst ensuring value for money for themore » customer, the Nuclear Decommissioning Authority. This paper will describe the management success by the Site owners in delivering a successful change programme. The paper will explain how the site has transitioned to the INPO Standard Nuclear Performance Model (SNPM) and how through the use of a change maturity matrix has contributed to the accelerated reduction in high risk high hazard nuclear facilities. The paper will explain in detail how the Decommissioning Programme Office has facilitated and coordinated the Governance and assured delivery of the change plan and how successful application of visual management has aided the communication of its progress. Finally, the paper will discuss how the Delivery Schedules have proved critical for presenting the change plan to Key Stakeholders, Government Owners and Powerful Regulators. Overall, this paper provides an insight into how a massive change programme is being managed within one of the world's highest regulated industries. (authors)« less

Cost-effectiveness of a disease management programme for secondary prevention of coronary heart disease and heart failure in primary care.

PubMed

Turner, D A; Paul, S; Stone, M A; Juarez-Garcia, A; Squire, I; Khunti, K

2008-12-01

To determine if a disease management programme for patients with coronary heart disease and heart failure represents an efficient use of health services resources. We carried out an economic evaluation alongside a cluster randomised control trial of 1163 patients with coronary heart disease and chronic heart failure in 20 primary care practices in the United Kingdom. Practices were randomised to either a control group, where patients received standard general practice care, or an intervention group where patients had access to a specialist nurse-led disease management programme. We estimated costs in both groups for coronary heart disease-related resource use. The main outcome measure used in the economic evaluation was quality adjusted life years (QALY) measured using the EuroQol. The disease management programme was associated with an increase in the QALY measured of 0.03 per year and an increase in the total NHS costs of 425 pounds (540 euros), of this only 83 pounds was directly associated with the provision of the nurse clinics. The clinics generated additional QALY at an incremental cost of 13 pounds 158 per QALY compared to the control group. The use of a nurse-led disease management programme is associated with increased costs in other coronary heart disease-related services as well as for the costs of the clinics. They are also associated with improvements in health. Even in the short term these disease management programmes may represent a cost-effective service, as additional QALY are generated at an acceptable extra cost.

[Indication guidelines for medical rehabilitation in the context of disease management programmes].

PubMed

Raspe, Heiner

2005-02-01

In current and upcoming disease management programmes in Germany, the provision of medical services is strongly oriented on ICD diagnoses and on services traditionally provided by the statutory health insurance. Multidisciplinary services, such as medical rehabilitation, mostly covered by other payers (e.g. pension funds) are not taken into account. On the other hand, many chronically-ill patients have complex and multifocal health complaints that are best addressed by multidisciplinary interventions. Considering this inherent deficit, in 2002 the German Society of Rehabilitation Sciences has initiated the research project "Indication Guidelines" aimed at developing indication criteria for rehabilitation in the context of disease management programmes. The concept presented in this paper relies on three basic requirements: 1. Impaired participation (according to ICF) caused by multifocal deficits leads to the definition of goals for rehabilitation, taking into account clinical and legal aspects as well as the patients preferences. 2. Multifocal health problems are best addressed by a multidisciplinary rehabilitation programme as it is currently provided by the German pension funds. 3. Scientific evidence has to demonstrate that these programmes are very likely to be effective (positive rehabilitation prognosis, evidence-based rehabilitation). Further requirements include adequate instruction of patients, as well as intensive and prolonged after-care. Both could be very well integrated into comprehensive disease management programmes.

Short-term effects of a peer co-led educational programme delivered before mental health treatment: A randomised controlled trial.

PubMed

Lara-Cabrera, M L; Gjerden, M; Gråwe, R W; Linaker, O M; Steinsbekk, A

2016-07-01

To investigate the 1-month effects of an educational programme co-led by peers delivered before treatment on treatment preferences, self-management knowledge and motivation in comparison to usual care. Adults referred to a community mental health centre were randomised to either a control group (n=48) or a peer co-led educational programme (intervention group, n=45). The programme consisted of an 8-hour group education session followed by an individual pretreatment planning session. The main topics of the educational programme were treatment options, patients' rights, self-management, the importance of patient activation and participation. At 1-month follow-up, a significantly larger proportion of the patients in the intervention group knew which type of treatment they preferred (76.7% vs. 32.5%, p<0.001). The intervention group had significantly higher self-management knowledge (p<0.001). There was no effect on treatment motivation (p=0.543). At 1-month following the delivery of a pretreatment educational programme, we found that participants' knowledge of treatment preferences and self-management had improved. Educational interventions co-led by peers can optimise the process of informing and educating outpatients, thereby helping patients to clarify their treatment preferences. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Assessing Sitting across Contexts: Development of the Multicontext Sitting Time Questionnaire

ERIC Educational Resources Information Center

Whitfield, Geoffrey P.; Pettee Gabriel, Kelley K.; Kohl, Harold W., III.

2013-01-01

Purpose: To describe the development and preliminary evaluation of the Multicontext Sitting Time Questionnaire (MSTQ). Method: During development of the MSTQ, contexts and domains of sitting behavior were utilized as recall cues to improve the accuracy of sitting assessment. The terms "workday" and "nonworkday" were used to…

Listening to music during sprint interval exercise: The impact on exercise attitudes and intentions.

PubMed

Stork, Matthew J; Martin Ginis, Kathleen A

2017-10-01

This study investigated the impact of listening to music during exercise on perceived enjoyment, attitudes and intentions towards sprint interval training (SIT). Twenty men (24.8 ± 4.5 years) and women (20.1 ± 2.6 years) unfamiliar with SIT exercise completed two acute sessions of SIT, one with and one without music. Perceived enjoyment, attitudes and intentions towards SIT were measured post-exercise for each condition. Attitudes and intentions to engage in SIT were also measured at baseline and follow-up. Post-exercise attitudes mediated the effects of enjoyment on intentions in the music condition (95% confidence interval [CI]: [0.01, 0.07], κ 2  = 0.36) and in the no music condition (95% CI: [0.01, 0.08], κ 2  = 0.37). Attitudes towards SIT were significantly more positive following the music than no music condition (P = 0.004), while intentions towards SIT were not (P = 0.29). Further, attitudes and intentions towards SIT did not change from baseline to follow-up (Ps > 0.05). These findings revealed that participants had relatively positive attitudes and intentions towards SIT, which did not become more negative despite experiencing intense SIT protocols. This study highlights the importance of acute affective responses to SIT exercise for influencing one's attitudes and intentions towards participating in SIT exercise. Such factors could ultimately play a key role in determining whether an individual engages in SIT exercise in the long term.

The Erasmus programme for postgraduate education in orthodontics in Europe: an update of the guidelines.

PubMed

Huggare, J; Derringer, K A; Eliades, T; Filleul, M P; Kiliaridis, S; Kuijpers-Jagtman, A; Martina, R; Pirttiniemi, P; Ruf, S; Schwestka-Polly, R

2014-06-01

In 1989, the ERASMUS Bureau of the European Cultural Foundation of the Commission of the European Communities funded the development of a new 3-year curriculum for postgraduate education in orthodontics. The new curriculum was created by directors for orthodontic education representing 15 European countries. The curriculum entitled 'Three years Postgraduate Programme in Orthodontics: the Final Report of the Erasmus Project' was published 1992. In 2012, the 'Network of Erasmus Based European Orthodontic Programmes' developed and approved an updated version of the guidelines. The core programme consists of eight sections: general biological and medical subjects; basic orthodontic subjects; general orthodontic subjects; orthodontic techniques; interdisciplinary subjects; management of health and safety; practice management, administration, and ethics; extramural educational activities. The programme goals and objectives are described and the competencies to be reached are outlined. These guidelines may serve as a baseline for programme development and quality assessment for postgraduate programme directors, national associations, and governmental bodies and could assist future residents when selecting a postgraduate programme.

IMHE-Info. OECD Programme on Institutional Management in Higher Education, July 2006

ERIC Educational Resources Information Center

Lafon, Valerie, Ed.

2006-01-01

IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: Higher Education: Quality, Equity and Efficiency. IMHE News, publications of interest and upcoming events are included.

Operational competency development in E and F grade nursing staff: preparation for management.

PubMed

Porter, S; Anderson, L; Chetty, A; Dyker, S; Murphy, F; Cheyne, H; Latto, D; Grant, A; McLachlan, M; Wild, P; McDonald, A; Kettles, A M

2006-07-01

There is limited literature for operational management competency development in E and F grade nursing staff. These grades of nursing staff have to take over from G grade nurses ward managers on a regular basis. With human resources doing less of the operational management and taking more of an advisory role, nursing staff are now required to deal with disciplinary procedures and other management issues in a more consistent manner. Therefore, this development programme in a Scottish primary care NHS psychiatric service was designed to enable E and F grade nurses to take over from ward managers and to enable ward managers to 'succession plan' for times when they will be absent. The literature is reviewed, the background to the development programme described and the design of the development programme is explained. The results from both the pilot study (n=13) and first group (n=8) through the course are presented, evaluated discussed.

Influence of sex on microvascular and macrovascular responses to prolonged sitting.

PubMed

Vranish, Jennifer R; Young, Benjamin E; Kaur, Jasdeep; Patik, Jordan C; Padilla, Jaume; Fadel, Paul J

2017-04-01

Increased daily sitting time is associated with greater cardiovascular risk, and, on average, women are more sedentary than men. Recent reports have demonstrated that prolonged sitting reduces lower leg microvascular (reactive hyperemia) and macrovascular [flow-mediated dilation (FMD)] vasodilator function. However, these studies have predominately included men, and the effects of sitting in young women are largely unexplored. This becomes important given known sex differences in vascular function. Thus, herein, we assessed popliteal artery reactive hyperemia and FMD before and after a 3-h sitting period in healthy young women ( n = 12) and men ( n = 8). In addition, resting popliteal artery hemodynamics (duplex Doppler ultrasound) and calf circumference were measured before, during, and after sitting. Resting popliteal artery shear rate was reduced to a similar extent in both groups during the sitting period (women: -48.5 ± 8.4 s -1 and men: -52.9 ± 12.3 s -1 , P = 0.45). This was accompanied by comparable increases in calf circumference in men and women ( P = 0.37). After the sitting period, popliteal artery FMD was significantly reduced in men (PreSit: 5.5 ± 0.9% and PostSit: 1.6 ± 0.4%, P < 0.001) but not women (PreSit: 4.4 ± 0.6% and PostSit: 3.6 ± 0.6%, P = 0.29). In contrast, both groups demonstrated similar reductions in hyperemic blood flow area under the curve (women: -28,860 ± 5,742 arbitrary units and men: -28,691 ± 9,685 arbitrary units, P = 0.99), indicating impaired microvascular reactivity after sitting. These findings indicate that despite comparable reductions in shear rate during 3 h of uninterrupted sitting, macrovascular function appears protected in some young women but the response was variable, whereas men exhibited more consistent reductions in FMD. In contrast, the leg microvasculature is susceptible to similar sitting-induced impairments in men and women. NEW & NOTEWORTHY We demonstrate that leg macrovascular function was consistently reduced in young men but not young women after prolonged sitting. In contrast, both men and women exhibited similar reductions in leg microvascular reactivity after sitting. These data demonstrate, for the first time, sex differences in vascular responses to prolonged sitting. Copyright © 2017 the American Physiological Society.

[Work schedule management in the health institutions of Abomey-Calavi (Benin)].

PubMed

Makoutodé, M; Kassanga, N N; Ouendo, E M; Agueh, V D; Diallo, P M

1999-12-01

Work time management of the health personnel of the health institutions in the sub-prefecture of Abomey-Calavi (Benin) This study was carried out with a sample size of 130, comprising health personnel, patients, members of management committees and twelve health institutions of the subprefecture of Abomey-Calavi. The survey was carried out through observation, one-on-one interviews and consultation of documents. The results reveal that work time is poorly managed in almost all of the programmes surveyed. There exist long waiting lines in almost all the health programmes. On average, the traffic report per service is 82 and 10 out of 12 of the programmes investigated do not have an agenda of activities.

Muscle activity patterns and spinal shrinkage in office workers using a sit-stand workstation versus a sit workstation.

PubMed

Gao, Ying; Cronin, Neil J; Pesola, Arto J; Finni, Taija

2016-10-01

Reducing sitting time by means of sit-stand workstations is an emerging trend, but further evidence is needed regarding their health benefits. This cross-sectional study compared work time muscle activity patterns and spinal shrinkage between office workers (aged 24-62, 58.3% female) who used either a sit-stand workstation (Sit-Stand group, n = 10) or a traditional sit workstation (Sit group, n = 14) for at least the past three months. During one typical workday, muscle inactivity and activity from quadriceps and hamstrings were monitored using electromyography shorts, and spinal shrinkage was measured using stadiometry before and after the workday. Compared with the Sit group, the Sit-Stand group had less muscle inactivity time (66.2 ± 17.1% vs. 80.9 ± 6.4%, p = 0.014) and more light muscle activity time (26.1 ± 12.3% vs. 14.9 ± 6.3%, p = 0.019) with no significant difference in spinal shrinkage (5.62 ± 2.75 mm vs. 6.11 ± 2.44 mm). This study provides evidence that working with sit-stand workstations can promote more light muscle activity time and less inactivity without negative effects on spinal shrinkage. Practitioner Summary: This cross-sectional study compared the effects of using a sit-stand workstation to a sit workstation on muscle activity patterns and spinal shrinkage in office workers. It provides evidence that working with a sit-stand workstation can promote more light muscle activity time and less inactivity without negative effects on spinal shrinkage.

Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers

PubMed Central

Waongenngarm, Pooriput; Rajaratnam, Bala S.; Janwantanakul, Prawit

2015-01-01

Background Prolonged sitting leads to low back discomfort and lumbopelvic muscle fatigue. This study examined the characteristics of body perceived discomfort and trunk muscle fatigue during 1 hour of sitting in three postures in office workers. Methods Thirty workers sat for 1 hour in one of three sitting postures (i.e., upright, slumped, and forward leaning postures). Body discomfort was assessed using the Body Perceived Discomfort scale at the beginning and after 1 hour of sitting. Electromyographic (EMG) signals were recorded from superficial lumbar multifidus, iliocostalis lumborum pars thoracis, internal oblique (IO)/transversus abdominis (TrA), and rectus abdominis muscles during 1 hour of sitting. The median frequency (MDF) of the EMG power spectrum was calculated. Results Regardless of the sitting posture, the Body Perceived Discomfort scores in the neck, shoulder, upper back, low back, and buttock significantly increased after 1 hour of sitting compared with baseline values (t(9) = −11.97 to −2.69, p < 0.05). The MDF value of the EMG signal of rectus abdominis, iliocostalis lumborum pars thoracis, and multifidus muscles was unchanged over time in all three sitting postures. Only the right and left IO/TrA in the slumped sitting posture was significantly associated with decreased MDF over time (p = 0.019 to 0.041). Conclusion Prolonged sitting led to increased body discomfort in the neck, shoulder, upper back, low back, and buttock. No sign of trunk muscle fatigue was detected over 1 hour of sitting in the upright and forward leaning postures. Prolonged slumped sitting may relate to IO/TrA muscle fatigue, which may compromise the stability of the spine, making it susceptible to injury. PMID:27014491

Test-to-test variability in motor activity during the suggested immobilization test in restless legs patients.

PubMed

Haba-Rubio, José; Sforza, Emilia

2006-10-01

To evaluate the test-to-test variability of the suggested immobilization test (SIT) in patients with restless legs syndrome (RLS). Twenty patients with primary RLS (12 men and eight women; age: 53.3+/-11.3 years) were selected for the study. We compared the results of two SITs performed on two consecutive evenings prior to polysomnographic recordings. Overall, the periodic leg movement index during the SIT (SIT PLM) and the SIT PLM index associated with sensory manifestations (SIT PLM+) were not significantly different between tests. The number of PLM sequences per SIT, the mean PLM duration and the PLM interval did not significantly change between the two consecutive tests. The pattern of temporal evolution of motor activity across the SIT was very reproducible, SIT PLM showing a clear tendency to a progressive increase across the test, with the SIT PLM+ index decreasing in the second half of the test. Despite good reproducibility, there were marked intra-individual differences. Considering the proposed cut-off value of 12 for the SIT PLM index to confirm RLS, 11 patients were positive at the first test and four additional patients became positive at the second test. SIT PLM index changes did not correlate with age, severity of disease and polysomnographic measures. Quantitative analysis of motor activity during two consecutive SITs in RLS patients showed a significant inter-test intra-individual variability unrelated to demographic, clinical or polysomnographic parameters. SIT PLM index variability suggests that a single test would not be sensitive enough for diagnostic purposes in unclear cases and that new criteria need to be applied to increase its specificity and sensitivity.

Barriers to community case management of malaria in Saraya, Senegal: training, and supply-chains.

PubMed

Blanas, Demetri A; Ndiaye, Youssoupha; Nichols, Kim; Jensen, Andrew; Siddiqui, Ammar; Hennig, Nils

2013-03-14

Health workers in sub-Saharan Africa can now diagnose and treat malaria in the field, using rapid diagnostic tests and artemisinin-based combination therapy in areas without microscopy and widespread resistance to previously effective drugs. This study evaluates communities' perceptions of a new community case management of malaria programme in the district of Saraya, south-eastern Senegal, the effectiveness of lay health worker trainings, and the availability of rapid diagnostic tests and artemisinin-based combination therapy in the field. The study employed qualitative and quantitative methods including focus groups with villagers, and pre- and post-training questionnaires with lay health workers. Communities approved of the community case management programme, but expressed concern about other general barriers to care, particularly transportation challenges. Most lay health workers acquired important skills, but a sizeable minority did not understand the rapid diagnostic test algorithm and were not able to correctly prescribe arteminisin-based combination therapy soon after the training. Further, few women lay health workers participated in the programme. Finally, the study identified stock-outs of rapid tests and anti-malaria medication products in over half of the programme sites two months after the start of the programme, thought due to a regional shortage. This study identified barriers to implementation of the community case management of malaria programme in Saraya that include lay health worker training, low numbers of women participants, and generalized stock-outs. These barriers warrant investigation into possible solutions of relevance to community case management generally.

The Effect of Peer-Led Self-Management Education Programmes for Adolescents with Asthma: A Systematic Review and Meta-Analysis

ERIC Educational Resources Information Center

Zhong, Connie S.; Melendez-Torres, G. J.

2017-01-01

Background: Adolescents with asthma face unique challenges due to hormonal changes, psychosocial development and healthcare transition. Peer-led self-management programmes may increase treatment adherence and social adjustment by addressing these challenges. The purpose of this study was to assess whether peer-led self-management programmes…

Ottawa Panel Evidence-Based Clinical Practice Guidelines for Patient Education Programmes in the Management of Osteoarthritis

ERIC Educational Resources Information Center

Health Education Journal, 2011

2011-01-01

Objective: The purpose of this study was to develop guidelines and recommendations on patient education programmes of any type, targeted specially to individuals with OA and which were designed to improve the clinical effectiveness of managing OA. Methods: The Ottawa Methods Group contacted specialized organizations that focus on management for…

Can a smart chair improve the sitting behavior of office workers?

PubMed

Roossien, C C; Stegenga, J; Hodselmans, A P; Spook, S M; Koolhaas, W; Brouwer, S; Verkerke, G J; Reneman, M F

2017-11-01

Prolonged sitting can cause health problems and musculoskeletal discomfort. There is a need for objective and non-obstructive means of measuring sitting behavior. A 'smart' office chair can monitor sitting behavior and provide tactile feedback, aiming to improve sitting behavior. This study aimed to investigate the effect of the feedback signal on sitting behavior and musculoskeletal discomfort. In a 12-week prospective cohort study (ABCB design) among office workers (n = 45) was measured sitting duration and posture, feedback signals and musculoskeletal discomfort. Between the study phases, small changes were observed in mean sitting duration, posture and discomfort. After turning off the feedback signal, a slight increase in sitting duration was observed (10 min, p = 0.04), a slight decrease in optimally supported posture (2.8%, p < 0.01), and musculoskeletal discomfort (0.8, p < 0.01) was observed. We conclude that the 'smart' chair is able to monitor the sitting behavior, the feedback signal, however, led to small or insignificant changes. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

PubMed Central

Yao, Katy; Nkengasong, John N.

2014-01-01

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

Is questionnaire-based sitting time inaccurate and can it be improved? A cross-sectional investigation using accelerometer-based sitting time.

PubMed

Gupta, Nidhi; Christiansen, Caroline Stordal; Hanisch, Christiana; Bay, Hans; Burr, Hermann; Holtermann, Andreas

2017-01-16

To investigate the differences between a questionnaire-based and accelerometer-based sitting time, and develop a model for improving the accuracy of questionnaire-based sitting time for predicting accelerometer-based sitting time. 183 workers in a cross-sectional study reported sitting time per day using a single question during the measurement period, and wore 2 Actigraph GT3X+ accelerometers on the thigh and trunk for 1-4 working days to determine their actual sitting time per day using the validated Acti4 software. Least squares regression models were fitted with questionnaire-based siting time and other self-reported predictors to predict accelerometer-based sitting time. Questionnaire-based and accelerometer-based average sitting times were ≈272 and ≈476 min/day, respectively. A low Pearson correlation (r=0.32), high mean bias (204.1 min) and wide limits of agreement (549.8 to -139.7 min) between questionnaire-based and accelerometer-based sitting time were found. The prediction model based on questionnaire-based sitting explained 10% of the variance in accelerometer-based sitting time. Inclusion of 9 self-reported predictors in the model increased the explained variance to 41%, with 10% optimism using a resampling bootstrap validation. Based on a split validation analysis, the developed prediction model on ≈75% of the workers (n=132) reduced the mean and the SD of the difference between questionnaire-based and accelerometer-based sitting time by 64% and 42%, respectively, in the remaining 25% of the workers. This study indicates that questionnaire-based sitting time has low validity and that a prediction model can be one solution to materially improve the precision of questionnaire-based sitting time. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Compilation of Abstracts of Theses Submitted by Candidates for Degrees.

DTIC Science & Technology

1984-06-01

Management System for the TI - 59 Programmable Calculator Kersh, T. B. Signal Processor Interface 65 CPT, USA Simulation of the AN/SPY-lA Radar...DESIGN AND IMPLEMENTATION OF A BASIC CROSS-COMPILER AND VIRTUAL MEMORY MANAGEMENT SYSTEM FOR THE TI - 59 PROGRAMMABLE CALCULATOR Mark R. Kindl Captain...Academy, 1974 The instruction set of the TI - 59 Programmable Calculator bears a close similarity to that of an assembler. Though most of the calculator

The Restorative Justice Center: An Alternative to School Detention

ERIC Educational Resources Information Center

Ashworth, Julie; Van Bockern, Steve; Ailts, Julie; Donnelly, Jason; Erickson, Kelsey; Woltermann, Jenna

2008-01-01

The traditional "stay silent, sit still, do nothing" school detention approach is a punitive and ineffective way to change behavior. It does little to create positive school climates. For children who have been traumatized through fear, isolation, and emotional abuse, poorly managed detention can add to that trauma. A restorative justice approach…

Understanding occupational sitting: prevalence, correlates and moderating effects in Australian employees.

PubMed

De Cocker, Katrien; Duncan, Mitch J; Short, Camille; van Uffelen, Jannique G Z; Vandelanotte, Corneel

2014-10-01

To (1) compare occupational sitting between different socio-demographic, health-related, work-related and psychosocial categories, (2) identity socio-demographic, health-related, work-related and psychosocial correlates of occupational sitting, and (3) examine the moderating effect of work-related factors in the relation between correlates and occupational sitting. Randomly-selected Australian adults completed a web-based survey assessing socio-demographic (country of birth, gender, age, education, income), health-related (general health, weight, physical activity), work-related (employment status, occupational task, occupational classification) and sedentary-specific psychosocial (social norm, social support, self-efficacy, control, advantages, disadvantage, intention) factors, and occupational sitting-time. t-tests, ANOVAs and multiple linear regression analyses were conducted (in 2013) on a sample of employees (n=993). Respondents sat on average for 3.75 (SD=2.45) h/day during work. Investigated correlates explained 41% of the variance in occupational sitting. More occupational sitting was associated with being male, being younger, higher education and income, part-time and full-time employment, sedentary job tasks, white-collar/professional occupations, higher BMI, and perceiving more advantages of sitting less at work. Employment status and occupational classification moderated the association between control to sit less and occupational sitting. A lack of control to sit less was associated with higher occupational sitting in part-time and full-time workers, but not in casual workers; and in white-collar and professional workers, but not in blue-collar workers. Most important contributors to occupational sitting were work-related and socio-demographic correlates. More research is needed to confirm present results. Copyright © 2014 Elsevier Inc. All rights reserved.

Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair.

PubMed

O'Sullivan, Kieran; McCarthy, Raymond; White, Alison; O'Sullivan, Leonard; Dankaerts, Wim

2012-01-01

Low back pain (LBP) is a common musculoskeletal disorder and prolonged sitting often aggravates LBP. A novel dynamic ergonomic chair ('Back App'), which facilitates less hip flexion while sitting on an unstable base has been developed. This study compared lumbar posture and trunk muscle activation on this novel chair with a standard backless office chair. Twelve painfree participants completed a typing task on both chairs. Lumbar posture and trunk muscle activation were collected simultaneously and were analysed using paired t-tests. Sitting on the novel dynamic chair significantly (p < 0.05) reduced both lumbar flexion and the activation of one back muscle (Iliocostalis Lumborum pars Thoracis). The discomfort experienced was mild and was similar (p > 0.05) between chairs. Maintaining lordosis with less muscle activation during prolonged sitting could reduce the fatigue associated with upright sitting postures. Studies with longer sitting durations, and in people with LBP, are required. Sitting on a novel dynamic chair resulted in less lumbar flexion and less back muscle activation than sitting on a standard backless office chair during a typing task among pain-free participants. Facilitating lordotic sitting with less muscle activation may reduce the fatigue and discomfort often associated with lordotic sitting postures.

The Effectiveness of a Web-Based Computer-Tailored Intervention on Workplace Sitting: A Randomized Controlled Trial.

PubMed

De Cocker, Katrien; De Bourdeaudhuij, Ilse; Cardon, Greet; Vandelanotte, Corneel

2016-05-31

Effective interventions to influence workplace sitting are needed, as office-based workers demonstrate high levels of continued sitting, and sitting too much is associated with adverse health effects. Therefore, we developed a theory-driven, Web-based, interactive, computer-tailored intervention aimed at reducing and interrupting sitting at work. The objective of our study was to investigate the effects of this intervention on objectively measured sitting time, standing time, and breaks from sitting, as well as self-reported context-specific sitting among Flemish employees in a field-based approach. Employees (n=213) participated in a 3-group randomized controlled trial that assessed outcomes at baseline, 1-month follow-up, and 3-month follow-up through self-reports. A subsample (n=122) were willing to wear an activity monitor (activPAL) from Monday to Friday. The tailored group received an automated Web-based, computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting. The generic group received an automated Web-based generic advice with tips. The control group was a wait-list control condition, initially receiving no intervention. Intervention effects were tested with repeated-measures multivariate analysis of variance. The tailored intervention was successful in decreasing self-reported total workday sitting (time × group: P<.001), sitting at work (time × group: P<.001), and leisure time sitting (time × group: P=.03), and in increasing objectively measured breaks at work (time × group: P=.07); this was not the case in the other conditions. The changes in self-reported total nonworkday sitting, sitting during transport, television viewing, and personal computer use, objectively measured total sitting time, and sitting and standing time at work did not differ between conditions. Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion, as the effects of the tailored condition were superior to the generic and control conditions. Clinicaltrials.gov NCT02672215; http://clinicaltrials.gov/ct2/show/NCT02672215 (Archived by WebCite at http://www.webcitation.org/6glPFBLWv).

Evidence of increasing sedentarism in Mexico City during the last decade: Sitting time prevalence, trends, and associations with obesity and diabetes.

PubMed

Medina, Catalina; Tolentino-Mayo, Lizbeth; López-Ridaura, Ruy; Barquera, Simón

2017-01-01

Sedentary behaviors such as sitting time are associated with obesity and diabetes independently of total reported physical activity. This study aimed to describe the current sitting time/day prevalence and trends and to examine the association of sitting time with sociodemographic and clinical variables in Mexico City. Two cross-sectional representative surveys in Mexico City were used for this analysis (2006: n = 1148 and 2015: n = 1329). Sedentary behavior questions from the International Physical Activity Questionnaire included time spent sitting on a weekday in the last week or on a Wednesday. Sitting time /day was divided into deciles, and participants in the highest decile (≥ 420 minutes/day) were classified within the high sitting category; others were classified in the low sitting time category. Multivariate logistic regression was used to evaluate the associations of sitting time with sociodemographic and clinical indicators, controlling for confounders and testing for potential interactions. A total of 13.7% (2006) and 14.8% (2015) adults were classified in the highest sitting time category (≥ 420 minutes/day). There was a significant increase in the average sitting time/day between the surveys (216.0 minutes in 2006 vs. 233.3 minutes in 2015, p < 0.001). In 2015, men, those aged 20-49 years, those in low-intensity jobs, students, and those with a high socioeconomic level were more likely to be in the highest sitting time category. Participants with overweight/obesity (OR = 2.37, 95% CI: 1.11, 5.09) and those with high glucose levels (survey finding) (OR = 2.34, 95% CI: 1.04, 5.25) were more likely to report sitting time in the highest category. Sitting time/day prevalence increased 8%, and average daily sitting minutes significantly increased by 8.2% (18 minutes) in the nine-year study period (2006-2015). Current public health policies should consider strategies not only for increasing physical activity levels, but also for reducing sitting time/day among the population as a measure to fight the growing epidemic of obesity and diabetes in Mexico.

Evidence of increasing sedentarism in Mexico City during the last decade: Sitting time prevalence, trends, and associations with obesity and diabetes

PubMed Central

Tolentino-Mayo, Lizbeth; López-Ridaura, Ruy; Barquera, Simón

2017-01-01

Introduction Sedentary behaviors such as sitting time are associated with obesity and diabetes independently of total reported physical activity. This study aimed to describe the current sitting time/day prevalence and trends and to examine the association of sitting time with sociodemographic and clinical variables in Mexico City. Methods Two cross-sectional representative surveys in Mexico City were used for this analysis (2006: n = 1148 and 2015: n = 1329). Sedentary behavior questions from the International Physical Activity Questionnaire included time spent sitting on a weekday in the last week or on a Wednesday. Sitting time /day was divided into deciles, and participants in the highest decile (≥ 420 minutes/day) were classified within the high sitting category; others were classified in the low sitting time category. Multivariate logistic regression was used to evaluate the associations of sitting time with sociodemographic and clinical indicators, controlling for confounders and testing for potential interactions. Results A total of 13.7% (2006) and 14.8% (2015) adults were classified in the highest sitting time category (≥ 420 minutes/day). There was a significant increase in the average sitting time/day between the surveys (216.0 minutes in 2006 vs. 233.3 minutes in 2015, p < 0.001). In 2015, men, those aged 20–49 years, those in low-intensity jobs, students, and those with a high socioeconomic level were more likely to be in the highest sitting time category. Participants with overweight/obesity (OR = 2.37, 95% CI: 1.11, 5.09) and those with high glucose levels (survey finding) (OR = 2.34, 95% CI: 1.04, 5.25) were more likely to report sitting time in the highest category. Discussion Sitting time/day prevalence increased 8%, and average daily sitting minutes significantly increased by 8.2% (18 minutes) in the nine-year study period (2006–2015). Current public health policies should consider strategies not only for increasing physical activity levels, but also for reducing sitting time/day among the population as a measure to fight the growing epidemic of obesity and diabetes in Mexico. PMID:29194458

Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study.

PubMed

Gupta, Nidhi; Christiansen, Caroline Stordal; Hallman, David M; Korshøj, Mette; Carneiro, Isabella Gomes; Holtermann, Andreas

2015-01-01

Studies on the association between sitting time and low back pain (LBP) have found contrasting results. This may be due to the lack of objectively measured sitting time or because socioeconomic confounders were not considered in the analysis. To investigate the association between objectively measured sitting time (daily total, and occupational and leisure-time periods) and LBP among blue-collar workers. Two-hundred-and-one blue-collar workers wore two accelerometers (GT3X+ Actigraph) for up to four consecutive working days to obtain objective measures of sitting time, estimated via Acti4 software. Workers reported their LBP intensity the past month on a scale from 0 (no pain) to 9 (worst imaginable pain) and were categorized into either low (≤ 5) or high (> 5) LBP intensity groups. In the multivariate-adjusted binary logistic regression analysis, total sitting time, and occupational and leisure-time sitting were both modeled as continuous (hours/day) and categorical variables (i.e. low, moderate and high sitting time). The multivariate logistic regression analysis showed a significant positive association between total sitting time (per hour) and high LBP intensity (odds ratio; OR = 1.43, 95%CI = 1.15-1.77, P = 0.01). Similar results were obtained for leisure-time sitting (OR = 1.45, 95%CI = 1.10-1.91, P = 0.01), and a similar but non-significant trend was obtained for occupational sitting time (OR = 1.34, 95%CI 0.99-1.82, P = 0.06). In the analysis on categorized sitting time, high sitting time was positively associated with high LBP for total (OR = 3.31, 95%CI = 1.18-9.28, P = 0.03), leisure (OR = 5.31, 95%CI = 1.57-17.90, P = 0.01), and occupational (OR = 3.26, 95%CI = 0.89-11.98, P = 0.08) periods, referencing those with low sitting time. Sitting time is positively associated with LBP intensity among blue-collar workers. Future studies using a prospective design with objective measures of sitting time are recommended.

Is Objectively Measured Sitting Time Associated with Low Back Pain? A Cross-Sectional Investigation in the NOMAD study

PubMed Central

Gupta, Nidhi; Christiansen, Caroline Stordal; Hallman, David M.; Korshøj, Mette; Carneiro, Isabella Gomes; Holtermann, Andreas

2015-01-01

Background Studies on the association between sitting time and low back pain (LBP) have found contrasting results. This may be due to the lack of objectively measured sitting time or because socioeconomic confounders were not considered in the analysis. Objectives To investigate the association between objectively measured sitting time (daily total, and occupational and leisure-time periods) and LBP among blue-collar workers. Methods Two-hundred-and-one blue-collar workers wore two accelerometers (GT3X+ Actigraph) for up to four consecutive working days to obtain objective measures of sitting time, estimated via Acti4 software. Workers reported their LBP intensity the past month on a scale from 0 (no pain) to 9 (worst imaginable pain) and were categorized into either low (≤5) or high (>5) LBP intensity groups. In the multivariate-adjusted binary logistic regression analysis, total sitting time, and occupational and leisure-time sitting were both modeled as continuous (hours/day) and categorical variables (i.e. low, moderate and high sitting time). Results The multivariate logistic regression analysis showed a significant positive association between total sitting time (per hour) and high LBP intensity (odds ratio; OR=1.43, 95%CI=1.15-1.77, P=0.01). Similar results were obtained for leisure-time sitting (OR=1.45, 95%CI=1.10-1.91, P=0.01), and a similar but non-significant trend was obtained for occupational sitting time (OR=1.34, 95%CI 0.99-1.82, P=0.06). In the analysis on categorized sitting time, high sitting time was positively associated with high LBP for total (OR=3.31, 95%CI=1.18-9.28, P=0.03), leisure (OR=5.31, 95%CI=1.57-17.90, P=0.01), and occupational (OR=3.26, 95%CI=0.89-11.98, P=0.08) periods, referencing those with low sitting time. Conclusion Sitting time is positively associated with LBP intensity among blue-collar workers. Future studies using a prospective design with objective measures of sitting time are recommended. PMID:25806808

The Effectiveness of a Web-Based Computer-Tailored Intervention on Workplace Sitting: A Randomized Controlled Trial

PubMed Central

De Bourdeaudhuij, Ilse; Cardon, Greet; Vandelanotte, Corneel

2016-01-01

Background Effective interventions to influence workplace sitting are needed, as office-based workers demonstrate high levels of continued sitting, and sitting too much is associated with adverse health effects. Therefore, we developed a theory-driven, Web-based, interactive, computer-tailored intervention aimed at reducing and interrupting sitting at work. Objective The objective of our study was to investigate the effects of this intervention on objectively measured sitting time, standing time, and breaks from sitting, as well as self-reported context-specific sitting among Flemish employees in a field-based approach. Methods Employees (n=213) participated in a 3-group randomized controlled trial that assessed outcomes at baseline, 1-month follow-up, and 3-month follow-up through self-reports. A subsample (n=122) were willing to wear an activity monitor (activPAL) from Monday to Friday. The tailored group received an automated Web-based, computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting. The generic group received an automated Web-based generic advice with tips. The control group was a wait-list control condition, initially receiving no intervention. Intervention effects were tested with repeated-measures multivariate analysis of variance. Results The tailored intervention was successful in decreasing self-reported total workday sitting (time × group: P<.001), sitting at work (time × group: P<.001), and leisure time sitting (time × group: P=.03), and in increasing objectively measured breaks at work (time × group: P=.07); this was not the case in the other conditions. The changes in self-reported total nonworkday sitting, sitting during transport, television viewing, and personal computer use, objectively measured total sitting time, and sitting and standing time at work did not differ between conditions. Conclusions Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion, as the effects of the tailored condition were superior to the generic and control conditions. Trial Registration Clinicaltrials.gov NCT02672215; http://clinicaltrials.gov/ct2/show/NCT02672215 (Archived by WebCite at http://www.webcitation.org/6glPFBLWv) PMID:27245789

Quality Assessment and Development in the Course of the EFMD CEL Programme Accreditation

ERIC Educational Resources Information Center

Meier, C.; Seufert, S.; Euler, D.

2012-01-01

This paper reviews the experiences and learnings derived from the European Foundation for Management Development's programme accreditation teChnology-Enhanced Learning (EFMD CEL) programme accreditation. The EFMD CEL quality framework is briefly described, and an overview of the programmes that have pursued accreditation is presented.…

Behaviour-change intervention in a multicentre, randomised, placebo-controlled COPD study: methodological considerations and implementation.

PubMed

Bourbeau, Jean; Lavoie, Kim L; Sedeno, Maria; De Sousa, Dorothy; Erzen, Damijan; Hamilton, Alan; Maltais, François; Troosters, Thierry; Leidy, Nancy

2016-04-04

Chronic obstructive pulmonary disease is generally progressive and associated with reduced physical activity. Both pharmacological therapy and exercise training can improve exercise capacity; however, these are often not sufficient to change the amount of daily physical activity a patient undertakes. Behaviour-change self-management programmes are designed to address this, including setting motivational goals and providing social support. We present and discuss the necessary methodological considerations when integrating behaviour-change interventions into a multicentre study. PHYSACTO is a 12-week phase IIIb study assessing the effects on exercise capacity and physical activity of once-daily tiotropium+olodaterol 5/5 µg with exercise training, tiotropium+olodaterol 5/5 µg without exercise training, tiotropium 5 µg or placebo, with all pharmacological interventions administered via the Respimat inhaler. Patients in all intervention arms receive a behaviour-change self-management programme to provide an optimal environment for translating improvements in exercise capacity into increases in daily physical activity. To maximise the likelihood of success, special attention is given in the programme to: (1) the Site Case Manager, with careful monitoring of programme delivery; (2) the patient, incorporating patient-evaluation/programme-evaluation measures to guide the Site Case Manager in the self-management intervention; and (3) quality assurance, to help identify and correct any problems or shortcomings in programme delivery and ensure the effectiveness of any corrective steps. This paper documents the comprehensive methods used to optimise and standardise the behaviour-change self-management programme used in the study to facilitate dialogue on the inclusion of this type of programme in multicentre studies. The study has been approved by the relevant Institutional Review Boards, Independent Ethics Committee and Competent Authority according to national and international regulations. The results of this study will be disseminated through relevant, peer-reviewed journals and international conference presentations. NCT02085161. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Excessive sitting at work and at home: Correlates of occupational sitting and TV viewing time in working adults.

PubMed

Hadgraft, Nyssa T; Lynch, Brigid M; Clark, Bronwyn K; Healy, Genevieve N; Owen, Neville; Dunstan, David W

2015-09-15

Recent evidence links sedentary behaviour (or too much sitting) with poorer health outcomes; many adults accumulate the majority of their daily sitting time through occupational sitting and TV viewing. To further the development and targeting of evidence-based strategies there is a need for identification of the factors associated with higher levels of these behaviours. This study examined socio-demographic and health-related correlates of occupational sitting and of combined high levels of occupational sitting/TV viewing time amongst working adults. Participants were attendees of the third wave (2011/12) of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study who worked full-time (≥35 h/week; n = 1,235; 38 % women; mean ± SD age 53 ± 7 years). Logistic and multinomial logistic regression analyses were conducted (separately for women and men) to assess cross-sectional associations of self-reported occupational sitting time (categorised as high/low based on the median) and also the combination of occupational sitting time/TV viewing time (high/low for each outcome), with a number of potential socio-demographic and health-related correlates. Higher levels of occupational sitting (>6 h/day) were associated with higher household income for both genders. Lower levels of occupational sitting were associated with being older (women only); and, for men only, having a blue collar occupation, having a technical/vocational educational attainment, and undertaking more leisure-time physical activity (LTPA). Attributes associated with high levels of both occupational sitting and TV viewing time included white collar occupation (men only), lower levels of LTPA (both genders), higher BMI (men), and higher energy consumption (women). Higher household income (both genders) and professional/managerial occupations (men only) were correlates of high occupational sitting time, relative to low occupational sitting time, while health-related factors (lower LTPA, higher BMI - men, and higher energy consumption - women) were associated with high levels of both occupational sitting and TV viewing time, relative to low occupational sitting and low TV viewing time. These findings suggest possible high-risk groups that may benefit from targeted interventions. Further research is needed on potentially modifiable environmental and social correlates of occupational sitting time, in order to inform workplace initiatives.

Use of programmable versus nonprogrammable shunts in the management of hydrocephalus secondary to aneurysmal subarachnoid hemorrhage: a retrospective study with cost-benefit analysis.

PubMed

Lee, Lester; King, Nicolas K K; Kumar, Dinesh; Ng, Yew Poh; Rao, Jai; Ng, Huiyu; Lee, Kah Keow; Wang, Ernest; Ng, Ivan

2014-10-01

The choice of programmable or nonprogrammable shunts for the management of hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH) remains undefined. Variable intracranial pressures make optimal management difficult. Programmable shunts have been shown to reduce problems with drainage, but at 3 times the cost of nonprogrammable shunts. All patients who underwent insertion of a ventriculoperitoneal shunt for hydrocephalus after aneurysmal SAH between 2006 and 2012 were included. Patients were divided into those in whom nonprogrammable shunts and those in whom programmable shunts were inserted. The rates of shunt revisions, the reasons for adjustments of shunt settings in patients with programmable devices, and the effectiveness of the adjustments were analyzed. A cost-benefit analysis was also conducted to determine if the overall cost for programmable shunts was more than for nonprogrammable shunts. Ninety-four patients underwent insertion of shunts for hydrocephalus secondary to SAH. In 37 of these patients, nonprogrammable shunts were inserted, whereas in 57 programmable shunts were inserted. Four (7%) of 57 patients with programmable devices underwent shunt revision, whereas 8 (21.6%) of 37 patients with nonprogrammable shunts underwent shunt revision (p = 0.0413), and 4 of these patients had programmable shunts inserted during shunt revision. In 33 of 57 patients with programmable shunts, adjustments were made. The adjustments were for a trial of functional improvement (n = 21), overdrainage (n = 5), underdrainage (n = 6), or overly sunken skull defect (n = 1). Of these 33 patients, 24 showed neurological improvements (p = 0.012). Cost-benefit analysis showed $646.60 savings (US dollars) per patient if programmable shunts were used, because the cost of shunt revision is a lot higher than the cost of the shunt. The rate of shunt revision is lower in patients with programmable devices, and these are therefore more cost-effective. In addition, the shunt adjustments made for patients with programmable devices also resulted in better neurological outcomes.

Total and domain-specific sitting time among employees in desk-based work settings in Australia.

PubMed

Bennie, Jason A; Pedisic, Zeljko; Timperio, Anna; Crawford, David; Dunstan, David; Bauman, Adrian; van Uffelen, Jannique; Salmon, Jo

2015-06-01

To describe the total and domain-specific daily sitting time among a sample of Australian office-based employees. In April 2010, paper-based surveys were provided to desk-based employees (n=801) in Victoria, Australia. Total daily and domain-specific (work, leisure-time and transport-related) sitting time (minutes/day) were assessed by validated questionnaires. Differences in sitting time were examined across socio-demographic (age, sex, occupational status) and lifestyle characteristics (physical activity levels, body mass index [BMI]) using multiple linear regression analyses. The median (95% confidence interval [CI]) of total daily sitting time was 540 (531-557) minutes/day. Insufficiently active adults (median=578 minutes/day, [95%CI: 564-602]), younger adults aged 18-29 years (median=561 minutes/day, [95%CI: 540-577]) reported the highest total daily sitting times. Occupational sitting time accounted for almost 60% of total daily sitting time. In multivariate analyses, total daily sitting time was negatively associated with age (unstandardised regression coefficient [B]=-1.58, p<0.001) and overall physical activity (minutes/week) (B=-0.03, p<0.001) and positively associated with BMI (B=1.53, p=0.038). Desk-based employees reported that more than half of their total daily sitting time was accrued in the work setting. Given the high contribution of occupational sitting to total daily sitting time among desk-based employees, interventions should focus on the work setting. © 2014 Public Health Association of Australia.

Who is at risk of chronic disease? Associations between risk profiles of physical activity, sitting and cardio-metabolic disease in Australian adults.

PubMed

Engelen, Lina; Gale, Joanne; Chau, Josephine Y; Hardy, Louise L; Mackey, Martin; Johnson, Nathan; Shirley, Debra; Bauman, Adrian

2017-04-01

To examine the associations of physical activity (PA) and sitting time (sit) with cardio-metabolic diseases. Cross-sectional data from the Australian National Nutrition and Physical Activity Survey 2011-2012 (n=9,435) were used to classify adults into low and high risk groups based on their physical activity and sitting behaviour profiles. Logistic regression models examined associations between low and high risk classifications (high PA-low sit; high PA-high sit; low PA-low sit; low PA-high sit;) and socio-demographic factors, and associations between low and high risk classifications and the prevalence of cardiovascular disease, Type 2 diabetes and metabolic syndrome. These results characterise chronic disease risk based on both physical activity and sitting behaviour. Adults with the highest risk lifestyle behaviour pattern (low PA-high sit) tended to be middle aged, male, at greater social disadvantage, smoke, report fair health, be abdominally obese and employed in administrative and driver occupations. These individuals had a substantially greater risk of cardiovascular disease and metabolic syndrome (OR=1.41, 95% CI 1.13, 1.75; OR= 2.37, 95% CI 1.63, 3.45, respectively). The findings highlight the importance of both sufficient physical activity and low sitting time for cardio-metabolic health. Implications for public health: Primary prevention focus should consider physical activity and reduced sitting time as well as provision of relevant advice for cardio-metabolic health. © 2017 The Authors.

Do Sitting, Standing, or Treadmill Desks Impact Psychobiological Indicators of Work Productivity?

PubMed

Gilson, Nicholas D; Hall, Caitlin; Renton, Angela; Ng, Norman; von Hippel, William

2017-10-01

This pilot study investigated the links between psychobiological indicators of work productivity, prolonged desk sitting, and conditions whereby office workers were able to interrupt sitting using a sit-stand or treadmill desk. Twenty participants visited our laboratory and completed their own desk work in counterbalanced sit-only, sit-stand (Varidesk Pro Plus 48™), and sit-walk conditions (Infiniti TR1200-DTS™). Steady-state visually evoked potentials calculated from electroencephalography recordings during a set task at the end of the workday assessed attentional resource. Salivary cortisol samples were taken during the morning and afternoon to measure stress response. Within-subject analyses were used to compare work productivity indicators relative to condition. No significant differences in mean steady-state visually evoked potential amplitude were observed, although attentional resource allocation was found to be the most effective following the sit-stand [1.01 (0.46) μV] compared with the sit-walk [0.9 (0.28) μV] and sit-only [0.91 (0.32) μV] conditions. The mean magnitude of decrease in cortisol was most apparent when workers used treadmill (1.5 nmol/L; P = .007) and sit-stand (1.6 nmol/L; P = .001) desks, and least evident in the sit-only condition (1.0 nmol/L; P = .146). The findings highlight the potential benefits of standing or active deskwork to the allocation of attentional resources and the regulation of stress.

New Possibilities in Life with Type 2 Diabetes: Experiences from Participating in a Guided Self-Determination Programme in General Practice.

PubMed

Karlsen, Bjørg; Rasmussen Bruun, Bettina; Oftedal, Bjørg

2018-01-01

Research suggests that guided self-determination programmes can support self-management of diabetes by empowering self-determined goal setting and competence building. As most research in this area has focused on people with type 1 diabetes, knowledge is lacking on how adults with type 2 diabetes mellitus experience participation in such programmes. This study reports the modelling phase of a complex intervention design that explored the experiences of adults with type 2 diabetes who participated in a nurse-led guided self-determination programme in general practice and examines how the programme affected patients' motivation to self-manage diabetes. The qualitative design with semistructured interviews included 9 adults with type 2 diabetes who participated in the programme. Qualitative content analysis was used to analyse the data. The findings indicate that the participants experienced new life possibilities after participating in the programme, which seemed to have a positive influence on their motivation for self-management. Through reflections about how to live with diabetes, the participants reinterpreted their life with diabetes by gradually developing a closer relationship with the disease, moving towards acceptance. The fact that dialogue with the nurses was seen to be on an equal footing helped support the participants to become more self-determined.

Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management.

PubMed

Zwerink, Marlies; Effing, Tanja; Kerstjens, Huib A M; van der Valk, Paul; Brusse-Keizer, Marjolein; Zielhuis, Gerhard; van der Palen, Job

2016-01-01

Information regarding cost-effectiveness of community-based exercise programmes in COPD is scarce. Therefore, we have investigated whether a community-based exercise programme is a cost-effective component of self-management for patients with COPD after 2 years of follow-up. All included COPD patients participated in four self-management sessions. Additionally, patients in the COPE-active group participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained 3 times/week for 6 months and two times/week during the subsequent 5 months. In both periods, one of these weekly training sessions was home-based (unsupervised). No formal physiotherapy sessions were offered to COPE-active patients in the second year. A decision analytical model with a 24-month perspective was used to evaluate cost-effectiveness. Incremental cost-effectiveness ratios (ICER) were calculated and cost-effectiveness planes were created. Data of 77 patients participating in the exercise programme and 76 patients in the control group were analysed. The ICER for an additional patient prevented from deteriorating at least 47.5 meters on the ISWT was €6257. The ICER for an additional patient with a clinically relevant improvement (≥ 500 steps/day) in physical activity was €1564, and the ICER for an additional quality-adjusted life year (QALY) was €10 950. Due to a lack of maintenance of beneficial effects on our primary outcome exercise capacity after 2 years of follow-up and higher costs of the programme, the community-based exercise programme cannot be considered cost-effective compared to self-management programmes only. Nevertheless, the ICERs for the secondary outcomes physical activity and QALY are generally considered acceptable.

Financial incentives for disease management programmes and integrated care in German social health insurance.

PubMed

Greb, Stefan; Focke, Axel; Hessel, Franz; Wasem, Jürgen

2006-10-01

As a result of recent health care reforms sickness funds and health care providers in German social health insurance face increased financial incentives for implementing disease management and integrated care. Sickness funds receive higher payments form the risk adjustment system if they set up certified disease management programmes and induce patients to enrol. If health care providers establish integrated care projects they are able to receive extra-budgetary funding. As a consequence, the number of certified disease management programmes and the number of integrated care contracts is increasing rapidly. However, contracts about disease management programmes between sickness funds and health care providers are highly standardized. The overall share of health care expenses spent on integrated care still is very low. Existing integrated care is mostly initiated by hospitals, is based on only one indication and is not fully integrated. However, opportunity to invest in integrated care may open up innovative processes, which generate considerable productivity gains. What is more, integrated care may serve as gateway for the introduction of more widespread selective contracting.

Application of a theoretical model to evaluate COPD disease management.

PubMed

Lemmens, Karin M M; Nieboer, Anna P; Rutten-Van Mölken, Maureen P M H; van Schayck, Constant P; Asin, Javier D; Dirven, Jos A M; Huijsman, Robbert

2010-03-26

Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care.

Application of a theoretical model to evaluate COPD disease management

PubMed Central

2010-01-01

Background Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting. Methods A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries. Results Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea. Conclusions The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care. PMID:20346135

A qualitative evaluation of a comprehensive self-management programme for COPD patients: effectiveness from the patients' perspective.

PubMed

Monninkhof, Evelyn; van der Aa, Maaike; van der Valk, Paul; van der Palen, Job; Zielhuis, Gerhard; Koning, Karen; Pieterse, Marcel

2004-11-01

The COPE self-management programme, including a self-management education course, self-treatment of exacerbations and a fitness programme, appeared to have no significant effect on health related quality of life (HRQoL) as measured by the St. George's Respiratory Questionnaire (SGRQ). This is in contrast to our hypothesis and despite expressions of satisfaction of patients to healthcare workers. To understand this discrepancy, a qualitative study was performed. A purposive sample of 20 participants of the COPE self-management programme were interviewed at home using in-depth, semi-structured interviews. Interviews were audio taped and transcribed verbatim and analysed according grounded theory. The fitness programme was most positively evaluated by patients due to the perceived increase of exercise capacity and the social aspect of the group training. Major effects gained by the self-management education course reported by patients were the skills to evenly distribute their energy and to listen to their body signals. Most patients thought favourable about self-treatment of exacerbations. The possibility to start early, not having to call a doctor and autonomy were raised as important advantages. Furthermore, several patients reported increased self-confidence and coping behaviour as important effects of the COPE programme. Finally, many patients reported feeling safe due to the frequent follow-up visits and 24h access to the hospital, and this aspect elicited to be very important. In this study, the qualitative interviews suggest that the SGRQ and possibly other existing HRQoL instruments might fail to capture the full experience of patients in self-management studies. The need for more elaborate qualitative research on this subject is indicated.

A proposed adaptation of the European Foundation for Quality Management Excellence Model to physical activity programmes for the elderly - development of a quality self-assessment tool using a modified Delphi process

PubMed Central

2011-01-01

Background There has been a growing concern in designing physical activity (PA) programmes for elderly people, since evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Complete programme evaluations are a necessary prerequisite to continuous quality improvements. Being able to refine, adapt and create tools that are suited to the realities and contexts of PA programmes for the elderly in order to support its continuous improvement is, therefore, crucial. Thus, the aim of this study was to develop a self-assessment tool for PA programmes for the elderly. Methods A 3-round Delphi process was conducted via the Internet with 43 national experts in PA for the elderly, management and delivery of PA programmes for the elderly, sports management, quality management and gerontology, asking experts to identify the propositions that they considered relevant for inclusion in the self-assessment tool. Experts reviewed a list of proposed statements, based on the criteria and sub-criteria from the European Foundation for Quality Management Excellence Model (EFQM) and PA guidelines for older adults and rated each proposition from 1 to 8 (disagree to agree) and modified and/or added propositions. Propositions receiving either bottom or top scores of greater than 70% were considered to have achieved consensus to drop or retain, respectively. Results In round 1, of the 196 originally-proposed statements (best practice principles), the experts modified 41, added 1 and achieved consensus on 93. In round 2, a total of 104 propositions were presented, of which experts modified 39 and achieved consensus on 53. In the last round, of 51 proposed statements, the experts achieved consensus on 19. After 3 rounds of rating, experts had not achieved consensus on 32 propositions. The resulting tool consisted of 165 statements that assess nine management areas involved in the development of PA programmes for the elderly. Conclusion Based on experts' opinions, a self-assessment tool was found in order to access quality of PA programmes for the elderly. Information obtained with evaluations would be useful to organizations seeking to improve their services, customer satisfaction and, consequently, adherence to PA programmes, targeting the ageing population. PMID:21958203

Exploring strategies used following a group-based fatigue management programme for people with multiple sclerosis (FACETS) via the Fatigue Management Strategies Questionnaire (FMSQ).

PubMed

Thomas, S; Kersten, P; Thomas, P W; Slingsby, V; Nock, A; Jones, R; Davies Smith, A; Galvin, K T; Baker, R; Hillier, C

2015-10-20

To explore cross-sectional patterns of use of fatigue management strategies in people with multiple sclerosis (MS) who had attended a group-based fatigue management programme, Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle ('FACETS'). In a multicentre randomised controlled trial (RCT) the FACETS programme was shown to reduce fatigue severity and improve self-efficacy and quality of life. A questionnaire substudy within a RCT involving the self-completed Fatigue Management Strategies Questionnaire (FMSQ). The FMSQ includes: (1) closed questions about the use and helpfulness of fatigue management strategies taught in FACETS and (2) open items about changes to lifestyle, attitudes or expectations, barriers or difficulties encountered and helpful strategies not covered in FACETS. All had a clinical diagnosis of MS, significant fatigue, were ambulatory and had attended at least 4 of 6 scheduled FACETS sessions. Participants (n=72) were posted the FMSQ with a prepaid return envelope 4 months after the end of the FACETS programme. 82% (59/72) of participants returned the FMSQ. The fatigue management strategies most frequently used since attending FACETS were prioritisation (80%), pacing (78%), saying no to others (78%), grading tasks (75%) and challenging unhelpful thoughts (71%). Adding in those participants who were already using the respective strategies prior to FACETS, the three most used strategies at 4 months were prioritisation (55/59), grading (54/59) and pacing (53/58). Free-text comments illustrated the complex interplay between attitudes/expectations, behaviours, emotions and the environment. Issues related to expectations featured strongly in participants' comments. Expectations (from self and others) were both facilitators and barriers to effective fatigue management. Individuals' comments highlighted the complex, multifaceted nature of fatigue management. Revising expectations and a greater acceptance of fatigue were important shifts following the programme. Findings support the relevance of a cognitive behavioural approach for fatigue management. Booster sessions might be a useful addition to the FACETS programme. Current controlled trials ISRCTN76517470; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Disease management for chronic heart failure patient].

PubMed

Bläuer, Cornelia; Pfister, Otmar; Bächtold, Christa; Junker, Therese; Spirig, Rebecca

2011-02-01

Patients with chronic heart failure (HF) are limited in their quality of life, have a poor prognosis and face frequent hospitalisations. Patient self-management was shown to improve quality of life, reduce rehospitalisations and costs in patients with chronic HF. Comprehensive disease management programmes are critical to foster patient self-management. The chronic care model developed by the WHO serves as the basis of such programmes. In order to develop self-management skills a needs orientated training concept is mandatory, as patients need both knowledge of the illness and the ability to use the information to make appropriate decisions according to their individual situation. Switzerland has no established system for the care of patients with chronic diseases in particular those with HF. For this reason a group of Swiss experts for HF designed a model for disease management for HF patients in Switzerland. Since 2009 the Swiss Heart Foundation offers an education programme based on this model. The aim of this programme is to offer education and support for practitioners, patients and families. An initial pilot evaluation of the program showed mixed acceptance by practitioners, whereas patient assessed the program as supportive and in line with their requirements.

Cross-sectional Examination of Long-term Access to Sit-Stand Desks in a Professional Office Setting.

PubMed

Carr, Lucas J; Swift, Maggie; Ferrer, Alex; Benzo, Roberto

2016-01-01

Prolonged sedentary behavior is an independent risk factor for many negative health outcomes. Although many employers have begun introducing sit-stand desks as means of reducing employee's occupational sitting time, few studies have examined the impact of prolonged access to such desks on sitting/standing time or cardiometabolic outcomes. The present study compared occupational sedentary/physical activity behaviors and cardiometabolic biomarkers among employees with long-term access to traditional sitting and sit-stand desks. This study used a naturalistic, cross-sectional study design. Occupational sedentary and physical activity behaviors and cardiometabolic health outcomes were collected in a controlled laboratory between February and June 2014. Data were analyzed in September 2014. Adults working in full-time sedentary desk jobs who reported having either a sit-stand desk (n=31) or standard sitting desk (n=38) for a minimum of 6 months were recruited. Employees with sit-stand desks sat less (p=0.02) and stood more at work (p=0.01) compared with employees with sitting desks. Significant inverse correlations were observed between several occupational physical activity outcomes (walking time, steps at work) and cardiometabolic risk factors (systolic blood pressure, weight, lean mass, BMI) over the entire sample. Employees with long-term access to sit-stand desks sat less and stood more compared with employees with sitting desks. These findings hold public health significance, as sit-stand desks represent a potentially sustainable approach for reducing sedentary behavior among the large, growing number of sedentary workers at increased risk for sedentariness-related pathologies. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Why Women Sit: Determinants of Leisure Sitting Time for Working Women.

PubMed

Walsh, Shana M; Umstattd Meyer, M Renée; Stamatis, Andreas; Morgan, Grant B

2015-01-01

Sedentary behavior is associated with negative health consequences independent of physical activity levels. Evidence suggests the work environment promotes sedentary behavior regardless of sector, and that employees with occupations requiring longer sitting times differ only marginally in leisure sitting time from those with more active occupations. Because physical activity opportunities may be limited across many work settings, leisure sedentary time may be more easily replaced with physical activity. Understanding correlates of leisure sedentary behaviors could inform interventions, specifically for women who are among the least active in America. Female employees at two universities completed online surveys (n = 156; mean age, 45.12 [SD = 12.5]; mean BMI, 26.7 kg/m(2) [SD = 5.9]; mean work hours/week, 43.7 [SD = 9.4]). Bivariate correlations and two hierarchical regression analyses were conducted to examine personal and behavioral correlates of weekday and weekend leisure sitting time. Final regression models revealed that greater weekday leisure sitting time (R(2) = 0.307) was related with being older (p = .006), having fewer children (p = .001), self-reporting poorer health (p = .006), and greater weekend sitting time (p < .001). Greater weekend leisure sitting time (R(2) = 0.261) was related with greater work-related sitting time (p = .020) and greater weekday leisure sitting time (p < .001). Physical activity was not related with weekday or weekend leisure sitting time. The most prominent correlates of leisure sitting time were other types of sedentary behaviors. This suggests that sedentary time in one segment of life predicts time spent sitting in other areas of life. Future interventions should target decreasing sedentary behaviors during leisure time specifically, in addition to increasing physical activity behavior. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Work engagement and its association with occupational sitting time: results from the Stormont study.

PubMed

Munir, Fehmidah; Houdmont, Jonathan; Clemes, Stacy; Wilson, Kelly; Kerr, Robert; Addley, Ken

2015-01-29

Evidence suggests that poor health outcomes and poor work-related health outcomes such as sickness presenteeism are associated with excessive sitting at work. Studies have yet to investigate the relationship between work engagement and occupational sitting. Work engagement is considered to be an important predictor of work-related well-being. We investigated the relationship between and self-reported work engagement and high occupational sitting time in Northern Ireland Civil Service (NICS) office-based workers. A cohort of 4436 NICS office-workers (1945 men and 2491 women) completed a questionnaire measuring work engagement and occupational sitting time. Logistic regression analyses were used to test the associations between work engagement and occupational sitting times. Compared to women, men reported lower mean occupational sitting time (385.7 minutes/day; s.d. = 1.9; versus 362.4 minutes/day; s.d. =2.5; p < .0001). After adjusting for confounding variables, men with high work engagement of vigor (OR = 0.49, 95% CI 0.34-0.98) and dedication (OR 0.68 95% CI 0.47-0.98) were less likely to have prolonged sitting time. Women with high work engagement of vigor (OR = 0.62, 95% CI 0.45-0.84) were also less likely to have prolonged occupational sitting times. In contrast, women with high absorption (OR = 1.29, 95% CI 1.01-1.65) were more likely to have prolonged sitting times. Being actively engaged in one's work is associated with lower occupational sitting times for men (vigor and dedication) and to a limited extent for women (vigor only). This suggests that interventions such as introducing sit-stand workstations to reduce sitting times, may be beneficial for work engagement.

Learning, assessment and professional identity development in public health training.

PubMed

Wood, Annette

2016-06-01

Professional identity formation is important for new recruits to training programmes. The integration of the accumulation of knowledge and assessment is a key aspect in its acquisition. This study assessed this interaction in Public Health Training in one English region. Semi-structured interviews were held with 15 registrars from the West Midlands Public Health Training Programme. Pre-interview questionnaires gathered background information. A thematic content analysis approach was taken. There was a lack of integration between academic and workplace learning, the professional examination process and professional identity development. Registrars considered sitting the examination and their workplace learning as two parallel processes. Passing the examination was considered a key part in the early development of a professional identity but this was replaced by the opinions of others by the third year of training. Having a Masters' in Public Health was less important but played a different role in their perceived acceptance by the wider Public Health workforce. The lack of integration between assessment and learning seemed to have a detrimental effect on professional identity development. A review of how these two aspects might combine in a more positive manner is needed.

IMHE-Info. OECD Programme on Institutional Management in Higher Education, April 2007

ERIC Educational Resources Information Center

Lafon, Valerie, Ed.

2007-01-01

IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) Regional Engagement: The Future for Higher Education?; and (2) Notes from Australia. IMHE News, publications of interest and upcoming events are included.

Developing a Virtual Engineering Management Community

ERIC Educational Resources Information Center

Hewitt, Bill; Kidd, Moray; Smith, Robin; Wearne, Stephen

2016-01-01

The paper reviews the lessons of planning and running an "Engineering Management" practitioner development programme in a partnership between BP and the University of Manchester. This distance-learning programme is for professional engineers in mid-career experienced in the engineering and support activities for delivering safe,…

The Sterile Insect Technique for Controlling Populations of Aedes albopictus (Diptera: Culicidae) on Reunion Island: Mating Vigour of Sterilized Males

PubMed Central

Oliva, Clelia F.; Jacquet, Maxime; Gilles, Jeremie; Lemperiere, Guy; Maquart, Pierre-Olivier; Quilici, Serge; Schooneman, François; Vreysen, Marc J. B.; Boyer, Sebastien

2012-01-01

Reunion Island suffers from high densities of the chikungunya and dengue vector Aedes albopictus. The sterile insect technique (SIT) offers a promising strategy for mosquito-borne diseases prevention and control. For such a strategy to be effective, sterile males need to be competitive enough to fulfil their intended function by reducing wild mosquito populations in natura. We studied the effect of irradiation on sexual maturation and mating success of males, and compared the sexual competitiveness of sterile versus wild males in the presence of wild females in semi-field conditions. For all untreated or sterile males, sexual maturation was completed within 13 to 20 h post-emergence and some males were able to inseminate females when 15 h old. In the absence of competition, untreated and sterile males were able to inseminate the same number of virgin females during 48 h, in small laboratory cages: an average of 93% of females was inseminated no matter the treatment, the age of males, and the sex ratio. Daily mating success of single sterile males followed the same pattern as for untreated ones, although they inseminated significantly fewer females after the ninth day. The competitiveness index of sterile males in semi-field conditions was only 0.14 when they were released at 1-day old, but improved to 0.53 when the release occurred after a 5-day period in laboratory conditions. In SIT simulation experiments, a 5∶1 sterile to wild male ratio allowed a two-fold reduction of the wild population’s fertility. This suggests that sterile males could be sufficiently competitive to mate with wild females within the framework of an SIT component as part of an AW-IPM programme for suppressing a wild population of Ae. albopictus in Reunion Island. It will be of interest to minimise the pre-release period in controlled conditions to ensure a good competitiveness without increasing mass rearing costs. PMID:23185329

Issues in Delivering Morbidity Management for Lymphatic Filariasis Elimination: A Study in Pondicherry, South India

PubMed Central

Kumari, A. Krishna; J, Yuvaraj; Das, L. K

2012-01-01

Lymphatic filariasis is a vector borne parasitic disease causing long term disability. The Global Programme to Eliminate Lymphatic Filariasis aims to achieve its objective through two strategies; Mass Drug Administration (MDA) to interrupt transmission and Morbidity Management (MM) to manage disability for those already affected. MDA is going on in full swing in endemic areas; but MM is lagging behind. An exploratory study was conducted in Pondicherry through focus group discussions to find out whether there are delivery issues if any, in the MM programme and get suggestions from end users. The study results show that MM has not received the same attention as MDA and there are shortcomings in the delivery mechanism of the programme. The importance of these findings are discussed and suggestions given for improving the programme. PMID:22654597

What is the appropriate business continuity management staff size?

PubMed

Walch, Damian; Merante, Jason

2008-04-01

This paper explores the question 'how many professionals does it take to build a resilient enterprise?' The paper describes the various segments of a comprehensive business continuity, disaster recovery and crisis management programme and then delves into the variables that determine the appropriate number of professionals required for the company. It is a thought-provoking examination that can help anybody in the `c-suite' examine their particular requirements, characteristics and culture to determine appropriate staffing levels. The reader will have a quantitative approach for determining the size and structure of a resilient enterprise which can provide a solid foundation for a programme that adapts and adjusts quickly and cost-effectively to disasters and events. It can also help build executive support for a programme management office which could ultimately increase the overall success of the programme.

The effect of a sit-stand workstation intervention on daily sitting, standing and physical activity: protocol for a 12 month workplace randomised control trial.

PubMed

Hall, Jennifer; Mansfield, Louise; Kay, Tess; McConnell, Alison K

2015-02-15

A lack of physical activity and excessive sitting can contribute to poor physical health and wellbeing. The high percentage of the UK adult population in employment, and the prolonged sitting associated with desk-based office-work, make these workplaces an appropriate setting for interventions to reduce sedentary behaviour and increase physical activity. This pilot study aims to determine the effect of an office-based sit-stand workstation intervention, compared with usual desk use, on daily sitting, standing and physical activity, and to examine the factors that underlie sitting, standing and physical activity, within and outside, the workplace. A randomised control trial (RCT) comparing the effects of a sit-stand workstation only and a multi-component sit-stand workstation intervention, with usual desk-based working practice (no sit-stand workstation) will be conducted with office workers across two organisations, over a 12 month period (N = 30). The multicomponent intervention will comprise organisational, environmental and individual elements. Objective data will be collected at baseline, and after 2-weeks, 3-months, 6-months and 12-months of the intervention. Objective measures of sitting, standing, and physical activity will be made concurrently (ActivPAL3™ and ActiGraph (GT3X+)). Activity diaries, ethnographic participant observation, and interviews with participants and key organisational personnel will be used to elicit understanding of the influence of organisational culture on sitting, standing and physical activity behaviour in the workplace. This study will be the first long-term sit-stand workstation intervention study utilising an RCT design, and incorporating a comprehensive process evaluation. The study will generate an understanding of the factors that encourage and restrict successful implementation of sit-stand workstation interventions, and will help inform future occupational wellbeing policy and practice. Other strengths include the objective measurement of physical activity during both work and non-work hours. Clinicaltrials.gov identifier NCT02172599, 22nd June 2014.

Disability management in a sample of Australian self-insured companies.

PubMed

Westmorland, M; Buys, N; Clements, N

2002-09-20

Disability management (DM) is a term developed in North America and refers to the prevention and management of injury and illness in the workplace. The purpose of this paper is to report findings of an Australian study that examined whether self-insured employers in that country have implemented integrated DM programmes. Key principles underpinning such programmes are explored to identify the extent to which Australian employers have adopted them. Data was collected from 29 self-insured Australian companies in three Australian States using a structured interview format with additional open-ended questions. It was found that companies have in place, to varying degrees, some of the key elements of disability management programmes. However, these elements were often not well integrated in a comprehensive disability management approach. The focus on workplace-based, early intervention in the area of return to work for injured employees was particularly strong, but there was little evidence of formal labour-management committee structures responsible for implementing DM programmes. If the concept of DM is relevant to the Australian environment then this study would suggest that self-insured companies need to undertake further work to develop integrated approaches to preventing and managing disability in the workplace. Several limitations of this study are highlighted and it is concluded that further work in this area is needed.

Description and preliminary results from a structured specialist behavioural weight management group intervention: Specialist Lifestyle Management (SLiM) programme

PubMed Central

Brown, Adrian; Gouldstone, Amy; Fox, Emily; Field, Annmarie; Todd, Wendy; Shakher, Jayadave; Bellary, Srikanth; Teh, Ming Ming; Azam, Muhammad; John, Reggie; Jagielski, Alison; Arora, Teresa; Thomas, G Neil; Taheri, Shahrad

2015-01-01

Background Specialist Lifestyle Management (SLiM) is a structured patient education and self-management group weight management programme. Each session is run monthly over a 6-month period providing a less intensive long-term approach. The groups are patient-centred incorporating educational, motivational, behavioural and cognitive elements. The theoretical background, programme structure and preliminary results of SLiM are presented. Subjects/methods The study was a pragmatic service evaluation of obese patients with a body mass index (BMI) ≥35 kg/m2 with comorbidity or ≥40 kg/m2 without comorbidity referred to a specialist weight management service in the West Midlands, UK. 828 patients were enrolled within SLiM over a 48-month period. Trained facilitators delivered the programme. Preliminary anonymised data were analysed using the intention-to-treat principle. The primary outcome measure was weight loss at 3 and 6 months with comparisons between completers and non-completers performed. The last observation carried forward was used for missing data. Results Of the 828 enrolled within SLiM, 464 completed the programme (56%). The mean baseline weight was 135 kg (BMI=49.1 kg/m2) with 87.2% of patients having a BMI≥40 kg/m2 and 12.4% with BMI≥60 kg/m2. The mean weight change of all patients enrolled was −4.1 kg (95% CI −3.6 to −4.6 kg, p=0.0001) at the end of SLiM, with completers (n=464) achieving −5.5 kg (95% CI −4.2 to −6.2 kg, p=0.0001) and non-completers achieving −2.3 kg (p=0.0001). The majority (78.6%) who attended the 6-month programme achieved weight loss with 32.3% achieving a ≥5% weight loss. Conclusions The SLiM programme is an effective group intervention for the management of severe and complex obesity. PMID:25854970

The Incredible Years Therapeutic Social and Emotional Skills Programme: A Pilot Study

ERIC Educational Resources Information Center

Hutchings, Judy; Bywater, Tracey; Gridley, Nicole; Whitaker, Christopher J.; Martin-Forbes, Pam; Gruffydd, Stella

2012-01-01

The Incredible Years (IY) universal child Classroom Dinosaur and Teacher Classroom Management programmes are delivered in all 102 primary schools in Gwynedd County, Wales. This article describes a pilot study of the IY Therapeutic (small group) Dinosaur School social and emotional coaching programme, developed as a treatment programme, in one such…

Exploring weight loss services in primary care and staff views on using a web-based programme.

PubMed

Ware, Lisa J; Williams, Sarah; Bradbury, Katherine; Brant, Catherine; Little, Paul; Hobbs, F D Richard; Yardley, Lucy

2012-01-01

Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of e-health into primary care may face challenges. To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery. Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36) involved in delivering weight loss services. Data were analysed using inductive thematic analysis. Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation. Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and 'ad hoc' services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Emergency and crisis management: critical incident stress management for first responders and business organisations.

PubMed

Guenthner, Daniel H

2012-01-01

A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.

Introducing Acceptance and Commitment Therapy to a physiotherapy-led pain rehabilitation programme: an Action Research study.

PubMed

Barker, Karen L; Heelas, Leila; Toye, Francine

2016-02-01

Recent developments in pain rehabilitation emphasise the importance of promoting psychological flexibility. Acceptance and Commitment Therapy (ACT) is one approach that has been shown to be effective for the treatment of chronic musculoskeletal pain. However, studies have shown that introducing innovative approaches such as ACT into established health care can cause some anxiety for professional groups. We used Action Research to evaluate the implementation of ACT to a physiotherapy-led pain rehabilitation programme. All staff in the pain service were invited to participate. Participants took part in focus groups, engaged in reflective sessions/meetings and completed reflective diaries. The analysis was undertaken by an experienced qualitative researcher using constant comparison. Participants reviewed emerging themes and validated the findings. Four key themes emerged from the study: (a) the need to see pain as an embodied, rather than dualistic, experience; (b) the need for a more therapeutic construction of 'acceptance'; (c) value-based goals as profound motivation for positive change; and (d) it's quite a long way from physiotherapy. Integral to a therapeutic definition of acceptance was the challenge of moving away from 'fixing' towards 'sitting with'. Participants described this as uncomfortable because it did not fit their biomedical training. This article describes how Action Research methodology was used in the introduction of ACT to a physiotherapy-led pain rehabilitation programme. The innovation of this study is that it helps us to understand the potential barriers and facilitators to embedding an ACT philosophy within a physiotherapy setting.

Impact of an intervention programme on knowledge, attitude and practice of healthcare staff regarding pharmaceutical waste management, Gaza, Palestine.

PubMed

Tabash, M I; Hussein, R A; Mahmoud, A H; El-Borgy, M D; Abu-Hamad, B A

2016-09-01

To assess knowledge, attitude and practice (KAP) of healthcare staff regarding pharmaceutical waste management; and to determine the impact of an educational programme on the KAP survey items. Pre-post-test intervention study. The pre-intervention phase was performed using a sample of 530 out of 1500 healthcare workers. A predesigned interview questionnaire was used to assess KAP. Next, an educational programme was designed and offered to a subsample of 69 healthcare workers. KAP were re-assessed for the programme attendees using the same interview questionnaire, both immediately (post-test) and six months after the end of the programme (follow-up test). The parametric paired sample t-test was used to assess the difference between pre-test and follow-up test results. Poor knowledge and poor practice levels (scores 50%) detected in the pre-intervention phase were found to improve to satisfactory levels (scores ≥75%) in the follow-up phase. Attitude was found to be positive (score ≥75%) in all phases of the study. The educational programme led to a significant improvement in KAP of healthcare staff regarding pharmaceutical waste management (P<0.001). Copyright © 2016. Published by Elsevier Ltd.

Influence of dietary nitrate supplementation on physiological and muscle metabolic adaptations to sprint interval training

PubMed Central

Thompson, Christopher; Wylie, Lee J.; Blackwell, Jamie R.; Fulford, Jonathan; Black, Matthew I.; Kelly, James; McDonagh, Sinead T. J.; Carter, James; Bailey, Stephen J.; Vanhatalo, Anni

2017-01-01

We hypothesized that 4 wk of dietary nitrate supplementation would enhance exercise performance and muscle metabolic adaptations to sprint interval training (SIT). Thirty-six recreationally active subjects, matched on key variables at baseline, completed a series of exercise tests before and following a 4-wk period in which they were allocated to one of the following groups: 1) SIT and NO3−-depleted beetroot juice as a placebo (SIT+PL); 2) SIT and NO3−-rich beetroot juice (~13 mmol NO3−/day; SIT+BR); or 3) no training and NO3−-rich beetroot juice (NT+BR). During moderate-intensity exercise, pulmonary oxygen uptake was reduced by 4% following 4 wk of SIT+BR and NT+BR (P < 0.05) but not SIT+PL. The peak work rate attained during incremental exercise increased more in SIT+BR than in SIT+PL (P < 0.05) or NT+BR (P < 0.001). The reduction in muscle and blood [lactate] and the increase in muscle pH from preintervention to postintervention were greater at 3 min of severe-intensity exercise in SIT+BR compared with SIT+PL and NT+BR (P < 0.05). However, the change in severe-intensity exercise performance was not different between SIT+BR and SIT+PL (P > 0.05). The relative proportion of type IIx muscle fibers in the vastus lateralis muscle was reduced in SIT+BR only (P < 0.05). These findings suggest that BR supplementation may enhance some aspects of the physiological adaptations to SIT. NEW & NOTEWORTHY We investigated the influence of nitrate-rich and nitrate-depleted beetroot juice on the muscle metabolic and physiological adaptations to 4 wk of sprint interval training. Compared with placebo, dietary nitrate supplementation reduced the O2 cost of submaximal exercise, resulted in greater improvement in incremental (but not severe-intensity) exercise performance, and augmented some muscle metabolic adaptations to training. Nitrate supplementation may facilitate some of the physiological responses to sprint interval training. PMID:27909231

A rapid assessment of a community health worker pilot programme to improve the management of hypertension and diabetes in Emfuleni sub-district of Gauteng Province, South Africa.

PubMed

Ndou, Tshipfuralo; van Zyl, Greer; Hlahane, Salamina; Goudge, Jane

2013-01-24

Non-communicable diseases (NCD) and infectious chronic illnesses are recognised as significant contributing factors to the burden of disease globally, specifically in South Africa, yet clinical management is often poor. The involvement of community health workers (CHWs) in TB and HIV care in South Africa, and other low- and middle-income settings, suggests that they could make an important contribution in the management of NCDs. Using a rapid assessment, this study examines the outcomes of a pilot CHW programme to improve the management of hypertension and diabetes in Gauteng province, South Africa. A record review compared outcomes of patients receiving home visits (n56) with a control group (n168) attending the clinic, matched, as far as possible, on age, gender, and condition. Focus group discussions and semi-structured interviews with CHWs, patients, district, clinic, and NGO staff were used to obtain descriptions of the functioning of the programme and patient experiences. Despite the greater age and co-morbidity among those in the pilot programme, the findings suggest that control of hypertension was improved by CHW home visits in comparison to usual clinic care. However, too few doctor visits, insufficient monitoring of patient outcomes by clinic staff, and a poor procurement process for supplies required by the CHWs hampered the programme's activities. The role of CHWs in the management of hypertension should be given greater consideration, with larger studies being conducted to provide more robust evidence. Adequate training, supervision, and operational support will be required to ensure success of any CHW programme.

Consideration of stakeholder interests in the planning of sustainable waste management programmes.

PubMed

López-Toro, Alberto A; Rubio-Romero, Juan Carlos; Suárez-Cebador, Manuel; Arjona-Jiménez, Rafael

2016-10-01

Those responsible for developing sustainable solid waste management programmes must consider the impacts of programme elements on everyone involved. This paper focuses on identifying the effects of waste management activities and assessing their overall impact on stakeholders. Collaborating with four focus groups and 36 experts, 19 effects were identified and nine questionnaires were designed to evaluate them, one for each stakeholder group. All told, 1805 people took part in the survey. The results show that the effects most important to the survey participants are: (a) recycling solid urban waste, (b) pollution and (c) corporate social responsibility. © The Author(s) 2016.

Implications of online learning for nurse managers.

PubMed

McCarthy, Jillian

2014-10-30

Online learning for nurses is growing in popularity, with programmes ranging from mandatory update training to part-time master's degrees. E-learning, as it is known, offers flexibility in access to learning, study time and learning styles. In busy clinical areas, where guidance is provided on minimum nurse staffing levels, e-learning provides solutions for managers who wish to encourage professional development while maintaining adequate nursing cover. Caution must be taken, however, when choosing e-learning programmes, as quality and efficacy differ across the range. This article highlights the properties of good e-learning pedagogy to prepare nurse managers for successful assessment of these programmes.

Evaluation of the district health management fellowship training programme: a case study in Iran

PubMed Central

Gholipour, Kamal; Tabrizi, Jafar Sadegh; Farahbakhsh, Mostafa; Iezadi, Shabnam; Ghiasi, Akbar; Jahanbin, Hasan

2018-01-01

Objective To evaluate the district health management fellowship training programme in the north-west of Iran. Data sources/study setting The programme was introduced to build the managerial capacity of district health managers in Iran. Eighty-nine heads of units in the province’s health centre, district health managers and the health deputies of the district health centres in the north-west provinces of Iran had registered for the district health management fellowship training programme in Tabriz in 2015–2016. Study design This was an educational evaluation study to evaluate training courses to measure participants' reactions and learning and, to a lesser extent, application of training to their job and the organisational impact. Data collection/extraction methods Valid and reliable questionnaires were used to assess learning techniques and views towards the fellowship, and self-assessment of health managers’ knowledge and skills. Also, pretest and post-test examinations were conducted in each course and a portfolio was provided to the trainees to be completed in their work settings. Principal findings About 63% of the participants were medical doctors and 42.3% of them had over 20 years of experience. Learning by practice (scored 18.37 out of 20) and access to publications (17.27) were the most useful methods of training in health planning and management from the participants’ perspective. Moreover, meeting peers from other districts and the academic credibility of teachers were the most important features of the current programme. Based on the managers’ self-assessment, they were most skilful in quality improvement, managing, planning and evaluation of the district. The results of the post-test analysis on data collected from district health managers showed the highest scores in managing the district (77 out of 100) and planning and evaluation (69) of the courses. Conclusion The results of this study indicated that training courses, methods and improvement in managers' knowledge about the health system and the skills necessary to manage their organisation were acceptable. PMID:29525773

Biomechanical effects of sitting with adjustable ischial and lumbar support on occupational low back pain: evaluation of sitting load and back muscle activity

PubMed Central

Makhsous, Mohsen; Lin, Fang; Bankard, James; Hendrix, Ronald W; Hepler, Matthew; Press, Joel

2009-01-01

Background Compared to standing posture, sitting decreases lumbar lordosis, increases low back muscle activity, disc pressure, and pressure on the ischium, which are associated with occupational LBP. A sitting device that reduces spinal load and low back muscle activities may help increase sitting comfort and reduce LBP risk. The objective of this study is to investigate the biomechanical effect of sitting with a reduced ischial support and an enhanced lumbar support (Off-Loading) on load, interface pressure and muscle activities. Methods A laboratory test in low back pain (LBP) and asymptomatic subjects was designed to test the biomechanical effect of using the Off-Loading sitting posture. The load and interface pressure on seat and the backrest, and back muscle activities associated with usual and this Off-Loading posture were recorded and compared between the two postures. Results Compared with Normal (sitting upright with full support of the seat and flat backrest) posture, sitting in Off-Loading posture significantly shifted the center of the force and the peak pressure on the seat anteriorly towards the thighs. It also significantly decreased the contact area on the seat and increased that on the backrest. It decreased the lumbar muscle activities significantly. These effects are similar in individuals with and without LBP. Conclusion Sitting with reduced ischial support and enhanced lumbar support resulted in reduced sitting load on the lumbar spine and reduced the lumbar muscular activity, which may potentially reduce sitting-related LBP. PMID:19193245

Evaluation of a group based cognitive behavioural therapy programme for menstrual pain management in young women with intellectual disabilities: protocol for a mixed methods controlled clinical trial

PubMed Central

2014-01-01

Background Menstrual pain which is severe enough to impact on daily activities is very common amongst menstruating females. Research suggests that menstrual pain which impacts on daily functioning may be even more prevalent amongst those with intellectual disabilities. Despite this, little research attention has focused on pain management programmes for those with intellectual disabilities. The aims of this pilot study were to develop and evaluate a theory-based cognitive behavioural therapy (CBT) programme for menstrual pain management in young women with intellectual disabilities. Methods/Design The study utilised a mixed methods controlled clinical trial to evaluate elements from a CBT programme called Feeling Better (McGuire & McManus, 2010). The Feeling Better programme is a modular, manualised intervention designed for people with an intellectual disability and their carers. The programme was delivered to 36 young women aged 12 – 30 years who have a Mild - Moderate Intellectual Disability, split between two conditions. The treatment group received the Feeling Better intervention and the control group received treatment as usual. To evaluate the effectiveness of the programme, measures were taken of key pain variables including impact, knowledge, self-efficacy and coping. Process evaluation was conducted to examine which elements of the programme were most successful in promoting change. Discussion Participants in the intervention group were expected to report the use of a greater number of coping strategies and have greater knowledge of pain management strategies following participation in the intervention and at three month follow-up, when compared to control group participants. A significant advantage of the study was the use of mixed methods and inclusion of process evaluation to determine which elements of a cognitive behavioural therapy programme work best for individuals with intellectual disabilities. Trial registration Current Controlled Trials ISRCTN75567759 PMID:25201648

Governance in community based health programmes in I.R of Iran.

PubMed

Falahat, Katayoun; Eftekhari, Monir Baradaran; Malekafzali, Hossein; Forouzan, Ameneh Setareh; Dejman, Masoumeh

2013-02-01

To assess the nature of community-based health programme experience in Iran, and use the results in order to advocate more friendly policies in community, academy and funding organisations. The qualitative study was done in 2010-11 at various locations in Iran using semi structural in-depth interviews with the principals and managers of programmes, and focus group discussions with volunteers and service users of 13 Community Based Health Programmes which were active for at least five years. A total of 21 in-depth interviews and 20 focus group discussions were conducted. Data analysis was based on deductive-inductive content analysis approach considering the pre-determined structure in accordance with the study questions. The participants' views were analysed within the main category of governance, including the three sub-categories of leadership, monitoring and evaluation, and resource mobilisation. According to the participants, governmental programmes have centralised decision-making and management processes and local volunteers have no role in selecting managers at different levels of a programme. Such programmes are funded by the governmental core resources. In non-government organisations, resources available for such purposes mainly come through charitable individuals, service delivery fees and profitable economical activities, financial participation of volunteers and by using other organisations' facilities. In most programmes, there were no systematic process for monitoring and evaluation. Community-based Health programmes in Iran need to be revised in line with the positive input.There is a need to have community-based units within the Ministry of Health and Medical Education and other relevant organisations.

Development and evaluation of a dietary self-management programme for older adults with low literacy and heart disease: pilot study of feasibility and acceptability.

PubMed

Shao, Jung-Hua; Chen, Su-Hui

2016-12-01

To develop a dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours for older adults with low literacy and heart disease and evaluate the feasibility and acceptability of the programme. Eating behaviours such as fluid, salt, fat and cholesterol intake are an important factor related to heart disease outcomes. People with low literacy have difficulty following recommended health behaviours, but limited research has investigated intervention programmes for this population. Programme development and pilot testing its feasibility and acceptability. Recommendations were also collected from participants and the research assistant for future large-scale interventions. The study had two phases. Phase I consisted of programme development based on previous qualitative findings, a systematic review of the literature, clinical practice experience and expert opinion. In Phase II, we pilot tested the programme from January - June 2014 in a convenience sample of 10 older adults with low literacy, heart disease and recruited from a medical centre in northern Taiwan. Pilot testing showed that our programme was feasible and acceptable to older adults with low literacy and heart disease. Moreover, the final version of the programme was revised based on participants' and the research assistant's recommendations. Our study results suggest that with guidance and assistance, older adults with low literacy and heart disease can be motivated to take action for their health and are empowered by learning how to self-manage their heart-healthy eating behaviours. © 2016 John Wiley & Sons Ltd.

An integrative review of graduate transition programmes: Developmental considerations for nursing management.

PubMed

Bakon, Shannon; Craft, Judy; Wirihana, Lisa; Christensen, Martin; Barr, Jennie; Tsai, Lily

2018-01-01

Graduate transition programmes have been developed to recruit new nursing staff and facilitate an effective transition from nursing student to Registered Nurse within the clinical environment. Therefore the aim of this paper was to explore the various elements included in nursing graduate transition programmes. An integrative review was undertaken incorporating a strict inclusion criterion, critical appraisal, and thematic analysis of 30 studies. There are numerous transition programmes available yet there remains a lack of transparency regarding their aims/objectives, course content, support timeframe and the type of support provided. This inconsistency has resulted in a lack of clarity regarding efficacy or superiority of any one programme over another. Innovative multifaceted programs may assist in supporting the graduate registered nurse to transition effectively into the clinical environment. Providing these support programmes may allow nurse managers to recruit new graduates and therefore decrease the staff budget expenditure. No graduate programme was shown to be superior to others yet graduate programmes appear to positively influence the experience of the graduate and increase staff recruitment. Comparative research is needed to ascertain the integral components of these programmes. Copyright © 2017. Published by Elsevier Ltd.

Sedentary behaviour as a new behavioural target in the prevention and treatment of type 2 diabetes.

PubMed

Henson, Joseph; Dunstan, David W; Davies, Melanie J; Yates, Thomas

2016-01-01

Our modern day society encompasses an ecological niche in which sedentary behaviour, labour-saving devices and energy dense foods have become the new reference of living. We now spend more time sedentary, defined as sitting, than in all other activities combined. It has recently been confirmed that the consequences of our modern chair dependency are substantial and a direct contributing factor to the ever increasing epidemic of chronic diseases witnessed within industrialized environments. Epidemiological evidence--from both cross-sectional and prospective observational studies--has indicated that the time spent in sedentary behaviour is a distinct risk factor for several health outcomes, including type 2 diabetes mellitus, insulin resistance, all-cause and cardiovascular disease mortality, depression and some types of cancer. Importantly, these detrimental associations remain even after accounting for time spent in moderate-to-vigorous physical activity, with the strongest and most persistent associations seen between sedentary time and type 2 diabetes mellitus. Importantly, experimental studies have started to confirm the observational associations, with mounting evidence showing that breaking prolonged sitting time with light ambulation is an effective strategy for improving postprandial glucose regulation. Indeed, there is even emerging evidence showing that simply substituting sitting for standing regularly throughout the day may be of sufficient stimulus to improve glucose regulation. We highlight some of the key definitions, issues and evidence underpinning the link between sedentary behaviour and chronic disease in order to better inform clinicians and patients about the importance of incorporating reduced sitting time into type 2 diabetes mellitus management and prevention pathways. Copyright © 2016 John Wiley & Sons, Ltd.

Does Using a Chair Backrest or Reducing Seated Hip Flexion Influence Trunk Muscle Activity and Discomfort? A Systematic Review.

PubMed

Curran, Máire; O'Sullivan, Leonard; O'Sullivan, Peter; Dankaerts, Wim; O'Sullivan, Kieran

2015-11-01

This paper systematically reviews the effect of chair backrests and reducing seated hip flexion on low back discomfort (LBD) and trunk muscle activation. Prolonged sitting commonly exacerbates low back pain (LBP). Several modifications to seated posture and chair design have been recommended, including using chairs with backrests and chairs that reduce hip flexion. Electronic databases were searched by two independent assessors. Part 1 of this review includes 26 studies comparing the effect of sitting with at least two different hip angles. In Part 2, seven studies that compared the effect of sitting with and without a backrest were eligible. Study quality was assessed using the PEDro scale. Significant confounding variables and a relatively small number of randomized controlled trials (RCTs) involving people with LBP complicates analysis of the results. There was moderate evidence that chair backrests reduce paraspinal muscle activation, and limited evidence that chair backrests reduce LBD. There was no evidence that chairs involving less hip flexion reduce LBP or LBD, or consistently alter trunk muscle activation. However, participants in several studies subjectively preferred the modified chairs involving less hip flexion. The limited evidence to support the use of chairs involving less seated hip flexion, or the effect of a backrest, is consistent with the limited evidence that other isolated chair design features can reduce LBP. LBP management is likely to require consideration of several factors in addition to sitting position. Larger RCTs involving people with LBP are required. © 2015, Human Factors and Ergonomics Society.

Striving for the impossible dream: a community-based multi-practice collaborative model of diabetes management.

PubMed

Distiller, L A; Brown, M A; Joffe, B I; Kramer, B D

2010-02-01

In 1994 the Centre for Diabetes and Endocrinology (CDE) based in Johannesburg, South Africa established a novel community-based capitation and risk-sharing model for diabetes management. We here describe the model and present a recent survey of the performance/outcomes of this unique diabetes care programme. Data on 17 043 patients managed by the CDE Diabetes Management Programme at its Centre and its 262 affiliated Centres were analysed from its national database. From this total cohort, 1520 Type 1 and 8026 Type 2 diabetes patients have been in the Programme for > 5 years. The 5-year outcome data on hospital admission rates, glycaemic control (HbA(1c)), and microvascular complication rates were assessed in this subgroup of patients. Major reductions in hospital admission rates for both acute metabolic emergencies and all causes (40% overall) were achieved in patients enrolled onto the Diabetes Management Programme. The mean HBA(1c) on enrolment was 9.2% for subjects with Type 1 and 8.8% for those with Type 2 diabetes. After 1 year, mean HbA(1c) fell to 7.6% and 7.3% for the Type 1 and Type 2 subjects, respectively. At 5 years the HbA(1c) remained similar at 7.7% for the Type 1 subjects and 7.4% for the Type 2 subjects, demonstrating sustained improvement. Progression of microvascular complications appears to have been delayed. This managed care model of diabetes care in the context of the South African Private Health Care System achieved long-term improvement in glycaemic control and all-cause hospital admission rates. This may be due to the cost-containment being in the hands of the treating doctor, supported by an annual training programme. This programme is based on an individualized and holistic approach encompassing intensive patient education to facilitate self-empowerment and including prompting for the management of risk factors.

The Receptor-Like Kinase SIT1 Mediates Salt Sensitivity by Activating MAPK3/6 and Regulating Ethylene Homeostasis in Rice[C][W

PubMed Central

Li, Chen-Hui; Wang, Geng; Zhao, Ji-Long; Zhang, Li-Qing; Ai, Lian-Feng; Han, Yong-Feng; Sun, Da-Ye; Zhang, Sheng-Wei; Sun, Ying

2014-01-01

High salinity causes growth inhibition and shoot bleaching in plants that do not tolerate high salt (glycophytes), including most crops. The molecules affected directly by salt and linking the extracellular stimulus to intracellular responses remain largely unknown. Here, we demonstrate that rice (Oryza sativa) Salt Intolerance 1 (SIT1), a lectin receptor-like kinase expressed mainly in root epidermal cells, mediates salt sensitivity. NaCl rapidly activates SIT1, and in the presence of salt, as SIT1 kinase activity increased, plant survival decreased. Rice MPK3 and MPK6 function as the downstream effectors of SIT1. SIT1 phosphorylates MPK3 and 6, and their activation by salt requires SIT1. SIT1 mediates ethylene production and salt-induced ethylene signaling. SIT1 promotes accumulation of reactive oxygen species (ROS), leading to growth inhibition and plant death under salt stress, which occurred in an MPK3/6- and ethylene signaling-dependent manner in Arabidopsis thaliana. Our findings demonstrate the existence of a SIT1-MPK3/6 cascade that mediates salt sensitivity by affecting ROS and ethylene homeostasis and signaling. These results provide important information for engineering salt-tolerant crops. PMID:24907341

Application of Machine Learning Approaches for Classifying Sitting Posture Based on Force and Acceleration Sensors.

PubMed

Zemp, Roland; Tanadini, Matteo; Plüss, Stefan; Schnüriger, Karin; Singh, Navrag B; Taylor, William R; Lorenzetti, Silvio

2016-01-01

Occupational musculoskeletal disorders, particularly chronic low back pain (LBP), are ubiquitous due to prolonged static sitting or nonergonomic sitting positions. Therefore, the aim of this study was to develop an instrumented chair with force and acceleration sensors to determine the accuracy of automatically identifying the user's sitting position by applying five different machine learning methods (Support Vector Machines, Multinomial Regression, Boosting, Neural Networks, and Random Forest). Forty-one subjects were requested to sit four times in seven different prescribed sitting positions (total 1148 samples). Sixteen force sensor values and the backrest angle were used as the explanatory variables (features) for the classification. The different classification methods were compared by means of a Leave-One-Out cross-validation approach. The best performance was achieved using the Random Forest classification algorithm, producing a mean classification accuracy of 90.9% for subjects with which the algorithm was not familiar. The classification accuracy varied between 81% and 98% for the seven different sitting positions. The present study showed the possibility of accurately classifying different sitting positions by means of the introduced instrumented office chair combined with machine learning analyses. The use of such novel approaches for the accurate assessment of chair usage could offer insights into the relationships between sitting position, sitting behaviour, and the occurrence of musculoskeletal disorders.

Which population groups are most unaware of CVD risks associated with sitting time?

PubMed

Duncan, Mitch J; Gilson, Nicholas; Vandelanotte, Corneel

2014-08-01

Prolonged sitting is an emerging risk factor for poor health yet few studies have examined awareness of the risks associated with sitting behaviours. This study identifies the population subgroups with the highest levels of unawareness regarding the cardiovascular disease (CVD) risks associated with sitting behaviours. Adults (n=1256) living in Queensland, Australia completed a telephone-based survey in 2011, analysis conducted in 2013. The survey assessed participant's socio-demographic characteristics, physical activity, sitting behaviours and awareness of CVD risks associated with three sitting behaviours: 1) sitting for prolonged periods, 2), sitting for prolonged periods whilst also engaging in regular physical activity, and 3) breaking up periods of prolonged sitting with short activity breaks. Population sub-groups with the highest levels of unawareness were identified based on socio-demographic and behavioural characteristics using signal detection analysis. Unawareness ranged from 23.3% to 67.0%. Age was the most important variable in differentiating awareness levels; younger adults had higher levels of unawareness. Body mass index, physical activity, TV viewing, employment status and time spent at work also identified population sub-groups. Unawareness of CVD risk for prolonged sitting was moderately high overall. Younger adults had high levels of unawareness on all of the outcomes examined. Copyright © 2014 Elsevier Inc. All rights reserved.

Center of pressure and the projection of the time-course of sitting skill acquisition.

PubMed

Haworth, Joshua L; Harbourne, Regina T; Vallabhajosula, Srikant; Stergiou, Nicholas

2013-09-01

A normal time-course for the acquisition of sitting is essential. A delay in sitting may affect other developmental milestones, resulting in deficiencies in overall skill. Therefore, our aim was to identify variables whose measures at the very beginning of sitting would allow for the projection of the evolution of the sitting skill. Center of pressure data were collected from the postural sway of twenty-six typically developing infants while sitting on a force platform with a beginning ability to sit upright. Spatial, temporal and frequency variables of postural sway were obtained from both the medial/lateral and anterior/posterior directions of sway. Discriminant function analysis was conducted to identify potential predictors of the duration between onset and fully independent sitting. Gender (p=0.025), median frequency (p=0.006), and correlation dimension (p=0.002) were identified to be predictive of grouping with 73.1% correct classification of the participating infants into short, mid, and long delay groups. In conclusion, measures taken at the earliest stage of sitting may allow the projection of the time-course to achieve independent sitting for typical infants. This approach may be useful for monitoring typical development. Copyright © 2013 Elsevier B.V. All rights reserved.

Financial aspects of veterinary herd health management programmes.

PubMed

Ifende, V I; Derks, M; Hooijer, G A; Hogeveen, H

2014-09-06

Veterinary herd health management (VHHM) programmes have been shown to be economically effective in the past. However, no current information is available on costs and benefits of these programmes. This study compared economics and farm performance between participants and non-participants in VHHM programmes in 1013 dairy farms with over 40 cows. Milk Production Registration (MPR) data and a questionnaire concerning VHHM were used. Based on the level of participation in VHHM (as indicated in the questionnaire), costs of the programmes were calculated using a normative model. The economic value of the production effects was similarly calculated using normative modelling based on MPR data. Participants in VHHM had a better performance with regard to production, but not with regard to reproduction. Over 90 per cent of the VHHM participants were visited at least once every six weeks and most participants discussed at least three topics. In most farms, the veterinarian did the pregnancy checks as part of the VHHM programmes. There was a benefit to cost ratio of about five per cow per year for VHHM participants, and a mean difference in net returns of €30 per cow per year after adjusting for the cost of the programme. This portrays that participation in a VHHM programme is cost-efficient. There is, however, much unexplained variation in the net returns, possibly due to diverse approaches by veterinarians towards VHHM or by other factors not included in this analysis, like nutritional quality or management abilities of the farmer. British Veterinary Association.

Hurrah for Mrs White

NASA Astrophysics Data System (ADS)

Osborne, Jonathan

2012-01-01

Your obituary of Rudolf Mössbauer (November 2011 p9) reminded me of a story he once told me when I had the pleasure of sitting next to him at a conference dinner. My somewhat simplistic question was on the lines of "How did you manage to get a Nobel prize?", and Mössbauer's response was that it was all down to luck.

Semiochemical mediated enhancement of males to complement sterile insect technique in management of the tephritid pest Bactrocera tryoni (Froggatt)

USDA-ARS?s Scientific Manuscript database

Queensland fruit fly, Bactrocera tryoni (Froggatt), is the most significant pest of Australia’s $9 billion horticulture industry. The sterile insect technique (SIT) and male annihilation technique (MAT) based on traps baited with a synthetic analogue of raspberry ketone (RK) are two of the most effe...

Cryopreservation of embryos of the Mediterranean fruit fly Ceratitis capitata Vienna 8 Genetic Sexing Strain

USDA-ARS?s Scientific Manuscript database

The Mediterranean fruit fly, Ceratitis capitata, is one of the most serious pests of fruit crops world-wide. During the last decades, area-wide pest management (AW-IPM) approaches with a sterile insect technique (SIT) component have been used to control populations of this pest in an effective and e...

Comparisons of musculoskeletal complaints and data entry between a sitting and a sit-stand workstation paradigm.

PubMed

Husemann, Britta; Von Mach, Carolin Yvonne; Borsotto, Daniel; Zepf, Kirsten Isabel; Scharnbacher, Jutta

2009-06-01

Seated working positions are often regarded as a cause for discomfort in the musculoskeletal system. Performing work in different working positions--that is, alternating between sitting and standing (sit-stand workstation paradigm)--could help reduce physical complaints. The questions were whether performing office work partly in a standing position leads to reduced complaints and whether standing would change the efficiency of data entry office work. We investigated the effect of a sit-stand workstation paradigmd during experimental data entry office work on physical and psychological complaints and data entry efficiency by conducting a randomized controlled trial with 60 male participants ages 18 to 35 years. In this experiment, musculoskeletal complaints were reduced by a sit-stand workstation paradigm. A trend could be identified indicating a small but nonsignificant loss of efficiency in data entry while standing. A sit-stand workstation paradigm reduces musculoskeletal complaints without considerably affecting data entry efficiency under the presented study conditions (young male participants, short duration, fixed and controlled sit-stand workstation paradigm, simulated experimental working condition). According to the present data, implementing a sit-stand workstation paradigm can be an effective workplace health intervention to reduce musculoskeletal complaints. This experiment encourages further studies on the effectiveness of a sit-stand workstation paradigm. Experimental research and field studies that prove the reduction of complaints when introducing a sit-stand workstation paradigm in the workplace could be the basis for evidence-based recommendations regarding such interventions.

A conceptual framework for cost management training in the Limpopo Province of South Africa.

PubMed

Jooste, Karien; Mothiba, Tebogo Maria

2014-10-01

This paper describes the perceptions of nurse managers about their dual role in nursing units as cost centres. The tertiary hospital in the Limpopo province is the first institution to appoint nurse managers with a dual role in cost centres. The development of a conceptual framework for a context-specific programme for Cost Centre Managers is the first of its nature in South Africa. A qualitative, exploratory, descriptive design was followed. The target population included nurse managers (n = 35) formally appointed as cost centre managers with a dual role of delivering quality care and cost management. A focus group and individual interviews were conducted until data saturation occurred. Personal and professional distress, an empowering potential of being a cost centre manager, and the need for decentralized cost centre management were indicated as barriers for nurse managers that led to a framework for a context-specific training programme. There is a need for a context-specific training programme for cost centre managers in a hospital with cost centres. The training of cost centre managers for their dual role in cost centres could enhance cost effectiveness, quality care and staff satisfaction. © 2013 John Wiley & Sons Ltd.

IMHE-Info. OECD Programme on Institutional Management in Higher Education, December 2007

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2007

2007-01-01

IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) How Do Rankings Impact on Higher Education?; and (2) OECD International Assessment of Higher Education Outcomes. IMHE News, publications of interest and upcoming events are included.

IMHE-Info. OECD Programme on Institutional Management in Higher Education, No.1, 2003

ERIC Educational Resources Information Center

Lafon, Valerie, Ed.

2003-01-01

IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) Education, Internationalisation and Trade; and (2) The GATS (General Agreement on Trade in Services) Explained. IMHE News, publications of interest and upcoming events are included.

Safe or Unsafe? The Paradox of Action Learning

ERIC Educational Resources Information Center

Robertson, Jane; Bell, Diane

2017-01-01

Business Driven Action Learning (BDAL), as a learning philosophy that attempts to create real value for business is often used by executive education providers in their management development programmes. As the action learning facilitator, I found that the learning that took place during such a management development programme resulted in…

RAAAF's office landscape The End of Sitting: Energy expenditure and temporary comfort when working in non-sitting postures.

PubMed

Caljouw, Simone R; de Vries, Rutger; Withagen, Rob

2017-01-01

An earlier study suggested that the activity-inviting office landscape called "The End of Sitting", designed by Rietveld Architecture Art Affordances (RAAAF), should be considered as an alternative working environment to prevent sedentary behavior. The End of Sitting lacks chairs and tables but consists instead of a myriad of sloped surfaces at different heights that afford workers to stand, lean or recline at different locations. In this study, we assessed the impact of four of its workspaces on physical intensity, temporary comfort and productivity of office work and compared the outcomes with sitting and standing behind a desk. Twenty-four participants worked for 10 minutes in each of the six test conditions. Energy expenditure, measured by indirect calorimetry, and heart rate were recorded. Questionnaires were used to assess the perceived comfort. The number of words found in the word search test was counted as a measure of productivity. The majority of The End of Sitting workspaces led to a significant increase in energy expenditure compared with sitting behind a desk (ps < .05). Average MET values ranged from 1.40 to 1.58 which is a modest rise in energy expenditure compared to sitting (1.32 METs) and not significantly different from standing (1.47 METs). The scores on the general comfort scale indicated that some workspaces were less comfortable than sitting (ps < .05), but the vast majority of participants reported that at least one of The End of Sitting workspaces was equally or more comfortable than sitting. No differences in productivity between the test conditions were found. Further long-term studies are required to assess the behavioral adaptations, productivity and the level of comfort when using The End of Sitting as a permanent office.

Reducing children's classroom sitting time using sit-to-stand desks: findings from pilot studies in UK and Australian primary schools.

PubMed

Clemes, Stacy A; Barber, Sally E; Bingham, Daniel D; Ridgers, Nicola D; Fletcher, Elly; Pearson, Natalie; Salmon, Jo; Dunstan, David W

2016-09-01

This research examined the influence of sit-to-stand desks on classroom sitting time in primary school children. Pilot controlled trials with similar intervention strategies were conducted in primary schools in Melbourne, Australia, and Bradford, UK. Sit-to-stand desks replaced all standard desks in the Australian intervention classroom. Six sit-to-stand desks replaced a bank of standard desks in the UK intervention classroom. Children were exposed to the sit-to-stand desks for 9-10 weeks. Control classrooms retained their normal seated desks. Classroom sitting time was measured at baseline and follow-up using the activPAL3 inclinometer. Thirty UK and 44 Australian children provided valid activPAL data at baseline and follow-up. The proportion of time spent sitting in class decreased significantly at follow-up in both intervention groups (UK: -9.8 ± 16.5% [-52.4 ± 66.6 min/day]; Australian: -9.4 ± 10% [-43.7 ± 29.9 min/day]). No significant changes in classroom sitting time were observed in the UK control group, while a significant reduction was observed in the Australian control group (-5.9 ± 11.7% [-28.2 ± 28.3 min/day]). Irrespective of implementation, incorporating sit-to-stand desks into classrooms appears to be an effective way of reducing classroom sitting in this diverse sample of children. Longer term efficacy trials are needed to determine effects on children's health and learning. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Temporal patterns of sitting at work are associated with neck-shoulder pain in blue-collar workers: a cross-sectional analysis of accelerometer data in the DPHACTO study.

PubMed

Hallman, David M; Mathiassen, Svend Erik; Heiden, Marina; Gupta, Nidhi; Jørgensen, Marie Birk; Holtermann, Andreas

2016-07-01

Our aim was to examine the extent to which temporal patterns of sitting during occupational work and during leisure-time, assessed using accelerometry, are associated with intense neck-shoulder pain (NSP) in blue-collar workers. The population consisted of 659 Danish blue-collar workers. Accelerometers were attached to the thigh, hip, trunk and upper dominant arm to measure sitting time and physical activity across four consecutive days. Temporal sitting patterns were expressed separately for work and leisure by the proportion of total time spent sitting in brief bursts (0-5 min), moderate (>5-20 min) and prolonged (>20 min) periods. The peak NSP intensity during the previous 3 months was assessed using a numerical rating scale (range 0-10) and dichotomized into a lower (≤4) and higher (>4) NSP score. Logistic regression analyses with multiple adjustments for individual and occupational factors were performed to determine the association between brief, moderate and prolonged sitting periods, and NSP intensity. Time in brief bursts of occupational sitting was negatively associated with NSP intensity (adjusted OR 0.68, 95 % CI 0.48-0.98), while time in moderate periods of occupational sitting showed a positive association with NSP (adjusted OR 1.32, 95 % CI 1.04-1.69). Time in prolonged periods of occupational sitting was not associated with NSP (adjusted OR 0.78, 95 % CI 0.78-1.09). We found no significant association between brief, moderate or prolonged sitting periods during leisure, and NSP. Our findings indicate that the association between occupational sitting time and intense NSP among blue-collar workers is sensitive to the temporal pattern of sitting.

Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit.

PubMed

Shum, Gary L K; Crosbie, Jack; Lee, Raymond Y W

2005-09-01

Experimental study to describe lumbar spine and hip joint movements during sit-to-stand and stand-to-sit. To examine differences in the kinematics and joint coordination of the lumbar spine and hips during sit-to-stand and stand-to-sit between healthy subjects and patients with subacute low back pain (LBP). There is a paucity of information on the coordination of movements of lumbar spine and hips during sit-to-stand and stand-to-sit. The effect of LBP, with or without nerve root signs, is largely unknown. A three-dimensional real-time electromagnetic tracking device was used to measure movements of the lumbar spine and hips during sit-to-stand and stand-to-sit. Sixty subacute LBP participants with or without straight leg raise signs and 20 healthy asymptomatic participants were recruited. The kinematic patterns of lumbar spine and hips were analyzed. Coordination between the two joints was studied by relative phase angle analysis. The mobility of the spine and hips was significantly limited in back pain subjects. It was observed that LBP subjects employed various strategies to compensate for the limited motions at the hips and lumbar spine. The contribution of the lumbar spine relative to that of the hip was found to be reduced for subjects with LBP. The lumbar spine-hip joint coordination was significantly altered in back pain subjects, in particular, those with positive straight leg raise sign. Back pain was related to changes in the kinematics and coordination of the lumbar spine and hips during sit-to-stand and stand-to-sit. Assessment of back pain patients should include kinematic analysis of the hips as well as the spine.

Impact of an 8-Month Trial Using Height-Adjustable Desks on Children’s Classroom Sitting Patterns and Markers of Cardio-Metabolic and Musculoskeletal Health

PubMed Central

Contardo Ayala, Ana María; Salmon, Jo; Timperio, Anna; Sudholz, Bronwyn; Ridgers, Nicola D.; Sethi, Parneet; Dunstan, David W.

2016-01-01

During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children’s cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure) and perceptions of musculoskeletal discomfort. Two Year-6 classes (24 students per class) in one primary school were assigned to either an intervention or control classroom. The intervention classroom was equipped with height-adjustable desks and the teacher was instructed in the delivery of pedagogical strategies to reduce and break-up sitting in class. The control classroom followed standard practice using traditional furniture. At baseline, and after 8-months, time spent sitting, standing, stepping, and sitting-bouts (occasions of continuous sitting) as well as the frequency of sit-to-stand transitions were obtained from activPAL inclinometers and the time spent in light-intensity physical activity was obtained from ActiGraph accelerometers. Demographics and musculoskeletal characteristics were obtained from a self-report survey. Hierarchical linear mixed models found that during class-time, children’s overall time spent sitting in long bouts (>10 min) were lower and the number of sit-to-stand transitions were higher in the intervention group compared to the control group, while no changes were observed for musculoskeletal pain/discomfort. No significant intervention effects were found for the anthropometrics measures and blood pressure. Height-adjustable desks and pedagogical strategies to reduce/break-up sitting can positively modify classroom sitting patterns in children. Longer interventions, larger and varied sample size may be needed to show health impacts; however, these desks did not increase musculoskeletal pain/discomfort. PMID:27973414

Small Steps: Preliminary effectiveness and feasibility of an incremental goal-setting intervention to reduce sitting time in older adults.

PubMed

Lewis, L K; Rowlands, A V; Gardiner, P A; Standage, M; English, C; Olds, T

2016-03-01

This study aimed to evaluate the preliminary effectiveness and feasibility of a theory-informed program to reduce sitting time in older adults. Pre-experimental (pre-post) study. Thirty non-working adult (≥ 60 years) participants attended a one hour face-to-face intervention session and were guided through: a review of their sitting time; normative feedback on sitting time; and setting goals to reduce total sitting time and bouts of prolonged sitting. Participants chose six goals and integrated one per week incrementally for six weeks. Participants received weekly phone calls. Sitting time and bouts of prolonged sitting (≥ 30 min) were measured objectively for seven days (activPAL3c inclinometer) pre- and post-intervention. During these periods, a 24-h time recall instrument was administered by computer-assisted telephone interview. Participants completed a post-intervention project evaluation questionnaire. Paired t tests with sequential Bonferroni corrections and Cohen's d effect sizes were calculated for all outcomes. Twenty-seven participants completed the assessments (71.7 ± 6.5 years). Post-intervention, objectively-measured total sitting time was significantly reduced by 51.5 min per day (p=0.006; d=-0.58) and number of bouts of prolonged sitting by 0.8 per day (p=0.002; d=-0.70). Objectively-measured standing increased by 39 min per day (p=0.006; d=0.58). Participants self-reported spending 96 min less per day sitting (p<0.001; d=-0.77) and 32 min less per day watching television (p=0.005; d=-0.59). Participants were highly satisfied with the program. The 'Small Steps' program is a feasible and promising avenue for behavioral modification to reduce sitting time in older adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Self-Reported Sitting Time in New York City Adults, The Physical Activity and Transit Survey, 2010–2011

PubMed Central

Bartley, Katherine F.; Firestone, Melanie J.; Lee, Karen K.; Eisenhower, Donna L.

2015-01-01

Introduction Recent studies have demonstrated the negative health consequences associated with extended sitting time, including metabolic disturbances and decreased life expectancy. The objectives of this study were to characterize sitting time in an urban adult population and assess the validity of a 2-question method of self-reported sitting time. Methods The New York City Health Department conducted the 2010–2011 Physical Activity and Transit Survey (N = 3,597); a subset of participants wore accelerometers for 1 week (n = 667). Self-reported sitting time was assessed from 2 questions on time spent sitting (daytime and evening hours). Sedentary time was defined as accelerometer minutes with less than 100 counts on valid days. Descriptive statistics were used to estimate the prevalence of sitting time by demographic characteristics. Validity of sitting time with accelerometer-measured sedentary time was assessed using Spearman’s correlation and Bland-Altman techniques. All data were weighted to be representative of the New York City adult population based on the 2006–2008 American Community Survey. Results Mean daily self-reported sitting time was 423 minutes; mean accelerometer-measured sedentary time was 490 minutes per day (r = 0.32, P < .001). The mean difference was 49 minutes per day (limits of agreement: −441 to 343). Sitting time was higher in respondents at lower poverty and higher education levels and lower in Hispanics and people who were foreign-born. Conclusion Participants of higher socioeconomic status, who are not typically the focus of health disparities–related research, had the highest sitting times; Hispanics had the lowest levels. Sitting time may be accurately assessed by self-report with the 2-question method for population surveillance but may be limited in accurately characterizing individual-level behavior. PMID:26020549

Self-reported sitting time in New York City adults, the Physical Activity and Transit Survey, 2010-2011.

PubMed

Yi, Stella S; Bartley, Katherine F; Firestone, Melanie J; Lee, Karen K; Eisenhower, Donna L

2015-05-28

Recent studies have demonstrated the negative health consequences associated with extended sitting time, including metabolic disturbances and decreased life expectancy. The objectives of this study were to characterize sitting time in an urban adult population and assess the validity of a 2-question method of self-reported sitting time. The New York City Health Department conducted the 2010-2011 Physical Activity and Transit Survey (N = 3,597); a subset of participants wore accelerometers for 1 week (n = 667). Self-reported sitting time was assessed from 2 questions on time spent sitting (daytime and evening hours). Sedentary time was defined as accelerometer minutes with less than 100 counts on valid days. Descriptive statistics were used to estimate the prevalence of sitting time by demographic characteristics. Validity of sitting time with accelerometer-measured sedentary time was assessed using Spearman's correlation and Bland-Altman techniques. All data were weighted to be representative of the New York City adult population based on the 2006-2008 American Community Survey. Mean daily self-reported sitting time was 423 minutes; mean accelerometer-measured sedentary time was 490 minutes per day (r = 0.32, P < .001). The mean difference was 49 minutes per day (limits of agreement: -441 to 343). Sitting time was higher in respondents at lower poverty and higher education levels and lower in Hispanics and people who were foreign-born. Participants of higher socioeconomic status, who are not typically the focus of health disparities-related research, had the highest sitting times; Hispanics had the lowest levels. Sitting time may be accurately assessed by self-report with the 2-question method for population surveillance but may be limited in accurately characterizing individual-level behavior.

Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence.

PubMed

Bosch-Capblanch, Xavier; Marceau, Claudine

2014-12-01

To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which included additional support of equipment and supplies, seemed to improve selected quality of care outcomes. However, current evaluation and reporting practices need to be revised in a new research agenda to address the methodological challenges of iCCM evaluations.

Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

PubMed Central

Bosch–Capblanch, Xavier; Marceau, Claudine

2014-01-01

Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong components of training, supervision, which included additional support of equipment and supplies, seemed to improve selected quality of care outcomes. However, current evaluation and reporting practices need to be revised in a new research agenda to address the methodological challenges of iCCM evaluations. PMID:25520793

Chronic disease management programmes for adults with asthma.

PubMed

Peytremann-Bridevaux, Isabelle; Arditi, Chantal; Gex, Grégoire; Bridevaux, Pierre-Olivier; Burnand, Bernard

2015-05-27

The burden of asthma on patients and healthcare systems is substantial. Interventions have been developed to overcome difficulties in asthma management. These include chronic disease management programmes, which are more than simple patient education, encompassing a set of coherent interventions that centre on the patients' needs, encouraging the co-ordination and integration of health services provided by a variety of healthcare professionals, and emphasising patient self-management as well as patient education. To evaluate the effectiveness of chronic disease management programmes for adults with asthma. Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, MEDLINE (MEDLINE In-Process and Other Non-Indexed Citations), EMBASE, CINAHL, and PsycINFO were searched up to June 2014. We also handsearched selected journals from 2000 to 2012 and scanned reference lists of relevant reviews. We included individual or cluster-randomised controlled trials, non-randomised controlled trials, and controlled before-after studies comparing chronic disease management programmes with usual care in adults over 16 years of age with a diagnosis of asthma. The chronic disease management programmes had to satisfy at least the following five criteria: an organisational component targeting patients; an organisational component targeting healthcare professionals or the healthcare system, or both; patient education or self-management support, or both; active involvement of two or more healthcare professionals in patient care; a minimum duration of three months. After an initial screen of the titles, two review authors working independently assessed the studies for eligibility and study quality; they also extracted the data. We contacted authors to obtain missing information and additional data, where necessary. We pooled results using the random-effects model and reported the pooled mean or standardised mean differences (SMDs). A total of 20 studies including 81,746 patients (median 129.5) were included in this review, with a follow-up ranging from 3 to more than 12 months. Patients' mean age was 42.5 years, 60% were female, and their asthma was mostly rated as moderate to severe. Overall the studies were of moderate to low methodological quality, because of limitations in their design and the wide confidence intervals for certain results.Compared with usual care, chronic disease management programmes resulted in improvements in asthma-specific quality of life (SMD 0.22, 95% confidence interval (CI) 0.08 to 0.37), asthma severity scores (SMD 0.18, 95% CI 0.05 to 0.30), and lung function tests (SMD 0.19, 95% CI 0.09 to 0.30). The data for improvement in self-efficacy scores were inconclusive (SMD 0.51, 95% CI -0.08 to 1.11). Results on hospitalisations and emergency department or unscheduled visits could not be combined in a meta-analysis because the data were too heterogeneous; results from the individual studies were inconclusive overall. Only a few studies reported results on asthma exacerbations, days off work or school, use of an action plan, and patient satisfaction. Meta-analyses could not be performed for these outcomes. There is moderate to low quality evidence that chronic disease management programmes for adults with asthma can improve asthma-specific quality of life, asthma severity, and lung function tests. Overall, these results provide encouraging evidence of the potential effectiveness of these programmes in adults with asthma when compared with usual care. However, the optimal composition of asthma chronic disease management programmes and their added value, compared with education or self-management alone that is usually offered to patients with asthma, need further investigation.

Men with pelvic pain: perceived helpfulness of medical and self-management strategies.

PubMed

Turner, Judith A; Ciol, Marcia A; Von Korff, Michael; Liu, Yung-Wen; Berger, Richard

2006-01-01

To assess the frequency of use of different treatments and pain management strategies and their perceived helpfulness in male patients with pelvic pain. Approximately 1 month after a health maintenance organization visit for pelvic pain, 286 men (mean age 46.7 years) completed telephone interviews about their symptoms and treatments and pain management strategies used in the past year. Participants rated the helpfulness of each treatment and strategy used on 0 to 10 scales. Even though men with identified bacterial etiology were excluded from the study, antibiotic medication was the most commonly reported treatment (67% of patients) and rated as the second most helpful treatment [mean (SD)=6.3 (3.6)]. Opiates were rated as the most helpful treatment on average [mean (SD)=7.9 (2.1)], but were used by only 12% of patients. Substantial minorities of patients reported several behaviors as helpful, including urinating (reported as helpful by 26%), taking warm baths (23%), and drinking water (23%), although patterns of effects differed for men with versus without urinary symptoms. Activities most commonly reported as worsening symptoms were sitting (42%), walking/jogging (27%), and sexual activity (25%). Patients with male pelvic pain syndrome are commonly prescribed antibiotics, which they perceive as moderately helpful, despite the lack of scientific evidence of efficacy. Clinicians may find it useful to support patient use of safe, inexpensive, self-management approaches, especially warm baths, increased water intake, and avoidance of prolonged sitting.

Quantification of lower extremity physical exposures in various combinations of sit/stand time duration associated with sit-stand workstation.

PubMed

Pei, Huining; Yu, Suihuai; Babski-Reeves, Kari; Chu, Jianjie; Qu, Min; Tian, Baozhen; Li, Wenhua

2017-05-16

Sit-stand workstations are available for office work purposes but there is a dearth of quantitative evidence to state benefits for lower limb outcomes while using them. And there are no guidelines on what constitutes appropriate sit/stand time duration. The primary aim of this study has been to compare muscle activity and perceived discomfort in the lower extremity during various combinations of sit/stand time duration associated with a sit-stand workstation separately and to evaluate the effects of the sit-stand workstation on the lower extremity during the text entry task. During the 5 days, all participants completed a 2-h text entry task each day for various sit/stand time duration combinations as follows: 5/25 min, 10/20 min, 15/15 min, 20/10 min, 25/5 min. Lower extremity muscular exposure of 12 male and 13 female participants was collected at 8 sites by surface electromyography and body discomfort was calculated by a questionnaire under those 5 conditions. Results have demonstrated that lower extremity muscle activity has been significantly varied among the 5 sit/stand time duration groups. Perceived level of discomfort (PLD) has not differed significantly for 9 out of 10 body parts. The muscle activity of the thigh region was influenced by sit/stand time duration significantly. Ergonomic exposures of lower extremity when using a sit-stand workstation were increased, particularly during the long time standing posture. Results indicate that body mass index (BMI) and gender were not significant factors in this study. Combination of sit/stand time duration 25/5 min appears to show positive effects on relief of muscle exposure of back of thigh in the shifts of sitting and standing work position. Med Pr 2017;68(3):315-327. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

"Thinking on your feet": A qualitative evaluation of sit-stand desks in an Australian workplace.

PubMed

Grunseit, Anne Carolyn; Chau, Josephine Yuk-Yin; van der Ploeg, Hidde Pieter; Bauman, Adrian

2013-04-18

Epidemiological research has established sitting as a new risk factor for the development of non-communicable chronic disease. Sit-stand desks have been proposed as one strategy to reduce occupational sedentary time. This formative research study evaluated the acceptability and usability of manually and electrically operated sit-stand desks in a medium-sized government organisation located in Sydney, Australia. Sitting time pre- and three months post -installation of the sit-stand desks was measured using validated self-report measures. Additionally, three group interviews and one key-informant interview were conducted with staff regarding perceptions about ease of, and barriers to, use and satisfaction with the sit-stand desks. All interviews were recorded, transcribed and analysed for themes regarding usability and acceptability. Of 31 staff, 18 completed baseline questionnaires, and 13 completed follow-up questionnaires. The median proportion of sitting time for work was 85% (range 50%-95%) at baseline and 60% (range 10%-95%) at follow-up. Formal statistical testing of paired data (n=11) showed that the change from baseline to follow-up in time spent sitting (mean change=1.7 hours, p=.014) was statistically significant. From the qualitative data, reasons given for initiating use of the desks in the standing position were the potential health benefits, or a willingness to experiment or through external prompting. Factors influencing continued use included: concern for, and experience of, short and long term health impacts; perceived productivity whilst sitting and standing; practical accommodation of transitions between sitting and standing; electric or manual operation height adjustment. Several trajectories in patterns of initiation and continued use were identified that centered on the source and timing of commitment to using the desk in the standing position. Sit-stand desks had high usability and acceptability and reduced sitting time at work. Use could be promoted by emphasizing the health benefits, providing guidance on appropriate set-up and normalizing standing for work-related tasks.

Effect of Sitting Pause Times on Balance After Supine to Standing Transfer in Dim Light.

PubMed

Johnson, Eric G; Albalwi, Abdulaziz A; Al-Dabbak, Fuad M; Daher, Noha S

2017-06-01

The risk of falling for older adults increases in dimly lit environments. Longer sitting pause times, before getting out of bed and standing during the night, may improve postural stability. The purpose of this study was to measure the effect of sitting pause times on postural sway velocity immediately after a supine to standing transfer in a dimly lit room in older adult women. Eighteen healthy women aged 65 to 75 years who were able to independently perform supine to standing transfers participated in the study. On each of 2 consecutive days, participants assumed the supine position on a mat table and closed their eyes for 45 minutes. Then, participants were instructed to open their eyes and transfer from supine to sitting, with either 2- or 30-second pause in the sitting position followed by standing. The sitting pause time order was randomized. A significant difference was observed in postural sway velocity between the 2- and 30-second sitting pause times. The results revealed that there was less postural sway velocity after 30-second than 2-second sitting pause time (0.61 ± 0.19 vs 1.22 ± 0.68, P < .001). Falls related to bathroom usage at night are the most common reported falls among older adults. In the present study, the investigators studied the effect of sitting pause times on postural sway velocity after changing position from supine to standing in a dimly lit environment. The findings showed that the mean postural sway velocity was significantly less after 30-second sitting pause time compared with 2-second sitting pause time. Postural sway velocity decreased when participants performed a sitting pause of 30 seconds before standing in a dimly lit environment. These results suggest that longer sitting pause times may improve adaptability to dimly lit environments, contributing to improved postural stability and reduced risk of fall in older adult women when getting out of bed at night.

Physical Activity, Study Sitting Time, Leisure Sitting Time, and Sleep Time Are Differently Associated With Obesity in Korean Adolescents: A Population-Based Study.

PubMed

Kong, Il Gyu; Lee, Hyo-Jeong; Kim, So Young; Sim, Songyong; Choi, Hyo Geun

2015-11-01

Low physical activity, long leisure sitting time, and short sleep time are risk factors for obesity, but the association with study sitting time is unknown. The objective of this study was to evaluate the association between these factors and obesity.We analyzed the association between physical activity, study sitting time, leisure sitting time, and sleep time and subject weight (underweight, healthy weight, overweight, and obese), using data from a large population-based survey, the 2013 Korea Youth Risk Behavior Web-based Survey. Data from 53,769 participants were analyzed using multinomial logistic regression analyses with complex sampling. Age, sex, region of residence, economic level, smoking, stress level, physical activity, sitting time for study, sitting time for leisure, and sleep time were adjusted as the confounders.Low physical activity (adjusted odds ratios [AORs] = 1.03, 1.12) and long leisure sitting time (AORs = 1.15, 1.32) were positively associated with overweight and obese. Low physical activity (AOR = 1.33) and long leisure sitting time (AOR = 1.12) were also associated with underweight. Study sitting time was negatively associated with underweight (AOR = 0.86) but was unrelated to overweight (AOR = 0.97, 95% confidence interval [CI] = 0.91-1.03) and obese (AOR = 0.94, 95% CI = 0.84-1.04). Sleep time (<6 hours; ≥6 hours, <7 hours; ≥7 hours, <8 hours) was adversely associated with underweight (AORs = 0.67, 0.79, and 0.88) but positively associated with overweight (AORs = 1.19, 1.17, and 1.08) and obese (AORs = 1.33, 1.36, and 1.30) in a dose-response relationship.In adolescents, increasing physical activity, decreasing leisure sitting time, and obtaining sufficient sleep would be beneficial in maintaining a healthy weight. However, study sitting time was not associated with overweight or obese.

“Thinking on your feet”: A qualitative evaluation of sit-stand desks in an Australian workplace

PubMed Central

2013-01-01

Background Epidemiological research has established sitting as a new risk factor for the development of non-communicable chronic disease. Sit-stand desks have been proposed as one strategy to reduce occupational sedentary time. This formative research study evaluated the acceptability and usability of manually and electrically operated sit-stand desks in a medium-sized government organisation located in Sydney, Australia. Methods Sitting time pre- and three months post -installation of the sit-stand desks was measured using validated self-report measures. Additionally, three group interviews and one key-informant interview were conducted with staff regarding perceptions about ease of, and barriers to, use and satisfaction with the sit-stand desks. All interviews were recorded, transcribed and analysed for themes regarding usability and acceptability. Results Of 31 staff, 18 completed baseline questionnaires, and 13 completed follow-up questionnaires. The median proportion of sitting time for work was 85% (range 50%-95%) at baseline and 60% (range 10%-95%) at follow-up. Formal statistical testing of paired data (n=11) showed that the change from baseline to follow-up in time spent sitting (mean change=1.7 hours, p=.014) was statistically significant. From the qualitative data, reasons given for initiating use of the desks in the standing position were the potential health benefits, or a willingness to experiment or through external prompting. Factors influencing continued use included: concern for, and experience of, short and long term health impacts; perceived productivity whilst sitting and standing; practical accommodation of transitions between sitting and standing; electric or manual operation height adjustment. Several trajectories in patterns of initiation and continued use were identified that centered on the source and timing of commitment to using the desk in the standing position. Conclusions Sit-stand desks had high usability and acceptability and reduced sitting time at work. Use could be promoted by emphasizing the health benefits, providing guidance on appropriate set-up and normalizing standing for work-related tasks. PMID:23597291

Efficacy of a Multi-Component Intervention to Reduce Workplace Sitting Time in Office Workers: A Cluster Randomized Controlled Trial.

PubMed

Maylor, Benjamin D; Edwardson, Charlotte L; Zakrzewski-Fruer, Julia K; Champion, Rachael B; Bailey, Daniel P

2018-05-30

The aim of this study was to investigate the efficacy of a work-based multicomponent intervention to reduce office workers' sitting time. Offices (n = 12; 89 workers) were randomized into an 8-week intervention (n = 48) incorporating organizational, individual, and environmental elements or control arm. Sitting time, physical activity, and cardiometabolic health were measured at baseline and after the intervention. Linear mixed modelling revealed no significant change in workplace sitting time, but changes in workplace prolonged sitting time (-39 min/shift), sit-upright transitions (7.8 per shift), and stepping time (12 min/shift) at follow-up were observed, in favor of the intervention group (P < 0.001). Results for cardiometabolic health markers were mixed. This short multicomponent workplace intervention was successful in reducing prolonged sitting and increasing physical activity in the workplace, although total sitting time was not reduced and the impact on cardiometabolic health was minimal.

Desk-based workers' perspectives on using sit-stand workstations: a qualitative analysis of the Stand@Work study.

PubMed

Chau, Josephine Y; Daley, Michelle; Srinivasan, Anu; Dunn, Scott; Bauman, Adrian E; van der Ploeg, Hidde P

2014-07-25

Prolonged sitting time has been identified as a health risk factor. Sit-stand workstations allow desk workers to alternate between sitting and standing throughout the working day, but not much is known about their acceptability and feasibility. Hence, the aim of this study was to qualitatively evaluate the acceptability, feasibility and perceptions of using sit-stand workstations in a group of desk-based office workers. This article describes the qualitative evaluation of the randomized controlled cross-over Stand@Work pilot trial. Participants were adult employees recruited from a non-government health agency in Sydney, Australia. The intervention involved using an Ergotron Workfit S sit-stand workstation for four weeks. After the four week intervention, participants shared their perceptions and experiences of using the sit-stand workstation in focus group interviews with 4-5 participants. Topics covered in the focus groups included patterns of workstation use, barriers and facilitators to standing while working, effects on work performance, physical impacts, and feasibility in the office. Focus group field notes and transcripts were analysed in an iterative process during and after the data collection period to identify the main concepts and themes. During nine 45-min focus groups, a total of 42 participants were interviewed. Participants were largely intrinsically motivated to try the sit-stand workstation, mostly because of curiosity to try something new, interest in potential health benefits, and the relevance to the participant's own and organisation's work. Most participants used the sit-stand workstation and three common usage patterns were identified: task-based routine, time-based routine, and no particular routine. Common barriers to sit-stand workstation use were working in an open plan office, and issues with sit-stand workstation design. Common facilitators of sit-stand workstation use were a supportive work environment conducive to standing, perceived physical health benefits, and perceived work benefits. When prompted, most participants indicated they were interested in using a sit-stand workstation in the future. The use of a sit-stand workstation in this group of desk-based office workers was generally perceived as acceptable and feasible. Future studies are needed to explore this in different desk-based work populations and settings.

Temporal changes in occupational sitting time in the Danish workforce and associations with all-cause mortality: results from the Danish work environment cohort study.

PubMed

van der Ploeg, Hidde P; Møller, Simone Visbjerg; Hannerz, Harald; van der Beek, Allard J; Holtermann, Andreas

2015-06-02

Prolonged sitting has been negatively associated with a range of non-communicably diseases. However, the role of occupational sitting is less clear, and little is known on the changes of occupational sitting in a working population over time. The present study aimed to determine 1) temporal changes in occupational sitting time between 1990 and 2010 in the Danish workforce; 2) the association and possible dose-response relationship between occupational sitting time and all-cause mortality. This study analysed data from the Danish Work Environment Cohort Study (DWECS), which is a cohort study of the Danish working population conducted in five yearly intervals between 1990 and 2010. Occupational sitting time is self-reported in the DWECS. To determine the association with all-cause mortality, the DWECS was linked to the Danish Register of Causes of Death via the Central Person Register. Between 1990 and 2010 the proportion of the Danish workforce who sat for at least three quarters of their work time gradually increased from 33.1 to 39.1%. All-cause mortality analyses were performed with 149,773 person-years of observation and an average follow-up of 12.61 years, during which 533 deaths were registered. None of the presented analyses found a statistically significant association between occupational sitting time and all-cause mortality. The hazard ratio for all-cause mortality was 0.97 (95% CI: 0.79; 1.18) when ≥24 hr/wk occupational sitting time was compared to <24 hr/wk for the 1990-2005 waves. Occupational sitting time increased by 18% in the Danish workforce, which seemed to be limited to people with high socio-economic status. If this increase is accompanied by increases in total sitting time, this development has serious public health implications, given the detrimental associations between total sitting time and mortality. The current study was inconclusive on the specific role that occupational sitting might play in the increased all-cause mortality risk associated with the total volume of sitting.

Breast cancer risk reduction--is it feasible to initiate a randomised controlled trial of a lifestyle intervention programme (ActWell) within a national breast screening programme?

PubMed

Anderson, Annie S; Macleod, Maureen; Mutrie, Nanette; Sugden, Jacqueline; Dobson, Hilary; Treweek, Shaun; O'Carroll, Ronan E; Thompson, Alistair; Kirk, Alison; Brennan, Graham; Wyke, Sally

2014-12-17

Breast cancer is the most commonly diagnosed cancer and the second cause of cancer deaths amongst women in the UK. The incidence of the disease is increasing and is highest in women from least deprived areas. It is estimated that around 42% of the disease in post-menopausal women could be prevented by increased physical activity and reductions in alcohol intake and body fatness. Breast cancer control endeavours focus on national screening programmes but these do not include communications or interventions for risk reduction. This study aimed to assess the feasibility of delivery, indicative effects and acceptability of a lifestyle intervention programme initiated within the NHS Scottish Breast Screening Programme (NHSSBSP). A 1:1 randomised controlled trial (RCT) of the 3 month ActWell programme (focussing on body weight, physical activity and alcohol) versus usual care conducted in two NHSSBSP sites between June 2013 and January 2014. Feasibility assessments included recruitment, retention, and fidelity to protocol. Indicative outcomes were measured at baseline and 3 month follow-up (body weight, waist circumference, eating and alcohol habits and physical activity). At study end, a questionnaire assessed participant satisfaction and qualitative interviews elicited women's, coaches, and radiographers' experiences. Statistical analysis used Chi squared tests for comparisons in proportions and paired t tests for comparisons of means. Linear regression analyses were performed, adjusted for baseline values, with group allocation as a fixed effect. A pre-set recruitment target of 80 women was achieved within 12 weeks and 65 (81%) participants (29 intervention, 36 control) completed 3 month assessments. Mean age was 58 ± 5.6 years, mean BMI was 29.2 ± 7.0 kg/m(2) and many (44%) reported a family history of breast cancer. The primary analysis (baseline body weight adjusted) showed a significant between group difference favouring the intervention group of 2.04 kg (95% CI -3.24 kg to -0.85 kg). Significant, favourable between group differences were also detected for BMI, waist circumference, physical activity and sitting time. Women rated the programme highly and 70% said they would recommend it to others. Recruitment, retention, indicative results and participant acceptability support the development of a definitive RCT to measure long term effects. The trial was registered with Current Controlled Trials (ISRCTN56223933).

Workplace interventions for reducing sitting at work.

PubMed

Shrestha, Nipun; Kukkonen-Harjula, Katriina T; Verbeek, Jos H; Ijaz, Sharea; Hermans, Veerle; Pedisic, Zeljko

2018-06-20

A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality. To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies. We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes. Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -10 minutes per day, 95% CI -45 to 24, two studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up. At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.

Coordination and Data Management of the International Arctic Buoy Programme (IABP)

DTIC Science & Technology

2001-09-30

Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...analyzed geophysical fields. APPROACH Coordination of the IABP falls into the categories of information, resource management, and meeting...the Polar Science Center (PSC) via anonymous ftp. These data and other research products of the IABP are available on the World Wide Web at http

Stand by Me: Qualitative Insights into the Ease of Use of Adjustable Workstations

PubMed Central

Leavy, Justine; Jancey, Jonine

2016-01-01

Background Office workers sit for more than 80% of the work day making them an important target for work site health promotion interventions to break up prolonged sitting time. Adjustable workstations are one strategy used to reduce prolonged sitting time. This study provides both an employees' and employers' perspective into the advantages, disadvantages, practicality and convenience of adjustable workstations and how movement in the office can be further supported by organisations. Methods This qualitative study was part of the Uprising pilot study. Employees were from the intervention arm of a two group (intervention n = 18 and control n = 18) study. Employers were the immediate line-manager of the employee. Data were collected via employee focus groups (n = 17) and employer individual interviews (n = 12). The majority of participants were female (n = 18), had healthy weight, and had a post-graduate qualification. All focus group discussions and interviews were recorded, transcribed verbatim and the data coded according to the content. Qualitative content analysis was conducted. Results Employee data identified four concepts: enhanced general wellbeing; workability and practicality; disadvantages of the retro-fit; and triggers to stand. Most employees (n = 12) reported enhanced general well-being, workability and practicality included less email exchange and positive interaction (n = 5), while the instability of the keyboard a commonly cited disadvantage. Triggers to stand included time and task based prompts. Employer data concepts included: general health and wellbeing; work engagement; flexibility; employee morale; and injury prevention. Over half of the employers (n = 7) emphasised back care and occupational health considerations as important, as well as increased level of staff engagement and strategies to break up prolonged periods of sitting. Discussion The focus groups highlight the perceived general health benefits from this short intervention, including opportunity to sit less and interact in the workplace, creating an ‘energised’ work environment. The retro-fit workstation and keyboard platform provided challenges for some participants. Supervisors emphasised injury prevention and employee morale as two important by products of the adjustable workstation. These were not mentioned by employees. They called for champions to advocate for strategies to break up prolonged sitting. Implications The findings of this novel research from both the employee and employer perspective may support installation of adjustable workstations as one component of a comprehensive approach to improve the long term health of employees. PMID:29546187

Stand by Me: Qualitative Insights into the Ease of Use of Adjustable Workstations.

PubMed

Leavy, Justine; Jancey, Jonine

2016-01-01

Office workers sit for more than 80% of the work day making them an important target for work site health promotion interventions to break up prolonged sitting time. Adjustable workstations are one strategy used to reduce prolonged sitting time. This study provides both an employees' and employers' perspective into the advantages, disadvantages, practicality and convenience of adjustable workstations and how movement in the office can be further supported by organisations. This qualitative study was part of the Uprising pilot study. Employees were from the intervention arm of a two group (intervention n = 18 and control n = 18) study. Employers were the immediate line-manager of the employee. Data were collected via employee focus groups (n = 17) and employer individual interviews (n = 12). The majority of participants were female (n = 18), had healthy weight, and had a post-graduate qualification. All focus group discussions and interviews were recorded, transcribed verbatim and the data coded according to the content. Qualitative content analysis was conducted. Employee data identified four concepts: enhanced general wellbeing; workability and practicality; disadvantages of the retro-fit; and triggers to stand. Most employees (n = 12) reported enhanced general well-being, workability and practicality included less email exchange and positive interaction (n = 5), while the instability of the keyboard a commonly cited disadvantage. Triggers to stand included time and task based prompts. Employer data concepts included: general health and wellbeing; work engagement; flexibility; employee morale; and injury prevention. Over half of the employers (n = 7) emphasised back care and occupational health considerations as important, as well as increased level of staff engagement and strategies to break up prolonged periods of sitting. The focus groups highlight the perceived general health benefits from this short intervention, including opportunity to sit less and interact in the workplace, creating an 'energised' work environment. The retro-fit workstation and keyboard platform provided challenges for some participants. Supervisors emphasised injury prevention and employee morale as two important by products of the adjustable workstation. These were not mentioned by employees. They called for champions to advocate for strategies to break up prolonged sitting. The findings of this novel research from both the employee and employer perspective may support installation of adjustable workstations as one component of a comprehensive approach to improve the long term health of employees.

The effect of sitting and calf activity on leg fluid and snoring.

PubMed

Singh, Bhajan; Yadollahi, Azadeh; Lyons, Owen; Alshaer, Hisham; Bradley, T Douglas

2017-06-01

Prolonged sitting may promote leg fluid retention that redistributes to the neck during sleep and contributes to snoring. This could be attenuated by calf activity while sitting. In 16 healthy non-obese subjects we measured leg fluid volume (LFV) below the knees using bioelectrical impedance while sitting for 4h, snoring using a portable BresoDx™ device, and Mallampati grade. Using a double cross-over study design, subjects were randomized to one of two arms and crossed-over one week later: control arm - no calf exercise while sitting; intervention arm - calf contraction against a pedal resistance while sitting. The effects of sitting±calf activity on LFV and snoring were compared. We found that LFV increased by 216±101.0ml (p<0.0001) after sitting. Calf activity while sitting attenuated LFV by 53.8ml (p<0.0001) and, in all five subjects with severe upper airway narrowing (Mallampati grade IV), reduced snoring duration (from 357±132.9 to 116.2±72.1s/h, p=0.02) suggesting reduced overnight rostral fluid shift to the neck. Copyright © 2017 Elsevier B.V. All rights reserved.

[Development of an evidence-based self-management programme for patients in the first year after renal transplantation with a focus on prevention of weight gain, physical exercise and drug adherence].

PubMed

Schmid-Mohler, Gabriela; Fehr, Thomas; Witschi, Patrick; Albiez, Thomas; Biotti, Beatrice; Spirig, Rebecca

2013-06-01

In the first year after kidney transplantation patients are challenged with incorporating new behaviour patterns into their daily lives. Due to the higher risk of cardiovascular disease amongst kidney transplant recipients, behaviours such as preventing undesired weight gain, exercising, avoiding smoking, and managing medications take on crucial importance. The aim of the project was to develop a programme based on prevailing evidence to promote self-management skills in this patient population. To this end a participatory action research approach was chosen. The programme was developed with inter-professional collaboration under the direction of an advanced practice nurse. As theoretical framework for the development of the intervention models of behaviour change and self-management were chosen. The content is based on current literature and includes the viewpoints of both patients and nursing experts. The programme consists of three elements: 1) Educational brochures developed through inter-professional collaboration and evaluated in a pilot survey. These brochures provide a framework for appointments with nursing professionals. 2) The appointments are a forum in which the patient can gain access to relevant information and can be supported in putting sustainable health-related behaviours into practice in daily life. 3) A peer programme that uses treatment plans to encourage patients deviating from preferred health-related behaviours to make changes in their behaviour. The programme evaluation started in May of 2012. Results of the pilot study are expected in 2014.

What Are the Risks of Sitting Too Much?

MedlinePlus

... that 60 to 75 minutes of moderately intense physical activity a day countered the effects of too much sitting. Another study found that sitting time contributed little to mortality for people who were most ... of sitting and physical activity on health. However, it seems clear that ...

Improving educational objectives of the Industrial and Management Systems Engineering programme at Kuwait University

NASA Astrophysics Data System (ADS)

Aldowaisan, Tariq; Allahverdi, Ali

2016-05-01

This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and update of the PEOs. For each PEO an assessment process is employed where performance measures are defined along with target attainment levels. Results from assessment tools are compared with the target attainment levels to measure performance with regard to the PEOs. The assessment indicates that the results meet or exceed the target attainment levels of the PEOs' performance measures.

Increasing passive energy expenditure during clerical work.

PubMed

Beers, Erik A; Roemmich, James N; Epstein, Leonard H; Horvath, Peter J

2008-06-01

Sitting on a therapy ball or standing may be a passive means of increasing energy expenditure throughout the workday. The purpose of this study was to determine the energy expenditure and liking of performing clerical work in various postures. Subjects included 24 men and women employed in sedentary clerical occupations. Energy expenditure was measured while word processing in three standardized postures; sitting in an office chair, sitting on a therapy ball, and standing. Adults ranked their comfort, fatigue, and liking of each posture and were asked to perform their choice of 20 min of additional clerical work in one of the postures. Energy expenditure was 4.1 kcal/h greater (p or= 0.48). Subjects also liked sitting on a therapy ball as much as sitting in an office chair and liked sitting on a therapy ball more than standing (p

Views of commissioners, managers and healthcare professionals on the NHS Health Check programme: a systematic review.

PubMed

Mills, Katie; Harte, Emma; Martin, Adam; MacLure, Calum; Griffin, Simon J; Mant, Jonathan; Meads, Catherine; Saunders, Catherine L; Walter, Fiona M; Usher-Smith, Juliet A

2017-11-15

To synthesise data concerning the views of commissioners, managers and healthcare professionals towards the National Health Service (NHS) Health Check programme in general and the challenges faced when implementing it in practice. A systematic review of surveys and interview studies with a descriptive analysis of quantitative data and thematic synthesis of qualitative data. An electronic literature search of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the International Standard Randomised Controlled Trial Number registry from 1 January 1996 to 9 November 2016 with no language restriction and manual screening of reference lists of all included papers. Primary research reporting views of commissioners, managers or healthcare professionals on the NHS Health Check programme and its implementation in practice. Of 18 524 citations, 15 articles met the inclusion criteria. There was evidence from both quantitative and qualitative studies that some commissioners and general practice (GP) healthcare professionals were enthusiastic about the programme, whereas others raised concerns around inequality of uptake, the evidence base and cost-effectiveness. In contrast, those working in pharmacies were all positive about programme benefits, citing opportunities for their business and staff. The main challenges to implementation were: difficulties with information technology and computer software, resistance to the programme from some GPs, the impact on workload and staffing, funding and training needs. Inadequate privacy was also a challenge in pharmacy and community settings, along with difficulty recruiting people eligible for Health Checks and poor public access to some venues. The success of the NHS Health Check Programme relies on engagement by those responsible for its commissioning, management and delivery. Recognising and addressing the challenges identified in this review, in particular the concerns of GPs, are important for the future of the programme. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A regional programme to improve skin cancer management.

PubMed

McGeoch, Graham R; Sycamore, Mark J; Shand, Brett I; Simcock, Jeremy W

2015-12-01

In 2008, public specialist and general practice services in Canterbury were unable to manage demand for skin cancer treatment. Local clinicians decided the solution was to develop a see-and-treat skin excision clinic staffed by plastic surgeons and general practitioners (GPs), and the introduction of subsidised excisions in general practice. This paper describes the collaboration between clinicians, managers and funders and the results and quality management measures of these initiatives. There is an increasing incidence of skin cancer. GPs in Canterbury were unable to meet increasing demand for skin cancer treatment because some lacked confidence and competence in skin cancer management. There was no public funding for primary care management of skin cancer, driving patients to fully funded secondary care services. Secondary care services were at capacity, with no coordinated programme across primary and secondary care. The programme has resulted in a greater number of skin cancers being treated by the public health system, a reduction in waiting times for treatment, and fewer minor skin lesions being referred to secondary care. Quality measures have been achieved and are improving steadily. Development of the programme has improved working relationships between primary and secondary care clinicians. The strategy was to facilitate the working relationship between primary and secondary care and increase the capacity for skin lesion excisions in both sectors. Skin cancer management can be improved by a coordinated approach between primary and secondary care.

Assessing the Food Safety Attitudes and Awareness of Managers of School Feeding Programmes in Mpumalanga, South Africa.

PubMed

Sibanyoni, J J; Tabit, F T

2017-08-01

The managers of school feeding programmes are responsible for ensuring the safety of the food which is provided to schoolchildren, but very few studies have been conducted on the food safety knowledge and awareness of these managers. The objective of this study is to evaluate the food safety attitudes and awareness of managers of the National School Nutrition Programme (NSNP) in schools in Mpumalanga, a province of South Africa. A cross-sectional survey study was conducted in which questionnaires were used to collect data from 300 NSNP food service managers. The majority of schools offering NSNP meals were located in informal settlements and most were found to lack basic resources such as electricity (power supplies to the food preparation facility) and potable tap water in their kitchens. No school was found to have implemented the hazard analysis and critical control points (HACCP) programme, and only a few staff had received food safety training. Food safety implementation is worst in informal schools in rural areas due to limited resources and infrastructure. The NSNP food service managers in some schools-especially those located in rural settlements-were found to have little knowledge and awareness of HACCP. These results indicate an urgent need to provide NSNP managers with food safety training and resources (potable water supplies, electricity, dedicated food preparation facilities), particularly in schools in rural settlements.

Using the Newly Developed Floor-Sitting Movement Analysis Proforma to Study the Effect of Age and Activity on Floor-Sitting in Indian Adults.

PubMed

Nagrajan, Anjana; D'Souza, Sebestina A

2017-03-01

Floor-sitting is culturally relevant to the Indian context. The present study aimed to examine the effect of age and activity on the movement patterns used and time taken to perform floor-sitting in Indian adults. Video-recordings of 30 young (23.30 ± 2.53 years) and 30 older (69.67 ± 6.45 years) adults performing floor-sitting without and with an activity (simulated feeding) were analyzed using the Floor-sitting Movement Analysis Proforma (FMAP) developed for the study. For inter-rater reliability of the FMAP, two raters analyzed the performance of a random sample of 20 participants. An almost perfect inter-rater agreeability (κ ≥ .8) was obtained for the FMAP. Cross-legged sitting was the most preferred (95%) floor-sitting position. Older adults used more number of movement components, asymmetrical patterns, more support, and more time (p < .001) as compared to the young adults. The activity facilitated the use of optimal movement strategies in young and older adults. The activity significantly increased time taken to rise from floor-sitting (p = .004). The study establishes the influence of age and activity on performance of floor-sitting. Older adults use lower developmental movement patterns that may be a "normal" adaptation to age-related sensorimotor changes. Retraining of floor-sitting is a "culturally" desired goal among Indian adults and should involve the practice of age-appropriate movement patterns in the context of meaningful activities.

The Evolution of Silicon Transport in Eukaryotes

PubMed Central

Marron, Alan O.; Ratcliffe, Sarah; Wheeler, Glen L.; Goldstein, Raymond E.; King, Nicole; Not, Fabrice; de Vargas, Colomban; Richter, Daniel J.

2016-01-01

Biosilicification (the formation of biological structures from silica) occurs in diverse eukaryotic lineages, plays a major role in global biogeochemical cycles, and has significant biotechnological applications. Silicon (Si) uptake is crucial for biosilicification, yet the evolutionary history of the transporters involved remains poorly known. Recent evidence suggests that the SIT family of Si transporters, initially identified in diatoms, may be widely distributed, with an extended family of related transporters (SIT-Ls) present in some nonsilicified organisms. Here, we identify SITs and SIT-Ls in a range of eukaryotes, including major silicified lineages (radiolarians and chrysophytes) and also bacterial SIT-Ls. Our evidence suggests that the symmetrical 10-transmembrane-domain SIT structure has independently evolved multiple times via duplication and fusion of 5-transmembrane-domain SIT-Ls. We also identify a second gene family, similar to the active Si transporter Lsi2, that is broadly distributed amongst siliceous and nonsiliceous eukaryotes. Our analyses resolve a distinct group of Lsi2-like genes, including plant and diatom Si-responsive genes, and sequences unique to siliceous sponges and choanoflagellates. The SIT/SIT-L and Lsi2 transporter families likely contribute to biosilicification in diverse lineages, indicating an ancient role for Si transport in eukaryotes. We propose that these Si transporters may have arisen initially to prevent Si toxicity in the high Si Precambrian oceans, with subsequent biologically induced reductions in Si concentrations of Phanerozoic seas leading to widespread losses of SIT, SIT-L, and Lsi2-like genes in diverse lineages. Thus, the origin and diversification of two independent Si transporter families both drove and were driven by ancient ocean Si levels. PMID:27729397

A new evidence-based model for weight management in primary care: the Counterweight Programme.

PubMed

Laws, Rachel

2004-06-01

Obesity has become a global epidemic, and a major preventable cause of morbidity and mortality. Management strategies and treatment protocols are however poorly developed and evaluated. The aim of the Counterweight Programme is to develop an evidence-based model for the management of obesity in primary care. The Counterweight Programme is based on the theoretical model of Evidence-Based Quality Assessment aimed at improving the management of obese adults (18-75 years) in primary care. The model consists of four phases: (1) practice audit and needs assessment, (2) practice support and training, (3) practice nurse-led patient intervention, and (4) evaluation. Patient intervention consisted of screening and treatment pathways incorporating evidence-based approaches, including patient-centred goal setting, prescribed eating plans, a group programme, physical activity and behavioural approaches, anti-obesity medication and weight maintenance strategies. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Eighty practices were recruited of which 18 practices were randomized to act as controls and receive deferred intervention 2 years after the initial audit. By February 2004, 58 of the 62 (93.5%) intervention practices had been trained to run the intervention programme, 47 (75.8%) practices were active in implementing the model and 1256 patients had been recruited (74% female, 26% male, mean age 50.6 years, SD 14). At baseline, 75% of patients had at one or more co-morbidity, and the mean body mass index (BMI) was 36.9 kg/m(2) (SD 5.4). Of the 1256 patients recruited, 91% received one of the core lifestyle interventions in the first 12 months. For all patients followed up at 12 months, 34% achieved a clinical meaningful weight loss of 5% or more. A total of 51% of patients were classed as compliant in that they attended the required level of appointments in 3, 6, and 12 months. For fully compliant patients, weight loss improved with 43% achieving a weight loss of 5% or more at 12 months. The Counterweight Programme is an evidence-based weight management model which is feasible to implement in primary care.

A taxonomy and results from a comprehensive review of 28 maternal health voucher programmes.

PubMed

Bellows, Ben W; Conlon, Claudia M; Higgs, Elizabeth S; Townsend, John W; Nahed, Matta G; Cavanaugh, Karen; Grainger, Corinne G; Okal, Jerry; Gorter, Anna C

2013-12-01

It is increasingly clear that Millennium Development Goal 4 and 5 will not be achieved in many low- and middle-income countries with the weakest gains among the poor. Recognizing that there are large inequalities in reproductive health outcomes, the post-2015 agenda on universal health coverage will likely generate strategies that target resources where maternal and newborn deaths are the highest. In 2012, the United States Agency for International Development convened an Evidence Summit to review the knowledge and gaps on the utilization of financial incentives to enhance the quality and uptake of maternal healthcare. The goal was to provide donors and governments of the low- and middle-income countries with evidence-informed recommendations on practice, policy, and strategies regarding the use of financial incentives, including vouchers, to enhance the demand and supply of maternal health services. The findings in this paper are intended to guide governments interested in maternal health voucher programmes with recommendations for sustainable implementation and impact. The Evidence Summit undertook a systematic review of five financing strategies. This paper presents the methods and findings for vouchers, building on a taxonomy to catalogue knowledge about voucher programme design and functionality. More than 120 characteristics under five major categories were identified: programme principles (objectives and financing); governance and management; benefits package and beneficiary targeting; providers (contracting and service pricing); and implementation arrangements (marketing, claims processing, and monitoring and evaluation). Among the 28 identified maternal health voucher programmes, common characteristics included: a stated objective to increase the use of services among the means-tested poor; contracted-out programme management; contracting either exclusively private facilities or a mix of public and private providers; prioritizing community-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.

A Taxonomy and Results from a Comprehensive Review of 28 Maternal Health Voucher Programmes

PubMed Central

Conlon, Claudia M.; Higgs, Elizabeth S.; Townsend, John W.; Nahed, Matta G.; Cavanaugh, Karen; Grainger, Corinne G.; Okal, Jerry; Gorter, Anna C.

2013-01-01

It is increasingly clear that Millennium Development Goal 4 and 5 will not be achieved in many low- and middle-income countries with the weakest gains among the poor. Recognizing that there are large inequalities in reproductive health outcomes, the post-2015 agenda on universal health coverage will likely generate strategies that target resources where maternal and newborn deaths are the highest. In 2012, the United States Agency for International Development convened an Evidence Summit to review the knowledge and gaps on the utilization of financial incentives to enhance the quality and uptake of maternal healthcare. The goal was to provide donors and governments of the low- and middle-income countries with evidence-informed recommendations on practice, policy, and strategies regarding the use of financial incentives, including vouchers, to enhance the demand and supply of maternal health services. The findings in this paper are intended to guide governments interested in maternal health voucher programmes with recommendations for sustainable implementation and impact. The Evidence Summit undertook a systematic review of five financing strategies. This paper presents the methods and findings for vouchers, building on a taxonomy to catalogue knowledge about voucher programme design and functionality. More than 120 characteristics under five major categories were identified: programme principles (objectives and financing); governance and management; benefits package and beneficiary targeting; providers (contracting and service pricing); and implementation arrangements (marketing, claims processing, and monitoring and evaluation). Among the 28 identified maternal health voucher programmes, common characteristics included: a stated objective to increase the use of services among the means-tested poor; contracted-out programme management; contracting either exclusively private facilities or a mix of public and private providers; prioritizing community-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.

Integrated disease management: a critical review of foreign and Portuguese experience.

PubMed

Coelho, Anabela; Leone, Cláudia; Ribeiro, Vanessa; Sá Moreira, Pedro; Dussault, Gilles

2014-01-01

The present article reviews findings from empirical evaluations of integrated disease management programmes. The objective is to provide insights on integration levels, priority interventions and their effect on patient outcomes. The literature review identified 1 251 articles, published from 2006 to 2011. Upon a detailed screening 61 articles were selected for bibliometric analysis and critical discussion. Among several findings, it can be noted that United States of America is the country with the highest amount of published evidence on the subject under study. The most frequently referred disease is diabetes mellitus and the main reported issue of integrated disease management is self-management support. The majority of the studies were developed and exclusively managed by managed care organizations, organized family doctors or hospitals. From a total of 360 interventions reported in studies, patient interventions are the most frequently used across all disease groups, followed by professional interventions. To monitor the effectiveness of the disease programmes, the most frequently used outcomes are patient physiological measures, service use and patient health status. Every country has its own way to implement the integrated disease management strategy. The focus of practice lies on patient empowerment, particularly through self-management. Physiological measures and service use are the outcomes with the highest rate of assessment, which are also the indicators that show higher impact among all integrated disease management programmes. The Portuguese health care system still faces challenges in the coordination and integration of care for patients with chronic disease thus improvements at integrated disease management programmes should be incorporate.

Increasing leadership capacity for HIV/AIDS programmes by strengthening public health epidemiology and management training in Zimbabwe

PubMed Central

Jones, Donna S; Tshimanga, Mufuta; Woelk, Godfrey; Nsubuga, Peter; Sunderland, Nadine L; Hader, Shannon L; St Louis, Michael E

2009-01-01

Background Increased funding for global human immunodeficiency virus prevention and control in developing countries has created both a challenge and an opportunity for achieving long-term global health goals. This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. Methods The programme used new HIV/AIDS programme-specific funds to build on the assets of a local education institution to strengthen and expand the general public health leadership capacity in Zimbabwe, simultaneously ensuring that they were trained in HIV interventions. Results The programme increased both numbers of graduates and retention of faculty. The expanded HIV/AIDS curriculum was associated with a substantial increase in trainee projects related to HIV. The increased number of public health professionals has led to a number of practically trained persons working in public health leadership positions in the ministry, including in HIV/AIDS programmes. Conclusion Investment of a modest proportion of new HIV/AIDS resources in targeted public health leadership training programmes can assist in building capacity to lead and manage national HIV and other public health programmes. PMID:19664268

Chinese Postgraduate Choices When Considering a UK Business and Management Programme

ERIC Educational Resources Information Center

Manns, Yihan; Swift, Jonathan

2016-01-01

This research investigated Chinese students' decision making processes for enrolling on a postgraduate taught business and management programme in a UK university, based on structured interviews, followed by a survey of just over 450 respondents. The validity and reliability of the research instrument were assessed prior to issuing the survey.…

An Innovative Supply Chain Management Programme Structure: Broadening the SCM Skill Set

ERIC Educational Resources Information Center

Okongwu, Uche

2007-01-01

This paper proposes a matrix structure for training Supply Chain Management (SCM) professionals. It is an innovative programme structure that combines two approaches: cross-border and inter-organisational. It enables the students to comprehend complex and specific business environments and to understand the diverse nature of SCM systems in both…

Efficacy of Using Career and Self-Construction to Help Learners Manage Career-Related Transitions

ERIC Educational Resources Information Center

Cook, A.; Maree, J. G.

2016-01-01

This article explores the extent to which an intervention programme helped learners from two contrasting educational settings manage career-related transitions. Forty-two learners from two schools were selected, using convenience and purposive sampling, to take part in an intervention programme. Two comparison groups comprised of 45 learners from…

The Winds of Change: Higher Education Management Programmes in Europe

ERIC Educational Resources Information Center

Pausits, Attila; Pellert, Ada

2009-01-01

Amid the Bologna Process and as a direct effect of it, European higher education institutions have to rethink their core institutional policies in order to effectively deal with the increasing demands and needs of their "customers" and society at large. The higher education management programmes across Europe, with some specific needs…

Determinants of Rural-Urban Variability in the Implementation of Educational Decentralisation Programmes in Developing Countries: The Nigeria Experience

ERIC Educational Resources Information Center

Ikoya, Peter O.; Ikoya, Oluremi V.

2005-01-01

Purpose: The purpose of this research is to identify some determinants of rural-urban disparity in the implementation of decentralised educational management programmes in Nigeria. Design/methodology/approach: The study examines how political leadership's disposition to decentralised educational management, allocation of funds and physical…

The influence of health system organizational structure and culture on integration of health services: the example of HIV service monitoring in South Africa.

PubMed

Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

2016-11-01

Administrative integration of disease control programmes (DCPs) within the district health system has been a health sector reform priority in South Africa for two decades. The reforms entail district managers assuming authority for the planning and monitoring of DCPs in districts, with DCP managers providing specialist support. There has been little progress in achieving this, and a dearth of research exploring why. Using a case study of HIV programme monitoring and evaluation (M&E), this article explores whether South Africa's health system is configured to support administrative integration. The article draws on data from document reviews and interviews with 54 programme and district managers in two of nine provinces, exploring their respective roles in decision-making regarding HIV M&E system design and in using HIV data for monitoring uptake of HIV interventions in districts. Using Mintzberg's configurations framework, we describe three organizational parameters: (a) extent of centralization (whether district managers play a role in decisions regarding the design of the HIV M&E system); (b) key part of the organization (extent to which sub-national programme managers vs district managers play the central role in HIV monitoring in districts); and (c) coordination mechanisms used (whether highly formalized and rules-based or more output-based to promote agency). We find that the health system can be characterized as Mintzberg's machine bureaucracy. It is centralized and highly formalized with structures, management styles and practices that promote programme managers as lead role players in the monitoring of HIV interventions within districts. This undermines policy objectives of district managers assuming this leadership role. Our study enhances the understanding of organizational factors that may limit the success of administrative integration reforms and suggests interventions that may mitigate this. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Assessment of a Targeted Trap-Neuter-Return Pilot Study in Auckland, New Zealand.

PubMed

Zito, Sarah; Aguilar, Glenn; Vigeant, Shalsee; Dale, Arnja

2018-05-13

There is a need for effective and humane management tools to manage urban stray cats and minimise negative impacts associated with stray cats. One such tool is targeted trap-neuter-return (TTNR), but no concerted implementation of this technique or formal assessments have been reported. To address this deficit, a TTNR programme was implemented and assessed in one Auckland suburb from May 2015 to June 2016; the programme sterilised and returned 348 cats (4.2 cats/1000 residents). Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray felines, underage euthanasias, and unsocialised stray cat euthanasias were all reduced for the targeted suburb when compared for the years before and after the programme (the percentage reduction in these parameters was −39, −17, −34, −7, and −47, respectively). These outcome measures had a greater reduction in the targeted suburb compared to the Auckland suburbs not targeted by the TTNR programme ( p < 0.01), although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable, humane cat management tool in urban New Zealand, and further assessment is warranted.

Critical pedagogy in a health service management development programme: can "critically thinking" managers change the NHS management culture?

PubMed

Sambrook, Sally

2009-01-01

Management development programmes available to NHS managers focus on a performance orientation and sustain a culture of managerial and medical domination. This paper aims to question whether it is possible to consider NHS management development from a critical (empowerment culture) perspective. Features of the critical management studies approach (CMS) are identified. A new MSc is evaluated against these characteristics, examining the teaching and learning processes and students' perceptions of the programme. The aim is to develop critical thinkers who can return to their organizations and challenge existing power structures and practices to change local cultures and enhance health services. Empirical research employed anonymous student questionnaires and a focus group. Student evaluations suggest the MSc can deliver a critical pedagogy and help managers understand issues of power and empowerment, challenge dominant cultures, innovate and effect small, local changes in the NHS culture. There is a need to continue evaluating the programme and include other stakeholders. Longitudinal research should assess the impact of the managers' changed values, attitudes and behaviours on colleagues, clients and the local cultures. The paper identifies some of the tensions of developing "critical" health service managers, and the problems they encounter back in the "uncritical" NHS context, as well as some of the challenges in "facilitating" a critical curriculum. It questions the ethics of developing (or not) a critical perspective in a local context unfamiliar with CMS. Management development in the NHS largely ignores critical pedagogy. This paper makes a small and unique contribution to understanding how developing "critically thinking" managers can challenge the dominant culture. However, the limitations of such a small-scale study and ethical implications are noted.

Building leadership capacity and future leaders in operational research in low-income countries: why and how?

PubMed

Zachariah, R; Reid, T; Srinath, S; Chakaya, J; Legins, K; Karunakara, U; Harries, A D

2011-11-01

Very limited operational research (OR) emerges from programme settings in low-income countries where the greatest burden of disease lies. The price paid for this void includes a lack of understanding of how health systems are actually functioning, not knowing what works and what does not, and an inability to propose adapted and innovative solutions to programme problems. We use the National Tuberculosis Control Programme as an example to advocate for strong programme-level leadership to steer OR and build viable relationships between programme managers, researchers and policy makers. We highlight the need to create a stimulating environment for conducting OR and identify some of the main practical challenges and enabling factors at programme level. We focus on the important role of an OR focal point within programmes and practical approaches to training that can deliver timely and quantifiable outputs. Finally, we emphasise the need to measure successful OR leadership development at programme level and we propose parameters by which this can be assessed. This paper 1) provides reasons why programmes should take the lead in coordinating and directing OR, 2) identifies the practical challenges and enabling factors for implementing, managing and sustaining OR and 3) proposes parameters for measuring successful leadership capacity development in OR.

[The National Programme for Disease Management Guidelines. Goals, contents, patient involvement].

PubMed

Ollenschläger, G; Kopp, I; Lelgemann, M; Sänger, S; Klakow-Franck, R; Gibis, B; Gramsch, E; Jonitz, G

2007-03-01

The Programme for National Disease Management Guidelines (German DM-CPG Programme) aims at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. The programme, focussing on high priority healthcare topics, has been sponsored since 2003 by the German Medical Association (BAEK), the Association of the Scientific Medical Societies (AWMF), and by the National Association of Statutory Health Insurance Physicians (KBV). It is organised by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the programme is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health care provision and facilitating the coordination of care for the individual patient through time and across disciplines. Within this framework experts from national patient self-help groups have been developing patient guidance based upon the recommendations for healthcare providers. The article describes goals, topics and selected contents of the DM-CPG programme - using asthma as an example.

Asthma disease management: a provider's perspective.

PubMed

Abisheganaden, J

2002-07-01

Asthma is a highly prevalent problem in Singapore, with an increasing societal and economic burden. However, asthma is also an eminently treatable condition, with evidence that integrated education-treatment efforts directed at important patient sub-groups can be cost-effective. What is important is a comprehensive and integrated asthma management programme, aimed at reducing the burden of asthma at all levels of the healthcare system, with the long-term goal of improving asthma care cost-effectively. This refers to asthma disease management. Asthma disease management should focus on identifying deficiencies in asthma management across the population diagnosed with the condition and establish a partnership between the patient, provider and the healthcare system to improve the overall quality of asthma care. The framework for implementing such a programme bridges key concepts and programmes that are already in place in the various institutions. These include patient and physician education, the use of clinical practice guidelines, clinical pathways, outcomes management, quality improvement processes, information technology, case management and existing asthma shared-care programmes and resources. In order to significantly reduce asthma morbidity, an integrated approach is required, involving individuals providing asthma care at various levels of care delivery. There is also a need to co-ordinate the efforts of such individuals and institutions involved so that there is good horizontal and vertical integration of care. The disease management approach described is intended to raise the overall standard of asthma care across a spectrum of patients with asthma.

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi.

PubMed

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; In 't Veen, Johannes C C M

2017-02-09

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories 'the A-I of difficult-to-manage asthma' to resonate with an established Dutch 'A-E acronym for determining asthma control'. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme.

Why do managers allocate resources to workplace health promotion programmes in countries with national health coverage?

PubMed

Downey, Angela M; Sharp, David J

2007-06-01

There is extensive evidence that worksite health promotion (WHP) programmes reduce healthcare costs and improve employee productivity. In many countries, a large proportion of healthcare costs are borne by the state. While the full benefits of WHP are still created, they are shared between employers and the state, even though the employer bears the full (after-tax) cost. Employers therefore have a lower incentive to implement WHP activity. We know little about the beliefs of managers with decision responsibility for the approval and implementation of WHP programmes in this context. This article reports the results of a study of the attitudes of Canadian senior general managers (GMs) and human resource managers (HRMs) in the auto parts industry in Ontario, Canada towards the consequences of increasing discretionary spending on WHP, using Structural Equation Modelling and the Theory of Planned Behaviour. We identified factors that explain managers' intentions to increase discretionary spending on wellness programmes. While both senior GMs and HRMs are motivated primarily by their beliefs that WHP reduces indirect costs of health failure, GMs were also motivated by their moral responsibility towards employees (but surprisingly HRMs were not). Importantly, HRMs, who usually have responsibility for WHP, felt constrained by a lack of power to commit resources. Most importantly, we found no social expectation that organizations should provide WHP programmes. This has important implications in an environment where the adoption of WHP is very limited and cost containment within the healthcare system is paramount.

Mortality and management of 96 shark attacks and development of a shark bite severity scoring system.

PubMed

Lentz, Ashley K; Burgess, George H; Perrin, Karen; Brown, Jennifer A; Mozingo, David W; Lottenberg, Lawrence

2010-01-01

Humans share a fascination and fear of sharks. We predict that most shark attacks are nonfatal but require skilled, timely medical intervention. The development of a shark bite severity scoring scale will assist communication and understanding of such an injury. We retrospectively reviewed records of the prospectively maintained International Shark Attack File (ISAF) at the University of Florida. The ISAF contains 4409 investigations, including 2979 documented attacks, 96 of which have complete medical records. We developed a Shark-Induced Trauma (SIT) Scale and calculated the level of injury for each attack. Medical records were reviewed for the 96 documented shark attack victims since 1921. Calculated levels of injury in the SIT Scale reveal 40 Level 1 injuries (41.7%), 16 Level 2 injuries (16.7%), 18 Level 3 injuries (18.8%), 14 Level 4 injuries (14.6%), and eight Level 5 injuries (8.3%). The overall mortality of shark attacks was 8.3 per cent. However, SIT Scale Level 1 injuries comprised the greatest percentage of cases at 41.7 per cent. Injury to major vascular structures increases mortality and necessitates immediate medical attention and definitive care by a surgeon. Shark bites deserve recognition with prompt resuscitation, washout, débridement, and follow up for prevention of infection and closure of more complex wounds.

A systematic review of standing and treadmill desks in the workplace.

PubMed

MacEwen, Brittany T; MacDonald, Dany J; Burr, Jamie F

2015-01-01

Standing and treadmill desks are intended to reduce the amount of time spent sitting in today's otherwise sedentary office. Proponents of these desks suggest that health benefits may be acquired as standing desk use discourages long periods of sitting, which has been identified as an independent health risk factor. Our objectives were thus to analyze the evidence for standing and treadmill desk use in relation to physiological (chronic disease prevention and management) and psychological (worker productivity, well-being) outcomes. A computer-assisted systematic search of Medline, PubMed, PsycINFO, SPORTDiscus, CINAHL, CENTRAL, and EMBASE databases was employed to identify all relevant articles related to standing and treadmill desk use. Treadmill desks led to the greatest improvement in physiological outcomes including postprandial glucose, HDL cholesterol, and anthropometrics, while standing desk use was associated with few physiological changes. Standing and treadmill desks both showed mixed results for improving psychological well-being with little impact on work performance. Standing and treadmill desks show some utility for breaking up sitting time and potentially improving select components of health. At present; however, there exist substantial evidence gaps to comprehensively evaluate the utility of each type of desk to enhance health benefits by reducing sedentary time. Copyright © 2014 Elsevier Inc. All rights reserved.

Educational interventions to enhance competencies for interprofessional collaboration among nurse and physician managers: An integrative review.

PubMed

Clausen, Christina; Cummins, Kelly; Dionne, Kelley

2017-11-01

Collaborative leadership and management structures are critical to transforming care delivery. Both nurse and physician managers are uniquely positioned to co-lead. However, little is known on how to prepare and support individuals for these co-leader arrangements. The re-design of healthcare professional education focuses on interprofessional collaboration, mutual learning, and a competency-based approach. While competencies for interprofessional collaboration have been delineated, competencies for collaborative management practice have yet to be addressed. An integrative review of empirical studies on existing educational interventions was conducted to critically appraise and synthesise the results regarding collaborative competence among nurse and physician leaders. We reviewed how these interventions have been designed, implemented, and evaluated within workplace settings in order to inform our understanding of what components are effective or ineffective for the future development of an educational programme. This review reports on key characteristics of nine empirical studies and emphasises that: a uniprofessional approach to leadership development is predominant within educational programmes and that the assessment of shared learning experiences are not addressed; there are inconsistency in terms used to describe competencies by individual researchers and limitations within the competency frameworks used in the studies reviewed; and there is a lack of suitable instruments available to assess whether competencies have been achieved through the educational programmes. None of the studies discussed the process of how individuals learned specific competencies or whether learning outcome were achieved. Educational programmes were developed based on a perceived lack of leadership preparation and orientation programmes for leaders in formal management positions and used multiple interventions. Only two of the programmes involved organisational or systems level competencies. Interprofessional co-leading requires enhanced capabilities and capacity for managers. There is a need for developing an in-action education intervention that addresses the unique learning needs of co-leader arrangements particularly among nurses and physicians who are new to their role.

Longitudinal Relationship Between Sitting Time on a Working Day and Vitality, Work Performance, Presenteeism, and Sickness Absence.

PubMed

Hendriksen, Ingrid J M; Bernaards, Claire M; Steijn, Wouter M P; Hildebrandt, Vincent H

2016-08-01

The aim of this study was to explore the longitudinal relationship between sitting time on a working day and vitality, work performance, presenteeism, and sickness absence. At the start and end of a five-month intervention program at the workplace, as well as 10 months after the intervention, sitting time and work-related outcomes were measured using a standardized self-administered questionnaire and company records. Generalized linear mixed models were used to estimate the longitudinal relationship between sitting time and work-related outcomes, and possible interaction effects over time. A significant and sustainable decrease in sitting time on a working day was observed. Sitting less was significantly related to higher vitality scores, but this effect was marginal (b = -0.0006, P = 0.000). Our finding of significant though marginal associations between sitting time and important work-related outcomes justifies further research.

Usage of Sit-Stand Workstations and Associations Between Work and Nonwork Sitting Time: An Observational Study.

PubMed

Mazzotta, Michael A; Ferrar, Katia; Fraysse, Francois; Lewis, Lucy K; McEvoy, Maureen

2018-05-01

No studies have objectively measured habitual usage of sit-stand workstations. Eighteen full-time office workers participated (47.9 ± 9.2 years, 61% female). Sitting time was objectively measured (activPAL, 24 h/7 days), and time at desk, desk position, and perceptions of desk use were self-reported. Participants sat for 39% of their daily workstation time, and changed workstation position twice daily. The most common reasons for standing included back pain (44%) and tiredness (22%). The majority of participants received no workstation occupational health (72%) or educational (61%) information. Workstation standing time had a significant moderate correlation with total daily standing time (P = 0.02). Office workers with sit-stand workstations rarely change desk position, and there is no relationship between the time spent sitting at the workstation, and total daily sitting time. Education about the workstations was limited.

Effects of deep breathing on internal oblique and multifidus muscle activity in three sitting postures

PubMed Central

Ko, Min-Joo; Jung, Eun-Joo; Kim, Moon-Hwan; Oh, Jae-Seop

2018-01-01

[Purpose] This study was to investigate differences in the level of activity of the external oblique (EO), internal oblique (IO), and multifidus (MF) muscles with deep breathing in three sitting postures. [Subjects and Methods] Sixteen healthy women were recruited. The muscle activity (EO, IO, MF) of all subjects was measured in three sitting postures (slumped, thoracic upright, and lumbo-pelvic upright sitting postures) using surface electromyography. The activity of the same muscles was then remeasured in the three sitting postures during deep breathing. [Results] Deep breathing significantly increased activity in the EO, IO, and MF compared with normal breathing. Comparing postures, the activity of the MF and IO muscles was highest in the lumbo-pelvic upright sitting posture. [Conclusion] An lumbo-pelvic upright sitting posture with deep breathing could increase IO and MF muscle activity, thus improving lumbo-pelvic region stability. PMID:29706695

Coordination and Data Management of the International Arctic Buoy Programme (IABP)

DTIC Science & Technology

1999-09-30

Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...Coordination of the IABP falls into the categories of information, resource management, and meeting planning. Information is primarily distributed via a...These data and other research products of the IABP are available on the World Wide Web at http://iabp.apl.washington.edu/. WORK COMPLETED Our recent

Coordination and Data Management of the International Arctic Buoy Programme (IABP)

DTIC Science & Technology

2000-09-30

Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...Coordination of the IABP falls into the categories of information, resource management, and meeting planning. Information is primarily distributed via a monthly...data and other research products of the IABP are available on the World Wide Web at http://iabp.apl.washington.edu/. Report Documentation Page Form

Practical assessment of the SWMM programme

NASA Astrophysics Data System (ADS)

Hlustik, P.

2017-10-01

The article describes the advantages and disadvantages of the SWMM programme user environment when working with it. The Storm Water Management Model (SWMM) is a programme developed by the U.S. EPA (United States Environmental Protection Agency). The SWMM programme is used worldwide to plan, analyse and design rainfall-runoff, combined and separate sanitary sewage systems and other drainage systems in urban areas [1]. The programme is freely available to download from the U.S. EPA website [2].

Practical Nursing Curriculum Guide. Including the Expanded Functions of I.V. Therapy and LPN Management. Invest in Success.

ERIC Educational Resources Information Center

Idaho State Dept. of Education, Boise. Div. of Vocational Education.

Under the Idaho state system for curriculum development in vocational education, Technical Committees made up solely of industry personnel are responsible for drawing up task lists for each program. The first part of this guide contains a curriculum for instruction of practical nurses who are eligible to sit for the license examination upon…

KSC00pp0142

NASA Image and Video Library

2000-02-01

KENNEDY SPACE CENTER, Fla. -- Space Shuttle Endeavour sits on Launch Pad 39A waiting for the Rotating Service Structure to be rolled back into its protective position. The launch of Space Shuttle Endeavour on mission STS-99 was delayed when NASA managers decided to replace the Enhanced Master Events Controller that became suspect during the Jan. 31 launch countdown. The next scheduled launch is NET Feb. 9

KSC-00pp0142

NASA Image and Video Library

2000-02-01

KENNEDY SPACE CENTER, Fla. -- Space Shuttle Endeavour sits on Launch Pad 39A waiting for the Rotating Service Structure to be rolled back into its protective position. The launch of Space Shuttle Endeavour on mission STS-99 was delayed when NASA managers decided to replace the Enhanced Master Events Controller that became suspect during the Jan. 31 launch countdown. The next scheduled launch is NET Feb. 9

Empowering Managers, Assuring Governors: The Introduction of Dual Assurance at the University of Exeter

ERIC Educational Resources Information Center

Weale, Gillian

2010-01-01

Since the start of the academic session 2007-08, the University of Exeter has been operating a unique system of governance known as dual assurance, which has replaced a more traditional system of committees sitting under Council, the governing body. This paper describes the background to the development of dual assurance at Exeter, and the reasons…

Student-Centred Learning: A Dream or Reality

ERIC Educational Resources Information Center

Ozola, Sandra

2012-01-01

Learning is an intangible production of a tangible product and like all production processes, it requires someone who knows how to manage the process in order to achieve the desired result. It really has been long enough--12 years in the new century and still one can see the 25-30 students in traditional classrooms with students sitting in rows at…

A century-old leadership style revitalizes the heroic hospital.

PubMed

Kania, A J

1993-01-01

"Those who fail history are destined to repeat it." Emmett C. Murphy, Ph.D., an international business consultant found that the key to individual and organizational leadership is a heroic commitment to service and the reengineering of the work that it requires. Murphy, whose clients include IBM, General Motors, Johns Hopkins, Centers for Disease Control, Johnson & Johnson, and Memorial Sloan Kettering; was a consultant with Booz-Allen Hamilton and served on the faculties of the Massachusetts Institute of Technology and the State University of New York before founding E. C. Murphy, Ltd. His firm focuses on the application of quality improvement and work reengineering strategies for creating a patient-focused "heroic" organization. Recently, Dr. Murphy and Michael Snell co-authored an intriguing management book based on the fundamental business strategies historically found in an unlikely western figure. The The Genius of Sitting Bull (Prentice Hall, 1993), Murphy and Snell examine the leadership styles of the Sioux chief and General Custer at the peaks of their careers and used 13 heroic strategies common to Sitting Bull's management style as a metaphor for for successful leadership on the great plains of American health care and business life.

Sagittal lumbar and pelvic alignment in the standing and sitting positions.

PubMed

Endo, Kenji; Suzuki, Hidekazu; Nishimura, Hirosuke; Tanaka, Hidetoshi; Shishido, Takaaki; Yamamoto, Kengo

2012-11-01

The sitting position has become the most common posture in today's workplace. In relation to this position, kinematic analysis of the lumbar spine is helpful in understanding the causes of low back pain and its prevention. In this study, we investigated the relationship between sagittal lumbar alignment and pelvic alignment in the standing and sitting positions for 50 healthy adults. Lumbar lordotic angle (LLA), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) were measured on lateral lumbar spine standing and sitting radiographs. Regarding changes from the standing to sitting positions, average LLA, SS, and PT were -16.6° (-49.8 %), -18.7° (-50.3 %), and 18.3° (284.8 %), respectively (P < 0.01). In the sitting position, lumbar lordosis was reduced and pelvic rotation became posterior. This study showed that LLA decreased by approximately 50 % and PT increased by approximately 25 % in the sitting position compared with the standing position. No significant gender differences were observed for LLA, SS, and PT in the standing position. In the sitting position, however, LLA and SS were markedly larger for women.

Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study.

PubMed

Hunt, Kate; Gray, Cindy M; Maclean, Alice; Smillie, Susan; Bunn, Christopher; Wyke, Sally

2014-01-21

The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. A mixed-methods study analysing baseline data on 747 men aged 35-65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at 'very high' risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35-44, 45-54 and 55-64 years respectively). A further 21%, 16% and 13% were at 'extremely high' risk. Qualitative data revealed that the powerful 'draw' of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others 'like them' and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt 'right' rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity.

Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study

PubMed Central

2014-01-01

Background The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. Methods A mixed-methods study analysing baseline data on 747 men aged 35–65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Results Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at ‘very high’ risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35–44, 45–54 and 55–64 years respectively). A further 21%, 16% and 13% were at ‘extremely high’ risk. Qualitative data revealed that the powerful ‘draw’ of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others ‘like them’ and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. Conclusions The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt ‘right’ rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity. PMID:24443845

Improving Cardiometabolic Health with Diet, Physical Activity, and Breaking Up Sitting: What about Sleep?

PubMed Central

Vincent, Grace E.; Jay, Sarah M.; Sargent, Charli; Vandelanotte, Corneel; Ridgers, Nicola D.; Ferguson, Sally A.

2017-01-01

Cardiometabolic disease poses a serious health and economic burden worldwide and its prevalence is predicted to increase. Prolonged sitting, lack of physical activity, poor diet, and short sleep duration are ubiquitous behaviors in modern society, and all are independent risk factors in the development of cardiometabolic disease. Existing evidence demonstrates that breaking up prolonged periods of sitting is beneficial for cardiometabolic health, however, studies have not controlled for prior sleep duration. This article examines how prolonged sitting and short sleep duration independently contribute to cardiometabolic risk, and how breaking up sitting and obtaining adequate sleep may reduce this risk. We suggest that as prolonged sitting and short sleep duration influence the same cardiometabolic parameters, there is potential for short sleep to attenuate the positive impact of breaking up prolonged sitting with physical activity. Likewise, breaking up prolonged sitting and obtaining adequate sleep together could improve predictors of cardiometabolic disease, i.e., the combined effect may be stronger than either alone. To explore these perspectives, we propose a research agenda to investigate the relationship between breaking up prolonged sitting with physical activity and short sleep duration. This will provide an evidence-base for informing the design of interventions to reduce the burden of cardiometabolic disease on communities worldwide. PMID:29167645

Relationship between postural alignment in sitting by photogrammetry and seated postural control in post-stroke subjects.

PubMed

Iyengar, Y R; Vijayakumar, K; Abraham, J M; Misri, Z K; Suresh, B V; Unnikrishnan, B

2014-01-01

This study was executed to find out correlation between postural alignment in sitting measured through photogrammetry and postural control in sitting following stroke. A cross-sectional study with convenient sampling consisting of 45 subjects with acute and sub-acute stroke. Postural alignment in sitting was measured through photogrammetry and relevant angles were obtained through software MB Ruler (version 5.0). Seated postural control was measured through Function in Sitting Test (FIST). Correlation was obtained using Spearman's Rank Correlation co-efficient in SPSS software (version 17.0). Moderate positive correlation (r = 0.385; p < 0.01) was found between angle of lordosis and angle between acromion, lateral epicondyle and point between radius and ulna. Strong negative correlation (r = -0.435; p < 0.01) was found between cranio-vertebral angle and kyphosis. FIST showed moderate positive correlation (r = 0.3446; p < 0.05) with cranio-vertebral angle and strong positive correlation (r = 0.4336; p < 0.01) with Brunnstrom's stage of recovery in upper extremity. Degree of forward head posture in sitting correlates directly with seated postural control and inversely with degree of kyphosis in sitting post-stroke. Postural control in sitting post-stroke is directly related with Brunnstrom's stage of recovery in affected upper extremity in sitting.

Simple assessment of olfaction in patients with chronic rhinosinusitis.

PubMed

Kim, Byung Guk; Oh, Jeong-Hoon; Choi, Ha Na; Park, So Young

2015-03-01

The brief-smell identification test (B-SIT) can substitute for the butanol threshold test (BTT) in screening of anosmia and postoperative assessment of olfactory outcomes in patients with chronic rhinosinusitis (CRS). A time-effective test battery composed of B-SIT and the visual analog scale (VAS) can be implemented for simple olfactory assessment in any otolaryngology clinic. Anosmia is a distinct clinical entity requiring special attention. Unpredictable olfactory outcomes after surgery make preoperative assessment more important. We compared the results of the BTT, B-SIT, and VAS to investigate whether B-SIT or VAS can substitute for BTT in screening of anosmia and postoperative follow-up. We collected data on 68 CRS patients who had bilateral CRS and underwent endoscopic sinus surgery. Olfactory performance was graded using the BTT: normosmia, hyposmia, or anosmia. VAS and B-SIT were also performed. All tests were repeated 6 months after surgery. Postoperative improvement was defined by an increase of the BTT score ≥ 2. The B-SIT and VAS scores of the anomics were significantly lower than those of the normosmics. B-SIT discriminated anosmia with high specificity. Within the improvement group, postoperative increase of B-SIT/VAS score showed significance. However, neither the B-SIT nor the VAS differentiated between no change and deterioration of olfaction.

Tipping the Balance

NASA Technical Reports Server (NTRS)

Smith, Claire

2003-01-01

As an activist for the project community at NASA's Ames Research Center, I see my role as finding out what resource project managers need to help them run successful projects. I need to go out and advocate for those resources, if necessary, and I need to be supportive, not just for the projects, but also for the project managers and their teams. It's not something I can do sitting at my desk waiting for the phone to ring. To me, that's what an activist does. It's public service. In this case my public is the project-practitioner community.

Heterogeneous distributed query processing: The DAVID system

NASA Technical Reports Server (NTRS)

Jacobs, Barry E.

1985-01-01

The objective of the Distributed Access View Integrated Database (DAVID) project is the development of an easy to use computer system with which NASA scientists, engineers and administrators can uniformly access distributed heterogeneous databases. Basically, DAVID will be a database management system that sits alongside already existing database and file management systems. Its function is to enable users to access the data in other languages and file systems without having to learn the data manipulation languages. Given here is an outline of a talk on the DAVID project and several charts.

Improving Hip-Worn Accelerometer Estimates of Sitting Using Machine Learning Methods.

PubMed

Kerr, Jacqueline; Carlson, Jordan; Godbole, Suneeta; Cadmus-Bertram, Lisa; Bellettiere, John; Hartman, Sheri

2018-02-13

To improve estimates of sitting time from hip worn accelerometers used in large cohort studies by employing machine learning methods developed on free living activPAL data. Thirty breast cancer survivors concurrently wore a hip worn accelerometer and a thigh worn activPAL for 7 days. A random forest classifier, trained on the activPAL data, was employed to detect sitting, standing and sit-stand transitions in 5 second windows in the hip worn accelerometer. The classifier estimates were compared to the standard accelerometer cut point and significant differences across different bout lengths were investigated using mixed effect models. Overall, the algorithm predicted the postures with moderate accuracy (stepping 77%, standing 63%, sitting 67%, sit to stand 52% and stand to sit 51%). Daily level analyses indicated that errors in transition estimates were only occurring during sitting bouts of 2 minutes or less. The standard cut point was significantly different from the activPAL across all bout lengths, overestimating short bouts and underestimating long bouts. This is among the first algorithms for sitting and standing for hip worn accelerometer data to be trained from entirely free living activPAL data. The new algorithm detected prolonged sitting which has been shown to be most detrimental to health. Further validation and training in larger cohorts is warranted.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

'The End of Sitting': An Empirical Study on Working in an Office of the Future.

PubMed

Withagen, Rob; Caljouw, Simone R

2016-07-01

Inspired by recent findings that prolonged sitting has detrimental health effects, Rietveld Architecture Art Affordances (RAAAF) and visual artist Barbara Visser designed a working environment without chairs and desks. This environment, which they called The End of Sitting, is a sculpture whose surfaces afford working in several non-sitting postures (e.g. lying, standing, leaning). In the present study, it was tested how people use and experience The End of Sitting. Eighteen participants were to work in this environment and in a conventional office with chairs and desks, and the participants' activities, postures, and locations in each working environment were monitored. In addition, participants' experiences with working in the offices were measured with a questionnaire. It was found that 83 % of participants worked in more than one non-sitting posture in The End of Sitting. All these participants also changed location in this working environment. On the other hand, in the conventional office all but one participant sat on a chair at a desk during the entire work session. On average, participants reported that The End of Sitting supported their well-being more than the conventional office. Participants also felt more energetic after working in The End of Sitting. No differences between the working environments were found in reported concentration levels and satisfaction with the created product. The End of Sitting is a potential alternative working environment that deserves to be examined in more detail.

Evaluation of ergonomic and education interventions to reduce occupational sitting in office-based university workers: study protocol for a randomized controlled trial.

PubMed

Radas, Antonia; Mackey, Martin; Leaver, Andrew; Bouvier, Anna-Louise; Chau, Josephine Y; Shirley, Debra; Bauman, Adrian

2013-10-12

Prolonged sitting is a specific occupational hazard in office workers. There is growing evidence that prolonged sitting is detrimental to metabolic health. The aim of this study is to determine whether providing office workers with education along with adjustable sit-stand workstations leads to reduction in sitting behavior. A randomized control trial (RCT) with three groups (one control group and two intervention groups) will be conducted in an office workplace setting. The education intervention group will receive an education package that encourages reduction in sitting behaviors. The sit-stand desk intervention group will receive the same education package along with an adjustable sit-stand desk. Participants will be included in the study if they are currently employed in a full-time academic or administrative role that involves greater than 15 hours per week or greater than 4 hours per day computer-based work. Baseline data will include participant's age, gender, weight, height, smoking habit, employment position, level of education, and baseline self-reported leisure time physical activity. The primary outcome is the average daily sedentary time during work hours, measured by an accelerometer. Participant recruitment commenced in March 2013 and will be completed by December 2013. This study will determine whether providing office workers with an adjustable sit-stand desk and individually targeted education, or education alone, is more effective in decreasing sitting behaviors than no intervention. Australian New Zealand Clinical Trials Registry: ACTRN12613000366752.

The Short-Term Effects of Lying, Sitting and Standing on Energy Expenditure in Women

PubMed Central

POPP, COLLIN J.; BRIDGES, WILLIAM C.; JESCH, ELLIOT D.

2018-01-01

The deleterious health effects of too much sitting have been associated with an increased risk for overweight and obesity. Replacing sitting with standing is the proposed intervention to increase daily energy expenditure (EE). The purpose of this study was to determine the short-term effects of lying, sitting, and standing postures on EE, and determine the magnitude of the effect each posture has on EE using indirect calorimetry (IC). Twenty-eight healthy females performed three separate positions (lying, sitting, standing) in random order. Inspired and expired gases were collected for 45-minutes (15 minutes for each position) using breath-by-breath indirect calorimetry. Oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured to estimate EE. Statistical analyses used repeat measures ANOVA to analyze all variables and post hoc t-tests. Based on the ANOVA the individual, time period and order term did not result in a statistically significant difference. Lying EE and sitting EE were not different from each other (P = 0.56). However, standing EE (kcal/min) was 9.0 % greater than lying EE (kcal/min) (P = 0.003), and 7.1% greater than sitting EE (kcal/min) (P = 0.02). The energetic cost of standing was higher compared to lying and sitting. While this is statistically significant, the magnitude of the effect of standing when compared to sitting was small (Cohen’s d = 0.31). Short-term standing does not offer an energetic advantage when compared to sitting.

Impaired Postural Control Reduces Sit-to-Stand-to-Sit Performance in Individuals with Chronic Obstructive Pulmonary Disease

PubMed Central

Janssens, Lotte; Brumagne, Simon; McConnell, Alison K.; Claeys, Kurt; Pijnenburg, Madelon; Goossens, Nina; Burtin, Chris; Janssens, Wim; Decramer, Marc; Troosters, Thierry

2014-01-01

Background Functional activities, such as the sit-to-stand-to-sit (STSTS) task, are often impaired in individuals with chronic obstructive pulmonary disease (COPD). The STSTS task places a high demand on the postural control system, which has been shown to be impaired in individuals with COPD. It remains unknown whether postural control deficits contribute to the decreased STSTS performance in individuals with COPD. Methods Center of pressure displacement was determined in 18 individuals with COPD and 18 age/gender-matched controls during five consecutive STSTS movements with vision occluded. The total duration, as well as the duration of each sit, sit-to-stand, stand and stand-to-sit phase was recorded. Results Individuals with COPD needed significantly more time to perform five consecutive STSTS movements compared to healthy controls (19±6 vs. 13±4 seconds, respectively; p = 0.001). The COPD group exhibited a significantly longer stand phase (p = 0.028) and stand-to-sit phase (p = 0.001) compared to the control group. In contrast, the duration of the sit phase (p = 0.766) and sit-to-stand phase (p = 0.999) was not different between groups. Conclusions Compared to healthy individuals, individuals with COPD needed significantly more time to complete those phases of the STSTS task that require the greatest postural control. These findings support the proposition that suboptimal postural control is an important contributor to the decreased STSTS performance in individuals with COPD. PMID:24533072

Reducing occupational sitting: Workers' perspectives on participation in a multi-component intervention.

PubMed

Hadgraft, Nyssa T; Willenberg, Lisa; LaMontagne, Anthony D; Malkoski, Keti; Dunstan, David W; Healy, Genevieve N; Moodie, Marj; Eakin, Elizabeth G; Owen, Neville; Lawler, Sheleigh P

2017-05-30

Office workers spend much of their time sitting, which is now understood to be a risk factor for several chronic diseases. This qualitative study examined participants' perspectives following their involvement in a cluster randomised controlled trial of a multi-component intervention targeting prolonged workplace sitting (Stand Up Victoria). The intervention incorporated a sit-stand workstation, individual health coaching and organisational support strategies. The aim of the study was to explore the acceptability of the intervention, barriers and facilitators to reducing workplace sitting, and perceived effects of the intervention on workplace culture, productivity and health-related outcomes. Semi-structured interviews (n = 21 participants) and two focus groups (n = 7) were conducted with intervention participants at the conclusion of the 12 month trial and thematic analysis was used to analyse the data. Questions covered intervention acceptability, overall impact, barriers and facilitators to reducing workplace sitting, and perceived impact on productivity and workplace culture. Overall, participants had positive intervention experiences, perceiving that reductions in workplace sitting were associated with improved health and well-being with limited negative impact on work performance. While sit-stand workstations appeared to be the primary drivers of change, workstation design and limited suitability of standing for some job tasks and situations were perceived as barriers to their use. Social support from team leaders and other participants was perceived to facilitate behavioural changes and a shift in norms towards increased acceptance of standing in the workplace. Multi-component interventions to reduce workplace sitting, incorporating sit-stand workstations, are acceptable and feasible; however, supportive social and environmental conditions are required to support participant engagement. Best practice approaches to reduce workplace sitting should address the multiple levels of influence on behaviour, including factors that may act as barriers to behavioural change.

Validity of a multi-context sitting questionnaire across demographically diverse population groups: AusDiab3.

PubMed

Clark, Bronwyn K; Lynch, Brigid M; Winkler, Elisabeth Ah; Gardiner, Paul A; Healy, Genevieve N; Dunstan, David W; Owen, Neville

2015-12-04

Sitting time questionnaires have largely been validated in small convenience samples. The validity of this multi-context sitting questionnaire against an accurate measure of sitting time is reported in a large demographically diverse sample allowing assessment of validity in varied demographic subgroups. A subgroup of participants of the third wave of the Australian Diabetes, Obesity, and Lifestyle (AusDiab3) study wore activPAL3™ monitors (7 days, 24 hours/day protocol) and reported their sitting time for work, travel, television viewing, leisure computer use and "other" purposes, on weekdays and weekend days (n = 700, age 36-89 years, 45% men). Correlations (Pearson's r; Spearman's ρ) of the self-report measures (the composite total, contextual measures and items) with monitor-assessed sitting time were assessed in the whole sample and separately in socio-demographic subgroups. Agreement was assessed using Bland-Altman plots. The composite total had a correlation with monitor-assessed sitting time of r = 0.46 (95% confidence interval [CI]: 0.40, 0.52); this correlation did not vary significantly between demographic subgroups (all >0.4). The contextual measure most strongly correlated with monitor-assessed sitting time was work (ρ = 0.25, 95 % CI: 0.17, 0.31), followed by television viewing (ρ = 0.16, 95 % CI: 0.09, 0.24). Agreement of the composite total with monitored sitting time was poor, with a positive bias (B = 0.53, SE 0.04, p < 0.001) and wide limits of agreement (±4.32 h). This multi-context questionnaire provides a total sitting time measure that ranks participants well for the purposes of assessing health associations but has limited accuracy relative to activPAL-assessed sitting time. Findings did not differ in demographic subgroups.

Patient knowledge, perceptions, expectations and satisfaction on allergen-specific immunotherapy: a survey.

PubMed

Baiardini, Ilaria; Puggioni, Francesca; Menoni, Stefania; Boot, Johan Diderik; Diamant, Zuzana; Braido, Fulvio; Canonica, Giorgio Walter

2013-03-01

Assessing patient's perspective provides useful information enabling a customized approach which has been advocated by current guidelines. In this multicentre cross-sectional study we evaluated personal viewpoints on allergen-specific immunotherapy (SIT) in patients treated with subcutaneous (SCIT) or sublingual (SLIT) immunotherapy. A survey of 28 questions assessing patient's knowledge, perceptions, expectations and satisfaction was developed by an expert panel and was applied by physicians from allergology centres in patients with respiratory allergy treated with SIT. Treating physicians independently reported their satisfaction level regarding SIT for each patient. Fully completed surveys from 434 patients (55.3% male; 66.7% poly-sensitized, 74% SLIT) were analysed. Mean duration of SIT was 2.5 years with different allergens. Most patients acquired their SIT knowledge from their physician (95%) and consequently, their physicians' opinion in their choice to start with SIT was important. Most patients perceived SIT to be safe and easy to integrate into their daily routine. The main motivations for SIT were its supposed potential to alter the course of the disease (45.7%), less need of (28.2%), or dissatisfaction with current pharmacotherapy (19.3%). Both patients' and physicians' satisfaction was high (VAS-scores 74/100 and 78/100, respectively) and showed a significant correlation (SCIT: r=0.612; SLIT: r=0.608). No major difference was found in patients' answers based on the level of education. In this real life study evaluating different aspects of patient's perspective on SIT, the majority of patients had an adequate level of knowledge, perceptions, expectations and satisfaction about SIT, which corresponded well with the physician's perceptions and satisfaction. Our data warrant the use of patient's perspectives on chronic SIT treatment. Copyright © 2012 Elsevier Ltd. All rights reserved.

Project Energise: Using participatory approaches and real time computer prompts to reduce occupational sitting and increase work time physical activity in office workers.

PubMed

Gilson, Nicholas D; Ng, Norman; Pavey, Toby G; Ryde, Gemma C; Straker, Leon; Brown, Wendy J

2016-11-01

This efficacy study assessed the added impact real time computer prompts had on a participatory approach to reduce occupational sedentary exposure and increase physical activity. Quasi-experimental. 57 Australian office workers (mean [SD]; age=47 [11] years; BMI=28 [5]kg/m 2 ; 46 men) generated a menu of 20 occupational 'sit less and move more' strategies through participatory workshops, and were then tasked with implementing strategies for five months (July-November 2014). During implementation, a sub-sample of workers (n=24) used a chair sensor/software package (Sitting Pad) that gave real time prompts to interrupt desk sitting. Baseline and intervention sedentary behaviour and physical activity (GENEActiv accelerometer; mean work time percentages), and minutes spent sitting at desks (Sitting Pad; mean total time and longest bout) were compared between non-prompt and prompt workers using a two-way ANOVA. Workers spent close to three quarters of their work time sedentary, mostly sitting at desks (mean [SD]; total desk sitting time=371 [71]min/day; longest bout spent desk sitting=104 [43]min/day). Intervention effects were four times greater in workers who used real time computer prompts (8% decrease in work time sedentary behaviour and increase in light intensity physical activity; p<0.01). Respective mean differences between baseline and intervention total time spent sitting at desks, and the longest bout spent desk sitting, were 23 and 32min/day lower in prompt than in non-prompt workers (p<0.01). In this sample of office workers, real time computer prompts facilitated the impact of a participatory approach on reductions in occupational sedentary exposure, and increases in physical activity. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

RAAAF’s office landscape The End of Sitting: Energy expenditure and temporary comfort when working in non-sitting postures

PubMed Central

de Vries, Rutger; Withagen, Rob

2017-01-01

Abstract An earlier study suggested that the activity-inviting office landscape called “The End of Sitting”, designed by Rietveld Architecture Art Affordances (RAAAF), should be considered as an alternative working environment to prevent sedentary behavior. The End of Sitting lacks chairs and tables but consists instead of a myriad of sloped surfaces at different heights that afford workers to stand, lean or recline at different locations. In this study, we assessed the impact of four of its workspaces on physical intensity, temporary comfort and productivity of office work and compared the outcomes with sitting and standing behind a desk. Twenty-four participants worked for 10 minutes in each of the six test conditions. Energy expenditure, measured by indirect calorimetry, and heart rate were recorded. Questionnaires were used to assess the perceived comfort. The number of words found in the word search test was counted as a measure of productivity. The majority of The End of Sitting workspaces led to a significant increase in energy expenditure compared with sitting behind a desk (ps < .05). Average MET values ranged from 1.40 to 1.58 which is a modest rise in energy expenditure compared to sitting (1.32 METs) and not significantly different from standing (1.47 METs). The scores on the general comfort scale indicated that some workspaces were less comfortable than sitting (ps < .05), but the vast majority of participants reported that at least one of The End of Sitting workspaces was equally or more comfortable than sitting. No differences in productivity between the test conditions were found. Further long-term studies are required to assess the behavioral adaptations, productivity and the level of comfort when using The End of Sitting as a permanent office. PMID:29125854

Effect of a novel two-desk sit-to-stand workplace (ACTIVE OFFICE) on sitting time, performance and physiological parameters: protocol for a randomized control trial.

PubMed

Schwartz, Bernhard; Kapellusch, Jay M; Schrempf, Andreas; Probst, Kathrin; Haller, Michael; Baca, Arnold

2016-07-15

Prolonged sitting is ubiquitous in modern society and linked to several diseases. Height-adjustable desks are being used to decrease worksite based sitting time (ST). Single-desk sit-to-stand workplaces exhibit small ST reduction potential and short-term loss in performance. The aim of this paper is to report the study design and methodology of an ACTIVE OFFICE trial. The study was a 1-year three-arm, randomized controlled trial in 18 healthy Austrian office workers. Allocation was done via a regional health insurance, with data collection during Jan 2014 - March 2015. Participants were allocated to either an intervention or control group. Intervention group subjects were provided with traditional or two-desk sit-to-stand workstations in either the first or the second half of the study, while control subjects did not experience any changes during the whole study duration. Sitting time and physical activity (IPAQ-long), cognitive performance (text editing task, Stroop-test, d2R test of attention), workload perception (NASA-TLX) and physiological parameters (salivary cortisol, heartrate variability and body weight) were measured pre- and post-intervention (23 weeks after baseline) for intervention and control periods. Postural changes and sitting/standing time (software logger) were recorded at the workplace for the whole intervention period. This study evaluates the effects of a novel two-desk sit-to-stand workplace on sitting time, physical parameters and work performance of healthy office based workers. If the intervention proves effective, it has a great potential to be implemented in regular workplaces to reduce diseases related to prolonged sitting. ClinicalTrials.gov Identifier: NCT02825303 , July 2016 (retrospectively registered).

Self-reported sitting time and physical activity: interactive associations with mental well-being and productivity in office employees.

PubMed

Puig-Ribera, Anna; Martínez-Lemos, Iván; Giné-Garriga, Maria; González-Suárez, Ángel Manuel; Bort-Roig, Judit; Fortuño, Jesús; Muñoz-Ortiz, Laura; McKenna, Jim; Gilson, Nicholas D

2015-01-31

Little is known about how sitting time, alone or in combination with markers of physical activity (PA), influences mental well-being and work productivity. Given the need to develop workplace PA interventions that target employees' health related efficiency outcomes; this study examined the associations between self-reported sitting time, PA, mental well-being and work productivity in office employees. Descriptive cross-sectional study. Spanish university office employees (n = 557) completed a survey measuring socio-demographics, total and domain specific (work and travel) self-reported sitting time, PA (International Physical Activity Questionnaire short version), mental well-being (Warwick-Edinburg Mental Well-Being Scale) and work productivity (Work Limitations Questionnaire). Multivariate linear regression analyses determined associations between the main variables adjusted for gender, age, body mass index and occupation. PA levels (low, moderate and high) were introduced into the model to examine interactive associations. Higher volumes of PA were related to higher mental well-being, work productivity and spending less time sitting at work, throughout the working day and travelling during the week, including the weekends (p < 0.05). Greater levels of sitting during weekends was associated with lower mental well-being (p < 0.05). Similarly, more sitting while travelling at weekends was linked to lower work productivity (p < 0.05). In highly active employees, higher sitting times on work days and occupational sitting were associated with decreased mental well-being (p < 0.05). Higher sitting times while travelling on weekend days was also linked to lower work productivity in the highly active (p < 0.05). No significant associations were observed in low active employees. Employees' PA levels exerts different influences on the associations between sitting time, mental well-being and work productivity. The specific associations and the broad sweep of evidence in the current study suggest that workplace PA strategies to improve the mental well-being and productivity of all employees should focus on reducing sitting time alongside efforts to increase PA.

What are the working mechanisms of a web-based workplace sitting intervention targeting psychosocial factors and action planning?

PubMed

De Cocker, Katrien; De Bourdeaudhuij, Ilse; Cardon, Greet; Vandelanotte, Corneel

2017-05-03

Office workers demonstrate high levels of sitting on workdays. As sitting is positively associated with adverse health risks in adults, a theory-driven web-based computer-tailored intervention to influence workplace sitting, named 'Start to Stand,' was developed. The intervention was found to be effective in reducing self-reported workplace sitting among Flemish employees. The aim of this study was to investigate through which mechanisms the web-based computer-tailored intervention influenced self-reported workplace sitting. Employees (n = 155) participated in a clustered randomised controlled trial and reported socio-demographics (age, gender, education), work-related (hours at work, employment duration), health-related (weight and height, workplace sitting and physical activity) and psychosocial (knowledge, attitudes, self-efficacy, social support, intention regarding (changing) sitting behaviours) variables at baseline and 1-month follow-up. The product-of-coefficients test of MacKinnon based on multiple linear regression analyses was conducted to examine the mediating role of five psychosocial factors (knowledge, attitudes, self-efficacy, social support, intention). The influence of one self-regulation skill (action planning) in the association between the intervention and self-reported workplace sitting time was investigated via moderation analyses. The intervention had a positive influence on knowledge (p = 0.040), but none of the psychosocial variables did mediate the intervention effect on self-reported workplace sitting. Action planning was found to be a significant moderator (p < 0.001) as the decrease in self-reported workplace sitting only occurred in the group completing an action plan. Future interventions aimed at reducing employees' workplace sitting are suggested to focus on self-regulatory skills and promote action planning when using web-based computer-tailored advice. Clinicaltrials.gov NCT02672215 ; (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02672215 ).

Effect of alternating standing and sitting on blood pressure and pulse wave velocity during a simulated workday in adults with overweight/obesity.

PubMed

Barone Gibbs, Bethany; Kowalsky, Robert J; Perdomo, Sophy J; Taormina, John M; Balzer, Jeffrey R; Jakicic, John M

2017-12-01

Reducing prolonged sitting at work has been recommended by an expert panel, but whether intermittent standing improves vascular health is unclear. We aimed to test whether using a sit-stand desk could reduce blood pressure (BP) and pulse wave velocity (PWV) during a simulated workday. Overweight/obese adults with pre-to-Stage 1 hypertension completed a randomized crossover study with two simulated workday conditions: STAND-SIT (alternating standing and sitting condition every 30 min) and SIT (continuous sitting condition). Oscillometric BP was measured hourly. Carotid-femoral, carotid-radial, and carotid-ankle PWV were measured in the morning, mid-day, and late afternoon using tonometry. Participants [n = 25, 64% male, 84% white, mean (SD) age: 42 (12) years] had average resting SBP of 132 (9) mmHg and DBP of 83 (8) mmHg. In linear mixed models, STAND-SIT resulted in a significantly lower DBP (mean ± SE: -1.0 ± 0.4 mmHg, P = 0.020) and mean arterial pressure (MAP) (-1.0 ± 0.4 mmHg, P = 0.029) compared with SIT. SBP (-0.9 ± 0.7 mmHg, P = 0.176) was not different across conditions. Carotid-ankle PWV was significantly lower during the STAND-SIT vs. SIT condition (-0.27 ± 0.13 m/s, P = 0.047), whereas carotid-femoral PWV (-0.03 ± 0.13 m/s, P = 0.831) and carotid-radial PWV (-0.30 ± 0.18 m/s, P = 0.098) were not. Changes in MAP partially explained changes in PWV. Interrupting prolonged sitting during deskwork with intermittent standing was a sufficient stimulus to slightly, but statistically significantly, decrease DBP, MAP, and carotid-ankle PWV. Though the clinical significance of the observed effects is modest, regular use of a sit-stand desk may be a practical way to lower BP and PWV while performing deskwork.

Impact of sit-stand desks at work on energy expenditure and sedentary time: protocol for a feasibility study.

PubMed

Mantzari, Eleni; Wijndaele, Katrien; Brage, Soren; Griffin, Simon J; Marteau, Theresa M

2016-01-01

Prolonged sitting, an independent risk factor for disease development and premature mortality, is increasing in prevalence in high- and middle-income countries, with no signs of abating. Adults in such countries spend the largest proportion of their day in sedentary behaviour, most of which is accumulated at work. One promising method for reducing workplace sitting is the use of sit-stand desks. However, key uncertainties remain about this intervention, related to the quality of existing studies and a lack of focus on key outcomes, including energy expenditure. We are planning a randomised controlled trial to assess the impact of sit-stand desks at work on energy expenditure and sitting time in the short and longer term. To reduce the uncertainties related to the design of this trial, we propose a preliminary study to assess the feasibility and acceptability of the recruitment, allocation, measurement, retention and intervention procedures. Five hundred office-based employees from two companies in Cambridge, UK, will complete a survey to assess their interest in participating in a trial on the use of sit-stand desks at work. The workspaces of 100 of those interested in participating will be assessed for sit-stand desk installation suitability, and 20 participants will be randomised to either the use of sit-stand desks at work for 3 months or a waiting list control group. Energy expenditure and sitting time, measured via Actiheart and activPAL monitors, respectively, as well as cardio-metabolic and anthropometric outcomes and other outcomes relating to health and work performance, will be assessed in 10 randomly selected participants. All participants will also be interviewed about their experience of using the desks and participating in the study. The findings are expected to inform the design of a trial assessing the impact of sit-stand desks at work on short and longer term workplace sitting, taking into account their impact on energy expenditure and the extent to which their use has compensation effects outside the workplace. The findings from such a trial are expected to inform discussions regarding the potential of sit-stand desks at work to alleviate the harm to cardio-metabolic health arising from prolonged sitting. ISRCTN44827407.

Study of Mycobacterium tuberculosis Complex Genotypic Diversity in Malaysia Reveals a Predominance of Ancestral East-African-Indian Lineage with a Malaysia-Specific Signature

PubMed Central

Ismail, Fazli; Couvin, David; Farakhin, Izzah; Abdul Rahman, Zaidah; Rastogi, Nalin; Suraiya, Siti

2014-01-01

Background Tuberculosis (TB) still constitutes a major public health problem in Malaysia. The identification and genotyping based characterization of Mycobacterium tuberculosis complex (MTBC) isolates causing the disease is important to determine the effectiveness of the control and surveillance programs. Objectives This study intended a first assessment of spoligotyping-based MTBC genotypic diversity in Malaysia followed by a comparison of strains with those prevailing in neighboring countries by comparison with an international MTBC genotyping database. Methods Spoligotyping was performed on a total of 220 M. tuberculosis clinical isolates collected in Kelantan and Kuala Lumpur. The results were compared with the SITVIT2 international database of the Pasteur Institute of Guadeloupe. Results Spoligotyping revealed 77 different patterns: 22 corresponded to orphan patterns while 55 patterns containing 198 isolates were assigned a Spoligo International Type (SIT) designation in the database (the latter included 6 newly created SITs). The eight most common SITs grouped 141 isolates (5 to 56 strains per cluster) as follows: SIT1/Beijing, n = 56, 25.5%; SIT745/EAI1-SOM, n = 33, 15.0%; SIT591/EAI6-BGD1, n = 13, 5.9%; SIT256/EAI5, n = 12, 5.5%; SIT236/EAI5, n = 10, 4.6%; SIT19/EAI2-Manila, n = 9, 4.1%; SIT89/EAI2-Nonthaburi, n = 5, 2.3%; and SIT50/H3, n = 3, 1.4%. The association between city of isolation and lineages was statistically significant; Haarlem and T lineages being higher in Kuala Lumpur (p<0.01). However, no statistically significant differences were noted when comparing drug resistance vs. major lineages, nor between gender and clades. Conclusions The ancestral East-African-Indian (EAI) lineage was most predominant followed by the Beijing lineage. A comparison of strains with those prevailing in neighboring countries in South Asia, East Asia and South East Asia underlined the phylogeographical specificity of SIT745 for Malaysia, and its probable ongoing evolution with locally evolved strains sharing a specific signature characterized by absence of spacers 37, 38, and 40. Pending complementary genotyping confirmation, we propose that SIT745/EAI-SOM is tentatively reclassified as SIT745/EAI-MYS. PMID:25502956

Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis

PubMed Central

Mayorga-Vega, Daniel; Merino-Marban, Rafael; Viciana, Jesús

2014-01-01

The main purpose of the present meta-analysis was to examine the scientific literature on the criterion-related validity of sit-and-reach tests for estimating hamstring and lumbar extensibility. For this purpose relevant studies were searched from seven electronic databases dated up through December 2012. Primary outcomes of criterion-related validity were Pearson´s zero-order correlation coefficients (r) between sit-and-reach tests and hamstrings and/or lumbar extensibility criterion measures. Then, from the included studies, the Hunter- Schmidt´s psychometric meta-analysis approach was conducted to estimate population criterion- related validity of sit-and-reach tests. Firstly, the corrected correlation mean (rp), unaffected by statistical artefacts (i.e., sampling error and measurement error), was calculated separately for each sit-and-reach test. Subsequently, the three potential moderator variables (sex of participants, age of participants, and level of hamstring extensibility) were examined by a partially hierarchical analysis. Of the 34 studies included in the present meta-analysis, 99 correlations values across eight sit-and-reach tests and 51 across seven sit-and-reach tests were retrieved for hamstring and lumbar extensibility, respectively. The overall results showed that all sit-and-reach tests had a moderate mean criterion-related validity for estimating hamstring extensibility (rp = 0.46-0.67), but they had a low mean for estimating lumbar extensibility (rp = 0. 16-0.35). Generally, females, adults and participants with high levels of hamstring extensibility tended to have greater mean values of criterion-related validity for estimating hamstring extensibility. When the use of angular tests is limited such as in a school setting or in large scale studies, scientists and practitioners could use the sit-and-reach tests as a useful alternative for hamstring extensibility estimation, but not for estimating lumbar extensibility. Key Points Overall sit-and-reach tests have a moderate mean criterion-related validity for estimating hamstring extensibility, but they have a low mean validity for estimating lumbar extensibility. Among all the sit-and-reach test protocols, the Classic sit-and-reach test seems to be the best option to estimate hamstring extensibility. End scores (e.g., the Classic sit-and-reach test) are a better indicator of hamstring extensibility than the modifications that incorporate fingers-to-box distance (e.g., the Modified sit-and-reach test). When angular tests such as straight leg raise or knee extension tests cannot be used, sit-and-reach tests seem to be a useful field test alternative to estimate hamstring extensibility, but not to estimate lumbar extensibility. PMID:24570599

Improving the management of non-ST elevation acute coronary syndromes: systematic evaluation of a quality improvement programme European QUality Improvement Programme for Acute Coronary Syndrome: The EQUIP-ACS project protocol and design

PubMed Central

2010-01-01

Background Acute coronary syndromes, including myocardial infarction and unstable angina, are important causes of premature mortality, morbidity and hospital admissions. Acute coronary syndromes consume large amounts of health care resources, and have a major negative economic and social impact through days lost at work, support for disability, and coping with the psychological consequences of illness. Several registries have shown that evidence based treatments are under-utilised in this patient population, particularly in high-risk patients. There is evidence that systematic educational programmes can lead to improvement in the management of these patients. Since application of the results of important clinical trials and expert clinical guidelines into clinical practice leads to improved patient care and outcomes, we propose to test a quality improvement programme in a general group of hospitals in Europe. Methods/Design This will be a multi-centre cluster-randomised study in 5 European countries: France, Spain, Poland, Italy and the UK. Thirty eight hospitals will be randomised to receive a quality improvement programme or no quality improvement programme. Centres will enter data for all eligible non-ST segment elevation acute coronary syndrome patients admitted to their hospital for a period of approximately 10 months onto the study database and the sample size is estimated at 2,000-4,000 patients. The primary outcome is a composite of eight measures to assess aggregate potential for improvement in the management and treatment of this patient population (risk stratification, early coronary angiography, anticoagulation, beta-blockers, statins, ACE-inhibitors, clopidogrel as a loading dose and at discharge). After the quality improvement programme, each of the eight measures will be compared between the two groups, correcting for cluster effect. Discussion If we can demonstrate important improvements in the quality of patient care as a result of a quality improvement programme, this could lead to a greater acceptance that such programmes should be incorporated into routine health training for health professionals and hospital managers. Trial registration Clinicaltrials.gov NCT00716430 PMID:20074348

Promoting Interdisciplinary Education: The Vienna Doctoral Programme on Water Resource Systems

NASA Astrophysics Data System (ADS)

Blöschl, Günter; Bucher, Christian; Carr, Gemma; Farnleitner, Andreas; Rechberger, Helmut; Wagner, Wolfgang; Zessner, Matthias

2010-05-01

An interdisciplinary approach is often described as a valuable strategy to assist in overcoming the existing and emerging challenges to water resource management. The development of educational approaches to instil a culture of interdisciplinarity in the future generation of water resource professionals will help to meet this strategic need. The Vienna Doctoral Programme on Water Resource Systems demonstrates how the adoption of an interdisciplinary education framework has been applied to a graduate programme in the water sciences. The interdisciplinary approach aims to provide doctoral research students with an understanding of the wide spectrum of processes relevant to water resource systems. This will enable them to bring together a range of ideas, strategies and methods to their current research and future careers. The education programme also aims to teach the softer skills required for successful interdisciplinary work such as the ability to communicate clearly with non-specialist professionals and the capacity to listen to and accommodate suggestions from experts in different disciplines, which have often not traditionally been grouped together. The Vienna Doctoral Programme achieves these aims through teaching an appreciation for a wide variety of approaches including laboratory analysis, field studies and numerical methods across the fields of hydrology, remote sensing, hydrogeology, structural mechanics, microbiology, water quality and resource management. Teaching takes the form of a detailed study programme on topics such as socio-economic concepts, resource and river basin management, modelling and simulation methods, health related water quality targets, urban water management, spatial data from remote sensing and basics for stochastic mechanics. Courses are also held by internationally recognised top scientists, and a guest scientist seminar series allows doctoral researchers to profit from the expertise of senior researchers from around the world. Through a structured one-on-one mentoring programme close interaction is ensured between the students and the internationally reputed staff of the programme. This gives the opportunity for the encouragement of interdisciplinary thinking at the individual level. Interdisciplinarity also evolves passively through interactions between the doctoral students in their daily research work, during journal clubs, meetings, workshops and courses. A total of 22 doctoral students are enrolled in the programme at any time which allows for cross-fertilisation across the wide range of research projects. Finally, the programme is holistic, incorporating all aspects of the hydrological system at the catchment and multi-catchment scale. The ultimate aim is to provide an education programme which not only equips the students with an understanding of the need for interdisciplinarity, but also with the skills required to deliver interdisciplinary work in keeping with the holistic catchment management paradigm adopted by the hydrological science community.

GPs' role security and therapeutic commitment in managing alcohol problems: a randomised controlled trial of a tailored improvement programme.

PubMed

Keurhorst, Myrna; van Beurden, Ivonne; Anderson, Peter; Heinen, Maud; Akkermans, Reinier; Wensing, Michel; Laurant, Miranda

2014-04-17

General practitioners with more positive role security and therapeutic commitment towards patients with hazardous or harmful alcohol consumption are more involved and manage more alcohol-related problems than others. In this study we evaluated the effects of our tailored multi-faceted improvement implementation programme on GPs' role security and therapeutic commitment and, in addition, which professional related factors influenced the impact of the implementation programme. In a cluster randomised controlled trial, 124 GPs from 82 Dutch general practices were randomised to either the intervention or control group. The tailored, multi-faceted programme included combined physician, organisation, and patient directed alcohol-specific implementation strategies to increase role security and therapeutic commitment in GPs. The control group was mailed the national guideline and patients received feedback letters. Questionnaires were completed before and 12 months after start of the programme. We performed linear multilevel regression analysis to evaluate effects of the implementation programme. Participating GPs were predominantly male (63%) and had received very low levels of alcohol related education before start of the study (0.4 h). The programme increased therapeutic commitment (p = 0.005; 95%-CI 0.13 - 0.73) but not role security (p = 0.58; 95%-CI -0.31 - 0.54). How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, contributed to the effect of the programme on therapeutic commitment. A tailored, multi-faceted programme aimed at improving GP management of patients with hazardous and harmful alcohol consumption improved GPs' therapeutic commitment towards patients with alcohol-related problems, but failed to improve GPs' role security. How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, both increased the impact of the programme on therapeutic commitment. It might be worthwhile to monitor proceeding of role security and therapeutic commitment throughout the year after the implementation programme, to see whether the programme is effective on short term but faded out on the longer term. ClinicalTrials.gov Identifier: NCT00298220.

Managing Vocational Education and Training in Central and Eastern European Countries. Report of a Programme on the Training of Researchers in the Management of Vocational Education and Training. IIEP Research and Studies Programme. The Development of Human Resources: New Trends in Technical and Vocational Education.

ERIC Educational Resources Information Center

Caillods, Francoise; And Others

This document provides materials prepared for and discussed at a workshop to analyze the problems facing Central and Eastern European countries in the management of the vocational education and training (VET) system. Part I gives an outline of the major research findings and reflects the discussions of the workshop. "Management of Vocational…

Perfect Partners or Uneasy Bedfellows? Competing Understandings of the Place of Business Management within Contemporary Education Partnerships

ERIC Educational Resources Information Center

Woods, Charlotte; Armstrong, Paul; Bragg, Joanna; Pearson, Diana

2013-01-01

This article examines illustrative cases of partnerships from a government-funded programme of experimental projects in England designed to test out the potential of senior business managers to provide leadership across a group of schools. The article places the programme within the context of international public service reforms and, more…

IMHE-Info. OECD Programme on Institutional Management in Higher Education, July 2007

ERIC Educational Resources Information Center

Lafon, Valerie, Ed.

2007-01-01

IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) Giving Knowledge for Free; The Emergence of Open Educational Resources; and (2) Education at a Glance 2007. IMHE News, publications of interest and upcoming events are included. (Contains 1 figure and 1 table.)

Multiplying a Force for Good? the Impact of Security Sector Management Postgraduate Education in Ethiopia

ERIC Educational Resources Information Center

Macphee, Paula-Louise; Fitz-Gerald, Ann

2014-01-01

This paper argues for the importance, benefits and wider impact of a donor-funded, locally supported postgraduate programme in security sector management (SSM) for government officials in Ethiopia. With the exception of specialised education and training programmes within the field of peace and conflict studies, the role of education in…

The Effectiveness of a Weight Maintenance Intervention for Adults with Intellectual Disabilities and Obesity: A Single Stranded Study

ERIC Educational Resources Information Center

Spanos, Dimitrios; Hankey, Catherine R.; Melville, Craig A.

2016-01-01

Background: The evidence base for weight management programmes incorporating a weight loss and a weight maintenance phase for adults with intellectual disabilities (ID) is limited. This study describes the weight maintenance phase of a multicomponent weight management programme for adults with intellectual disability and obesity (TAKE 5).…

Monitoring and Evaluation of an Early Childhood Development Programme: Implications for Leadership and Management

ERIC Educational Resources Information Center

Hodgson, Sarah; Papatheodorou, Theodora; James, Mary

2014-01-01

The article aims to discuss preliminary findings from a participatory monitoring and evaluation (M&E) framework, used in a community-based early childhood development (ECD) programme in KwaZulu-Natal South Africa, and their implications for leadership and management. The purposes of the M&E were for LETCEE, the implementing organization,…

Impact of parental weight status on a school-based weight management programme designed for Mexican-American children

USDA-ARS?s Scientific Manuscript database

While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impa...

Rethinking Leadership Learning in Postgraduate Public Management Programmes

ERIC Educational Resources Information Center

Briggs, Ian; Raine, John

2013-01-01

Leadership forms a key component of the curriculum of most Master of Public Administration and other public management programmes, usually doing so on the basis of assumptions that leadership is (a) both a subject and a responsibility that all such students might expect to embrace in the course of their careers; and (b) in some respects at least,…

Treatment guidelines for primary nonretentive encopresis and stool toileting refusal.

PubMed

Kuhn, B R; Marcus, B A; Pitner, S L

1999-04-15

Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency. An organic cause for nonretentive encopresis is rarely identified. The medical assessment is usually normal, and signs of constipation are noticeably absent. A full developmental and behavioral assessment should be made to establish that the child is ready for intervention to correct encopresis and to identify any barriers to success, particularly disruptive behavior problems. Successful interventions depend on the presence of soft, comfortable bowel movements and addressing toilet refusal behavior. Daily scheduled positive toilet sits are recommended. Incentives may be used to reinforce successful defecation during these sits. A plan for management of stool withholding should be agreed on by the parents/caretakers and the family physician before intervention.

Effects of Irradiation Dose on Sterility Induction and Quality Parameters of Drosophila suzukii (Diptera: Drosophilidae).

PubMed

Krüger, Alexandra Peter; Schlesener, Daniele Cristine Hoffmann; Martins, Liliane Nachtigall; Wollmann, Jutiane; Deprá, Maríndia; Garcia, Flávio Roberto Mello

2018-04-02

Drosophila suzukii (Matsumura, 1931) (Diptera: Drosophilidae) is a widely distributed pest of soft-skinned and stone fruits that is controlled mainly with pesticides. An alternative to the chemical control is the sterile insect technique (SIT), an ecologically friendly method of pest management that could be used against D. suzukii. The objective of the present study was to evaluate the effects of gamma radiation on reproductive sterility, ovarian morphometry, and quality parameters of D. suzukii. Full female sterility was achieved at 75 Gy, while an adequate level of male sterility (99.67%) was obtained at 200 Gy. The ovarian size showed an exponential decay in function of irradiation dose increase. There was no significant influence of irradiation dose on the quality parameters evaluated. Our data suggest that gamma radiation can be recommended to be used in an SIT program for D. suzukii.

Where you stand depends on where you sit: Qualitative inquiry into notions of fire adaptation

USGS Publications Warehouse

Brenkert-Smith, Hannah; Meldrum, James; Champ, Patricia A.; Barth, Christopher

2017-01-01

Wildfire and the threat it poses to society represents an example of the complex, dynamic relationship between social and ecological systems. Increasingly, wildfire adaptation is posited as a pathway to shift the approach to fire from a suppression paradigm that seeks to control fire to a paradigm that focuses on “living with” and “adapting to” wildfire. In this study, we seek insights into what it means to adapt to wildfire from a range of stakeholders whose efforts contribute to the management of wildfire. Study participants provided insights into the meaning, relevance, and use of the concept of fire adaptation as it relates to their wildfire-related activities. A key finding of this investigation suggests that social scale is of key importance in the conceptualization and understanding of adaptation for participating stakeholders. Indeed, where you stand in terms of understandings of fire adaptation depends in large part on where you sit.

The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis.

PubMed

Brosseau, Lucie; Thevenot, Odette; MacKiddie, Olivia; Taki, Jade; Wells, George A; Guitard, Paulette; Léonard, Guillaume; Paquet, Nicole; Aydin, Sibel Z; Toupin-April, Karine; Cavallo, Sabrina; Moe, Rikke Helene; Shaikh, Kamran; Gifford, Wendy; Loew, Laurianne; De Angelis, Gino; Shallwani, Shirin Mehdi; Aburub, Ala' S; Mizusaki Imoto, Aline; Rahman, Prinon; Álvarez Gallardo, Inmaculada C; Cosic, Milkana Borges; Østerås, Nina; Lue, Sabrina; Hamasaki, Tokiko; Gaudreault, Nathaly; Towheed, Tanveer E; Koppikar, Sahil; Kjeken, Ingvild; Mahendira, Dharini; Kenny, Glen P; Paterson, Gail; Westby, Marie; Laferrière, Lucie; Longchamp, Guy

2018-06-01

To identify programmes involving therapeutic exercise that are effective for the management of hand osteoarthritis and to provide stakeholders with updated, moderate to high-quality recommendations supporting exercises for hand osteoarthritis. A systematic search and adapted selection criteria included comparable trials with exercise programmes for managing hand osteoarthritis. Based on the evaluated evidence, a panel of experts reached consensus through a Delphi approach endorsing the recommendations. A hierarchical alphabetical grading system (A, B, C+, C, C-, D-, D, D+, E, F) was based on clinical importance (≥15%) and statistical significance ( P < 0.05). Ten moderate- to high-quality studies were included. Eight studies with programmes involving therapeutic exercise (e.g. range of motion (ROM) + isotonic + isometric + functional exercise) seemed to be effective. Forty-six positive grade recommendations (i.e. A, B, C+) were obtained during short-term (<12 weeks) trials for pain, stiffness, physical function, grip strength, pinch strength, range of motion, global assessment, pressure pain threshold, fatigue and abductor pollicis longus moment and during long-term (>12 weeks) trials for physical function and pinch strength. Despite that many programmes involving exercise with positive recommendations for clinical outcomes are available to healthcare professionals and hand osteoarthritis patients that aid in the management of hand osteoarthritis, there is a need for further research to isolate the specific effect of exercise components.

Educating for action: Aligning skills with policies for sustainable development in the Danube river basin.

PubMed

Irvine, Kenneth; Weigelhofer, Gabriele; Popescu, Ioana; Pfeiffer, Ellen; Păun, Andrei; Drobot, Radu; Gettel, Gretchen; Staska, Bernadette; Stanica, Adrian; Hein, Thomas; Habersack, Helmut

2016-02-01

Sustainable river basin management depends on knowledge, skills and education. The DANCERS project set out to identify feasible options for achieving education for sustainable water management across the Danube river basin, and its integration with broader education and economic development. The study traced the historic, regulatory and educational landscape of water management in the basin, contrasting it with the complex political decision-making, data-heavy decision support, learning-centred collaboration, and information-based participation that are all inherent components of Integrated Water Resource Management (IWRM). While there is a wide range of educational opportunities and mobility schemes available to individuals, there is no coherent network related to training in water management and sustainable development in the study region. Progress in addressing the multi-layered environmental challenges within the basin requires further aligning of economic, environmental and educational policies, advancing the EU Bologna Process across the region, and the development of dedicated training programmes that combine technical and relational skills. The DANCERS project identified key short and medium term needs for education and research to support progressive adoption of sustainable development, and the necessary dialogue across the public and private sectors to align policies. These include the development of new education networks for masters and PhD programmes, including joint programmes; improved access to technical training and life-long learning programmes for skills development; developing formalized and certified competency structures and associated accreditation of institutions where such skilled individuals work; and developing a co-ordinated research infrastructure and pan-basin programme for research for water management and sustainable development. Copyright © 2015 Elsevier B.V. All rights reserved.

Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands.

PubMed

Detaille, Sarah I; van der Gulden, Joost W J; Engels, Josephine A; Heerkens, Yvonne F; van Dijk, Frank J H

2010-06-21

Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme. The method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed. The intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease) and work-related personal factors (such as self-efficacy at work). The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease. Intervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.

Creating meaningful business continuity management programme metrics.

PubMed

Strong, Brian

2010-11-01

The popular axiom, 'what gets measured gets done', is often applied in the quality management and continuous improvement disciplines. This truism is also useful to business continuity practitioners as they continually strive to prove the value of their organisation's investment in a business continuity management (BCM) programme. BCM practitioners must also remain relevant to their organisations as executives focus on the bottom line and maintaining stakeholder confidence. It seems that executives always find a way, whether in a hallway or elevator, to ask BCM professionals about the company's level of readiness. When asked, they must be ready with an informed response. The establishment of a process to measure business continuity programme performance and organisational readiness has emerged as a key component of US Department of Homeland Security 'Voluntary Private Sector Preparedness (PS-Prep) Program' standards where the overarching goal is to improve private sector preparedness for disasters and emergencies. The purpose of this paper is two-fold: to introduce continuity professionals to best practices that should be considered when developing a BCM metrics programme as well as providing a case study of how a large health insurance company researched, developed and implemented a process to measure BCM programme performance and company readiness.

[Evaluation of disease management programmes--assessing methods and initial outcomes from a health economic perspective].

PubMed

Birnbaum, Dana Sophie; Braun, Sebastian

2010-01-01

Evaluation represents a substantial component of the concept of Disease Management Programmes. This and the fact that the implementation of Disease Management Programmes constitutes a major change in the German healthcare system require that the criteria established by the German Federal Social Insurance Authority (Bundesversicherungsamt) be carefully reviewed. The present paper focuses on the evaluation method and the economic data. The pre-/-post study design used in the evaluation is known to be vulnerable to threats to internal validity. The objective of this paper is to analyze whether these threats to internal validity which have been known theoretically are confirmed by the results of the final reports. A review of the final reports of health insurance companies like the AOK, Barmer and a group of the BKK in Westfalen-Lippe shows that this question can be answered in the affirmative. The pre-/-post design without control groups is unable to recognize the failure or success of the Disease Management concept. The reasons include a high drop-out rate as well as the lack of consideration of the characteristics of chronic disease. Hence the evaluation method has failed to prove the quality of Disease Management Programmes in Germany. This is why consistent further development is needed.

Management of children exposed to Mycobacterium tuberculosis: a public health evaluation in West Java, Indonesia.

PubMed

Rutherford, Merrin E; Ruslami, Rovina; Anselmo, Melissa; Alisjahbana, Bachti; Yulianti, Neti; Sampurno, Hedy; van Crevel, Reinout; Hill, Philip C

2013-12-01

To investigate qualitatively and quantitatively the performance of a programme for managing the child contacts of adult tuberculosis patients in Indonesia. A public health evaluation framework was used to assess gaps in a child contact management programme at a lung clinic. Targets for programme performance indicators were derived from established programme indicator targets, the scientific literature and expert opinion. Compliance with tuberculosis screening, the initiation of isoniazid preventive therapy in children younger than 5 years, the accuracy of tuberculosis diagnosis and adherence to preventive therapy were assessed in 755 child contacts in two cohorts. In addition, 22 primary caregivers and 34 clinic staff were interviewed to evaluate knowledge and acceptance of child contact management. The cost to caregivers was recorded. Gaps between observed and target indicator values were quantified. THE GAPS BETWEEN OBSERVED AND TARGET PERFORMANCE INDICATORS WERE: 82% for screening compliance; 64 to 100% for diagnostic accuracy, 50% for the initiation of preventive therapy, 54% for adherence to therapy and 50% for costs. Many staff did not have adequate knowledge of, or an appropriate attitude towards, child contact management, especially regarding isoniazid preventive therapy. Caregivers had good knowledge of screening but not of preventive therapy and had difficulty travelling to the clinic and paying costs. The study identified widespread gaps in the performance of a child contact management system in Indonesia, all of which appear amenable to intervention. The public health evaluation framework used could be applied in other settings where child contact management is failing.

Longitudinal analysis on the development of hospital quality management systems in the Netherlands.

PubMed

Dückers, Michel; Makai, Peter; Vos, Leti; Groenewegen, Peter; Wagner, Cordula

2009-10-01

Many changes have been initiated in the Dutch hospital sector to optimize health-care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment combinations, intensified monitoring of quality and a multi-layered organizational development programme based on quality improvement collaboratives. The objective is to answer the question as to whether these changes were accompanied by a further development of hospital quality management systems and to what extent did the development within the multi-layered programme hospitals differ from that in other hospitals. Longitudinal data were collected in 1995, 2000, 2005 and 2007 using a validated questionnaire. Descriptive analyses and multi-level modelling were applied to test whether: (1) quality management system development stages in hospitals differ over time, (2) development stages and trends differ between hospitals participating or not participating in the multi-layered programme and (3) hospital size has an effect on development stage. Dutch hospital sector between 1995 and 2007. Hospital organizations. Changes through time. Quality management system development stage. Since 1995, hospital quality management systems have reached higher development levels. Programme participants have developed their quality management system more rapidly than have non-participants. However, this effect is confounded by hospital size. Study results suggest that the combination of policy measures at macro level was accompanied by an increase in hospital size and the further development of quality management systems. Hospitals are entering the stage of systematic quality improvement.

Sitting ducks face chronic disease: an analysis of newspaper coverage of sedentary behaviour as a health issue in Australia 2000-2012.

PubMed

Chau, Josephine Y; Bonfiglioli, Catriona; Zhong, Amy; Pedisic, Zeljko; Daley, Michelle; McGill, Bronwyn; Bauman, Adrian

2017-08-01

Issue addressed This study examines how sedentary behaviour (too much sitting) was covered as a health issue by Australian newspapers and how physical activity was framed within this newspaper coverage. Methods Articles featuring sedentary behaviour published in Australian newspapers between 2000 and 2012 were analysed for content and framing. Main outcome measures were volume, number and content of newspaper articles; framing and types of sedentary behaviour; responsibility for the problem of and solutions to high levels of sedentary behaviour; and physical activity mentions and how it was framed within sedentary behaviour coverage. Results Out of 48 articles, prolonged sitting was framed as bad for health (52%) and specifically as health compromising for office workers (25%). Adults who sat a lot were framed as 'easy targets' for ill health (21% of headlines led with 'sitting ducks' or 'sitting targets'). Prolonged sitting was framed as an issue of individual responsibility (>90%) with less mention of environmental and sociocultural contributors. Thirty-six of 48 articles mentioned physical activity; 39% stated that being physically active does not matter if a person sits for prolonged periods of time or that the benefits of physical activity are undone by too much sitting. Conclusions News coverage should reflect the full socio-ecological model of sedentary behaviour and continually reinforce the independent and well-established benefits of health-enhancing physical activity alongside the need to limit prolonged sitting. So what? It is important that the entire 'move more, sit less, every day!' message is communicated by news media.

Communication in ecosystem management: a case study of cross-disciplinary integration in the assessment phase of the interior Columbia Basin Ecosystem Management Project.

PubMed

Jakobsen, Christine Haugaard; McLaughlin, William J

2004-05-01

Effective communication is essential to the success of collaborative ecosystem management projects. In this paper, we investigated the dynamics of the Interior Columbia Basin Ecosystem Management Project's (ICBEMP) cross-disciplinary integration process in the assessment phase. Using a case study research design, we captured the rich trail of experience through conducting in-depth interviews and collecting information from internal and public documents, videos, and meetings related to the ICBEMP. Coding and analysis was facilitated by a qualitative analysis software, NVivo. Results include the range of internal perspectives on barriers and facilitators of cross-disciplinary integration in the Science Integration Team (SIT). These are arrayed in terms of discipline-based differences, organizational structures and activities, individual traits of scientists, and previous working relationships. The ICBEMP organization included a team of communication staffs (CT), and the data described the CT as a mixed group in terms of qualifications and educational backgrounds that played a major role in communication with actors external to the ICBEMP organization but a minor one in terms of internal communication. The data indicated that the CT-SIT communication was influenced by characteristics of actors and structures related to organizations and their cultures. We conclude that the ICBEMP members may not have had a sufficient level of shared understanding of central domains, such as the task at hand and ways and timing of information sharing. The paper concludes by suggesting that future ecosystem management assessment teams use qualified communications specialists to design and monitor the development of shared cognition among organization members in order to improve the effectiveness of communication and cross-disciplinary integration.

Sit-stand desks in call centres: associations of use and ergonomics awareness with sedentary behavior.

PubMed

Straker, Leon; Abbott, Rebecca A; Heiden, Marina; Mathiassen, Svend Erik; Toomingas, Allan

2013-07-01

To investigate whether or not use of sit-stand desks and awareness of the importance of postural variation and breaks are associated with the pattern of sedentary behavior in office workers. The data came from a cross-sectional observation study of Swedish call centre workers. Inclinometers recorded 'seated' or 'standing/walking' episodes of 131 operators over a full work shift. Differences in sedentary behavior based on desk type and awareness of the importance of posture variation and breaks were assessed by non-parametric analyses. 90 (68.7%) operators worked at a sit-stand desk. Working at a sit-stand desk, as opposed to a sit desk, was associated with less time seated (78.5 vs 83.8%, p = 0.010), and less time taken to accumulate 5 min of standing/walking (36.2 vs 46.3 min, p = 0.022), but no significant difference to sitting episode length or the number of switches between sitting and standing/walking per hour. Ergonomics awareness was not associated with any sedentary pattern variable among those using a sit-stand desk. Use of sit-stand desks was associated with better sedentary behavior in call centre workers, however ergonomics awareness did not enhance the effect. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Uprising: An examination of sit-stand workstations, mental health and work ability in sedentary office workers, in Western Australia.

PubMed

Tobin, Rochelle; Leavy, Justine; Jancey, Jonine

2016-10-17

Office-based staff spend around three quarters of their work day sitting. People who sit for long periods while at work are at greater risk of adverse health outcomes. The pilot study aimed to determine the effect of sit-stand workstations on office-based staff sedentary and physical activity behaviors, work ability and self-reported physical and mental health outcomes. A two-group pre-post study design assessed changes in sedentary and physical activity behaviors (time spent sitting, standing and stepping and sit-stand transitions and number of steps taken) work ability and physical and mental health. Physical activity behaviors were measured using activPAL activity monitors and self-reported data on work ability and physical and mental health were collected using an online questionnaire. Relative to the controls (n=19), the intervention group (n=18) significantly decreased time spent sitting by 100 minutes (p<0.001) and increased standing time by 99 minutes (p<0.001). There was a decrease in self-reported current work ability when compared to lifetime best (p=0.008). There were no significant differences for all other sedentary behavior, other workability outcomes, physical health or mental health outcomes at follow-up. The Uprising Study found that sit-stand workstations are an effective strategy to reduce occupational sitting time in office-based workers over a one month period.

Periodically Relieving Ischial Sitting Load to Decrease the Risk of Pressure Ulcers

PubMed Central

Makhsous, Mohsen; Rowles, Diane M.; Rymer, William Z.; Bankard, James; Nam, Ellis K.; Chen, David; Lin, Fang

2010-01-01

Objective To investigate the relieving effect on interface pressure of an alternate sitting protocol involving a sitting posture that reduces ischial support. Design Repeated measures in 2 protocols on 3 groups of subjects. Setting Laboratory. Participants Twenty able-bodied persons, 20 persons with paraplegia, and 20 persons with tetraplegia. Interventions Two 1-hour protocols were used: alternate and normal plus pushup. In the alternate protocol, sitting posture was alternated every 10 minutes between normal (sitting upright with ischial support) and with partially removed ischial support (WO-BPS) postures; in the normal plus pushup protocol, sitting was in normal posture with pushups (lifting the subject off the seat) performed every 20 minutes. Main Outcome Measure Interface pressure on seat and backrest. Results In WO-BPS posture, the concentrated interface pressure observed around the ischia in normal posture was significantly repositioned to the thighs. By cyclically repositioning the interface pressure, the alternate protocol was superior to the normal plus pushup protocol in terms of a significantly lower average interface pressure over the buttocks. Conclusions A sitting protocol periodically reducing the ischial support helps lower the sitting load on the buttocks, especially the area close to ischial tuberosities. PMID:17601466

Sitting Posture Monitoring System Based on a Low-Cost Load Cell Using Machine Learning

PubMed Central

Roh, Jongryun; Park, Hyeong-jun; Lee, Kwang Jin; Hyeong, Joonho; Kim, Sayup

2018-01-01

Sitting posture monitoring systems (SPMSs) help assess the posture of a seated person in real-time and improve sitting posture. To date, SPMS studies reported have required many sensors mounted on the backrest plate and seat plate of a chair. The present study, therefore, developed a system that measures a total of six sitting postures including the posture that applied a load to the backrest plate, with four load cells mounted only on the seat plate. Various machine learning algorithms were applied to the body weight ratio measured by the developed SPMS to identify the method that most accurately classified the actual sitting posture of the seated person. After classifying the sitting postures using several classifiers, average and maximum classification rates of 97.20% and 97.94%, respectively, were obtained from nine subjects with a support vector machine using the radial basis function kernel; the results obtained by this classifier showed a statistically significant difference from the results of multiple classifications using other classifiers. The proposed SPMS was able to classify six sitting postures including the posture with loading on the backrest and showed the possibility of classifying the sitting posture even though the number of sensors is reduced. PMID:29329261

Frequency of postural changes during sitting whilst using a desktop computer--exploring an analytical methodology.

PubMed

Niekerk, Sjan-Mari van; Louw, Quinette Abigail; Grimmer-Sommers, Karen

2014-01-01

Dynamic movement whilst sitting is advocated as a way to reduce musculoskeletal symptoms from seated activities. Conventionally, in ergonomics research, only a 'snapshot' of static sitting posture is captured, which does not provide information on the number or type of movements over a period of time. A novel approach to analyse the number of postural changes whist sitting was employed in order to describe the sitting behaviour of adolescents whilst undertaking computing activities. A repeated-measures observational study was conducted. A total of 12 high school students were randomly selected from a conveniently selected school. Fifteen minutes of 3D posture measurements were recorded to determine the number of postural changes whilst using computers. Data of 11 students were able to be analysed. Large intra-subject variation of the median and IQR was observed, indicating frequent postural changes whilst sitting. Better understanding of usual dynamic postural movements whilst sitting will provide new insights into causes of musculoskeletal symptoms experienced by computer users.

The Association of Sitting Time With Sarcopenia Status and Physical Performance at Baseline and 18-Month Follow-Up in the Residential Aged Care Setting.

PubMed

Reid, Natasha; Keogh, Justin W; Swinton, Paul; Gardiner, Paul A; Henwood, Timothy R

2018-06-18

This study investigated the association of sitting time with sarcopenia and physical performance in residential aged care residents at baseline and 18-month follow-up. Measures included the International Physical Activity Questionnaire (sitting time), European Working Group definition of sarcopenia, and the short physical performance battery (physical performance). Logistic regression and linear regression analyses were used to investigate associations. For each hour of sitting, the unadjusted odds ratio of sarcopenia was 1.16 (95% confidence interval [0.98, 1.37]). Linear regression showed that each hour of sitting was significantly associated with a 0.2-unit lower score for performance. Associations of baseline sitting with follow-up sarcopenia status and performance were nonsignificant. Cross-sectionally, increased sitting time in residential aged care may be detrimentally associated with sarcopenia and physical performance. Based on current reablement models of care, future studies should investigate if reducing sedentary time improves performance among adults in end of life care.

The value of theory in programmes to implement clinical guidelines: Insights from a retrospective mixed-methods evaluation of a programme to increase adherence to national guidelines for chronic disease in primary care

PubMed Central

Sheringham, Jessica; Solmi, Francesca; Ariti, Cono; Baim-Lance, Abigail; Morris, Steve; Fulop, Naomi J.

2017-01-01

Background Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in ‘real-world’ rather than research settings. Materials and methods This mixed-methods study tested a retrospective theory-based approach to evaluate a ‘real-world’ programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care. Quantitative analyses comprised controlled before-and-after analyses to test ‘early’ and evolved’ programme theories with comparators grounded in each theory. ‘Early’ theory predicted the programme would reduce emergency hospital admissions (EHA). It was tested using national analysis of standardized borough-level EHA rates between programme and comparator boroughs. ‘Evolved’ theory predicted practices with higher programme participation would increase guideline adherence and reduce EHA and costs. It was tested using a difference-in-differences analysis with linked primary and secondary care data to compare changes in diagnosis, management, EHA and costs, over time and by programme participation. Results Contrary to programme planners’ predictions in ‘early’ and ‘evolved’ programme theories, admissions did not change following the programme. However, consistent with ‘evolved’ theory, higher guideline adoption occurred in practices with greater programme participation. Conclusions Retrospectively constructing theories based on the ideas of programme planners can enable evaluators to address some limitations encountered when evaluating programmes without a theoretical base. Prospectively articulating theory aided by existing models and mid-range implementation theories may strengthen guideline adoption efforts by prompting planners to scrutinise implementation methods. Benefits of deriving programme theory, with or without the aid of mid-range implementation theories, however, may be limited when the evidence underpinning guidelines is flawed. PMID:28328942

Malaria community health workers in Myanmar: a cost analysis.

PubMed

Kyaw, Shwe Sin; Drake, Tom; Thi, Aung; Kyaw, Myat Phone; Hlaing, Thaung; Smithuis, Frank M; White, Lisa J; Lubell, Yoel

2016-01-25

Myanmar has the highest malaria incidence and attributed mortality in South East Asia with limited healthcare infrastructure to manage this burden. Establishing malaria Community Health Worker (CHW) programmes is one possible strategy to improve access to malaria diagnosis and treatment, particularly in remote areas. Despite considerable donor support for implementing CHW programmes in Myanmar, the cost implications are not well understood. An ingredients based micro-costing approach was used to develop a model of the annual implementation cost of malaria CHWs in Myanmar. A cost model was constructed based on activity centres comprising of training, patient malaria services, monitoring and supervision, programme management, overheads and incentives. The model takes a provider perspective. Financial data on CHWs programmes were obtained from the 2013 financial reports of the Three Millennium Development Goal fund implementing partners that have been working on malaria control and elimination in Myanmar. Sensitivity and scenario analyses were undertaken to outline parameter uncertainty and explore changes to programme cost for key assumptions. The range of total annual costs for the support of one CHW was US$ 966-2486. The largest driver of CHW cost was monitoring and supervision (31-60% of annual CHW cost). Other important determinants of cost included programme management (15-28% of annual CHW cost) and patient services (6-12% of annual CHW cost). Within patient services, malaria rapid diagnostic tests are the major contributor to cost (64% of patient service costs). The annual cost of a malaria CHW in Myanmar varies considerably depending on the context and the design of the programme, in particular remoteness and the approach to monitoring and evaluation. The estimates provide information to policy makers and CHW programme planners in Myanmar as well as supporting economic evaluations of their cost-effectiveness.

Evaluating a diabetes self-management support peer leader training programme for the English- and Punjabi-speaking South-Asian community in Vancouver.

PubMed

Tang, T S; Sohal, P S; Garg, A K

2013-06-01

The purpose of this single-cohort study was to implement and evaluate a programme that trains peers to deliver a diabetes self-management support programme for South-Asian adults with Type 2 diabetes and to assess the perceived efficacy of and satisfaction with this programme. We recruited eight South-Asian adults who completed a 20-h peer-leader training programme conducted over five sessions (4 h per session). The programme used multiple instructional methods (quizzes, group brainstorming, skill building, group sharing, role-play and facilitation simulation) and provided communication, facilitation, and behaviour change skills training. To graduate, participants were required to achieve the pre-established competency criteria in four training domains: active listening, empowerment-based facilitation, five-step behavioural goal-setting, and self-efficacy. Participants were given three attempts to pass each competency domain. On the first attempt six (75%), eight (100%), five (63%) and five (63%) participants passed active listening, empowerment-based facilitation, five-step behavioural goal-setting, and self-efficacy, respectively. Those participants who did not pass a competency domain on the first attempt were successful in passing on the second attempt. As a result, all eight participants graduated from the training programme and became peer leaders. Satisfaction ratings for programme length, balance between content and skills development, and preparation for leading support activities were uniformly high. Ratings for the instructional methods ranged between effective and very effective. Findings suggest it is feasible to train and graduate peer leaders with the necessary skills to facilitate a diabetes self-management support intervention. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

Universities, SMEs and Social Capital: Can You Get Too Much of a Good Thing? An Illustrative Analysis of One University's Knowledge Exchange Programme

ERIC Educational Resources Information Center

Gordon, Ian

2016-01-01

This article explores a university knowledge exchange programme for small and medium-sized enterprise (SME) owner-managers. Specifically, it considers why a programme designed to achieve growth in a group of SMEs through the creation of a network high in social capital may have become a constraint on the programme's effectiveness over a period of…

The effect of participation in a weight loss programme on short-term health resource utilization.

PubMed

van Walraven, Carl; Dent, Robert

2002-02-01

Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervised weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, multifaceted weight loss programme in a universal health care system were studied. Patient information was anonymously linked with administrative databases to measure health resource utilization for 1 year before and after the programme. Mean body mass index (BMI) decreased by more than 15%. The mean annual physician visits (pre = 9.6, post = 9.4) did not change significantly after the programme. However, patients saw a significantly fewer number of different physicians per year following the programme (pre = 4.5, post = 3.9; P < 0.001). Mean annual number of emergency visits (pre = 0.2; post = 0.2) and hospital admissions (pre = 0.05; post = 0.08) did not change. Neither baseline BMI, nor its change during the programme, influenced changes in health resource utilization. Our study suggests that weight loss in a supervised weight management programme does not necessarily decrease short-term health resource utilization. Further study is required to determine if patients who maintain their weight loss experience a decrease in health utilization.

Evaluating disease management programme effectiveness: an introduction to the regression discontinuity design.

PubMed

Linden, Ariel; Adams, John L; Roberts, Nancy

2006-04-01

Although disease management (DM) has been in existence for over a decade, there is still much uncertainty as to its effectiveness in improving health status and reducing medical cost. The main reason is that most programme evaluations typically follow weak observational study designs that are subject to bias, most notably selection bias and regression to the mean. The regression discontinuity (RD) design may be the best alternative to randomized studies for evaluating DM programme effectiveness. The most crucial element of the RD design is its use of a 'cut-off' score on a pre-test measure to determine assignment to intervention or control. A valuable feature of this technique is that the pre-test measure does not have to be the same as the outcome measure, thus maximizing the programme's ability to use research-based practice guidelines, survey instruments and other tools to identify those individuals in greatest need of the programme intervention. Similarly, the cut-off score can be based on clinical understanding of the disease process, empirically derived, or resource-based. In the RD design, programme effectiveness is determined by a change in the pre-post relationship at the cut-off point. While the RD design is uniquely suitable for DM programme evaluation, its success will depend, in large part, on fundamental changes being made in the way DM programmes identify and assign individuals to the programme intervention.

A technology ecosystem perspective on hospital management information systems: lessons from the health literature.

PubMed

Bain, Christopher A; Standing, Craig

2009-01-01

Hospital managers have a large range of information needs including quality metrics, financial reports, access information needs, educational, resourcing and decision support needs. Currently these needs involve interactions by managers with numerous disparate systems, both electronic such as SAP, Oracle Financials, PAS' (patient administration systems) like HOMER, and relevant websites; and paper-based systems. Hospital management information systems (HMIS) can be thought of sitting within a Technology Ecosystem (TE). In addition, Hospital Management Information Systems (HMIS) could benefit from a broader and deeper TE model, and the HMIS environment may in fact represents its own TE (the HMTE). This research will examine lessons from the health literature in relation to some of these issues, and propose an extension to the base model of a TE.

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi

PubMed Central

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; in ’t Veen, Johannes C C M

2017-01-01

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories ‘the A–I of difficult-to-manage asthma’ to resonate with an established Dutch ‘A–E acronym for determining asthma control’. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme. PMID:28184039

Disease management programme for diabetes mellitus in Nepal.

PubMed

Dulal, R K; Karki, S

2009-01-01

The prevalence of diabetes in elderly is being out-numbered and continuously rising. Individuals expect miracles from their health care providers as everything is curable in the eyes of the patient. Disease Management Programme for diabetes mellitus is sensible from the medical and economic point of view since it organizes care in multidisciplinary, multicomponent, proactive approach focusing on the whole course of a disease, using evidence-based standards of care that reduce health care costs and hospital stay. In Nepal, health care professionals today need to be aware that the patients are more and more aware about their disease and technology and their increased awareness demand innovative services. Authenticated data used for the purpose of projection were drawn purely from urban or rural hospital-based. To estimate the prevalence of diabetes mellitus (DM), the data in pairs (i.e. prevalence and year) were fed into IDL - an inbuilt mathematical software program for best-fit regression. Literatures on DM prevalence and Disease Management Programme were examined. The overall projection for the DM prevalence in Nepal suggests that the prevalence of diagnosed DM will be 12.73%, 15.11% and 17.49% in 2010, 2015 and 2020 respectively. Diabetes disease management programme appeared to be helpful in reduction of health care costs and hospital stay. If the attributing factor for DM remains as it is today, many new cases of DM will be added each year. There is a need of effective disease management programme in the country. The increased level of awareness among the patients demands innovative services in future.

Management of the camera electronics programme for the World Space Observatory ultraviolet WUVS instrument

NASA Astrophysics Data System (ADS)

Patel, Gayatri; Clapp, Matthew; Salter, Mike; Waltham, Nick; Beardsley, Sarah

2016-08-01

World Space Observatory Ultraviolet (WSO-UV) is a major international collaboration led by Russia and will study the universe at ultraviolet wavelengths between 115 nm and 320 nm. The WSO Ultraviolet Spectrograph (WUVS) subsystem is led by a consortium of Russian institutes and consists of three spectrographs. RAL Space is contracted by e2v technologies Ltd to provide the CCD readout electronics for each of the three WUVS channels. The programme involves the design, manufacturing, assembly and testing of each Camera Electronics Box (CEB), its associated Interconnection Module (ICM), Electrical Ground Support Equipment (EGSE) and harness. An overview of the programme will be presented, from the initial design phase culminating in the development of an Engineering Model (EM) through qualification whereby an Engineering Qualification Model (EQM) will undergo environmental testing to characterize the performance of the CEB against the space environment, to the delivery of the Flight Models (FMs). The paper will discuss the challenges faced managing a large, dynamic project. This includes managing significant changes in fundamental requirements mid-programme as a result of external political issues which forced a complete re-design of an existing CEB with extensive space heritage but containing many ITAR controlled electronic components to a new, more efficient solution, free of ITAR controlled parts. The methodology and processes used to ensure the demanding schedule is maintained through each stage of the project will be presented including an insight into planning, decision-making, communication, risk management, and resource management; all essential to the continued success of the programme.

Professional development of Russian HEIs' management and faculty in CDIO standards application

NASA Astrophysics Data System (ADS)

Chuchalin, Alexander; Malmqvist, Johan; Tayurskaya, Marina

2016-07-01

The paper presents the approach to complex training of managers and faculty staff for system modernisation of Russian engineering education. As a methodological basis of design and implementation of the faculty development programme, the CDIO (Conceive-Design-Implement-Operate) Approach was chosen due to compliance of its concept to the purposes and tasks of engineering education development in Russia. The authors describe the structure, the content and implementation technology of the programme designed by Tomsk Polytechnic University and Skolkovo Institute of Science and Technology with the assistance of Chalmers University of Technology and KTH Royal Institute of Technology and other members of the CDIO Initiative. The programme evaluation based on the questionnaire results showed that the programme content is relevant, has high practical value and high level of novelty for all categories of participants. Therefore, the CDIO approach was recommended for implementation to improve various elements of the engineering programme such as learning outcomes, content and structure, teaching, learning and assessment methods. Besides, the feedback results obtained through programme participants' survey contribute to identification of problems preventing development of engineering education in Russia and thus serve as milestones for further development of the programme.

Long-Term Resolution of Severe Ankle Contractures Using Botulinum Toxin, Serial Casting, Splinting, and Motor Retraining.

PubMed

Leung, Joan; Stroud, Katarina

2018-01-01

Purpose: Serial casting for ankle contractures is traditionally performed in prone, a position that patients may not easily tolerate. Also, although serial casting is effective in correcting contracture, its effect dissipates quickly. This case report describes a procedure for performing casting for ankle contractures in a supine or sitting position. It also describes a process that enables the effect of serial casting to be maintained long term. Client Description: The client was an adult who had suffered traumatic brain injury and severe bilateral ankle contractures. Intervention: He received botulinum toxin and serial casting for his bilateral ankle contractures, one ankle at 8 months and the other at 13 months after the injury. He then underwent a programme of splinting and motor training. Measures and Outcome: The client gained more than 40° dorsiflexion for both ankles after receiving botulinum toxin injections and serial casting. The improvement in ankle range enabled him to progress to walking practice. Ankle splinting was gradually reduced. On discharge at 25 months post-injury, the ankle joint range was maintained. Implications: The use of botulinum toxin and serial casting, followed by an intensive programme of splinting and motor training, may be an option to consider for effective long-term resolution of severe contractures after acquired brain injury.

The effect of anti-IgE treatment on in vitro leukotriene release in children with seasonal allergic rhinitis.

PubMed

Kopp, Matthias Volkmar; Brauburger, Jens; Riedinger, Frank; Beischer, Dorothee; Ihorst, Gabriele; Kamin, Wolfgang; Zielen, Stefan; Bez; Friedrichs, Frank; Von Berg, Andrea; Gerhold, Kerstin; Hamelmann, Eckard; Hultsch; Kuehr, Joachim

2002-11-01

Binding of allergens with IgE to the IgE receptors on mast cells and basophils results in the release of inflammatory mediators as sulfidoleukotrienes (SLTs), triggering allergic cascades that result in allergic symptoms, such as asthma and rhinitis. We sought to investigate whether anti-IgE (Oma-lizumab), a humanized monoclonal anti-IgE antibody, in addition to specific immunotherapy (SIT) affects the leukotriene pathway. Ninety-two children (age range, 6-17 years) with sensitization to birch and grass pollens and with seasonal allergic rhinitis were included in a phase III, placebo- controlled, multicenter clinical study. All subjects were randomized to one of 4 treatment groups. Two groups subcutaneously received birch SIT and 2 groups received grass SIT for at least 14 weeks before the start of the birch pollen season. After 12 weeks of SIT titration, placebo or anti-IgE was added for 24 weeks. The primary clinical efficacy variable was symptom load (ie, the sum of daily symptom severity score and rescue medication score during pollen season). Blood samples taken at baseline and at the end of study treatment after the grass pollen season were used for separation of leukocytes in this substudy. After in vitro stimulation of the blood cells with grass and birch pollen allergens, SLT release (LTC4, LTD4, and LTE4) was quantified by using the ELISA technique. Before the study treatment, SLT release to birch and grass pollen exposure did not differ significantly among the 4 groups. Under treatment with anti-IgE + SIT-grass (n = 23), a lower symptom load occurred during the pollen season compared to placebo + SIT-grass (n = 24, P =.012). The same applied to both groups receiving birch SIT (n = 23 and n = 22, respectively; P =.03). At the end of treatment, the combination of anti-IgE plus grass SIT, as well as anti-IgE plus birch SIT, resulted in significantly lower SLT release after stimulation with the corresponding allergen (416 ng/L [5th-95th percentile, 1-1168] and 207 ng/L [1-860 ng/L], respectively) compared with placebo plus SIT (2490 ng/L [384-6587 ng/L], P =.001; 2489 ng/L [1-5670 ng/L], P =.001). In addition, treatment with anti-IgE was also followed by significantly lower SLT releases to the allergens unrelated to SIT (grass SIT: 300 ng/L [1-2432 ng/L] in response to birch allergen; birch SIT: 1478 ng/L [1-4593 ng/L] in response to grass pollen) in comparison with placebo (grass SIT: 1850 ng/L [1-5499 ng/L], P =.001; birch SIT: 2792 ng/L [154-5839 ng/L], P =.04]. Anti-IgE therapy reduces leukotriene release of peripheral leukocytes stimulated with allergen in children with allergic rhinitis undergoing allergen immunotherapy independent of the type of SIT allergen used.

A leadership programme for critical care.

PubMed

Crofts, Linda

2006-08-01

This paper describes the genesis, design and implementation of a leadership programme for critical care. This was an initiative funded by the National Health Service (NHS) Nursing Leadership Project and had at the core of its design flexibility to meet the needs of the individual hospitals, which took part in it. Participation was from the multi-disciplinary critical care team. Six NHS hospitals took part in the programme which was of 20 days duration and took place on hospital sites. The programme used the leadership model of as its template and had a number of distinct components; a baseline assessment, personal development, principles of leadership and critical case reviews. The programme was underpinned by three themes; working effectively in multi-professional teams to provide patient focussed care, managing change through effective leadership and developing the virtual critical care service. Each group set objectives pertinent to their own organisation's needs. The programme was evaluated by a self-reporting questionnaire; group feedback and feedback from stakeholders. Programme evaluation was positive from all the hospitals but it was clear that the impact of the programme varied considerably between the groups who took part. It was noted that there was some correlation between the success of the programme and organisational 'buy in' as well as the organisational culture within which the participants operated. A key feature of the programme success was the critical case reviews, which were considered to be a powerful learning tool and medium for group learning and change management.

Football Fans in Training: the development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits

PubMed Central

2013-01-01

Background The prevalence of obesity in men is rising, but they are less likely than women to engage in existing weight management programmes. The potential of professional sports club settings to engage men in health promotion activities is being increasingly recognised. This paper describes the development and optimization of the Football Fans in Training (FFIT) programme, which aims to help overweight men (many of them football supporters) lose weight through becoming more active and adopting healthier eating habits. Methods The MRC Framework for the design and evaluation of complex interventions was used to guide programme development in two phases. In Phase 1, a multidisciplinary working group developed the pilot programme (p-FFIT) and used a scoping review to summarize previous research and identify the target population. Phase 2 involved a process evaluation of p-FFIT in 11 Scottish Premier League (SPL) clubs. Participant and coach feedback, focus group discussions and interviews explored the utility/acceptability of programme components and suggestions for changes. Programme session observations identified examples of good practice and problems/issues with delivery. Together, these findings informed redevelopment of the optimized programme (FFIT), whose components were mapped onto specific behaviour change techniques using an evidence-based taxonomy. Results p-FFIT comprised 12, weekly, gender-sensitised, group-based weight management classroom and ‘pitch-side’ physical activity sessions. These in-stadia sessions were complemented by an incremental, pedometer-based walking programme. p-FFIT was targeted at men aged 35-65 years with body mass index ≥ 27 kg/m2. Phase 2 demonstrated that participants in p-FFIT were enthusiastic about both the classroom and physical activity components, and valued the camaraderie and peer-support offered by the programme. Coaches appreciated the simplicity of the key healthy eating and physical activity messages. Suggestions for improvements that were incorporated into the optimized FFIT programme included: more varied in-stadia physical activity with football-related components; post-programme weight management support (emails and a reunion session); and additional training for coaches in SMART goal setting and the pedometer-based walking programme. Conclusions The Football Fans in Training programme is highly acceptable to participants and SPL coaches, and is appropriate for evaluation in a randomised controlled trial. PMID:23496915

"…Because There's Nobody Who Can Just Sit That Long": Teacher Perceptions of Classroom-Based Physical Activity and Related Management Issues

ERIC Educational Resources Information Center

Stylianou, Michalis; Kulinna, Pamela Hodges; Naiman, Tyler

2016-01-01

Classroom teachers are increasingly called upon to help increase pupils' physical activity (PA). Grounded in Guskey's model of teacher change, this study was part of an intervention that provided classroom teachers with training for implementing classroom-based PA (CBPA). The study examined teachers' attempts to implement CBPA and focused on their…

Future War: An Assessment of Aerospace Campaigns in 2010,

DTIC Science & Technology

1996-01-01

theoretician: "The impending sixth generation of warfare, with its centerpiece of superior data-processing to support precision smart weaponry, will radically...tions concept of " smart push, warrior pull." If JFACC were colocated with the worldwide intelligence manager, unit taskings and the applicable...intelligence information could be distributed concurrently (" smart push"). Intelligence officers sitting alongside the operational tasking officers would

A Mixed-Methods Evaluation of the Longer-Term Implementation and Utility of a Teacher Classroom Management Training Programme in Irish Primary Schools

ERIC Educational Resources Information Center

Leckey, Yvonne; Hyland, Lynda; Hickey, Gráinne; Lodge, Anne; Kelly, Paul; Bywater, Tracey; Comiskey, Catherine; Donnelly, Michael; McGilloway, Sinéad

2016-01-01

Inappropriate, aggressive and disruptive behaviour in the classroom can be detrimental to child and teacher well-being. This study involved a longer-term evaluation of the "Incredible Years Teacher [Classroom Management]" programme (IYTP) undertaken mainly within disadvantaged schools in south-west Ireland. The IYTP is designed to…

Effects of a Tailored Incredible Years Teacher Classroom Management Programme on On-Task Behaviour of School Children with ADHD in Addis Ababa

ERIC Educational Resources Information Center

Mohammed, Feruz

2018-01-01

Attention-Deficit/Hyperactivity Disorder (ADHD) is a persistent pattern of behaviours characterized by inattention, hyperactivity and impulsivity. This study evaluates the effects of a tailored Incredible Years Teacher Classroom Management (IYTCM) programme aimed to improve participating children's on-task behaviour in a group of 6 to 10 year old…

Didactic Approaches to Child-Managed Play: Analyses of Teacher's Interaction Styles in Kindergartens and After-School Programmes in Norway

ERIC Educational Resources Information Center

Løndal, Knut; Greve, Anne

2015-01-01

This article explores the nature of teachers' involvement in child-managed play. We approached this didactic issue through analysis of interactional situations in a kindergarten and an after-school programme and by drawing on relational theory and the concept of "pedagogical tact". Qualitative material was gathered from observations and…

Higher Education Curriculum for Sustainability: Course Contents Analyses of Purchasing and Supply Management Programme of Polytechnics in Ghana

ERIC Educational Resources Information Center

Etse, Daniel; Ingley, Coral

2016-01-01

Purpose: The purpose of this study is to determine the degree of attention to and the nature of sustainability issues in the curriculum of the Higher National Diploma (HND) Purchasing and Supply Management programme of Ghana. Design/Methodology/Approach: Documentary research is the approach used to analyse the curriculum document for the programme…

A Global Approach to School Education and Local Reality: A Case Study of Community Participation in Haryana, India

ERIC Educational Resources Information Center

Narwana, Kamlesh

2015-01-01

In post-Jomtien phase, community participation in school education management has appeared as one of the most prominent features in all educational development programmes at global level. In line with this trend, India has also placed a significant focus on local communities in school management through various programmes such as LokJumbish,…

Innovation and Alliances in International Management Programmes; Redefining and Extending the Model. The "Transcontinental Tracks" at Grenoble EM

ERIC Educational Resources Information Center

Thomas, Mark; O'Sullivan, Patrick; Zahner, Martin; Silvestre, Joelle

2015-01-01

Purpose: The purpose of this paper is to describe an innovative international management programme that has been developed across four countries for Master-level students. It first analyses the advantages and disadvantages of two of the most common forms of internationalisation in higher education; the student exchange and full-scale offshore…

Professional commitment to changing chronic illness care: results from disease management programmes.

PubMed

Lemmens, Karin; Strating, Mathilde; Huijsman, Robbert; Nieboer, Anna

2009-08-01

The aim of this exploratory study was to investigate to what extent primary care professionals are able to change their systems for delivering care to chronic obstructive pulmonary disease (COPD) patients and what professional and organizational factors are associated with the degree of process implementation. Quasi-experimental design with 1 year follow-up after intervention. Three regional COPD management programmes in the Netherlands, in which general practices cooperated with regional hospitals. All participating primary care professionals (n = 52). COPD management programme. Professional commitment, organizational context and degree of process implementation. Professionals significantly changed their systems for delivering care to COPD patients, namely self-management support, decision support, delivery system design and clinical information systems. Associations were found between organizational factors, professional commitment and changes in processes of care. Group culture and professional commitment appeared to be, to a moderate degree, predictors of process implementation. COPD management was effective; all processes improved significantly. Moreover, theoretically expected associations between organizational context and professional factors with the implementation of COPD management were indeed confirmed to some extent. Group culture and professional commitment are important facilitators.

Analysis of Mycobacterium tuberculosis Genotypic Lineage Distribution in Chile and Neighboring Countries

PubMed Central

Lagos, Jaime; Couvin, David; Arata, Loredana; Tognarelli, Javier; Aguayo, Carolina; Leiva, Tamara; Arias, Fabiola; Hormazabal, Juan Carlos; Rastogi, Nalin; Fernández, Jorge

2016-01-01

Tuberculosis (TB), caused by the pathogen Mycobacterium tuberculosis (MTB), remains a disease of high importance to global public health. Studies into the population structure of MTB have become vital to monitoring possible outbreaks and also to develop strategies regarding disease control. Although Chile has a low incidence of MTB, the current rates of migration have the potential to change this scenario. We collected and analyzed a total of 458 M. tuberculosis isolates (1 isolate per patient) originating from all 15 regions of Chile. The isolates were genotyped using the spoligotyping method and the data obtained were analyzed and compared with the SITVIT2 database. A total of 169 different patterns were identified, of which, 119 patterns (408 strains) corresponded to Spoligotype International Types (SITs) and 50 patterns corresponded to orphan strains. The most abundantly represented SITs/lineages were: SIT53/T1 (11.57%), SIT33/LAM3 (9.6%), SIT42/LAM9 (9.39%), SIT50/H3 (5.9%), SIT37/T3 (5%); analysis of the spoligotyping minimum spanning tree as well as spoligoforest were suggestive of a recent expansion of SIT42, SIT50 and SIT37; all of which potentially evolved from SIT53. The most abundantly represented lineages were LAM (40.6%), T (34.1%) and Haarlem (13.5%). LAM was more prevalent in the Santiago (43.6%) and Concepción (44.1%) isolates, rather than the Iquique (29.4%) strains. The proportion of X lineage was appreciably higher in Iquique and Concepción (11.7% in both) as compared to Santiago (1.6%). Global analysis of MTB lineage distribution in Chile versus neighboring countries showed that evolutionary recent lineages (LAM, T and Haarlem) accounted together for 88.2% of isolates in Chile, a pattern which mirrored MTB lineage distribution in neighboring countries (n = 7378 isolates recorded in SITVIT2 database for Peru, Brazil, Paraguay, and Argentina; and published studies), highlighting epidemiological advantage of Euro-American lineages in this region. Finally, we also observed exclusive emergence of patterns SIT4014/X1 and SIT4015 (unknown lineage signature) that have hitherto been found exclusively in Chile, indicating that conditions specific to Chile, along with the unique genetic makeup of the Chilean population, might have allowed for a possible co-evolution leading to the success of these emerging genotypes. PMID:27518286

Does the addition of virtual reality training to a standard program of inpatient rehabilitation improve sitting balance ability and function after stroke? Protocol for a single-blind randomized controlled trial.

PubMed

Sheehy, L; Taillon-Hobson, A; Sveistrup, H; Bilodeau, M; Fergusson, D; Levac, D; Finestone, H

2016-03-31

Sitting ability and function are commonly impaired after stroke. Balance training has been shown to be helpful, but abundant repetitions are required for optimal recovery and patients must be motivated to perform rehabilitation exercises repeatedly to maximize treatment intensity. Virtual reality training (VRT), which allows patients to interact with a virtual environment using computer software and hardware, is enjoyable and may encourage greater repetition of therapeutic exercises. However, the potential for VRT to promote sitting balance has not yet been explored. The objective of this study is to determine if supplemental VRT-based sitting balance exercises improve sitting balance ability and function in stroke rehabilitation inpatients. This is a single-site, single-blind, parallel-group randomized control trial. Seventy six stroke rehabilitation inpatients who cannot stand independently for greater than one minute but can sit for at least 20 minutes (including at least one minute without support) are being recruited from a tertiary-care dedicated stroke rehabilitation unit. Participants are randomly allocated to experimental or control groups. Both participate in 10-12 sessions of 30-45 minutes of VRT performed in sitting administered by a single physiotherapist, in addition to their traditional therapy. The experimental group plays five games which challenge sitting balance while the control group plays five games which minimize trunk lean. Outcome measures of sitting balance ability (Function in Sitting Test, Ottawa Sitting Scale, quantitative measures of postural sway) and function (Reaching Performance Scale, Wolf Motor Function Test, quantitative measures of the limits of stability) are administered prior to, immediately following, and one month following the intervention by a second physiotherapist blind to the participant's group allocation. The treatment of sitting balance post-stroke with VRT has not yet been explored. Results from the current study will provide important evidence for the use of low-cost, accessible VRT as an adjunct intervention to increase sitting balance in lower-functioning patients receiving inpatient rehabilitation. The motivating and enjoyable attributes of VRT may increase exercise dosage, leading to improved function and optimal results from rehabilitation. https://clinicaltrials.gov/; Identifier: NCT02285933. Registered 06 November 2014. Funded by the Heart & Stroke Foundation of Canada and a generous donation from Tony & Elizabeth Graham.

Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability.

PubMed

Burkow, Tatjana M; Vognild, Lars K; Østengen, Geir; Johnsen, Elin; Risberg, Marijke Jongsma; Bratvold, Astrid; Hagen, Tord; Brattvoll, Morten; Krogstad, Trine; Hjalmarsen, Audhild

2013-03-05

The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers.This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user's own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home. The digital health diary was used as background information in the individual consultations and by some participants as a self-management tool. Participant retention was high, with no dropouts. None of the participants reported that the six-week duration of the home programmes was too long. The Internet-enabled programmes for home-based groups in pulmonary rehabilitation and diabetes education were generally well accepted by the participants. Our findings indicate that conventional programmes have the potential to be delivered in socially supportive group settings at home.

Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability

PubMed Central

2013-01-01

Background The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers. This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. Methods We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user’s own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Results Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home. The digital health diary was used as background information in the individual consultations and by some participants as a self-management tool. Participant retention was high, with no dropouts. None of the participants reported that the six-week duration of the home programmes was too long. Conclusions The Internet-enabled programmes for home-based groups in pulmonary rehabilitation and diabetes education were generally well accepted by the participants. Our findings indicate that conventional programmes have the potential to be delivered in socially supportive group settings at home. PMID:23496829

The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization - a cluster-randomised controlled trial

PubMed Central

2013-01-01

Background The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. Methods The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. Results The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Conclusions Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Trial registration Clinicaltrials.gov identifier: NCT01228708. PMID:24090189

The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization--a cluster-randomised controlled trial.

PubMed

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

2013-10-03

The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Clinicaltrials.gov identifier: NCT01228708.

A Cluster Randomized Controlled Trial to Reduce Office Workers' Sitting Time: Effect on Activity Outcomes.

PubMed

Healy, Genevieve N; Eakin, Elizabeth G; Owen, Neville; Lamontagne, Anthony D; Moodie, Marj; Winkler, Elisabeth A H; Fjeldsoe, Brianna S; Wiesner, Glen; Willenberg, Lisa; Dunstan, David W

2016-09-01

This study aimed to evaluate the initial and long-term effectiveness of a workplace intervention compared with usual practice, targeting the reduction of sitting on activity outcomes. Office worksites (≥1 km apart) from a single organization in Victoria, Australia, were cluster randomized to intervention (n = 7) or control (n = 7). Participants were 231 desk-based office workers (5-39 participants per worksite) working at least 0.6 full-time equivalent. The workplace-delivered intervention addressed organizational, physical environment, and individual behavioral changes to reduce sitting time. Assessments occurred at baseline, 3 months, and 12 months, with the primary outcome participants' objectively measured (activPAL3 device) workplace sitting time (minutes per 8-h workday). Secondary activity outcomes were workplace time spent standing, stepping (light, moderate to vigorous, and total), and in prolonged (≥30 min) sitting bouts (hours per 8-h workday); usual duration of workplace sitting bouts; and overall sitting, standing, and stepping time (minutes per 16-h day). Analysis was by linear mixed models, accounting for repeated-measures and clustering and adjusting for baseline values and potential confounders. At baseline, on average, participants (68% women; mean ± SD age = 45.6 ± 9.4 yr) sat, stood, and stepped for 78.8% ± 9.5%, 14.3% ± 8.2%, and 6.9% ± 2.9% of work hours, respectively. Workplace sitting time was significantly reduced in the intervention group compared with the controls at 3 months (-99.1 [95% confidence interval = -116.3 to -81.8] min per 8-h workday) and 12 months (-45.4 [-64.6 to -26.2] min per 8-h workday). Significant intervention effects (all favoring intervention) were observed for standing, prolonged sitting, and usual sitting bout duration at work, as well as overall sitting and standing time, with no significant or meaningful effects observed for stepping. This workplace-delivered multicomponent intervention was successful at reducing workplace and overall daily sitting time in both the short term and the long term.

Minimal Intensity Physical Activity (Standing and Walking) of Longer Duration Improves Insulin Action and Plasma Lipids More than Shorter Periods of Moderate to Vigorous Exercise (Cycling) in Sedentary Subjects When Energy Expenditure Is Comparable

PubMed Central

Duvivier, Bernard M. F. M.; Schaper, Nicolaas C.; Bremers, Michelle A.; van Crombrugge, Glenn; Menheere, Paul P. C. A.; Kars, Marleen; Savelberg, Hans H. C. M.

2013-01-01

Background Epidemiological studies suggest that excessive sitting time is associated with increased health risk, independent of the performance of exercise. We hypothesized that a daily bout of exercise cannot compensate the negative effects of inactivity during the rest of the day on insulin sensitivity and plasma lipids. Methodology/Principal Findings Eighteen healthy subjects, age 21±2 year, BMI 22.6±2.6 kgm−2 followed randomly three physical activity regimes for four days. Participants were instructed to sit 14 hr/day (sitting regime); to sit 13 hr/day and to substitute 1 hr of sitting with vigorous exercise 1 hr (exercise regime); to substitute 6 hrs sitting with 4 hr walking and 2 hr standing (minimal intensity physical activity (PA) regime). The sitting and exercise regime had comparable numbers of sitting hours; the exercise and minimal intensity PA regime had the same daily energy expenditure. PA was assessed continuously by an activity monitor (ActivPAL) and a diary. Measurements of insulin sensitivity (oral glucose tolerance test, OGTT) and plasma lipids were performed in the fasting state, the morning after the 4 days of each regime. In the sitting regime, daily energy expenditure was about 500 kcal lower than in both other regimes. Area under the curve for insulin during OGTT was significantly lower after the minimal intensity PA regime compared to both sitting and exercise regimes 6727.3±4329.4 vs 7752.0±3014.4 and 8320.4±5383.7 mU•min/ml, respectively. Triglycerides, non-HDL cholesterol and apolipoprotein B plasma levels improved significantly in the minimal intensity PA regime compared to sitting and showed non-significant trends for improvement compared to exercise. Conclusions One hour of daily physical exercise cannot compensate the negative effects of inactivity on insulin level and plasma lipids if the rest of the day is spent sitting. Reducing inactivity by increasing the time spent walking/standing is more effective than one hour of physical exercise, when energy expenditure is kept constant. PMID:23418444

Development of an e-supported illness management and recovery programme for consumers with severe mental illness using intervention mapping, and design of an early cluster randomized controlled trial.

PubMed

Beentjes, Titus A A; van Gaal, Betsie G I; Goossens, Peter J J; Schoonhoven, Lisette

2016-01-19

E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. One possible solution might be to blend e-health with face-to-face delivery of a recovery-oriented treatment, like the Illness Management & Recovery (IMR) programme. This paper describes the development of an e-health application for the IMR programme and the design of an early clustered randomized controlled trial. We developed the e-IMR intervention according to the six-step protocol of Intervention Mapping. Consumers joined the development group to address important and relevant issues for the target group. Decisions during the six-step development process were based on qualitative evaluations of the Illness Management & Recovery programme, structured interviews, discussion in the development group, and literature reviews on qualitative papers concerning consumers with severe mental illness, theoretical models, behavioural change techniques, and telemedicine for consumers with severe mental illness. The aim of the e-IMR intervention is to help consumers with severe mental illness to involve others, manage achieving goals, and prevent relapse. The e-IMR intervention consists of face-to-face delivery of the Illness Management & Recovery programme and an e-health application containing peer-testimonials on videos, follow up on goals and coping strategies, monitoring symptoms, solving problems, and communication opportunities. We designed an early cluster randomized controlled trial that will evaluate the e-IMR intervention. In the control condition the Illness Management & Recovery programme is provided. The main effect-study parameters are: illness management, recovery, psychiatric symptoms severity, self-management, quality of life, and general health. The process of the IMR program will be evaluated on fidelity and feasibility in semi-structured interviews with participants and trainers. Intervention Mapping provided a systematic procedure for the development of this e-health intervention for consumers with severe mental illness and the preparation of an early randomized controlled trial. The trial is registered in the Dutch Trial Register: NTR4772 .

Primary School Teachers' Views on Constructive Classroom Management

ERIC Educational Resources Information Center

Ari, Ercan; Kizilaslan Tunçer, Berfu; Demir, Mehmet Kaan

2016-01-01

Behavioural teaching programmes that had long been used in Turkey began changing in 2005. In a significant development, new programmes based on constructivism have come to the fore. The adaptation of teachers in this transitional process and their internalization of this new approach have been of utmost importance for the success of the programme.…

Defense Automation Resources Management Manual

DTIC Science & Technology

1988-09-01

Electronic Command Signals Programmer, Plugboard Programmers Punch, Card Punch, Paper Tape Reader, Character Reader-Generator, Time Cards Reader...Multiplexor-Shift Register Group Multiplier Panel Control, Plugboard Panel, Interconnection, Digital Computer Panel, Meter-Attenuator, Tape Recorder PC Cards...Perforator, Tape Plug-In Unit Potentiometer, Coefficient, Analog Computer Programmer, Plugboard Punch, Paper Tape Racks Reader, Time Code Reader

Mentees' Views of a Structured Mentoring Programme at Unisa

ERIC Educational Resources Information Center

Schulze, S.

2010-01-01

The Management of one college at Unisa initiated a structured mentoring programme to develop researchers, among others. This article reports the views of 43 mentees of the programme one year after implementation. The research design was a survey. The items in a questionnaire were influenced by the self-efficacy theory and the constructivist views…